Denialism

South Atlantic Quarterly

Volumn 103, Issue 4, 2004, Pages 769-811

  Sitze, Adam ^a  

^a NONE

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[No Author keywords available]

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EID: 37249038176     PISSN: 00382876     EISSN: 15278026     Source Type: Journal    
DOI: 10.1215/00382876-103-4-769     Document Type: Review

References (248)

1. See Phillipe Riviére, "In Denial about a Deadly Future: South Africa's AIDS Apartheid," trans. Malcolm Greenwood, Le Monde Diplomatique (August 2002), http://mondediplo .com/2002/08/04aids (accessed April 4, 2004)
2. This essay will instead take up the line of inquiry opened by Mandisa Mbali, who suggests that denialism is "a new '-ism' in South Africa," and Ulrike Kistner, who argues that it is "a new way of exercising political power in matters of life and death." See Mandisa Mbali, "HIV/AIDS Policy-Making in Post-Apartheid South Africa," in State of the Nation: South Africa 2003-2004, ed. J. Daniel, A. Habib, and R. Southall (CapeTown: Human Sciences Research Council Press, 2003), 327n 1
3. Ulrike Kistner, "The Constitutional Right to Live, and the Political Power to Let Die," Debate 8 (September 2002): 16
4. See also Thabo Mbeki, "Letter from Thabo Mbeki to Bill Clinton," Washington Post, April 18, 2000
5. Barton Gellman, "South African President Escalates AIDS Feud," Washington Post, April 19, 2000
6. Thabo Mbeki, "Speech of the President of South Africa at the Opening Session of the Conference" (speech given at the Thirteenth International AIDS Conference, Durban, South Africa, July 9, 2000)
7. Jon Jeter, "Political Resistance in South Africa Blocks Wide Use of HIV Drugs; Leaders Ambivalent about Distribution of Anti-retrovirals," Washington Post, October 1, 2001
8. Jaspreet Kindra and Drew Forrest, "ANC Closes Ranks; Government Officials Refuse to Defy President Thabo Mbeki on the Issue of AIDS Treatment," Mail and Guardian, February 22, 2002
9. Ferial Haffajee, "Questions and Answers with Peter Mokaba; 'No Antiretrovirals, Please,'" Financial Mail, March 1, 2002
10. Rachel Swarns, "An AIDS Skeptic in South Africa Feeds Simmering Doubts (Interview with Peter Mokaba)," New York Times, March 31, 2002
11. Thabo Mbeki, "Health, Human Dignity, and Partners for Poverty Reduction," ANC Today, April 5, 2002
12. Richard Pithouse argues that "Mbeki's failure to seize the opportunity provided by the defeat of the pharmaceutical companies cannot be explained by a desire to put the market before people's health. Even market fundamentalists agree that it is cost effective to provide the medicines that can prevent new infections and treat existing infections rather than endure the cost of mass ill health and early death. Mbeki's inaction can only be explained by the fact that he genuinely takes the denialist view, supported by a tiny group of right-wing Americans, that the HI virus doesn't cause AIDS and that AIDS medicines are toxic" ("AIDS Activists Take ANC Government to Court," Green Left Weekly, December 12, 2001
13. compare Richard Pithouse, "Mbeki's AIDS Stance Slammed," Green Left Weekly, July 26, 2000, 15)
14. See Mandisa Mbali, "Mbeki's Bizarre AIDS Theories," Mail and Guardian, March 21, 2002
15. Mahmood Mamdani, Citizen and Subject (Princeton: Princeton University Press, 1996), 27
16. See Rod Nordland, "Africa in the Plague Years," Newsweek, November 24, 1986, 44
17. Michael Serrill, "In the Grip of the Scourge," Time, February 16, 1987, 58
18. Marilyn Chase, "AIDS Has Spread 'Almost Everywhere' in Africa, Zaire Doctor Tells Parley," Wall Street Journal, June 24, 1986
19. Renee Sabatier, Martin Foreman, Jon Tinker, and Marty Radlett, AIDS and the Third World (London: Panos Institute, 1989)
20. Susan Sontag, AIDS and Its Metaphors (New York: Farrar, Straus, and Giroux, 1988), 91
21. See Achille Mbembe, On the Postcolony (Berkeley: University of California Press, 2001), 1-4
22. Simon Watney, "Missionary Positions: AIDS, 'Africa,' and Race," in Practices of Freedom: Selected Writings on HIV/AIDS (Durham: Duke University Press, 1994), 103-20
23. but compare Ato Quayson, "Obverse Denominations: Africa?" Public Culture 14.3 (Fall 2002): 587
24. See E. B. Gouws and B. G.Williams, "Science and HIV/AIDS in South Africa: A Review of the Literature," South African Journal of Science 96 (June 2000): 274
25. Louis Grundlingh, "HIV/AIDS in South Africa: A Case of Failed Reponses Because of Stigmatization, Discrimination, and Morality, 1983-1994," New Contree 46 (November 1999): 55-81
26. Louis Grundlingh, "Government Reponses to HIV/AIDS in South Africa as Reported in the Media, 1983-1994," South African Historical Journal 45 (November 2001): 125-53
27. R. Sher, "Acquired Immune Deficiency Syndrome (AIDS) in the RSA (Supplement)," South African Medical Journal (October 1986): 23-26
28. W. Becker, "HTLV-III Infection in the RSA (Supplement)," South African Medical Journal (October 1986): 26-27
29. compare R. Sher, "HIV Infection in South Africa, 1982-1988-A Review," South African Medical Journal 76.7 (October 1989): 314-18
30. See J. A. van der Merwe, "AIDS" (unpublished paper, Sud Afrikaanse Nasionale Trust en Assuransie Maatskappij Beperk [SANLAM], 1988)
31. G. M. Oppenheimer and R. A. Padgug, "AIDS: The Risks to Insurers, the Threat to Equity," Hastings Center Report 16.5 (October 1986): 18-22
32. W. A. van Niekerk, "Information on HIV/AIDS" (report released by the Republic of South Africa, Department of National Health and Population Development, November 1988)
33. B. D. Schoub et al., "Epidemiological Considerations of the Present Status and Future Growth of the Acquired Immunodeficiency Syndrome Epidemic in South Africa," South African Medical Journal 70.4 (August 20, 1988): 153-57
34. P. G. du Plessis, "The Potential Influence of AIDS on the South African Investment Milieu" (partial fulfillment of MBA, Department of Business Management, University of Stellenbosch, 1991)
