Women With AIDS: Will It Change aids Service Organizations?

In the early 1980s, gay men formed AIDS service organizations (ASOs) in areas hardest hit by the disease, such as San Francisco and New York City, to provide assistance to infected members of their own communities. The Ryan White CARE Act of 1990 made funds available for community-based groups, such as ASOs, to provide support services to all people with HIV/AIDS. The epidemiology of AIDS has changed greatly in recent years, and increasing numbers of poor, minority women with children now contract HIV/AIDS. To determine if ASOs are in compliance with the CARE Act, this study surveyed 20 ASOs across the country and a number of their female clients to see if ASOs, some of which were started by gay men, have tailored their services for a growing minority, heterosexual population. The results indicate that a number of ASOs have been slow in responding to the diverse needs of women. Recommendations are offered to make the organizations more responsive.     

Impact of the Ryan White CARE Act on the Availability of HIV/AIDS Services

This article assesses the extent to which the availability of HIV/AIDS services in the Baltimore and Oakland eligible metropolitan areas (EMAs) increased after receipt of funding under Title I of the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act. Survey data on the availability of HIV/AIDS services in each EMA were collected from samples of organizations at two points in time: 1 year before (1991) and 1 year after (1993) the Oakland and Baltimore EMAs received their first installments of CARE Act Title I funds. Cross-sectional and longitudinal analyses of the data were performed to assess changes in the availability of HIV/AIDS services. The results showed that after CARE Act Title I funding became available, the availability of ambulatory medical and social support services in the Baltimore and Oakland EMAs increased. However, the way service availability increased varied significantly, reflecting differing opportunities and constraints present in each community. In Baltimore, the increase in the availability of HIV/AIDS services was due largely to the creation of new organizations that used Title I funds to provide services (system expansion). In Oakland, relatively few new organizations were created, but existing organizations added new HIV/AIDS services (service line expansion). Our data also indicated that in both EMAs the majority of HIV/AIDS organizations receiving Title I funds expanded the capacity of their existing services to meet growing demand.     

Privileging prevention,gendering responsibility: an analysis of the Ghanaian campaign against HIV/AIDS

This article focuses on the discourses around HIV/AIDS in the national Ghanaian ‘Stop AIDS Love Life!’ public health campaign, within non-governmental HIV/AIDS publications, and the Ghanaian national print media. I have used critical discourse analysis to interpret and deconstruct a range of these social texts collected between June and September of 2001 and 2003 in and around Greater Accra, Ghana. I argue, firstly, that these discourses are shaped by an international politics of funding for HIV/AIDS that privileges prevention through behaviour change over treatment action under the premise that prevention is a more cost-effective option for the Global South. I critique this stance, highlighting the emerging possibilities for integrated prevention–treatment efforts in resource-poor settings such as Ghana. Secondly, I argue that the discourses around HIV/AIDS presented in prevention campaign materials powerfully construct normative and gendered subjectivities with assigned roles and responsibilities. The fight against HIV/AIDS is constructed as a national project in which an idealized, and often very young, female citizen is positioned as educator, volunteer, carer and protector of herself and society. This discursive coding of responsibility places the many burdens of HIV upon some of the most vulnerable in society, ignoring the structural constraints of gender, generational and economic inequality. I conclude my paper by arguing that efforts to reduce transmission rates, stigma, and the burden of care for those living with HIV/AIDS in Ghana must integrate both preventative efforts and treatment action. Where prevention campaigns are utilized I suggest that these must recognize the limitations of behaviour change initiatives that primarily target women and acknowledge the gendered constraints faced by those very subjects identified as responsible for the protection and education of the nation.     

"New Governance" and Associative Pluralism: The Case of Drug Policy in Swiss Cities

Throughout the 1990s, hierarchical administrative governance structures have been replaced by self-governing networks for various motives, one of which is to improve the authenticity and democratic quality of public decisions. Thus, "new governance" has been praised for its propensity to provide a plurality of civil society organizations with access to the decision process. This article explores these claims based on the case of drug policy in Swiss cities. We show that self-governing networks indeed seem to have increased the involvement of civil society organizations in the policy process. However, we also find evidence that self-governing networks may in the longer run induce state control over civil society organizations, thus ultimately reducing associative pluralism. They do so either by imposing a policy paradigm or by excluding actors who do not comply with the dominant paradigm from the networks. We conclude by arguing that self-organizing networks should not be dismissed, given that former hierarchical bureaucratic approaches to drug-related problems have failed even worse. Rather, their long-term effects should be subject to further examination aimed at developing adequate responses to their shortcomings.     

