Evidence and AIDS activism: HIV scale-up and the contemporary politics of knowledge in global public health

Abstract

The HIV epidemic is widely recognised as having prompted one of the most remarkable intersections ever of illness, science and activism. The production, circulation, use and evaluation of empirical scientific ‘evidence’ played a central part in activists' engagement with AIDS science. Previous activist engagement with evidence focused on the social and biomedical responses to HIV in the global North as well as challenges around ensuring antiretroviral treatment (ART) was available in the global South. More recently, however, with the roll-out and scale-up of large public-sector ART programmes and new multi-dimensional prevention efforts, the relationships between evidence and activism have been changing. Scale-up of these large-scale treatment and prevention programmes represents an exciting new opportunity while bringing with it a host of new challenges. This paper examines what new forms of evidence and activism will be required to address the challenges of the scaling-up era of HIV treatment and prevention. It reviews some recent controversies around evidence and HIV scale-up and describes the different forms of evidence and activist strategies that will be necessary for a robust response to these new challenges.

Keywords:

• HIV/AIDS
• evidence
• activism
• health policy
• antiretroviral treatment (ART)

Acknowledgements

The thinking behind this paper emerged from a number of different projects around HIV and knowledge production that I have conducted with a wide range of academics, scientists, policy-makers, activists and community members in South Africa and elsewhere. I am grateful to all of them for their insights and engagement. I am also grateful to the two anonymous reviewers of an earlier version of this manuscript for their very helpful comments.

Funding

Time to work on this paper was partially supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health [award number R24HD077976]. The content is solely the responsibility of the author and does not necessarily represent the official views of the National Institutes of Health.

Additional information

Funding

Funding: Time to work on this paper was partially supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health [award number R24HD077976]. The content is solely the responsibility of the author and does not necessarily represent the official views of the National Institutes of Health.