35. R. Schall, "Statistical Analysis of HIV Prevalence," South African Medical Journal 77. 1 (January 1990): 52
36. E. Osborn, "Forward Projection of HIV Prevalence," South African Medical Journal 78.6 (September 1990): 373
37. C. J. van Gelderen, "Insurance and Compensation in the Event of HIV Infection," South African Medical Journal 81.6 (March 1992): 33
38. See G. N. Padayachee and R. Schall, "Short-term Predictions of the Prevalence of Human Immunodeficiency Virus Infection among the Black Population in South Africa," South African Medical Journal 77.7 (April 1990): 329-33
39. R. Schall, "On the Maximum Size of the AIDS Epidemic among the Heterosexual Black Population in South Africa," South African Medical Journal 78.9 (November 1990): 507-11
40. See Grundlingh, "Government Responses to HIV/AIDS," 134
41. See Gouws and Williams, "Science and HIV/AIDS," 274-75
42. See Roger Ricklefs, "Living with AIDS: Thanks to New Drugs, Patients Are Surviving and Working Longer-They Are a Greater Presence in the Workplace Today; Employers Are Adapting-The Costs of Chronic Illness," Wall Street Journal, September 2, 1988
43. See E. M. Connor et al., "Reduction of Maternal-Infant Transmission of Human Immunodeficiency Virus Type I with Zidovudine Treatment," New England Journal of Medicine 331.18 (1994): 1173-80
44. compare Emory Thomas Jr., "AZT Is Found to Slash the Transmission of HIV from Mothers to Their Infants," Wall Street Journal, February 22, 1994
45. See Gilles Deleuze, Foucault, trans. Sean Hand (Minneapolis: University of Minnesota Press, 1988), 34-44
46. See Gilbert Elbaz, "Beyond Anger: The Activist Construction of the AIDS Crisis," Social Justice 22.4 (December 1995): 43
47. Paula Treichler, How to Have Theory in an Epidemic: Cultural Chronicles of AIDS (Durham: Duke University Press, 1999), 278-314
48. See Marilyn Chase, "Pricing Battle: Burroughs Wellcome Reaps Profits, Outrage from Its AIDS Drug," Wall Street Journal, September 15, 1989
49. Naomi Freundlich, "Now That AIDS Is Treatable, Who'll Pay the Crushing Cost?" Business Week, September 11, 1989, 115
50. Steve Taravella, "AIDS Drug Brings Providers Challenge of Distribution," Modern Healthcare 19 (September 1989): 39
51. "The Costs of Cures" (editorial), Wall Street Journal, October 4, 1989
52. Jacob Smith Yang, "750 Protest Bush," Gay Community News, October 12, 1991, 12
53. "Burroughs-Wellcome Hit over High AIDS Drug Profits," Chemical Marketing Reporter 243.26 (June 1993): 7
54. See Monitoring the AIDS Pandemic (MAP), "The Status and Trends of the HIV/AIDS Epidemics in the World," Preliminary Report (June 26, 1998), 19
55. The first study to conclude on the unaffordability of ARVs in sub-Saharan Africa was Mansergh et al., "Cost-Effectiveness of Short-Course Zidovudine to Prevent Perinatal HIV Type I Infection in Sub-Saharan African Developing Country Setting," Journal of the American Medical Association 276.2 (July 1996): 139-45
56. Later studies codified this conclusion without also questioning the political economic conditions of possibility for the drug prices they took as their point of departure. See Katherine Floyd and Charles Gilks, "Cost and Financing of Providing Anti-Retroviral Therapy: A Background Paper," World Health Organization (April 1997), www.worldbank.org/aids-econ/arv/floyd/whoarv. pdf (accessed April 4, 2004), which concludes that "ARV therapy does not appear to be either cost-saving or cost-effective in a developing country context, and this is true for prophylaxis to pregnant women as well as more general provision to HIV-infected individuals" (13)
57. See UNAIDS Fact Sheet, "Access to HIV Treatment and Care," September 2003, www .unaids.org/en/media/fact+sheets.asp (accessed April 4, 2004)
58. See Achille Mbembe, "Necropolitics," trans. Libby Meintjes, Public Culture 15.1 (2003): 17
59. See Bryan Rostron, "The New Apartheid?" Mail and Guardian, February 25, 2002, 15
60. Mark Gevisser, "AIDS: The New Apartheid," The Nation, May 14, 2001, 5-6
61. Salih Booker and William Minter, "Global Apartheid," The Nation, July 9, 2001, 11-17
62. Martine Bulard, "Apartheid of Pharmacology," Le Monde Diplomatique, trans. Malcolm Greenwood (January 2000), http://mondediplo.com/ 2000/01/12bulard? [accessed April 4, 2004])
63. See, more generally, Titus Alexander, Unraveling Global Apartheid: An Overview of World Politics (Cambridge, UK: Polity Press, 1996)
64. Patrick Bond, Against Global Apartheid: South Africa Meets the World Bank, IMF, and International Finance (Cape Town: University of Cape Town Press, 2001)
65. In 1995, the WHO estimated that during 1994 over 19.5 million people had been infected with HIV, and estimated that 40 million could be infected by 2000 ("The Current Global Situation of the HIV/AIDS Pandemic," WHO Report [January 3, 1995]). These were the same numbers the WHO provided to Big Pharma on May 23, 1991, and that the CIA made available to President George H. W. Bush that same year in Interagency Intelligence Memorandum 91-10005
66. See Gellman, "Unequal Calculus"
67. David Fidler, "Racism or Realpolitik? U.S. Foreign Policy and the HIV/AIDS Catastrophe in Sub-Saharan Africa," The Journal of Gender, Race, and Justice 7 (2003): 109
68. See Fidler, "Racism or Realpolitik?" 110
69. See Emmanuel Todd, After the Empire: The Breakdown of the American Order, trans. C. Jon Delogu (New York: Columbia University Press, 2003), 75-76
70. See "Intellectual Property ... Is Theft," The Economist, January 22, 1994, 72
71. See Robert Weissman, "A Long Strange TRIPs: The Pharmaceutical Industry Drive to Harmonize Global Intellectual Property Rules, and the Remaining WTO Legal Alternatives Available to Third World Countries," University of Pennsylvania Journal of Economic Law 17 (1996): 1069-1125, esp. 1075-93
72. Which, as Sanjay Basu has emphasized, include but are not limited to HIV/AIDS therapies. See "The Dangerous Deradicalization of AIDS Discourse," ZNet Commentary (October 25, 2003), www.zmag.org/content/ showarticle.cfm?SectionID=14&ItemID=4398 (accessed April 4, 2004)
