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TWO Targeting the Empowered Individual: Transnational Policy Making, the Global Economy of Aid, and the Limitations of Biopower in Tanzania Hansjörg Dilger In october 2001, Amelia Jacob from Tanzania was among the four awardees of the prestigious Africa Prize for Leadership, an award presented on an annual to biannual basis to outstanding African leaders whose “accomplishments have improved the lives of tens of millions of people.”1 The award—among whose previous recipients were the former South African President Nelson Mandela (1994) and the founder of the Green Belt Movement in Kenya, Wangara Muta Maathai (1991)—acknowledged Jacob’s long-term engagement in the fight against HIV/AIDS in Tanzania. According to the award-giving institution, the New York–based Hunger Project, the example set by Jacob, who has lived openly with her illness since she was diagnosed as being HIV-positive in 1993, “has empowered people living with HIV/AIDS to come forth and become spokespersons. [Jacob] has demanded that the public treat people with HIV/ AIDS with dignity and compassion while advocating that any effective treatment must include warmth and respect to those living with HIV/AIDS.”2 The Africa Prize for Leadership—which in 2001 included a grant of 50,000 USD—helped to change the work and face of the Tanzanian self-help organization SHDEPHA+ (Service, Health, and Development for People Living Positively with HIV/AIDS) of which Jacob was one of the co-founders. While the award was probably not exclusively responsible for the subsequent developments , it certainly contributed to the organization’s steep rise in membership , which according to SHDEPHA+ had grown to 50,000 by 2003. In the same year, the NGo opened its membership to people who are not infected with HIV but “who show solidarity with those who are.” Furthermore, SHDEPHA+ expanded its services in counseling, care, and advocacy and started to implement a wide range of programs targeting the capacity-building of community groups as well as “the elimination of stigma” in Tanzanian communities. When I returned to the organization in 2003, three years after I had completed the bulk of my fieldwork, approximately 40 branches had been, or were in the process of being, established all over the country; the TARGETING THE EMPoWERED INDIVIDUAL 61 new building in Dar es Salaam into which the NGo headquarters had moved was buzzing with new and old members. An external consultant had been contracted in order to help the organization to come to grips with the challenges that the growing membership presented (in addition to problems stemming from claims of embezzlement of funds that were circulating inside and outside the donor community). Finally, there were signs of a growing political consciousness within the organization itself: in 2003, the tenth anniversary of SHDEPHA+, a group of about 80 to 100 men and women, many of them living openly with HIV, marched through the streets of downtown Dar es Salaam demanding from the government the provision of free access to antiretroviral medications (ARVs). The developments within the Tanzanian self-help organization SHDEPHA+ at the turn of the century are emblematic of the HIV/AIDS response as it evolved across wide parts of southern and eastern Africa from the early 2000s onwards. Not only was the organization among the many NGos in the region that became involved in the fight against the epidemic during the 1990s and that received a significant boost in funding after the establishment of the Global Fund for the Fight Against AIDS, Tuberculosis, and Malaria in 2001, and the U.S. Presidential Emergency Plan for AIDS Relief (PEPFAR) in 2003. The work of SHDEPHA+ also reflects an internal shift in the world of HIV/AIDS work, which has increasingly come to integrate people living with HIV/AIDS into a holistic approach to the fight against the epidemic and which relies heavily on an internationally compatible language of empowerment, dignity, and human rights (see, e.g., UNAIDS 1999). Finally, the example of SHDEPHA+ has become emblematic of the positioning of civil society actors in a country where the formerly socialist government has had difficulties in coming to terms with the political engagement of nongovernmental organizations (NGos) (Mercer 1999), and where the face of the civil society response to HIV/AIDS has been increasingly shaped by neoliberal market forces and by the increased privatization of the health field and its dependency on international funding priorities. Introduction: The Anthropology of Policy Making in the Era of AIDS This chapter is concerned with the...

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