AIDS Activism in Pakistan: Diminishing Funds,Evasive State

This article draws on a year of ethnographic fieldwork in the HIV/AIDS sector of Pakistan at the moment of rolling back a World Bank‐financed programme. Classified by UN agencies as at ‘high risk’ of a generalized HIV epidemic, Pakistan has an epidemiology driven by injecting drug use, and a Penal Code and Islamist legislation which criminalize non‐therapeutic drug use and extra‐marital sex. In recent years, a sharp increase in the numbers of registered HIV‐positive people has necessitated a shift from HIV prevention among ‘high risk groups’ to the provision of care to those living with HIV/AIDS. The rolling back of external funding, which was further compounded by the effects of devolution on the Ministry of Health, created challenges for AIDS activism in Pakistan, as reflected in the everyday lives — and deaths — of the patient‐activists and their community‐based organizations. This article recounts the story of one such aspiring AIDS activist caught in multiple dilemmas emanating from these macro‐processes. This story throws light on the limitations of the complex agency of actors in development, and shows how the shifting loci of power from the state to non‐state entities in the global neoliberal order impacts the provision of vital services like HIV prevention and AIDS control.     

Medical Research Council Programme on AIDS in Uganda – the first 10 years

Abstract

The Medical Research Council (MRC) Programme on AIDS in Uganda is based at the Uganda Virus Research Institute of the Ugandan Ministry of Health in Entebbe on the shores of Lake Victoria. The programme was established following a request in 1988 from the Ugandan Government to the UK Government for assistance with AIDS, which had recently been discovered to be a large and growing health problem in the country. At that time Uganda had the worst published rates of HIV infection in the world. Over the past 10 years, Uganda has to some extent controlled its AIDS problem while other countries have been overtaken by even worse epidemics. From the outset of the epidemic Ugandan political leaders have discussed the dangers that HIV infection presented to the country and looked for support from community and opinion leaders, including religious groups. They have used available human resources in a relevant manner to trigger important social changes. Sex education is becoming integrated into the school curriculum, programmes have been established to improve the treatment of sexually transmitted diseases throughout the country, and the use of condoms has been actively and widely promoted through free distribution and social marketing. In Uganda today, experts estimate that 10–25% of the urban population and 4–10% of the rural population are infected with HIV.     

Contemporary conflicts,cross‐border military operations,and the declining role of the UN: The case of Turkey and Saudi Arabia

This article examines an emerging trend of cross‐border conflicts between states and non‐state actors. It looks at the narratives fronted by Turkey and Saudi Arabia to justify their operations in northern Syria and Yemen, respectively. The authors argue that the increased inaction and lack of influence by the UN in response to such operations reaffirm states as the core actors in international politics and that national security and interests continue to shape the behavior of actors at the international level. The article concludes that the UN needs to adjust to the new forms of conflicts, actors, and behavior being experienced at the international level if it is to retain its relevance as an anchor of peace and international security.     

Rebranding the State: Uganda's Strategic Use of the International Criminal Court

When governments invite the International Criminal Court (ICC) to conduct investigations within their own borders, they seem to indicate acceptance of global norms of accountability for wartime atrocities. The first of these self‐referrals came from Uganda, whose government requested investigation into its conflict with the Lord's Resistance Army (LRA), a conflict within which it, too, committed large‐scale human rights violations. This article argues that Uganda used the ICC to help solve a problem faced by many of the world's least powerful states, whose domestic politics are often structured through patron–client networks. Their rulers need to distribute basic state resources, including physical protection, to loyal clients without alienating donors who demand provision of these same resources by right to all citizens. By inviting external scrutiny and manipulating the investigative process, the Ugandan government received an international seal of approval for practices that the ICC would normally punish. This strategy has system‐wide consequences in that repeated mislabelling of rights violations as compliant with international norms causes the meaning of compliance to become incoherent, and norms are less able to constrain the behaviour of all states in the long run.     

The politics of civil society in confronting HIV/AIDS

Civil society organizations have been at the forefront of the response to the HIV/AIDS epidemic. However, the contributions and the models of action they offer have remained marginalized by most governments and international organizations. This article looks at the initiatives of civil society actors. It discusses some of the political reasons and rationale behind the less than enthusiastic support for these initiatives from governments and large aid agencies. Two reasons are suggested: many politicians fear providing support and credibility to civil society organizations that might then build upon their success to question and challenge development failures; and the threat perceived by national and international bureaucrats to their own assumed expertise and solutions to the pandemic. In some cases, civil society organizations have been co-opted to fill gaps that governments themselves can not or will not address. However, even here, governments assume the credit for 'successes' in controlling HIV/AIDS.     