73. By its own estimates, the failure rate of World Bank projects in the poorest regions of the world is 65 to 70 percent. See Bond, Against Global Apartheid, 210. Even the World Bank's own attempts to redress the debt crises caused by its policies have, by its own admission, failed
74. See Fantu Cheru, "Debt Relief and Social Investment: Linking the HIPC Initiative to the HIV/AIDS Epidemic in Africa: The Case of Zambia," Review of African Political Economy 86 (2000): 520-22
75. See Alison Marshall with Tom Pravda, "The Vicious Circle: AIDS and Third World Debt," report by the World Development Movement for the UN Special Session on HIV/ AIDS, June 25, 2001, www.wdm.org.uk/cambriefs/debt/ vicircle.pdf (accessed March 19, 2004)
76. L. Squire, "Confronting AIDS," Finance and Development (March 1998): 15-17
77. Nana Poku, "Africa's AIDS Crisis in Context: How the Poor Are Dying," Third World Quarterly 22.2 (2001): 200-1
78. Carolyn Baylies, "International Partnership in the Fight against AIDS: Addressing Need and Redressing Injustice?" Review of African Political Economy 81 (1999): 393
79. Carol Barker and Meredeth Turshen, "AIDS in Africa," Review of African Political Economy 13.36 (Summer 1986): 54
80. Meredeth Turshen, "US Aid to AIDS in Africa," Review of African Political Economy 13.35 (Summer 1986): 98-99
81. This is not to suggest, however, that an advanced health infrastructure is necessary before ARVs can begin to be administered successfully. On the contrary, recent studies have shown that the poors in Cape Town adhere more strictly to prescribed ARV regimens than do people in the United Kingdom, thus putting the lie to the argument that "poor Africans, many of whom lack watches and literacy, would break the strict regime of taking certain pills at certain times, risking the emergence of a drug-resistant strain of HIV" (Rory Carroll, "Aids Orphans' Survival Offers Africa Hope; Ground-Breaking Treatment Debunks Drug Firm Myths in Cape Town," The Observer, May 25, 2003,19
82. see C. Orrell, D. R. Bangsberg, M. Badri, R.Wood "Adherence Is Not a Barrier to Successful Antiretroviral Therapy in South Africa" AIDS 17.9 [June 2003]: 1369-75)
83. See Floyd and Gilks, "Cost and Financing Aspects of Providing Anti-Retroviral Therapy." Nicholas Prescott argues, meanwhile, for the feasibility of AZT perinatal treatment, but without inquiring into the conditions of possibility for the "realistic" budget constraints he cites
84. See "Setting Priorities for Government Involvement with Antiretrovirals," in The Implications of Antiretroviral Treatments: Informal Consultation, ed. Eric van Praag, Susan Fernyak, and Alison Martin Katz (Geneva: WHO in collaboration with UNAIDS, 1997), 57-62
85. Karl Marx, "Economic and Philosophic Manuscripts," in Early Writings, trans. R. Livingstone and Gregor Benton (New York: Vintage Books, 1975), 286
86. compare Karl Marx, Grundrisse: Foundations of the Critique of Political Economy (Rough Draft), trans. M. Nicolaus (New York: Penguin Books, in association with New Left Review, 1973), 706
87. On the point of "surplus populations," the predominantly anthropological and phenomenological terms of M bembe's analysis of violence lead his discussion of generalized sovereignty astray. In the case of HIV/AIDS, generalized sovereignty's "destruction of human bodies and populations" is not, as Mbembe suggests, linked to "the generalized instrumentalization of human existence" ("Necropolitics," 13). On the contrary, the people abandoned by capital's replication of surplus value are not instrumentalized at all, which is why capital abandons them. The violence of this abandonment is neither phenomenological nor anthropological but immanent to the circuits of capital itself
88. This estimate is based on a study that is, in turn, the "result of a hypothetical model of the costs of a package of care likely to be received by those people with HIV or AIDS who gain access to health care services. This excludes the very significant proportion of people who, we believe, will not gain access to health services at all" (65). See "AIDS in South Africa: The Demographic and Economic Implications" (a paper prepared by the Centre for Health Policy, Department of Community Health Medical School, University of Witwatersrand, Johannesburg, no. 23, September 1991, 69)
89. Jonathan Broomberg, Malcolm Steinberg, Patrick Masobe, and Grame Behr, "The Economic Impact of the AIDS Epidemic in South Africa," in Facing Up to AIDS: The Socio-Economic Impact in Southern Africa, ed. Sholto Cross and Alan Whiteside (New York: St. Martin's Press, 1993), 161
90. Sholto Cross, "A Socio-Economic Analysis of the Long-Run Effects of AIDS in South Africa," in Cross and Whiteside, Facing Up to AIDS, 139. Cross goes on to argue that "in the South African case, there is very strong evidence for the neo-Malthusian position: obscured as the situation has been by the social engineering policies of apartheid, nevertheless the intrinsically low levels of employment and the high reproduction rates-in association with a primary-resource based economy with no obvious possibilities for rural involution-mean that there is a strong correlation between high population growth rates and the entrapment in poverty of the majority. To the extent that AIDS will bring about an overall reduction in population growth rates, there is thus a prima facie case that the effect on economic growth-and of course on per capita income, although this in itself is no very satisfactory indicator-will from one point of view be positive" (140-41)
91. Anonymous banker, quoted in Jean-Loup Motchane, "WHO's Responsible?" Le Monde Diplomatique trans. Luke Sanford (July 2002), http://mondediplo.com/2002/07/17who? (accessed April 4, 2004)
92. George Soros, quoted in Patrick Bond, "Sacrificing AIDS Victims for Corporate Profits," Green Left Weekly, July 3, 2002, 18
93. See Karl Marx, Capital: A Critique of Political Economy, Volume 1, trans. Ben Fowkes (New York: Vintage Books, 1977), 247-57
