Global agenda-setting in multilateral AIDS governance : testing the Vanwesenbeeck model

[摘要] ENGLISH ABSTRACT: Globally as well as nationally, AIDS is politically contested. Since AIDS was first identifiedin 1981 there have been several responses to the pandemic, reflecting AIDS' biomedical,political and social nature and implications. Although there are many ways to frame andapproach AIDS, no single approach appears to be universally superior to any other, especiallyas these various approaches are essential for a comprehensive global response to thepandemic. However, these several responses can also represent contested constructs of howAIDS is inter-subjectively problematised based on different ontological understandings andepistemological preferences. The existence of such contested constructs suggests thatmultilateral AIDS governance is shaped by binaries and zero-sum games where the overallapproach ought to be holistic. As such, some scholars claim that HIV is increasingly treatedas something medical, and outside the context of overall development issues, sexual andreproductive health, human rights and structural violence. Recently, Vanwesenbeeck (2011)offered a simplified model of 'high-road' and 'low-road' solutions to the pandemic,problematising specifically the global policy/political response. Vanwesenbeeck's modelsuggests that biomedical, vertically distributed and asexual high-road approaches areprioritised at the expense of the more community oriented, sexual and rights-based low-roadapproaches. This, Vanwesenbeeck argues, is because current ideas and norms of the market,moralism and medicalisation are more aligned with the de-contextual, de-sexual andquantifiable characteristics of high-road approaches. This study tests the analytical utility ofVanwesenbeeck's model with a case study of the policy and political narratives emergingfrom the International AIDS Society's nine International AIDS Conferences from 1996 until2012. The research question this study investigates is thus: Can Vanwesenbeeck's (2011)model of high-road and low-road solutions be identified in and illuminate the policy ideas,problem definitions and political binaries that play out in the discourse surrounding thebiennial International AIDS Conferences between 1996 and 2012? This main research question is complemented by three sub-questions concerning 1) the strengths and limitationsof Vanwesenbeeck's model, 2) the general trends and developments in global AIDSpolicy/political responses during, before and after the biennial International AIDSConferences and 3) the impact of the Global Financial Crisis on the global AIDS response.Applying a qualitative methodology, the study finds that Vanwesenbeeck's model can both beidentified in and elucidate the political discourses, policy implementations and binariessurrounding the International AIDS Conferences between 1996 and 2012, albeit not all. Theanalytical utility of Vanwesenbeeck's model is limited by oversimplification of the highroad/low-road binary and the exclusion of alternative ideas for high-road prioritisation, suchas humanitarianism, securitisation/sensationalism and the neoliberal ideological link betweenmedicalisation and the market, as well as negligence of the impact of the Global FinancialCrisis.

[发布机构] Stellenbosch University