Aid(s) Politics and Power: A Critique of Global Governance

Abstract

This article provides a case study of overseas development assistance for AIDS to South African civil society; it analyses how power is exercised as well as resisted in the context of international aid. While it is argued that governance theory tends to underestimate power inequalities in the context of policy networks, this case is instead related to the theoretical debate regarding whether current global power structures can be analysed in terms of a (US-led) neo-imperialism, or whether they should rather be understood in terms of post-imperialist power constellations based on ‘regulation of self-regulation’ through market mechanisms, and with an emphasis on ‘civil society participation’. While the case demonstrates how US aid under the Bush administrations to a certain extent involved a ‘civilising mission’, it is argued that ‘regulation of self-regulation’ was the more significant form of governing AIDS aid networks, contributing to a development through which AIDS activism went through a process of ‘NGO-isation’, de-politicising the AIDS issue.1

Notes

An earlier version of this article (Thörn, 2011) was published in Olesen (2011). It has been updated and is reproduced here with the kind permission of the publisher.

Today 67% of the infected live in this part of the world (UNAIDS, 2008, p. 32), a region where more than 40 percent live on less than one dollar per day (UNAIDS, 2008, p. 88).

In this chapter, I use ‘NGO’ as a broad term for a wide range of organisations that partake in civil society activities, such as social movement organisations (SMOs), community-based organisations (CBOs) and faith-based organisations (FBOs). In other contexts (for example in some of the documents quoted here) the term ‘civil society organisation’ (CSO) is used synonymously with NGO. Although I use a broad definition of ‘NGO’, I regard the criticism against ‘NGO-isation or ‘quangoisation’ of politics and activism (Kinsman, 1996; Ottaway and Carothers, 2000, Kaldor, 2003; Miller and Rose, 2008) as valid as it first and foremost refers to a proliferation of professionalised types of NGOs, which can not be considered as activist organisations (SMOs) but more or less function as complements, or service providers, in relation to official or private institutions.

The research project was carried out between 2006 and 2009, studying state agencies (USAID/PEPFAR, SIDA), foundations (the Global Fund, the Bill and Melissa Gates Foundation), international NGOs (Medicins sans Frontières, World Vision) and South African NGOs (Treatment Action Campaign, the AIDS Foundation of South Africa, Sonke Gender Justice Network). In addition to discourse analysis of policy documents of donor organisations, 11 interviews with key informants (including donor representatives working in South Africa, South African NGO representatives and South African researchers) were carried out. The interviews and selection of donor documents that this chapter is based on was made in 2006/7 by Agnes Dahné, Christoph Haug and the author. Additional material was collected in 2009 by Tim Bomanson. In addition to our own material, we have also closely studied two research reports by South African NGOs on the consequences of AIDS aid to civil society in Southern Africa (Sonke Gender Justice Network, 2007; Birdsall and Kelly 2007). The author would like to thank Agnes Dahné, Christoph Haug, Tim Bomanson and Ingemar Bohlin for productive discussions in connection with the analysis of the material.

The report is based on 40 key informant interviews (conducted July–November 2006, with assistance from UCLA's programme in Global Health) with representatives of South African NGOs, international NGOs and US Government officials (Sonke Gender Justice Network, 2007, p. 1).

This report (and the fact that it is available through GF's homepage and thus could be considered as ‘authorised’ by the GF), produced by an NGO ‘whose mission is to reinforce the effectiveness of the Global Fund’ (www.aidspan.org), is an example of the symbiotic and technocratic relationship between funders and NGOs that sometimes exists in the context of governance networks. Although AIDSPAN presents itself as an independent watchdog of the Global Fund, the Beginner's Guide quoted above, which is produced in order to ‘provide a broad introduction to the Global Fund for people who have little or no prior experience of the Fund’ (Garmaise, 2009, p. 7), is not a critical evaluation of the GF, but rather a descriptive user's guide.

The Paris Declaration, which came about as a response to widespread criticism of the ineffectiveness and fragmentation of international aid, meant that the leading international donor agencies committed to work with developing countries to better coordinate and streamline their activities at country level.

TAC also criticised the state agencies for using donor money to purchase ARVs from medical corporations based in their own countries, which are much more expensive than those imported from Brazil (interview 4).

All interviews carried out by the author except *, carried out by Agnes Dahné.

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Notes on contributors

Håkan Thörn

Professor of Sociology, Gothenburg University, Sweden.