94. See Bulard, "Apartheid of Pharmacology."
95. Though it certainly is that. See Andy Gray and Jenni Smit, "Improving Access to HIV-Related Drugs in South Africa: A Case of Colliding Interests," Review of African Political Economy 27.86 (December 2000): 586
96. See Thomas Lemke, " 'The Birth of Bio-politics,' Michel Foucault's Lecture at the Collège de France on Neo-Liberal Governmentality," Economy and Society 30.2 (May 2001): 197
97. Marx, "Economic and Philosophical Manuscripts," 328
98. See Giorgio Agamben, Means without Ends: Essays on Politics, trans. C. Casarino and V. Binetti (Minneapolis: University of Minnesota Press, 2002), 11, 116.1 am grateful to Amy Kapczynski for formulating this problem
99. Germán Velásquez, "Unhealthy Profits," trans. J. Stoker, Le Monde Diplomatique (July 2003), http://mondediplo.com/2003/07/ 10velasquez? (accessed April 4, 2004)
100. See also Phillipe Quéau, "Who Owns Knowledge?" trans. Malcolm Greenwood, Le Monde Diplomatique (January 2000), http://mondediplo.com/ 2000/01/13queau? (accessed April 4, 2004)
101. Inge Kaul, "Biens publics globaux: un concept ré volutionnaire," Le Monde Diplomatique (June 2000): 22-23
102. Mark Heywood, "Life-Sustaining Medicines Are a Basic Need," Mail and Guardian, March 25, 2003
103. The concept of the commons has become one of the key grounds for altermondialiste struggle, up to and including the struggle for treatment access. Thus, of the various groups engaged in such struggles, Naomi Klein could argue, "the spirit they share is a radical reclaiming of the commons" ("Reclaiming the Commons," New Left Review 9 [May-June 2001]: 82
104. compare Alternatives to Economic Globalization: A Better World Is Possible; A Report of the International Forum on Globalization [San Francisco: Berrett-Koehler, 2002], 79-104, esp. 86)
105. But as compelling and correct as this characterization may be, the commons is often narrated in the genre of a kind of pastoral heterotopia, implying that models for late modern global anticapitalism can be derived from ante-capitalist Europe. The problem with this is not only its nostalgia, but also the relation of its rhetoric of crisis to the Malthusian probémalique that has governed some of the more prominent late modern returns to the notion of the commons. That the latter is also a response to the "problem of overpopulation" is evident from Garrett Hardin's "The Tragedy of the Commons," which concludes by arguing that "it is the role of education to reveal to all the necessity of abandoning the freedom to breed. Only so, can we put an end to this [populational] aspect of the tragedy of the commons" [Science 162 [1968]: 1248)
106. It remains an open question whether Negri's theorization of the "immeasurable opening" of the common, which tacitly cites Rancière's rereading of Plato, departs from this problématique (Time for Revolution, trans. Mateo Mandarini [New York: Continuum Books, 2003], 181-93)
107. See Bond, "Sacrificing AIDS Victims," 18
108. Doyal quoted in Gray and Smit, "Improving Access," 588
109. Jonathan Mann, "AIDS: Why It Isn't Being Defeated," Green Left Weekly, April 28, 1993
110. See Immanuel Wallerstein, The Decline of American Power (New York: New Press, 2003), 250
111. See Sanjay Basu, "AIDS, Empire, and Public Health Behaviourism," Znet Commentary (August 2, 2003), www.zmag.org/content/ showarticle.cfm?SectionID=2&ItemID=3988 (accessed April 4, 2004)
112. See Zackie Achmat, "Living Nonracialism," Mail and Guardian, May 2, 2003
113. See also Nicoli Nattrass, "We Need to Fight AIDS and Poverty," Mail and Guardian, March 25, 2003
114. Which is an immanentist reformulation of the argument that (as Paul Farmer puts it in his 2001 defense of Mbeki) "inequality is the major co-factor in this epidemic" ("AIDS Heretic," New Internationalist 331 [January-February 2001]: 16) or that "AIDS and economics are completely entwined" ("Misunderstanding Mbeki," statement prepared by the Institute for Health and Social Justice at the Department of Social Medicine, Harvard Medical School, www.zmag.org/misunderstanding-mbeki.htm [accessed April 4, 2004])