After Westgate: opportunities and challenges in the war against Al‐Shabaab

The attack on the Westgate Mall in Nairobi, Kenya, in September 2013 intensified international scrutiny of the war against Harakat Al‐Shabaab Mujahideen (Movement of the Warrior Youth). This article analyses the current state of affairs with reference to the three principal sets of actors in this war: Al‐Shabaab, the African Union Mission in Somalia (AMISOM) and its international partners, and the various actors currently involved in building the Somali Federal Government's security forces. It argues that although the newly reconfigured Al‐Shabaab poses a major tactical threat in Somalia and across the wider Horn of Africa, the movement is becoming a less important actor in Somalia's national politics. As Al‐Shabaab loses territory and its popularity among Somalis continues to dwindle, other clan‐ and region‐based actors will become more salient as national debates over federalism, the decentralization of governance mechanisms beyond Mogadishu and the place of clannism will occupy centre stage. As a consequence, AMISOM's principal roles should gradually shift from degrading Al‐Shabaab towards a broader stabilization agenda: encouraging a national consensus over how to build effective governance structures; developing an effective set of Somali National Security Forces; and ensuring that the Federal Government delivers services and effective governance to its citizens, especially beyond Mogadishu in the settlements recently captured from Al‐Shabaab. As it stands, however, AMISOM is not prepared to carry out these activities. More worryingly, nor is the Somali Federal Government.     

Tropical forests in the global states system

The purpose of this article is to point to an inherent ambivalence within international society related to tropical forests. As peripheral and often relatively insulated terrestrial spaces, tropical forests have been subject to enduring attempts by state structures to consolidate political authority and their connection to nodes of economic power. However, as they have come to be increasingly degraded and cleared, policy reform agendas have been enacted to promote their conservation. Involving a range of state and non‐state actors at a national and international level, forest policy reform agendas have sought to create a structure of economic incentives aimed at their ‘sustainable management’ and thus their preservation as forests. Paradoxically, a key impact of these evolving agendas has been to further the extension of state power. Arguing that this points to a deep‐seated tension within international society related to the governance of peripheral spaces, it will be suggested that state‐making ambitions have tended to shape and ultimately negate international tropical forest conservation initiatives.     

What Does the Somali Experience Teach Us about the Social Contract and the State?

Since 1991 the international system has struggled and failed to recreate a state on the territory of the former Somalia. Proto‐state systems have been formed by Somalis themselves in Somaliland and Puntland and alternative forms of governance and order exist in other parts of Somalia, but none enjoys international recognition. The polities of Somalia offer important lessons concerning our general theories about social contract, the role that states play in creating wealth, indigenous systems of governance, and the failure of existing international approaches to state reconstruction. Contemporary Somali politics is re‐explored here to extract these lessons. The article explores the assumptions embedded in the works of the classic Western social contract theorists in the light of Somali experience in order to show that the underlying conceptual structure of international state reconstruction work needs to be rethought. We conclude that it frequently is better to allow for bottom‐up, organic, disjointed negotiation of indigenous governance solutions (even though they probably will not conform to Western ideas of liberal democracy) than for the international system to impose top‐down answers. The former more closely tracks the history of state formation in Europe and the latter is troubled by the inconsistent and not necessarily benign interests of the international actors involved. Indigenous, local political systems are changed by the stresses of violent conflict, so prompt action to employ them in a post‐conflict situation is indicated.     

EU multi‐level governance patterns and the cohesion fund

The new Cohesion Fund (1993–1999) seems to challenge the multi‐level pattern of governance of the Structural Funds, where sub‐national actors and Commission have a prominent role in the decision‐making and implementation procedures. The current article analyses the apparent ‘state‐centred’ nature of this new redistributive instrument of the EU, through three main points. Firstly, by a study of the role of the Commission in the implementation of the Cohesion Fund projects; secondly, by looking at the recent attempts to enforce the conditionality principle; and finally, by a study of the role of sub‐national actors in Spain in implementing the Fund. The article concludes with mixed results, showing how non‐state actors play a larger role in the implementation stage than it seemed at first glance, but also that important state‐centric elements coexist, as one of the states has recently achieved a political compromise with the Commission about the enforcement of the conditionality principle following most of its initial premises.     

Nationalism studies between methodological nationalism and orientalism: an alternative approach illustrated with the case of El Greco in Toledo,Spain

Methodological nationalism is still dominant in nationalism studies. When studying the construction of national identities, scholars generally limit their study to the borders of one nation‐state, while only paying attention to members of that particular nation. Implicitly, foreign actors and influences are left out of the picture. I will challenge this methodological nationalism with a case study, which demonstrates that the place of Toledo within the Spanish national imagination, and more particularly that of El Greco, the most important representative of the city's artistic heritage, was largely determined by foreigners. During the nineteenth century, El Greco was rediscovered primarily by foreign scholars and artists. Moreover, it would be the rise of international tourism in the early twentieth century that convinced Toledans to adopt El Greco as the city's main artistic icon. This case, thus, clearly shows that in nationalism studies methodological nationalism can be avoided by also including foreign actors.     