The Impact of AIDS on Rural Households in Africa: A Shock Like Any Other?

In areas where HIV prevalence is high, household production can be significantly affected and the integrity of households compromised. Yet policy responses to the impact of HIV/AIDS have been muted in comparison to outcomes of other shocks, such as drought or complex political emergencies. This article looks at the reasons for the apparent under–reaction to AIDS, using data from Zambia, and examines recent calls to mitigate the effects of AIDS at household level. Critical consideration is directed at proposals relating to community safety nets, micro–finance and the mainstreaming of AIDS within larger poverty alleviation programmes. It is argued that effective initiatives must attend to the specific features of AIDS, incorporating both an assault on those inequalities which drive the epidemic and sensitivity to the staging of AIDS both across and within households. A multi–pronged approach is advocated which is addressed not just at mitigation or prevention, but also at emergency relief, rehabilitation and development.     

Global governance and the politics of culture: campaigns against female circumcision in East Africa

International organizations, national governments, and civil society organizations have condemned female genital cutting (FGC). In doing so, campaigners and policy-makers often describe female excision as backward, barbaric, and a problem of African culture. What does widespread international condemnation of FGC as a so-called traditional practice mean for campaigns against excision ‘on the ground?’ Drawing on critical global governance scholarship, this article argues that pervasive understandings of female excision as a problem of African culture obscure the far-reaching politics of campaigns against genital cutting. Focusing on efforts to criminalize female circumcision and educational projects in Tanzania and Kenya, I illustrate ways in which campaigns against female circumcision are dynamic sites of conflict characterized by politicized negotiations and resistance. I argue that initiatives that view FGC as a cultural problem in narrow terms may have unanticipated consequences when campaigns inscribe the communities they identify with female excision as local, traditional, and marginal. Notably, campaigns against the so-called traditional culture can counterproductively politicize diverse practices of excision as reified markers of ‘insider’ cultural identity. As a result, campaigns against excision may lead to outcomes antithetical to their stated goals of reducing practices of genital cutting.     

Corporate accountability in South Africa: the role of community mobilizing in environmental governance

Contrasting perspectives of international companies and civil society groups have divided recent debates about corporate responsibility in developing countries. The Corporate Social Responsibility discourse has been promoted by business lobbies, emphasizing the role of international companies in voluntarily contributing towards the solution of pressing social and environmental problems through partnerships with other stakeholders. The notion of corporate accountability has become the rallying point for sustainable development, demanding stricter regulation of corporate behaviour by national governments and the enactment of an international corporate accountability convention. This article assesses the promises and pitfalls of these two competing approaches to industries in South Africa. The article argues that a multi-level approach is necessary to the impact of CSR and corporate accountability initiatives. It concludes that CSR may improve environmental management systems and reduce corporate pollution levels whereas corporate accountability approaches may provide important incentives for companies to improve their environmental performance, assist in the development of national environmental governance frameworks guiding company-community interaction, and facilitate the enforcement of national legislation pertaining to corporate responsibility. However, both approaches fail to address the underlying, globallevel structural causes of conflicts between companies and stakeholders affected by their operations. These conflicts can only be reversed by fundamental changes in the global economy.     

Embedding the War on Terror: State and Civil Society Relations

The global war on terror was used by the Bush administration and its allies to defend a US dominated geopolitical configuration. To this end, counter‐terrorism measures (CTMs) were introduced which strengthened the alignment of development aid with diplomacy and defence. The broad, adverse effects of CTMs on civil liberties and human rights are well documented. Despite the advent of a new US administration and a ‘soft power’ approach to international relations, the legacy of the war on terror remains embedded in the laws, policies and attitudes of many states and regimes that continue to enclose the lives of citizens. This article describes the experiences of civil society organizations (CSOs) as ‘securitization’ processes unfolded. Studies over two years involving some forty countries provide an on‐the‐ground view to probe the gains and losses of securitization, both for governments in the US‐led ‘coalition of the willing’ and for civil society in terms of the pressures emerging from a development‐for‐security agenda. The authors identify some of the perverse zero‐sum effects on governments of CTM philosophy and the means employed. Findings also show asymmetry between northern and southern CSOs in terms of their negative‐sum subordination, found in the definition of security and in the vulnerability to new risks involved in undertaking development work.     