115. See Karl Marx, Capital, 1:342
116. See Mary Catherine Bateson and Richard Goldsby, Thinking AIDS (New York: Addison-Wesley, 1988), 51-58
117. Velásquez, "Unhealthy Profits."
118. See Gardiner Harris and Michael Waldholz, "AIDS Drug Plan Spurs Call to Cut Prices Elsewhere," Wall Street Journal, May 12, 2000
119. See Baylies, "Overview: HIV/AIDS in Africa," Review of African Political Economy 86 (2000): 491
120. Zackie Achmat explains that "in Botswana, for every dollar Merck gives, the Gates Foundation gives a dollar, which comes back to the company when they buy Merck drugs at wholesale price, which can be added to Merck's tax deduction on the donation" (Robert Weissman and Zackie Achmat, "Defying the Drug Cartel: The South African Campaign for Access to Essential Medicines," Multinational Monitor [January-February 2001]: 32)
121. Similarly, a one-billion-dollar loan announced by Clinton in 2000 carried "the condition that the drugs must be bought from American pharmaceutical firms" (Cheru, "Debt Relief and Social Investment," 527
122. Gellman, "World Shunned Signs")
123. See Michael Waldholz, "AZT Price Cut for Third World Mothers-to-Be," Wall Street Journal, March 5, 1998
124. Quoted in James Still, "Slashed Drug Costs 'Will Not Touch Kenya's Aids Crisis,'" The Guardian, November 7, 2000
125. For his part, Achmat endorses local production of medicines in both the private and public sectors. See Weissman and Achmat, "Defying the Drug Cartel," 31
126. See Robert Weissman, "The AIDS Fund Fight," The Nation, July 9, 2001, 14
127. Allyn Taylor, "Public-Private Partnerships for Health: The United Nations Global Fund on AIDS and Health," The John Marshall Law Review35 (2002): 404-5
128. See Naomi Klein, "Bush's Aids 'Gift' Has Been Seized by Industry Giants," The Guardian, October 13, 2003, www.guardian.co.uk/wto/article/o, 2763,1061786,oo.html (accessed April 4, 2004)
129. In his critique of PEPFAR, James Love observes that "Bush, like President Bill Clinton before him, has noisily combated generic drugs in international forums, even though, to quote Bush, their lower cost 'places an immense possibility within our grasp'" ("Prescription for Pain," Le Monde Diplomatique [March 2003], http://mondediplo.com/2003/ 03/12generks? [accessed April 4, 2004])
130. See Nancy Dunne, "US. Warns Brazil on Protection for Drug Patents," Financial Times, July 23, 1988, 3
131. See Stephen Buckley, "Brazil Becomes Model in Fight against AIDS," Washington Post, September 17, 2000
132. Tina Rosenberg, "Look at Brazil," New York Times, January 28, 2001
133. John Culhane has noted, however, that in Brazil as in the United States, the success of ARV therapy has been limited along lines of race and gender. In Brazil, significantly more women than men are infected, and in the United States, African-American women account for two-thirds of all new infections. See "Recurring Nightmare: Barriers to Effective Treatment of HIV in the United States and Internationally," John Marshall Law Review 35 (2002): 382
134. See L. J. Sellers, "Success Story," Pharmaceutical Executive 21.3 (March 2001): 30
135. See "Policy Position of Brazil at the TRIPs Council on Access to Medicines" (June 20, 2001), www.cptech.org/ip/wto/tc/brazil.html (accessed April 4, 2004)
136. Sara Ford, "Compulsory Licensing Provisions under the TRIPs Agreement: Balancing Pills and Patents," American University International Law Review 15 (2000): 954
137. Robert Weissman, "'Free Trade' and Medicines in the Americas," Foreign Policy in Focus 6.13 (April 2001): 1
138. The United States' aggressive assertion of patent rights, even in cases where its own national security interests seem to dictate otherwise (witness the debates around Cipro in October 2001), has ultimately undermined even the hegemony of its own institutions of neoliberal economics. The attempts by the United States in December 2002 and August 2003 to dilute paragraph 6 of the WTO's November 2001 Doha Ministerial Declaration heralded, if not also concretely prepared the way for, the collapse of the WTO trade talks in Cancun in September 2003. See "The Right Fix?" The Economist, August 28, 2003, 1.The United States' assertion of such rights is not, of course, a new development
139. See Sana Siwolop, "Reagan Turns Up the Heat on Patent-Pilfering Countries," Business Week, April 21, 1986, 47
140. Kevin Watkins, "A Harsh Campaign to Prevent Affordable AIDS Treatment," International Herald Tribune, February 12, 2001
141. Ford, "Compulsory Licensing Provisions," 952
142. See Patrick Bond, "Globalization, Pharmaceutical Pricing, and South African Health Policy: Managing Confrontation with U.S. Firms and Politicians," International Journal of Health Services 29.4 (1999): 768
143. Jonathan King, "Commentary: Life Patents and AIDS Drug Access," GeneWatch 14.5 (September 2001): 11
144. See Bond, "Globalization, Pharmaceutical Pricing, and South African Health Policy," 775
145. See Robert Weissman, "AIDS Drugs for Africa," Multinational Monitor (September 1999): 10-11
146. Michelle Nerozzi, "The Battle over Life-Saving Pharmaceuticals: Are Developing Countries Being 'TRIPped' by Developed Countries?" Villanova Law Review 47 (2002): 607
147. Cheru, "Debt Relief and Social Investment," 527-28
148. See Weissman, "AIDS Drugs for Africa," 9
149. Richard Kim, "ACT UP Goes Global," The Nation, July 9, 2001, 17
150. Klein suggests that altermondialiste struggles begin with the Zapatista uprising of January 1, 1994 ("Reclaiming the Commons," 81)
151. At the time, a generic version of Fluconazole cost US$0.30 in Thailand; under patent in South Africa and Kenya, the same medicine cost US$15.00 and US$18.00, respectively (Poku, "Africa's AIDS Crisis," 202
