In this
post, we share Prof Richard Ballard’s comments on Dr Mandisa Mbali’s new book,
‘South African AIDS Activism and Global Health Politics’. Richard gave this
review speech at the launch of the book in Durban last month. In addition to providing a commentary on
Mandisa’s work, Richard provides some insightful reflections on the study of
social movements, which have a wider relevance in South Africa and beyond.
Richard Ballard is Professor in the Department of Population Studies and
Development Studies at the University of KwaZulu Natal. Mandisa Mbali is Lecturer in the Department of Sociology
and Social Anthropology at the University of Stellenbosch.
Thanks very much for asking me to speak on this occasion. My
job here this evening is an easy one because Mandisa has produced a wonderful
book for us. It is impressive, firstly, because of its scope. One expects it to
be a story of the Treatment Action Campaign but in fact the TAC is located
within a much greater universe of doctors, scientists, gay activists, gender
activists, international activists, multilateral organisations, and politicians
that precede and exceed the TAC. The book represents the subject in something
approaching its multifaceted entirety rather than privileging some actors’
roles.
Second is the depth of the research. Mandisa has poured
through a great many newspaper articles and documents and she cites around 70
interviews. Since she is a historian, her first priority is to be empirically
exacting and this gives the book an overriding sense of accuracy. But all this
research has also produced the nuggets which make the story interesting. I was
amused by the World Bank report which concocts a fictional African country
called ‘Muzumbuka’ to refer euphemistically to a real country which couldn’t
afford ARVs, or the Sunday Times article in 1993 which insisted, without any
irony, that black people lacked political correctness.
Third the tremendous complexity of the subject is organized
according to relatively bite-sized thematic and historical episodes which make
it possible to understand the variety of parallel stories that constitute AIDS
activism. Although the effect is of an elegant whole, each of these chapters
could also be read on its own. The prose is clear, direct, efficient, and yet
unhurried.
Fourth, her historian’s method is able to overcome the
reductionism that sometimes characterizes writing on social movements. Scholars
sometimes reify social movements into singular blocky forces rather than
networks of real people. Activists in this story come from a variety of
standpoints: gay/straight; black/white; activists in the global South and
activists in the North; women/men; middle class and poor; professionals and
grassroots activists. While the struggle for HIV related healthcare does
provide the platform for unifying interactions between these diverse groups
there are also accusations of imperialism by those in the south of those from
the north, or the marginalization of women by men. Mandisa sensitively engages
accusations of sexual harassment within the TAC itself.
Fifth, her historian’s method is also able to counter the
idealism that saturates a great deal of writing about social movements and
activism. At a conference in 2004 I heard Mark Heyward say that social
movements were a figment of the left’s imagination. Given that he was a key
figure in the TAC, this seems paradoxical. What he was saying of course was
that he didn’t recognise himself and his organization in the kinds of
descriptions he was hearing. Leftist scholars sometimes project their own
political desires onto reality with the result that movements are romanticized
as worthy subalterns if they accord with the scholar’s politics, or condemned
as reformist if they fail to live up to the scholar’s revolutionary
expectations. But solid empirical accounts of social movements such as
Mandisa’s show that activists do not abstractly choose their politics as if
from a menu. Social movements are often quite reactive things, taking real
actions in response to the contexts around them. Ideology is retrospectively
identified just as often as it is the stimulus of cause of activism in the
first place.
Similarly, adversaries are also idealized in a great deal of
writing on social movements: they are
generally constructed as some variation of evil neoliberals doing satan’s work
on earth. Some of those who blocked progress in the progressive management of
HIV are certainly hateworthy, motivated by greed, or racist, sexist and
homophobic contempt of those who needed help. But blockages also originated
from those who thought of themselves as progressive and anti-imperialist.
Furthermore, important breakthroughs in opening the taps of international aid
came not from our hero activists but from less expected quarters, such as
conservative Christian Republicans. Accounts of activism that start with
empirical reality are able to transcend the Manichean simplicities that keep
some accounts of social movements in the realm of wishful thinking.
That said, the book is principled and driven by a clear
sense of justice. Even though we all lived through the media coverage of big
pharma’s greed, the development industry’s insistence that treatment was not
cost effective, and the defiant contrarianism of the Mbeki presidency, these
outrages still caused me to gasp in amazement and turn the page to see what
happened next. It was thrilling to read again of Mandela’s visit to Zackie
Achmat and his decision to pull on an HIV positive T Shirt, and of the
judiciary’s various rulings in favour of treatment. And it was humbling to read
of ordinary people who fought for recognition and treatment at sometimes great
personal cost.
This book allows us to reflect on one of the fundamental
themes that any of us can think about: namely how governments come to establish
mechanisms to enable those who have little to have greater life possibilities.
Since the late 1990s, Social Policy has enjoyed something of a renaissance in
the Global South fuelled in no small part by the crushing effects of austerity
since the early 80s. Few are going so far as to say that we are in a
post-neoliberal era, most governments still look to market led growth as their
vehicles of development. But alongside this enduring market faith, there has
been a renewed interest in the ability of governments to put in place
distributional systems that channel life sustaining flows to people on the
margins. One of the major innovations is that around 45 countries in the global
south have now put in place cash transfer schemes, such as the child support
grant in this country and the Bolsa Familia in Brazil, which in some contexts
have been shown to reduce poverty and inequality.
Struggles for mechanisms that address social ills are useful
in drawing attention to the ways in which some lives seem to authorities less
worth saving than others. No doubt many of the actors involved would recognize
the limits of single mechanisms in confronting the profoundly complex effects
of uneven development and poverty. But single mechanisms alone can make a
profound difference and cannot be taken for granted once they have become
normalised. As the last part of Mandisa’s book shows, the gains which have been
made on HIV have been fragile indeed. As a result of recession, the Global Fund
has not been receiving money pledged to it and this has thrown into doubt many
treatment programmes in poorer countries. The role of civil society in bringing
about and sustaining important life sustaining mechanisms is abundantly evident
in this account and it is a role that is as urgent as it ever was.
Mandisa has produced a masterful book and we should all congratulate her for her wonderful achievement.
