Dependent Agency in the Global Health Regime: Local African by Emma-Louise Anderson, Amy S. Patterson

By Emma-Louise Anderson, Amy S. Patterson

This quantity examines how neighborhood actors reply to Africa’s excessive dependence on donor healthiness money. It specializes in the massive infusion of donor cash to deal with HIV and AIDS into Malawi and Zambia and the following slow-down in that investment after 2009. How do area people reply to this dynamic reduction structure and the myriad of possibilities and constraints that accompany it? This publication conceptualizes established supplier, and the within which neighborhood actors can at the same time act and be established, and investigates stipulations less than which based enterprise happens. Drawing upon empirical facts from Malawi and Zambia gathered among 2005 and 2014, the paintings interrogates the nuanced suggestions of established corporation: performances of compliance, extraversion, and resistance under the road. The findings elucidate the dynamic interactions among actors which regularly take place “off degree” yet which undergird macro-level improvement processes.

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Extra resources for Dependent Agency in the Global Health Regime: Local African Responses to Donor AIDS Efforts

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As a result, by 2015, 15 million people (or 41 % of those who needed ART) could access AIDS medications. In 2002, only one million PLHIV globally (and only 300,000 PLHIV in low and middle-income countries) had ART access. 7 million in 2015; in 2014, 43 % of PLHIV in sub-Saharan Africa who needed the medications could access them (UNAIDS 2015; WHO, UNICEF, and UNAIDS 2013). We acknowledge that the norm of universal access to ART is threatened by the slowdown in AIDS funding, AIDS fatigue among donors and citizens in the West and Africa, and the fact that the number of PLHIV 1 DEPENDENT AGENCY AND THE AIDS ENTERPRISE: GLOBAL PROGRAMS .

Being “authentic” could open the door for donor support. As donors began to work with communities, their goal was to test as many people as possible for HIV in order to get them enrolled in ART treatment. Donors depended on rapid scale up to meet their goals and to illustrate to key constituencies that they were acting on AIDS (Benton 2015). Prior to the scale up in ART, many people did not test for the HIV virus until they were very ill; people perceived that it was useless to know their HIV status because infection meant certain death (MSF 2001) Some also avoided testing, because they assumed HIV was highly transmissible and therefore, they would test positive (Kaler and Watkins 2010).

In Malawi, the Chewas and Tumbukas are relatively large groups with antagonistic relations. Political parties are formed along ethnic lines and because the Chewa are more numerous (roughly one-third of the population), they have more opportunities to shape political outcomes (Posner 2004). Both countries are highly dependent on foreign aid. In 2011, 40 % of the Malawian government’s overall budget came from external resources and 40 % of that aid came from the United Kingdom (Interview, MoF civil servant, Lilongwe, June 26, 2014; International Business Times, November 19, 2013).

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