Science, Power, and Policy Intersecting at the HIV/AIDS Pandemic

Ahmed C. Bawa Science, Power, and Policy Intersecting at the HIV/AIDS Pandemic INTRODUCTION THE HIV/AIDS PANDEM IC IS FIRM LY THREADED INTO THE FABRIC THAT is South Africa and it has many diverse and complex influences on the texture ofthat fabric.' These influences drive new sets ofsocial and politi­ cal dynamics that have severe long-term implications. The first demo­ cratic election late in April 1994 took South Africa across a threshold with popular hopes and promises of justice, peace, human rights, and social development. South Africa is a theatre with a myriad of stages, each shaping new imaginations of a society in creation, a society in tran­ sition, a society in transformation. These imaginations find expression in discourses of various kinds, including the development of policy frame­ works and the creation ofnew social institutions or the transformation of existing ones. These discourses are constrained by local and global condi­ tions that are constantly evolving. The HIV/AIDS pandemic is perhaps the most powerful of all ofthese because it brings enormous stresses to bear on South Africa’s delicate and fragile processes of democracy construc­ tion, nation building, and social and economic reconstruction. This paper addresses the way in which this infectious disease forces new kinds of intersections between science, power, and policy within the framework of a nascent democracy and it presents an opportunity to reflect on and rethink the way in which infectious diseases are socially constructed and how they affect the nature and essences of democracies. This paper is also an attempt to understand the way in which the pandemic in all of its social expressions forces diverse South African social research Vol 72 : No 3 : Fall 2005 605 voices to intersect and interact with each other. While the science, power, and policy tale is briefly told, it is supplemented through an approach based on the multitude of metaphors that are used to discuss the pandemic (Bawa, 2005).1 THE SOCIAL EXPRESSIONS OF THE HIV/AIDS PANDEMIC IN SOUTH AFRICA The social expressions of this pandemic are many. (Kauffman and Lindauer, 2004) The most vivid are the pure devastation of individual lives—notjust death and destruction but also the complex psychosocial alienation of infected individuals who live in communities that see the disease through the lenses of various kinds of moral certitudes. The impact of this localized devastation on the nature of community, its structure and its cohesion, has long-term implications in the context of a society that has only begun to emerge from the devastation to community by the apartheid system. Claude Ake, the late Nigerian political scientist, visited South Africa in the early 1990s and after trav­ eling through rural and urban KwaZulu-Natal and talking with people, shared his thoughts with students and faculty in Durban. His main observation was that while he had seen greater poverty and deprava­ tion in other parts of Africa, he had not ever seen the utter breakdown of community that he witnessed as he traveled through rural villages and urban townships. This was due primarily to the impact ofapartheid South Africa’s deeply racialized migrant labor system, the lifeblood of South Africa’s capitalist system. How would these already depleted communities respond to the challenges of the pandemic? And notwith­ standing the wonderful strides made by the new democracy in shaping a strong culture of human and civil rights, how would they emerge from it? What impact would it have on the future coherence of the broader society? For instance, with all the advances made in constitu­ tionally securing gender rights, how would the pandemic affect gender relations within households and in communities? These questions lead to macro social expressions that relate to the long-term behavior of the social and economic health of the soci­ 606 social research ety in general. Economists have carried out extensive studies of the impact of the pandemic on the state of the economy and in particu­ lar, its impact on the capacity of the economy to grow—a requirement for postapartheid reconstruction (Sachs and Sachs, 2004; Poku and Whiteside, 2004). Yet another form of the pandemic’s social expression is repre­ sented by the stresses it brings to...