South Africa’s HIV/AIDS policy, 1994–2004: How can it be explained?

Butler, Anthony

doi:10.1093/afraf/adi036

Cited by 67 publications

(55 citation statements)

References 19 publications

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“…The HIV/AIDS field in South Africa has been marked by intense contestation and repeated resistance by the state to claims made of it e whether relating to individual rights of people with HIV/AIDS or to treatment access (Butler, 2005;Mbali, 2005;Schneider, 2002). These battles, however, were as much about socio-economic rights as about the vexed question of who should and how to speak about HIV/ AIDS e both to define the problem, its extent and causes and to generate appropriate responses (Schneider, 2002).…”

Section: Methodsmentioning

confidence: 99%

“…It gave rise to a discourse saturated with 'rights talk' on all sides: on the one hand, the right to individual autonomy, access to treatment and a 'scientific' approach to HIV/AIDS drawing on constitutional notions of individual human rights; on the other hand, appeals to different kinds of entitlements -national sovereignity, unique African responses, cultural dignity and communal rights. This produced, in Butler's (2005) words, two distinct policy paradigms: a mobilisation/ biomedical paradigm and a nationalist/ameliorative paradigm. Each claimed to speak for the poor and vulnerable, and both tapped into deeply held collective experience, even if the elements of crude denialism on the part of President Mbeki were rejected by many.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Globalisation and health inequalities: Can a human rights paradigm create space for civil society action?

London

Schneider

2012

Social Science & Medicine

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Globalisation and health inequalities: Can a human rights paradigm create space for civil society action?

London

Schneider

2012

Social Science & Medicine

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“…Butler and Mosley both argue that the mono-causal/multi-causal divide might have underpinned Mbeki's denialism (although they each use slightly different language to make this point). Butler (2005) remains neutral about the relative merits of these perspectives and focuses instead on describing the context that allowed for the ascendancy of the multi-causal approach in South Africa. Mosley (2004) argues that the mono-causal and multi-causal approaches are both legitimate perspectives to adopt toward disease.…”

Section: Was There Really An Explanatory Gap In the Case Of Aids?mentioning

confidence: 99%

Mono-Causal and Multi-Causal Theories of Disease: How to Think Virally and Socially about the Aetiology of AIDS

Furman

2017

J Med Humanit

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In this paper, I utilise the tools of analytic philosophy to amalgamate mono-causal and multi-causal theories of disease. My aim is to better integrate viral and socio-economic explanations of AIDS in particular, and to consider how the perceived divide between monocausal and multi-causal theories played a role in the tragedy of AIDS denialism in South Africa in the early 2000s. Currently, there is conceptual ambiguity surrounding the relationship between mono-causal and multi-causal theories in biomedicine and epidemiology. Monocausal theories focus on single, typically microbial, sources of illness and are most concerned with infectious diseases. By contrast, multi-causal theories allow for multiple factors to underpin a disease's aetiology, including socio-economic and behavioural factors, and they usually focus on chronic non-communicable diseases. However, if these theories are taken to be strictly distinct, this prevents the inclusion of both microbial and socio-economic factors in a single explanation of any particular disease. This strict distinction became a problem when trying to explain the disproportionate prevalence of AIDS in southern Africa and ultimately contributed to the tragedy of AIDS denialism in South Africa. In tandem with viewing how the perceived divide between multi-causal and mono-causal theories underpinned AIDS denialism, I examine Thabo Mbeki's specific role, while acknowledging that AIDS is being deprioritised on a broader international level. Overall, I will demonstrate that any long-term plan to eliminate AIDS will require viral and socio-economic factors to be considered simultaneously and that such a theoretical approach requires a clearer understanding of the underlying concepts of disease aetiology.

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“…• political/institutional as exemplified by (Butler 2005), (Lodge 2002); (Fourie and Meyer 2010); (Kauffman 2004); (Sheckels 2004); (Myburgh 2009); (Mulwo, Tomaselli et al 2012) • biographical/psychological (Kenyon 2009); (Gevisser 2007); (Gumede 2007) • social/anthropological (Fassin 2007), (Phillips 2004), (Mbali 2004), (Youde 2005) See e.g. (Schneider and Fassin 2002); (Lodge 2002); (Mbali 2003(Mbali , 2004; (Nattrass 5 2003, Nattrass 2007Nattrass , 2008; (Sitze 2004); (Schuklenk 2004); (Kauffman 2004); (van der Vliet 1004); (Sheckels 2004); (Mosley 2004); (Butler 2005); (Youde 2005); (Cameron 2005); (Gevisser 2007); (Epstein 2007); (Gumede 2007); (Thornton 2008); (Chigwedere, Seage et al 2008); (Kenyon 2009); (Kalichman 2009); (Cullinan and Thom 2009); (Chigwedere and Essex 2010); (Geffen 2010); (Fourie and Meyer 2010); (Mulwo, Tomaselli et al 2012).…”

Section: Mbeki Hermeneuticsmentioning

confidence: 99%

Thabo Mbeki, postmodernism, and the consequences

Kowalenko

2015

South African Journal of Philosophy

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Explanations of former South African President Thabo Mbeki's public and private views on the aetiology of the HIV/AIDS epidemic in the country remain partial at best without the recognition that the latter presuppose and imply a postmodernist/postcolonialist philosophy of science that erases the line separating the political from the scientific. Evidence from Mbeki's public speeches, interviews, and private and anonymous writings suggests that it was postmodernist/postcolonialist theory that inspired him to doubt the "Western" scientific consensus on HIV/AIDS and to implement a public health policy that dragged its feet on full roll-out of antiretroviral therapy, causing thousands of avoidable deaths. A weak reductio ad absurdum allows us to conclude from this premise that postmodernist/postcolonial critique of "Western" science ought to be shunned. A comparative argument from consequences further suggests that in a situation where a misguided health policy has lead to a humanitarian catastrophe, and where postmodernist/postcolonialist critique of science can and has been used to justify this policy, an alternative theory ought to be preferred on which such justification would not be possible. The paper closes with a call for a non-relativist alternative to postmodernist/postcolonialist philosophy of science, and evaluates the potential of recent developments in 'Studies of Expertise" to yield such.

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South Africa’s HIV/AIDS policy, 1994–2004: How can it be explained?

Cited by 67 publications

References 19 publications

Globalisation and health inequalities: Can a human rights paradigm create space for civil society action?

Globalisation and health inequalities: Can a human rights paradigm create space for civil society action?

Mono-Causal and Multi-Causal Theories of Disease: How to Think Virally and Socially about the Aetiology of AIDS

Thabo Mbeki, postmodernism, and the consequences

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