The Political Economy of HIV in Africa

Biomedical revolutions seem to have radically altered the environment for HIV transmission: anti-retrovirals (ARVs) and drugs to reduce mother-to-child transmission promise to cut HIV transmission rates, as does male medical circumcision. However, the hopeful messages of UNAIDS are tempered with warning about expenditure shortfalls and calls for funding. Contributions to this book remind us that, along with the external financial constraints, there have been new fractures in state power and in the organisation of health systems. More than this, the book fundamentally calls into question whether biomedical interventions can change the social roots of this disease. As well as considering new policy approaches, the book reasserts a long-standing political economy approach to HIV and to adapt it to reflect new competing theoretical approaches. The chapters attempt to connect the debates about HIV/AIDS to larger discussions about globalisation, class differentiation, inequity and uneven development in African countries. This book was originally published as a special issue of Review of African Political Economy.

Deborah Johnston is a Reader in Development Economics at SOAS University of London, UK. She is a development economist whose research looks at the application of economics, political economy and feminist economics to issues of poverty, ill-health and wellbeing. Kevin Deane is a Senior Lecturer in International Development at the University of Northampton, UK. His educational background is in development economics, but his research draws on a range of disciplines including political economy, development studies, economics, public health and epidemiology, with an application to the economic and social drivers of the HIV/AIDS epidemic. Matteo Rizzo is Senior Lecturer in Development Research Methods at the Department of Development Studies, Senior Lecturer in the Economics of Africa at the Department of Economics and a Member of the Centre of African Studies, all at SOAS University of London, UK. He is an editorial board member of the Review of African Political Economy.

Introduction: The political economy of HIV 1. Trapped in the prison of the proximate: structural HIV/AIDS prevention in southern Africa 2. The political economy of concurrent partners: toward a history of sex-love-gift connections in the time of AIDS 3. Wealthy and healthy? New evidence on the relationship between wealth and HIV vulnerability in Tanzania 4. Paying the price of HIV in Africa: cash transfers and the depoliticisation of HIV risk 5. Exploring the complexity of microfinance and HIV in fishing communities on the shores of Lake Malawi 6. Revisiting the economics of transactional sex: evidence from Tanzania Debates 7. The key questions in the AIDS epidemic in 2015 8. 15 years of 'War on AIDS': what impact has the global HIV/AIDS response had on the political economy of Africa? 9. Breaking out of silos - the need for critical paradigm reflection in HIV prevention 10. Microfinance and HIV prevention