Global Health Interventions and the “Common Sense” of Neoliberalism: A Dialectical Analysis of PEPFAR

Abstract

Neoliberal ideologies, implicated in increasing global inequality, have significantly influenced how global health interventions are conceived and executed. In this article, we take a critical stance towards the market-based impetus of neoliberalism as articulated in the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), the largest comprehensive effort against the global HIV/AIDS epidemic. Using a variety of PEPFAR policy documents, our analysis points to the operation of a neoliberal “common sense” that provides a justification for intervention. Our analysis resulted in three themes: (a) the body as labor, (b) the gendering of the intervention, and (c) political economies of partnerships.

Keywords:

• Health Communication
• HIV/AIDS
• Critical-Cultural Approaches
• PEPFAR
• Neoliberal Ideology

Acknowledgments

The authors would like to thank the three anonymous reviewers for their insightful guidance through several versions of this manuscript. An earlier version of this paper was presented at the International Communication Association convention in Boston, May 2011.

Notes

1. Nauta (2010) notes, for instance, that up until 2005, treatment in the form of ART (anti-retroviral treatment) was not a prominent part of PEPFAR funded programs in Africa. Instead, prevention behaviors were the focal point of interventions. Recent years have seen a gradual shift in that agenda.

2. The WHO Health Promotion Glossary defines health outcomes as “A change in the health status of an individual, group, or population which is attributable to a planned intervention or series of interventions, regardless of whether such an intervention was intended to change health status” (World Health Organization, 1998, p. 10).

3. The above partnership includes the following stakeholders: Accenture, The Africa Media Broadcast Partnerships Against HIV/AIDS/ Global Media AIDS Initiative, APCO Worldwide, The Coca-Cola Africa Foundation, The Draper Richards Foundation, Girl Scouts of the USA, Grassroot Soccer, The Global Business Coalition, Hasbro, Intel, Junior Achievement, AmericaShare/Micato Safaris, Microsoft, Mitchell Silberberg & Knupp LLP, The MTV Staying Alive Foundation, Nike Foundation, Rotarians for Fighting AIDS, TechnoServe, and Warner Bros. Advanced Media Services Inc. (Office of the U.S. Global AIDS Coordinator, 2010c)

Additional information

Notes on contributors

Shaunak Sastry

Shaunak Sastry is at Department of Communication, University of Cincinnati

Mohan Jyoti Dutta

Mohan Jyoti Dutta is at Department of Communications and New Media, National University of Singapore