Epilogue: Homegrown in PNG — Rural Responses to HIV and AIDS

ABSTRACT A three‐years‐long, multi‐sited, multi‐method study conducted throughout Papua New Guinea by the Institute of Medical Research revealed a staggering prevalence of sexually transmitted disease (STD) that threatens an already fragile political‐economy and health services delivery system. Logistics, methodological complexities, and political and especially religious sensitivities hampered conduct of such research. Extremely little HIV social research has been allowed to inform interventions or serosurveillance protocols. Well‐ intended but ill‐conceived international initiatives have promoted a normative AIDS paradigm that misconstrues HIV transmission risk, incites greater fear, increases stigma, and promotes anti‐condom rhetoric. This collection ‘HIV/AIDS in Rural Papua New Guinea’ presents a sustained series of ethnographically based accounts of rural responses. In this epilogue I situate the importance of those responses in a discussion of the great divide between the lived realities of HIV infection and AIDS related suffering on the one hand, and the discursive practices and policies of media, public health, international donors and NGOs on the other.     

When open data and data activism meet: An analysis of civic participation in Cape Town,South Africa

Municipal open data projects are motivated by a desire to democratize data access and knowledge production, strengthen transparency, and advance cities socially and economically. However, their effects and implications are insufficiently analyzed. This paper examines civic engagement in open data in Cape Town, South Africa, the continent's first municipal-level open data initiative. Findings reveal how local civil society organizations have been driving engagement with municipal open data as part of their recent turn towards technology and data-driven forms of public engagement and activism. This analysis highlights the important role of the “smart civil society organization”—occupying a position between the smart city and smart citizen—that is developing significant capacity to produce and share data about the city's informal settlements with stakeholders in government, the private sector, and wider society. Minimal engagement with or recognition of civil society efforts illustrates the limits to the city's philosophy of data openness, which is largely restricted to releasing selected government datasets to the public. The notion of “bi-directional open data” is developed here to characterize emerging possibilities for data openness between governments and the public. This may be particularly relevant for cities like Cape Town with a highly active, capable, and data-literate civil society.     

Securing the World and Challenging Civil Society: Before and After the ‘War on Terror’

Following President Bush's declaration of a ‘War on Terror’ in 2001, governments around the world introduced a range of counter‐terrorist legislation, policies and practices. These measures have affected not only human rights and civil liberties but also civil society and aid frameworks. Although the Obama administration has renounced the language of the ‘War on Terror’ and taken steps to revoke aspects such as water‐boarding and the detention facility at Guantanamo Bay, the bulk of the legislation and practices associated with the post‐9/11 global security framework remain. The cluster of papers which follow provide detailed studies of the effects of the War on Terror regime on civil society in four contexts: the USA, Spain, Kenya and Uzbekistan. In this way it lays a basis for civil society actors and aid agencies to reflect more strategically on how they should engage with security debates and initiatives in a way that best protects the spaces of civil society and the interests of minority and vulnerable groups. This introduction sets out the three key themes pursued throughout the cluster articles, namely, the selective impact of counter‐terrorist measures on civil society; the particularity of civil society responsiveness to these measures; and the role of aid and diplomacy in pursuing security objectives and its consequences for civil society.     

U.S. Civil Society Assistance to Egypt: Thinking Long Term

The interim Egyptian government's excoriation of U.S. support for nongovernmental organizations (NGOs) in the country has sparked a crisis that some analysts have called the worst deterioration of United States–Egypt relations in history. As Cairo's smear campaigns against the civil society community foment public mistrust among many Egyptians of NGO activity and foreign funding, U.S. policymakers and practitioners face new challenges in supporting civil society work in Egypt. For a number of reasons, however, Washington's assistance to Egypt should and almost certainly will continue, even if the environment for civil society activity in the country does not improve. Grantors and implementers must think seriously, therefore, about long‐term strategies for assisting civil society development in Egypt, which will require at least some coordination with a government that may be suspicious of U.S. efforts. By standing firm on red lines, improving public messaging in Egypt, carefully fostering local ownership of projects, remaining strictly neutral in identifying grantees and diversifying partnerships, distinguishing between short‐term foreign policy objectives and long‐term efforts to assist civil society development, and using varied democracy assistance tools appropriately, the United States can assist NGOs in Egypt in a way that gives them—and democracy—the best chance for success.     

Creating Civil Society? The Emergence of NGOs in Vietnam

Based on recent research in Hanoi, this article examines the emergence of NGOs in Vietnam, and relates their development to the civil society discourse which is used by elements of the international donor community to predict the growth of pluralism and democracy. After examining the social and political environment of post-reform Vietnam, it does not appear evident that these organizations fit into any definition of civil society which stresses independence from the state and opposition to state ideology.     

