When Bodies Remember: Experiences and Politics of AIDS in South Africa (review)

Didier Fassin's When Bodies Remember focuses on a notorious controversy in South Africa. The author, a medical anthropologist and sociologist, explores why Thabo Mbeki and his supporters do not believe that a sexually transmitted disease is contributing to "the collapse of millions of our people" (15). Here, Fassin performs a delicate balancing act. He accepts the viral etiology of AIDS but sidesteps the epidemiologists, politicians, and activists who dismiss Mbeki as a vindictive conspiracy-monger. Indeed, Fassin seems far more concerned with lending a sympathetic ear to Mbeki's "flatearthers" who attribute the sudden rise in South Africa's mortality rate to chronic malnutrition. Unlike most academic studies of AIDS, When Bodies Remember claims not to choose sides: it delves critically into the rationale behind AIDS "denialism," looking beyond Mbeki to probe why some South Africans doubt the existence of HIV and choose to blame other factors for its consequences.

The opening chapters introduce the roots of AIDS denialism by tracing its links to three major sources: the normalization of democratic discourse-i.e., South Africa's transition from a pariah state to open-minded participant in global debates over equitable development and public health; Mbeki's keen interest in "AIDS dissidents" like Dr. Peter Duesberg (55); and a resurgent creed of black nationalism that aims to heal post-apartheid society by healing the national injuries inflicted by racist rule (a creed that Mbeki promotes as the "African Renaissance"). Many of Mbeki's fiercest critics scorn AIDS dissidence and wince at mention of the African Renaissance. Instead, they champion of equitable development and public health; their ranks include eminent medical scientists and members of South Africa's Treatment Action Campaign (TAC), who accuse Mbeki of committing genocide through his willful neglect of the AIDS crisis. These well-meaning researchers and activists see themselves as ethically grounded, wholly reasonable, and justly angry. They make up a righteous group that Fassin calls the "orthodoxy." Throughout his book, Fassin treats this orthodoxy as old news in prose that reveals impatience and even annoyance. This may be because When Bodies Remember seeks to challenge the moral ground on which the orthodoxy stands by compelling its proponents to question with equal vehemence why black people, from officials to citizens, are wary of AIDS-prevention.

Without apparent pre-judgment, Fassin carefully untangles the contrarian strands that bind denialist thought. His intent is to interrogate the AIDS controversy from multiple angles, drawing on an analytical framework that incorporates post-modern and post-colonial theory, medical anthropology, epidemiology, and social histories of colonial policies that criminalized the "sick native." Of all the factors informing denialism, Fassin suggests that disease-control laws that underpin white supremacy exacerbated African suspicions of AIDS. With this past in mind, Fassin engages the toxic disputes between the denialists and their opponents. The latter, he argues, have shown an astonishing capacity to ignore Mbeki's seemingly justified view of global health and colonial history. The South African president embraces the AIDS dissidents, Fassin writes, because they acknowledge the long-standing inequalities in Third World health care and emphasize that AIDS is an over-hyped phenomenon obscuring what really sickens South Africa. What ailment is this? It is a different retro virus, namely the insidious effects of white subjugation-a politically created misfortune that has decimated thousands and threatens the lives of millions more. Such reasoning enables the denialists to blame the proliferation of deadly infections on apartheid rulers who further entrenched black poverty, thus weakening the bodies of the majority population. It is this strain of denialism that permeates Mbeki when he evokes the specters of racism in speeches about the pandemic. Regardless of whether readers accept this point, particularly when considering the spread of drug-resistant TB, Fassin urges them at least to ponder the legacies of past epidemics, which incubated in mine shafts and crowded labor compounds, where black migrants could not escape killer contagions (134-140). The illnesses...