152. Médecins Sans Frontières, "Untangling the Web of Price Reductions: A Pricing Guide for the Purchase of ARVs for Developing Countries" [July 1, 2002], www.accessmed-msf.org/documents/purple2.pdf [accessed April 4, 2004]). In March 2000, the TAC challenged Pfizer to reduce the price of Fluconazole to US$0.50 per 200 milligram. In the same month, Cipla offered Nevirapine for 135 rupees per tab, more than half Boehringer Ingelheim's price of 344 rupees for the "brand-name" version of the same. In October 2000, the TAC announced the Christopher Moraka Defiance Campaign against patent abuse, and began illegally importing Fluconazole from Thailand. In January 2001, the first illegal shipment of Fluconazole arrived
153. It was not until 1999 that the World Bank could bring itself to publicly articulate this consensus: "Nowhere is the effort big enough, or well-resourced enough to turn the epidemic back" (World Bank, Intensifying Action against HIV/AIDS in Africa, Responding to a Development Crisis, (Washington, DC: The International Bank for Reconstruction and Development, Africa Region, 1999)
154. The latest efforts remain governed by the same consensus. Even though 6 million people with AIDS will be in immediate clinical need of ARVs by 2005, and 11.5 million by 2008, the WHO's goal is to treat only 3 million by 2005, and PEPFAR's only 2 million by 2008.The massively underfunded GFATM, mean-while, is at this point capable of providing ARVs to only 491,000 people with HIV/AIDS by 2008 (HealthGAP, "Treat the People-Commit to Treat Those in Immediate Clinical Need," [May 13, 2003], on file with author)
155. See Claude Lefort, Democracy and Political Theory, trans. D. Macey (Minneapolis: University of Minnesota Press, 1988), 37, 40
156. See also Wole Soyinka, The Burden of Memory, the Muse of Forgiveness (New York: Oxford University Press, 1999), 70-72
157. See Michel Foucault, The History of Sexuality, vol. 1: An Introduction, trans. R. Hurley (New York: Vintage Books, 1990), 138, emphasis in original
158. compare "Society Must Be Defended": Lectures at the Collège de France, 1975-76, trans. D. Macey (New York: Picador, 2003), 241, 247
159. See Foucault, The History of Sexuality, 1:143
160. See Foucault, Madness and Civilization: A History of Insanity in the Age of Reason, trans. R. Howard (New York: Vintage Books, 1965), 283
161. See Gilles Deleuze, "What Is a Dispositif?" in Michel Foucault, Philosopher, trans. Timothy Armstrong (New York: Routledge, 1992), 159-66
162. See Culhane, "Recurring Nightmare," 386
163. The ACT UP slogan "SILENCE = DEATH" was aimed, in large part, at Reagan, who did not even utter the word AIDS until May 31, 1987-six years after the emergence of HIV in the United States. The murderous homophobia of this silence must not be forgotten. The assumption of early epidemiologists was that AIDS would be limited to gay communities and drug users, and that after "saturating" these populations, it would soon "run out of victims" or "run its course." The same epidemiologists wondered aloud whether Africans did not already somehow possess a natural immunity to the virus. See F. P. Siegal and M. Siegal, AIDS: The Medical Mystery (New York: Grove Press, 1983), 121-24
164. Nana Poku argues that "with the exception of Uganda and Senegal, African leaders are engaged in denial, typically asserting that the moral values of their societies would not permit transmission of an agent such as HIV that is
165. Carolyn Baylies concurs, noting that instead of intervening in the pandemic, African governments have responded with a "stance of denial, or, alternately, official acknowledgement of the need for an AIDS policy coupled with a persistent failure to accept the depth of the crisis of the urgency of the situation, much less to follow through on the construction of a comprehensive policy" (Baylies, "Overview: HIV/AIDS in Africa," 488, 491
166. See Alain Badiou, Ethics: An Essay on the Understanding of Evil, trans. Peter Hallward (New York: Verso, 2002), 30-39; especially 35
167. I take it as axiomatic that, since the days of the Dutch East Indies Company, if not earlier, corporations have arrogated to themselves the prerogatives of sovereignty (territorial control, monopoly over legitimate violence, right to decide life and death, police power in the broadest sense, etc.) and that the Kantian distinction between a land's "supreme owner" (Obereigentümer) and its "supreme commander" (Oberbefehlshaber) is no longer helpful, if it ever was, for grasping manifestations of sovereign power. Instead, as Agamben argues, sovereignty can no longer be understood as an "exclusively political concept, an exclusively juridical category, a power external to law, or the supreme rule of the juridical order" (Giorgio Agamben, Homo Sacer I: Sovereign Power and Bare Life, trans. Daniel Heller-Roazen [Stanford: Stanford University Press, 1998], 28)
168. See Immanuel Kant, The Metaphysics of Morals, trans. M. Gregor (Cambridge: Cambridge University Press, 1996), 99-100
169. Ernest Mandel, Marxist Economic Theory, vol. 2, trans. Brian Pearce (New York: Monthly Review Press, 1968), 469-72
170. Michael Hardt and Antonio Negri, Empire (Cambridge: Harvard University Press, 2000), 305, 331, 336
171. Mbembe, On the Postcolony 29-30, 78-79
172. Giorgio Agamben, The Coming Community, trans. Michael Hardt (Minneapolis: University of Minnesota Press, 1993), 79
173. For the opposing view, see Carl Schmitt's critique of Weber and Kelsen in The Crisis of Parliamentary Democracy, trans. Ellen Kennedy (Cambridge: MIT Press, 1988), 24-25
174. Quoted in Mark Schoofs, "Flirting with Pseudoscience," Village Voice, March 21, 2000, 56
175. In October 1999, Mbeki made his denialism public in a speech before the National Council of Provinces. In May 2000, he convened an HIV/AIDS "advisory panel" composed of denialists. In July 2000, Mbeki delivered the opening address to the Thirteenth International AIDS Conference, in which he declared that he doubted whether everything could be blamed on a single virus. In September 2000, Mbeki offered denialist remarks in Time magazine, and Minister of Health Tshabalala-Msimang offered similar remarks on South African radio. See Mbali, "HIV/AIDS Policy-Making," 319-20
