FORUM 2016

Bridget O'Laughlin and Moritz Hunsmann

Development and Change, 2016, vol. 47, issue 4, 798-817

Abstract: type="main">

By affecting the lives and survival of numerous people, global health initiatives deeply alter local landscapes of inequality. They tackle some conditions at the origin of ill health while leaving others untouched, and they inevitably generate new inequalities. Yet, despite their inherently conflictual nature, global health players often minimize the political dimension of their interventions. Taking international AIDS control efforts in Tanzania as an example, this contribution discusses some modalities — and political causes — of the structural neglect of conflict in global health discourse and practice. It analyses how African HIV epidemics continue to be framed and managed in ways that obscure both the health inequalities at their origin, and those that result from efforts to control them. AIDS policy makers conceal inequalities by framing the epidemic as a problem of individual sexual behaviour, and by implicitly rationing access to HIV-prevention and -treatment services. Furthermore, the imposition of disease hierarchies set by international fora excludes broader health-related allocation decisions from domestic democratic debate. Drawing on a theoretical consideration of depoliticization as artificial deconflictualization, the article concludes by calling for a more open acknowledgement of conflict in global health policy making, and explores some analytical and practical implications of such a re-politicization of public health.

Date: 2016
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