Strengthening gender justice in the Asia-Pacific through the Rome Statute

Many conflicts in the Asia-Pacific region have included sexual violence crimes targeted primarily against women. However, in comparison to other regions, Asia-Pacific states have been reluctant to embrace international law innovations to end impunity for such crimes into the future, as evidenced by their unwillingness to become signatories to the Rome Statute of the International Criminal Court. Of the 39 countries constituting the Asia-Pacific region, only 17—less than half—have joined the Rome Statute. This article initially surveys some of the reasons for non-ratification of the Statute. It further examines the role of civil society and the potential normative impact of the Statute to enhance national sexual violence legislation and prosecutions. Finally, it identifies some practical steps that the Australian government could take to encourage regional states to ratify, implement and enforce the Rome Statute in order to further protect all victims of international crimes and bolster the broader Women, Peace and Security framework.     

Shifting Environmental Governance in a Neoliberal World: US AID for Conservation

Abstract: By exploring the shifting and uneven power relations among state, market and civil society organizations in US environmental foreign aid policy‐making, this article forges new ground in conversations about conservation and neoliberalism. Since the 1970s, an evolving group of non‐governmental organizations (NGOs) has lobbied the US Congress to support environmental foreign assistance. However, the 1980s and 1990s rise of neoliberalism laid the conditions for the formation of a dynamic alliance among representatives of the US Congress, the US Agency for International Development, environmental NGOs and the private sector around biodiversity conservation. In this alliance, idealized visions of NGOs as civil society and a countering force to corporations have underpinned their influence, despite their contemporary corporate partnerships. Furthermore, by focusing on international biodiversity conservation, the group has attracted a broad spectrum of political and corporate support to shape public policy and in the process create new spaces for capital expansion.     

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.     

Research on human subjects,exploitation, and global principles of ethics

Abstract

In 1997, 5.8 million people became infected with HIV, 30.6 million people were living with HIV/AIDS, and infection was running at about sixteen thousand new infections a day, of which more than 90% were in low income countries. Against this background the urgency and importance of the fight against HIV/AIDS can scarcely be exaggerated. While a cure for AIDS remains elusive research to discover more effective treatment and possible vaccines is vital. It is at this crucial moment that moral criticism has emerged of some of the most promising research towards treatments and vaccines for HIV/AIDS. This criticism has focused on, and purports to be justified by, the major current international principles and protocols on the ethics of research on human subjects. If this criticism is valid and no better ways of prosecuting successful research on AIDS can be found, the consequences, as the figures above indicate, are truly bleak. This paper will attempt to provide an appropriate framework for assessing the ethics of research on human subjects generally and in doing so will assess the relevance and force of the major ethical criticisms that have been levelled at current research on human subjects in the context of HIV/AIDS therapy and vaccines.     

The ambivalent relations behind civil society’s engagement in the “grey zones” of migration and integration governance: Case studies from Belgium

Based on qualitative data collected in two different Belgian cities (Brussels and Liège), this article focuses on the emergence of civil society initiatives to address the grey zones of migration and integration governance in the country. We define the concept of grey zones as situations that appear in specific time-spaces where problematic issues arise and the state fails to intervene. This triggers the intervention of civil society to deal with specific governance issues. In Belgium, the state – through an indifference-as-policy approach – delegates the responsibilities of reception and integration policies to multiple actors and leaves space for a variety of citizens’ initiatives to emerge. The grey zones of government policies become spaces for possible citizen-organised actions aimed at both providing initial reception and legal support to migrants, and denouncing the absence of state intervention. These citizen actions operate in particular on the issue of housing and reception of forced migrants with different legal status and migration aspirations. We also highlight the ambivalent relations emerging between civil society actors and the state. Through the analysis of two situated case studies, this article aims to provide evidence on how these civil society initiatives develop and how their humanitarian approach becomes political.     

Counter‐terrorism and the Politics of Aid: Civil Society Responses in Kenya

Against the backdrop of terrorist attacks in 1998 and 2002, Kenya has come under pressure from aid donors and diplomatic circles to co‐operate in achieving the political and military objectives of the War on Terror. The Kenyan government has received legal, technical and financial support to implement new counter‐terrorism structures. However, while these have raised concerns around human rights and the ability of people to come together and organize on shared interests, the response of civil society in Kenya has been muted. It is mainly human rights campaigners, lawyers, Muslim organizations and leaders, and some politicians that have opposed proposed anti‐terrorism legislation. Even fewer groups have spoken out against the government's participation in a regional rendition programme in the Horn of Africa supported by the United States. This weak response reflects the significant ethnic and regional fragmentation that prevails in the country. This article critically examines the impacts of counter‐terrorism in Kenya and civil society responses to these in a shifting political landscape.