176. Of "Castro Hlongwane," Achmat said, "On the record, you had, for the first time, an indication of the madness, the irrationality, the blindness, the willfulness, the vindictiveness of Mbeki on this question" (quoted in Samantha Powers, "The AIDS Rebel," The New Yorker, May 19, 2003, 65)
177. Compare also Pieter-Dirk Uys "'AIDS Comes from Venus; HIV Comes from Mars!'" Index on Censorship 4 (2001): 21-22
178. Newaal Deane, "The Madness of Queen Manto," Mail and Guardian, April II, 2003
179. "Bernstein makes the important observation that '[AIDS is] the first disease that no one can survive by definition. Not only is this description of AIDS logically bankrupt, it sends the demoralising and inaccurate message to people with HIV or AIDS that they have a disease that is not worth fighting. A more legitimate, and more hopeful, definition must be devised.' Because of all this, it has become imperative for us to know as precisely as possible what our people are dying from, specifically. To say that our people are dying of AIDS will not help us in our struggle to improve the health of our people. As Bernstein says, to say this would be to say our people have a disease that is not worth fighting.This would certainly condemn them to premature death. It is this that would constitute genocide" (58; emphasis in original). In a similar vein, Mokaba argued that "we cannot allow our people to take something [i.e., ARV therapy] so dangerous that it will actually exterminate them. However well meaning, the hazards of misplaced compassion could lead to genocide" (quoted in Peter Kwan, "Biography of a Nightmare: HIV/AIDS in South Africa," The John Marshall Law Review 35 [2002]: 394)
180. See Jacques Lacan, Écrits: A Selection, trans. A. Sheridan (New York: Norton, 1981), 200
181. See Jacques Lacan, The Ethics of Psychoanalysis, 1959-1960, in The Seminar of Jacques Lacan, book 7, ed. J-A. Miller, trans. D. Porter (New York: Norton, 1992), 66
182. Lacan, Écrits, 190, 202-4, 206
183. See Mbembe, On the Postcolony, 189
184. Carl Schmitt, Political Theology: Four Chapters on the Concept of Sovereignty, trans. G. Schwab (Cambridge: MIT Press, 1988), 36
185. Carl Schmitt, Die Diktatur (Berlin: Duncker and Humblot, 1994), 139
186. See Gilles Deleuze and Félix Guattari, Anti-Oedipus: Capitalism and Schizophrenia, trans. R. Hurley, M. Seem, and H. R. Lane (Minneapolis: University of Minnesota Press, 1983), 214
187. Giorgio Agamben, Homo Sacer, 1:51
188. See Powers, "The AIDS Rebel," 60, 63
189. Drew Forrest, "Social Movements: 'Ultra-Left' or 'Global Citizens,' Mail and Guardian, January 31, 2003
190. See Richard Calland, "A Case of Power and Who Controls It," Mail and Guardian, January 18, 2002
191. Klug; "Five Years On: How Relevant Is the South African Constitution?" Vermont Law Review 26.4 (Summer 2002): 810-14
192. See Forrest, "Social Movements," 8
193. Powers, "The AIDS Rebel," 56, 60-61, 64-65
194. Nyameko Barney Pityana, "Revolution within the Law?", in Bounds of Possibility: The Legacy of Steve Biko and Black Consciousness, ed. N. B. Pityana, M. Ramphele, M. Mpumlwana, L.Wilson (Cape Town: David Philip, 1991), 202-4
195. See Hoyt.Webb, "The Constitutional Court of South Africa: Rights Interpretation and Comparative Constitutional Law," Journal of Constitutional Law 1.2 (Fall 1998): 281
196. J.Tholakele H. Madala, "Rule under Apartheid and the Fledgling Democracy in South Africa: The Role of the Judiciary," North Carolina Journal of International Law and Commercial Regulation 26 (2001): 748, 750-56, 759
197. See Patric Mzolisi Mtshaulana, "The History and Role of the Constitutional Court of South Africa," in The Post-Apartheid Constitutions: Perspectives on South Africa's Basic Law, ed. P. Andrews and S. Ellmann (Johannesburg: Witwatersrand University Press, 2001), 547
198. See Pierre de Vos, "Pious Wishes or Directly Enforceable Human Rights? Social and Economic Rights in South Africa's 1996 Constitution," South African Journal of Human Rights 13.1 (1997): 67-101
199. It should be noted, however, that because of South Africa's quasi-federal system, the executive does not directly control AIDS spending. See Helen Schneider and Joanne Stein, "Implementing AIDS Policy in Post-Apartheid South Africa," Social Science and Medicine 52 (2001): 724
200. Klug, "Five Years On," 819
201. compare Heinz Klug, "Introducing the Devil: An Institutional Analysis of the Constitutional Power of Review," South African Journal of Human Rights 13 (1997): 185-207
202. See Calland, "A Case of Power and Who Controls It"
203. "Accountable to the Constitution," Mail and Guardian, January 18, 2002
204. "A Failure of Legal Imagination in Pro-Poor Law," Mail and Guardian, May 13, 2003
205. See Klug, "How Relevant Is the South African Constitution," 819
206. Which, under Pityana's leadership, had earlier capitulated to pressure from the executive to withdraw its support for the TAC's lawsuit. See Thuli Nhlapo and Nawaal Deane, "How Pityana Buckled," Mail and Guardian, November 30, 2001
207. In fact, no systematic ARV roll-out has taken place even after Mbeki's cabinet directed the Department of Health in August 2003 to develop an operational plan within one month to provide ARVs in the public sector, after Mbeki's announcement in November 2003 that his administration would triple its AIDS budget to $1.7 billion, or after the TAC's pressure in South Africa's Competition Commission forced GlaxoSmithKline and Boehringer Ingelheim, in a controversial December 2003 settlement, to issue licenses on AZT and Lamivudine to four generic producers. See Sharon LaFraniere, "South Africa Is Criticized for Delay in AIDS Treatment," New York Times, February 20, 2004
208. On the primarily temporal mode of the sovereign exception, see Agamben, Means without Ends, 39, 43
209. Kistner, "The Constitutional Right to Live, and the Political Power to Let Die," 16
210. see also Achille Mbembe, "Biopolitics and Sovereignty," Newsletter of the Wits Institute for Social and Economic Research 2.1 (June 2003): 13, 19
