Dependent Agency in the Global Health Regime: Local African by Emma-Louise Anderson, Amy S. Patterson

By Emma-Louise Anderson, Amy S. Patterson

This quantity examines how neighborhood actors reply to Africa’s excessive dependence on donor wellbeing and fitness cash. It makes a speciality of the big infusion of donor funds to deal with HIV and AIDS into Malawi and Zambia and the following slow-down in that investment after 2009. How do local community reply to this dynamic relief structure and the myriad of possibilities and constraints that accompany it? This ebook conceptualizes established company, and the situation within which neighborhood actors can at the same time act and be based, and investigates stipulations below which established business enterprise happens. Drawing upon empirical info from Malawi and Zambia accumulated among 2005 and 2014, the paintings interrogates the nuanced innovations of established employer: performances of compliance, extraversion, and resistance less than the road. The findings elucidate the dynamic interactions among actors which regularly ensue “off degree” yet which undergird macro-level improvement processes.

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37 Zambian and Malawian civil society organizations had played a crucial role in reestablishing democracy in the 1990s (Bratton 1999; Bartlett 2000; Newell 1995), and donors praised their continued activism on the AIDS issue. (Civil society has played a larger role in the AIDS response than originally acknowledged. ) For example, Bishop Joshua Banda of the Northmead Assemblies of God, a Pentecostal megachurch in Lusaka, and several Catholic leaders in Ndola developed AIDS care and support programs (Patterson 2013; Interview, FBO official, August 16, 2007).

First, many of the implementing groups were outside of the government’s control. This fact enabled the government to claim credit for nonstate actors’ successes, such as when CHAZ quickly increased the number of PLHIV on treatment (Interview, DfID official, Lusaka, August 15, 2007). In the process, government “looked good” to its citizens, though it was not directly responsible for funding or implementing half of Zambia’s ART programs (see Fox 2014). But CHAZ and ZNAN could also be viewed as competitors with government, a fact that could benefit these groups as they worked with donor states like the United States that have tended to be suspicious of government ministries (Interviews, DfID official and ZNAN official, Lusaka, August 15 and August 20, 2007; on undermining state ministries, see Harman 2009).

In short, the well-being of the American parishioners’ spiritual life partially rested on the relationship with a Zambian FBO. The dependence of donors on Zambians and Malawians could create the opportunity for local agency. It was apparent that donors appreciated both countries’ AIDS activities. In interviews in 2007, donors praised Zambia’s AIDS efforts, which included the provision of free ART access after 2005, the removal of user fees at clinics in 2006, the establishment of the NAC, the development of a multisectoral National Strategic Framework, and the incorporation of civil society into the country’s AIDS response (Interview, Zambia NAC official, Lusaka, August 14, 2007).

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