Since the arrival of an enormous amount of international aid in the 1990s, Cambodia has evolved into a globalised society constituted by a vast network of socio-culturally diverse actors. Heterogeneous value systems and ways of acting and thinking cohabit and become entangled. This thesis offers a study of the operation of a globally established norm within Cambodia, in order to contribute to our understanding of the mechanisms underlying the interconnection between the global and the local. Today, almost all HIV/AIDS programmes involve users in the implementation of activities that concern them and in discussions on community choices. Lay participation has become a global norm, promoted by all institutions combating AIDS. The first part of the thesis defines the generally agreed rules of this norm ; this is followed by a description of its uses and its local meaning in Cambodia. Participation is based on the principles of knowledge-sharing, distribution of authority, valuation of lay status and democratization of the process of decision-making, which are difficult to achieve in Cambodia. Since the spread of this norm, lay actors have been introduced at all levels of the care structure in most parts of the country, although in the main these actors assume executive roles. Where there are opportunities to exercise influence over decisions within the public domain this norm is undermined in two ways. On the one hand, lay actors hesitate to show that they have any authority, even to debate openly in public; on the other hand, most members of the elite who decide on and set up development activities retain control over participation and 'silt up' lay voices. For many actors, the principles of hierarchy and nonconfrontation, which are characteristic of Cambodian society, contrast with the principles and values of participation. The globalised norm is thus reinterpreted in accordance with the Cambodian structural and socio-historical context. It takes a completely different form, which is sometimes contrary to its initial goal.