211. See Pat Sidley, "Churches, Unions Lay Down Line on AIDS," Business Day, September 21, 2001, 3
212. It is hard to know what constitutional provisions could be deployed against this non-application of sovereign power: even though Section 37(3) of the 1996 Constitution gives the judiciary the power to limit executive declarations of states of emergency, no clauses provide powers that would enable the judiciary to require the executive to declare a health emergency. The TAC's MTCT case was, in a way, designed to force Mbeki's hand on this question. MTCT
213. There is also a sense in which the TAC's implicitly pronatal legal strategy played into the biopolitical reduction of women to and as reproductive organs, while at the same time embracing the tropes of innocence that become available once one advocates on behalf of infants. As Heinz Klug's reading of the case suggests, the limit of this strategy was apparent in the discourse of the ruling itself ("How Relevant Is the South African Constitution?" 817)
214. See Jacques Rancière, Disagreement: Politics and Philosophy, trans. Julie Rose (Minneapolis: University of Minnesota Press, 1999), 13-19
215. compare G. W. F. Hegel, Phenomenology of Spirit, trans. A. Miller (Oxford: Oxford University Press, 1977), para. 591
216. See "Why AIDs Campaigns Are Not Working," Nursing RSA 6.6 (June 1991): 6
217. The necessity and possibility for these campaigns had been outlined in a series of 1988 articles by C. B. Ijsselmuiden, et al. See "AIDS and South Africa-Towards a Comprehensive Strategy; Part I: The World-Wide Experience," "Part II: Screening and Control," and "Part III: The Role of Education," South African Medical Journal 73.8 (April 1988): 455-60, 461-64, 465-67
218. Writing in 1992, Alan Fleming argues that one of the unique features of the HIV/AIDS pandemic in South Africa is precisely this foreknowledge: "East and central African countries had no warning, as the epidemic was mature and seroprevalence already high when serological tests were first introduced in 1985, whereas South Africa had the warning seven years ago when seroprevalence was still extremely low but the spread southward of HIV-1 was inevitable" ("South Africa and AIDS-Seven Years Wasted," Current AIDS Literature 5.11 [November 1992]: 425
219. Fleming's article was also published in Nursing RSA 8.7 [July 1993]: 18-19)
220. See Grundlingh, "HIV/AIDS in South Africa," 57, 80-81
221. Grundlingh, "Government Réponses to HIV/AIDS," 126, 152-53
222. Discussing HIV/AIDS educational programs, Fleming argues that "to date nothing is in place in the government schools, which are attended by the majority in all ethnic groups," while "the 11 established AIDS Training and Information Centres (ATICs) are in locations where they serve almost exclusively the white population, and only now [1992] has an ATIC in Soweto been 'approved'" ("Seven Years Wasted," 427)
223. See Schneider and Stein, "Implementing AIDS Policy," 725
224. See Kwan, "Biography of a Nightmare," 389
225. Fleming, "Seven Years Wasted," 428
226. Wilson Carswell, "HIV in South Africa," Lancet 342 (July 1993): 132
227. Sontag, AIDS and Its Metaphors, 62
228. See Bronwen Roberts, "Apartheid Forces Spread AIDS," Mail and Guardian, November 12, 1999
229. Compare Jacques Pauw, Into the Heart of Darkness: Confessions of Apartheid's Assassins (Johannesburg: Jonathan Ball Publishers, 1997), 70-71
230. Uys, "'AIDS Comes from Venus'," 29
231. Steven Biko, I Write What I Like, ed. A. Stubbs (New York: Harper and Row, 1986), 86
232. See John Donnelly, "A Vigilant Voice for AIDS Victims," The Boston Globe, May 31, 2003
233. Margarette Driscoll, "I Won't Buy Life While Others Die," Sunday Times (London), May 25, 2003
234. Nicol Innocenti, "Aids Activist in Gandhi Mould," Financial Times, March 24, 2003
235. Tina Rosenberg, "In South Africa, a Hero Measured by the Advance of a Deadly Disease," New York Times, January 13, 2003
236. Rory Carroll, "A Good Man in Africa," The Guardian, December 10, 2002
237. Matt Steinglass, "Killing Him Softly," Boston Globe, December 8, 2002
238. Zackie Achmat, "Off the Control Track: Power, Resistance, and Representation in South African Documentaries," The Journal of the International Institute 1.2 (Summer 1994), www.umich.edu/∼iinet/journal/ vol1no2/achmet.html (accessed April 4, 2004)
239. Achmat, "Off the Control Track," part 1; emphasis in original
240. In "Off the Control Track," Achmat clarifies that his concluding section "is really only a beginning" (part 5), while he concludes "My Childhood as an Adult Molester" with the sentence, "It was the beginning of a life of sex and politics" (in Defiant Desire, ed. Mark Gevisser and Edwin Cameron [New York: Routledge, 1995]. 341)-
241. Foucault, History of Sexuality, 1:135
242. See Kant, Metaphysics of Morals, paragraph 34
243. G.W. F. Hegel, Philosophy of Right, trans. A. M. Knox (Oxford: Oxford University Press, 1967), paras. 177-80
244. See Michel Foucault, Ethics, Subjectivity, and Truth: The Essential Works of Michel Foucault, 1954-1984, vol. 1, ed. P. Rabinow, trans. R. Hurley et al. (New York: New Press, 1997), 81-85, 242-45
245. Achmat, "My Childhood as an Adult Molester," 325
246. Alexander García Düttmann, At Odds with AIDS: Thinking and Talking about a Virus, trans. P. Gilgen and C. Scott-Curtis (Stanford: Stanford University Press, 1996), 2
247. The authority of which, as Partha Chatterjee points out, is "derived entirely from a moral claim-of personal courage and sacrifice and a patent [sic] adherence to truth. So much so that the supreme test of political leadership was death itself" (Nationalist Thought and the Colonial World: A Derivative Discourse [Minneapolis: University of Minnesota Press, 1993], 109)
248. "I am not the only one," Achmat said of being without ARVs to Tavis Smiley in a November 14, 2003, interview, www.npr.org/features/feature. php?wfld=150614 (accessed April 4, 2004)