In the beginning of the 2000s Botswana was the country with the highest HIV prevalence in the world. At the same time, Botswana was touted as a model by international organisations for the fight against AIDS and access to free antiretroviral treatments. This doctoral research is based on ethnographic fieldwork at Princess Marina hospital in Gaborone and among patients, health care professionals and public health officers, throughout 2007 and 2009. Access to ARV is described as a set of care practices and public policies understood within a socio-political and historical framework. The fight against AIDS is the product of a particular form of nationalism, paternalism, and political benevolence from the State. By analysing national imagination and public health policies, this research demonstrates that free ARVs are conceived as an entitlement for citizens and administered through a process that redefines the boundaries of the national and moral community, characterised by tensions over power relations, gender and social inequalities and the exclusion of migrants. Besides, the politics of AIDS is also described as the outcome of international biomedical research and pharmaceutical philanthropy. Indeed, this research shows that access to free medication was made possible through the constitution of Botswana as an attractive site for international biomedical research and analyses the tensions that arise thereof. In short, this dissertation is a sociological study of contemporary public health and international medical cooperation in Africa.
Taking care of its population. AIDS in Botswana : global politics of drugs and local practices of citizenship