South Africa has the world's largest number of people living with HIV. This book offers a history of AIDS activism in South Africa from its origins in gay and anti-apartheid activism to the formation and consolidation of the Treatment Action Campaign (TAC), including its central role in the global HIV treatment access movement.

The globalization of trade, investment, and finance continues apace. Many have benefited from this, but deep inequalities persist. This book argues that the interconnections established by globalization make possible a critique of its inequality. For those who take seriously human dignity, equality is a basic presumption of social institutions.

An ethnographic account of the South African AIDS movement and activists From the historical roots of AIDS activism in the struggle for African liberation to the everyday work of community education in Khayelitsha, Sustaining Life tells the story of how the rights-based South African AIDS movement successfully transformed public health institutions, enabled access to HIV/AIDS treatment, and sustained the lives of people living with the disease. Typical accounts of the South African epidemic have focused on the political conflict surrounding it, Theodore Powers observes, but have yet to examine the process by which the national HIV/AIDS treatment program achieved near-universal access. In Sustaining Life, Powers demonstrates the ways in which non-state actors, from caregivers to activists, worked within the state to transform policy and state-based institutions in order to improve health-based outcomes. He shows how advocates in the South African AIDS movement channeled the everyday experiences of poor and working-class people living with HIV/AIDS into tangible policy changes at varying institutional levels, revealing the primacy of local action for expanding treatment access. In his analysis of the transformation of the state health system, Powers addresses three key questions: How were the activists of the movement able to overcome an AIDS-dissident faction that was backed by government power? How were state health institutions and HIV/AIDS policy transformed to increase public sector access to treatment? Finally, how should the South African campaign for treatment access inform academic debates on social movements, transnationalism, and the state? Based on extended participant observation and in-depth interviews with members of the South African AIDS movement, Sustaining Life traces how the political principles of the anti-apartheid movement were leveraged to build a broad coalition that changed national HIV/AIDS policy norms and highlights how changes in state-society relations can be produced by local activism.

Speech and Song at the Margins of Global Health tells the story of a unique Zulu gospel choir comprised of people living with HIV in South Africa, and how they maintained healthy, productive lives amid globalized inequality, international aid, and the stigma that often comes with having HIV. By singing, joking, and narrating about HIV in Zulu, the performers in the choir were able to engage with international audiences, connect with global health professionals, and also maintain traditional familial respect through the prism of performance. The focus on gospel singing in the narrative provides a holistic viewpoint on life with HIV in the later years of the pandemic, and the author’s musical engagement led to fieldwork in participants’ homes and communities, including the larger stigmatized community of infected individuals. This viewpoint suggests overlooked ways that aid recipients contribute to global health in support, counseling, and activism, as the performers set up instruments, waited around in hotel lobbies, and struck up conversations with passersby and audience members. The story of the choir reveals the complexity and inequities of global health interventions, but also the positive impact of those interventions in the crafting of community.

One in six adults in sub-Saharan Africa will die in their prime of AIDS. It is a stunning cataclysm, plunging life expectancy to pre-modern levels and orphaning millions of children. Yet political trauma does not grip Africa. People living with AIDS are not rioting in the streets or overthrowing governments. In fact, democratic governance is spreading. Contrary to fearful predictions, the social fabric is not being ripped apart by bands of unsocialized orphan children. AIDS and Power explains why social and political life in Africa goes on in a remarkably normal way, and how political leaders have successfully managed the AIDS epidemic so as to overcome any threats to their power. Partly because of pervasive denial, AIDS is not a political priority for electorates, and therefore not for democratic leaders either. AIDS activists have not directly challenged the political order, instead using international networks to promote a rights-based approach to tackling the epidemic. African political systems have proven resilient in the face of AIDS's stresses, and rulers have learned to co-opt international AIDS efforts to their own political ends. In contrast with these successes, African governments and international agencies have a sorry record of tackling the epidemic itself. AIDS and Power concludes without political incentives for HIV prevention, this failure will persist.

Successive South African governments have had controversial views on HIV and AIDS which have led to allegations that South Africa is in a state of denial about the AIDS epidemic. This book attempts to determine the validity of such claims of government denial by formulating and testing a denial hypothesis.The hypothesis is contextualized with an overview of the South African epidemic as well as a review of allegations of government denial. It reveals possible political factors that may motivate policy-makers to resort to official denial and tentatively concludes with a confirmation of the allegations contained in the denial hypothesis. However, this is done within the broader notion that denial is inherently vague and couched in language (rarely in writing) and therefore difficult to test with certainty and as such this book's real value lies in the insights gained into the complex politics of denial. By exploring the dynamics of denial and denialism and applying this to the South African AIDS epidemic, this study provides a comprehensive analysis.

In this book, France's leading medical anthropologist takes on one of the most tragic stories of the global AIDS crisis—the failure of the ANC government to stem the tide of the AIDS epidemic in South Africa. Didier Fassin traces the deep roots of the AIDS crisis to apartheid and, before that, to the colonial period. One person in ten is infected with HIV in South Africa, and President Thabo Mbeki has initiated a global controversy by funding questionable medical research, casting doubt on the benefits of preventing mother-to-child transmission, and embracing dissidents who challenge the viral theory of AIDS. Fassin contextualizes Mbeki's position by sensitively exploring issues of race and genocide that surround this controversy. Basing his discussion on vivid ethnographical data collected in the townships of Johannesburg, he passionately demonstrates that the unprecedented epidemiological crisis in South Africa is a demographic catastrophe as well as a human tragedy, one that cannot be understood without reference to the social history of the country, in particular to institutionalized racial inequality as the fundamental principle of government during the past century.