Militarization of the Market and Rent‐Seeking Coalitions in Turkey

This article analyses the role of historically‐determined institutional and political characteristics in determining both the nature of the adjustment process, and its economic and political outcomes, in Turkey. In particular, the author explores the degree to which the formation of rent‐seeking coalitions has contributed to the failure of neo‐liberal economic reforms in the country. The analysis suggests that the Turkish experience since the early 1980s offers a unique case for studying the relationships between the state bureaucracy, the military, the business sector, civil society, and international economic actors. Unlike previous research in this area, this article focuses especially on the role of the military as an interest group in the process of economic liberalization in Turkey.     

‘Turning Sex into a Game’: Gogodala Men's Response to the AIDS Epidemic and Condom Promotion in Rural Papua New Guinea

ABSTRACT Rugby league is the national sport of Papua New Guinea and the game's huge popularity and international profile has been used in recent condom promotion campaigns in the nation's fight against the HIV/AIDS epidemic. In this paper, I argue that the promotion of condom use through rugby league requires a national campaign strategy that includes understandings of condom use and masculinity at the rural level. I demonstrate this through a study of Gogodala men's understandings of the epidemic and condom use in Western Province. The Gogodala are a Christian‐based society and many blame the national condom promotion strategy for an increase in promiscuity and for ‘turning sex into a game’. Condom availability in this rural area continues to be restricted to a family planning program that promotes Christian values and excludes unmarried men. I explore the male condom dilemma where young men are more concerned with avoiding accusations that their sexual behaviour puts them at risk of contracting HIV despite acknowledging the preventative value of using condoms. In this context young men disassociate themselves from the disease and condom use through a process of calculated risk or risk minimisation.     

Poverty, debt and Africa's HIV/AIDS crisis

As Africa enters its third decade of structural adjustment pressures, the promised advantages of economic restructuring—as hailed by the various lending bodies— have not been forthcoming. The indelible picture emanating from the continent is one of a people relegated to a position of extreme poverty as state managers and the international community either fail to, or seem unable to, pursue policies that will secure the basic needs of its citizens. To compound matters, HIV and AIDS are threatening to erode the continent's already fragile development capacity. Predicated on the continent's limited economic capabilities, this article charts the relationship between poverty, debt relief and the politics of effective response to HIV/AIDS in Africa. The article begins with an assessment of the societal causes and consequences of the epidemic, moving on to contextualize the case for debts cancellation. It concludes by examining the crucial relationship between debt relief and the successful implementation of effective strategies against the pandemic in Africa.     

Filling the Void?: Anglo-American Strategic Relations,Philippine Independence,and the Containment of Japan, 1932–1937

The declaration in 1932 of the United States to allow Philippine independence in March 1934 was an act that had a number of unintended consequences for the stability of the Far Eastern balance of power system. Given the state of tension existing in the international system between the major actors in the region: Japan, China, the Soviet Union, Great Britain and the United States, any movement in the existing boundaries of the international spheres of influence between them could generate a significant destabilizing reaction. The American proposal to allow Philippine independence was such an act. If America surrendered its position and interests in the Philippines, who would replace it? What would happen if it was not replaced? Was it realistic, given the nature of the international competition for resources and strategic position, all linked to the creation and use of maritime power, that the Philippines could exist ‘on its own..’. This essay will analyse how the United States and Great Britain dealt with this instability, as well as how those interactions allowed a closer and more harmonious Anglo-American informal strategic relationship to be developed. That relationship would thereafter evolve into a collaborative alliance aimed at deterring further Japanese expansion.     

Governance with Empty Pockets: The Education Sector in the Democratic Republic of Congo

The education sector has virtually disappeared from the Congolese state budget since the mid‐1980s. Yet schools have both managed to survive on school fees and to reproduce the public education sector, even though complete privatization would have been a realistic option. In this article, the authors understand this engagement with the state whilst simultaneously bending its rules as a negotiation strategy for better terms of inclusion in the state system. Different state actors cultivate their ‘own’ practical versions of official rules. In this way, they create space to respond to parents’ demand for education, to increase the number of teachers and their salaries far beyond what would otherwise have been possible, and to reproduce the system over time. One may wonder, however, whether the resilience of the sector in the face of the implosion of the state budget does not come at the price of building a more inclusive and higher quality education system.     

City networks: breaking gridlocks or forging (new) lock‐ins?

