The Politics and Anti-Politics of HIV: healthcare and welfare in contemporary Kenya.

Abstract

The chapter addresses HIV care and treatment programmes, funded by the US, which touch upon thousands of western Kenyans’ lives and draw upon funds that dwarf the Ministry of Health’s budget. During the past decade these programmes have produced a medicalized economy of care and welfare, which provides much of the resources circulating in the local economy, otherwise marked by economic crisis, rising food prices, corruption and socioeconomic inequality. HIV-interventions open up pathways of opportunity for some – employment, workshops, and training, part-time volunteering – creating what is locally referred to as a new middle class. For HIV-positive people however, these opportunities are highly volatile, and access depends upon one’s visibility and legibility to NGOs. This leads to the proliferation of new social forms aiming at producing precisely this: self-help groups that make ‘community’ and particular HIV-groupings visible; projects and proposals that express needs in the terminology of overseas funders and NGOs. While one might therefore interpret HIV programmes as anti-political forms of governmentality, one should recognize the fact that such programmes allow patients to make visible their hunger and poverty, to articulate needs and make claims - albeit in terms that are orientated to foreign donors rather than their own government. By exploring the edges of seemingly clear biopolitical forms and attending to smaller politics of life, ethnographic research opens up a recognition of surprising possibilities rather than redrawing a hegemonic order.