Aids Policy in Uganda: Evidence, Ideology, and the Making of an African Success Story (review)

HIV/AIDS is one of the worst human tragedies in the history of Africa, where it has devastated several countries, but there are some success stories in efforts to combat its effects. AIDS Policy in Uganda: Evidence, Ideology, and the Making of an African Success Story, an excellent and useful book, authored by John Kinsman, Ph.D., Research Fellow at the University of Amsterdam’s Center for Global Health and Inequality, and Guest Senior Lecturer at the Umea International School of Public Health in northern Sweden, offers a comprehensive history of what the publishers have underscored, in a summary, to be “Africa’s best-known AIDS ‘success story’, from the start of the epidemic in the early 1980s up until 2005.” The book focuses on the ways in which important factors, including evidence and ideology, contributed to a national policy on AIDS in the East African nation of Uganda. This policy puts Uganda’s development of an innovative prevention and treatment strategies, in the words of the publishers in a cover summary, “into the context of international, national, and local processes.”

Kinsman demonstrates in this book how Uganda has become an important influence in redefining global AIDS control strategies. As other scholars have pointed out, his work shows unlimited sensibility to the Ugandan people and culture. He utilizes the approach of a political economy, whereby he has amply shown that HIV/AIDS in Uganda is not purely a medical problem, but one “that is anchored in multiple economic and structural contexts, globally, nationally and locally” (quoting C. B. Rwabukwali of Makerere University in Uganda).

AIDS Policy in Uganda is divided into seven well-researched chapters, subdivided into well-delineated segments: an introduction (chapter 1); key themes and concepts (chapter 2); “accepting the unacceptable,” on establishing a national response to AIDS in Uganda, “working on a hunch” (chapter 3); a history of HIV prevention in Uganda (chapter 4); “overcoming resistance,” on the influence of big-men on antiretroviral therapy provision (chapter 5); the Masaka intervention trial, a case study in interpreting research findings (chapter 6); and finally, “What Has Guided AIDS Control Policy in Uganda” (chapter 7). The book provides a list of figures and tables (p. xi–xii), acknowledgments (pp. xiii–xiv), a map of Uganda (p. xv), acronyms and abbreviations (p. xvii), an appendix of a multilevel timeline of key events (pp. 187–194), notes (pp. 195–204), references (pp. 205–226), and an index (pp. 227–240).

This study took meaningful shape after Robert Pool, Kinsman’s friend and colleague, suggested that he “approach the Amsterdam School for Social Science Research” to complete a Ph.D. by studying issues that had arisen during the five years that he had worked with the Medical Research Council Program, and Kinsman thanks the school for having given him “extremely generous financial support” for his “multi-sited fieldwork” (p. xii). AIDS Policy in Uganda, a revised version of his doctoral dissertation, is a useful book, which should benefit medical and general researchers, public-health teachers, students, and any readers who want to learn more about efforts to combat HIV/AIDS in Africa, especially in the subregion of East Africa.