There is today a global recognition that we live in an ‘urban age’ of near‐planetary urbanization where cities are at the forefront of all sorts of agendas. Yet little attention is offered to the active role of cities as political drivers of the urban age. There might today be more than two hundred ‘city networks’ globally, with thousands of para‐diplomatic connections actively defining relations between cities, international organization and corporate actors. This actively networked texture of the urban age shapes all areas of policy and, not least, international relations, and holds much promise as to possible urban solutions to global challenges. Based on an overview of a representative subset of this mass of city‐to‐city cooperation (n=170), this article illustrates the landscape of city networking, its issue areas and institutional shapes, and its critical features. As we argue, city networks today are faced by a crucial challenge: while trying to overcome state‐centric ‘gridlocks’ cities are, at the same time, building both political–economic as well as very material ‘lock‐ins’. We need to pay serious attention to this impact of city diplomacy in international affairs, developing a greater appreciation of the path dependencies and responsibilities this diplomatic activity purports.     

State Absence and State Formation in Solomon Islands: Reflections on Agency,Scale and Hybridity

This article engages ethnographic research on perceptions of disputation, justice and security in rural Solomon Islands to reflect on issues of agency, power and scale in areas of limited statehood. Set against widespread popular perceptions of state retreat in Solomon Islands, the authors situate their study within the literature which addresses engagements with conflict‐affected and fragile countries and, in particular, literature with an interest in the spaces created by prolonged state absence as potential sites of innovation and transformation. The article examines the role of agency and power at different scales in the highly contested processes of state formation underway in post‐conflict Solomon Islands. Taking issue with the presumed privileging by local actors of non‐state over state forms that runs through much of the hybridity literature, the authors suggest that international ‘state‐building’ interventions, such as that recently experienced in Solomon Islands, require a more nuanced and historically informed understanding of local agency vis‐à‐vis the state in fragile and conflict‐affected settings.     

Introduction

The aim of this special issue of International Affairs is to address the changing dynamics in the international economic system from an interdisciplinary standpoint, in order to unpack some of the emerging processes of globalization and to investigate the relationship between power and rule‐setting. The idea is to bridge the gap between the traditional realist accounts of the international system that place the nation‐state at the centre of the analysis, and the liberal, market‐driven approach that focuses on the problems of an increasingly integrated global economy and fragmented political authority. The framing question is how the global order (governance) has to change in order to accommodate the enlargement of the playing field and in particular the emergence of fast‐growing developing economies. How is this shift going to affect the distribution of power, both among nations and between state and non‐state actors? Is this shift going to drive a fundamental rethinking of the rules governing relations between countries—and regions—and institutions? The thread that links the articles in this special issue is the rather benign view of globalization, leaning towards ‘liberal ingenuity’ that sees governance as a way to accommodate conflicting interests through institutions in such a way as to minimize the potential for conflict.     

The temporary as the future: Ready‐to‐use therapeutic food and nutraceuticals in South Africa

The reconfiguration of food as a pharmaceutical in biomedical regimes has been considered by scholars along two axes: (1) food supplementation as humanitarian intervention, based on a specific value of life and delivered in ‘crisis’ situations with a short temporal horizon; (2) food supplementation as commodity, marketed as enhancing ‘wellness’ or potential, based on notions of risk in broad temporal frames. We consider nutraceuticals and ready‐to‐use‐therapeutic foods as they are deployed by state and commercial actors in South Africa in relation to two key figures: the pregnant woman and the HIV‐positive population. These biopolitical expressions of post‐apartheid regimes of knowledge, care and governance reveal how state distribution and the corporate marketing of supplements employ a future‐oriented logic that appeals to notions of power, energy and potential. Therapeutic foods in this context are thus not merely humanitarian technologies that reconfigure crisis as a chronic condition – the temporary becoming permanent – but are premised on new potentialities, in which the temporary may (re)shape the future.     

Wealth alone does not buy health: Political capacity,democracy, and the spread of AIDS

Although there have been have numerous studies on AIDS documenting its mortality, its epidemiological features, and its relationship to poverty and development, few studies have systematically analyzed how political factors and policies may help curtail the spread of AIDS. In this paper I consider how a variety of domestic factors influence HIV infection rates across countries. I argue that states with higher state capacity are better able to reduce the spread of the HIV/AIDS epidemic. Moreover, I argue that while strong autocracies can implement efficient policies with fewer constraints, democracies tend to be more responsive to the needs of the population and can be more efficient in curtailing the spread of HIV/AIDS. I empirically evaluate the hypotheses using a cross-sectional time-series sample of 117 countries. The empirical results indicate that greater state capacity indeed appears to help curtail HIV/AIDS infection rates.