Postcolonial Constructions of HIV/AIDS: Meaning, Culture, and Structure

Abstract

As a field of inquiry, postcolonial health communication seeks to apprehend processes implicated in the construction of “primitive” versus “modern” with respect to issues of health. In the case of HIV/AIDS, the sociocultural representations of the disease have a profound impact on how the disease is configured medically and symbolically in dominant cultural imagination. Postcolonial constructions of disease are mobilized around the political and economic interests of the dominant power structures in global spaces. In this article, a thematic analysis of the constructions of HIV/AIDS in India in the mainstream U.S. news media was conducted. A corpus of news articles from the Lexis-Nexis database was created with the keywords “HIV,” “AIDS,” and “India.” Three themes emerged from the study: (a) India as a site of biomedical control; (b) the economic logics of HIV/AIDS; and (c) AIDS, development, and the “Third World.”

Notes

¹This essay on postcolonialism particularly builds on the work of Spivak. Other key figures in postcolonial theory such as Bhabha, Chaturvedi, Chatterjee, and Mohanty provide us with additional entry points for engaging with public relations theory. However, given the emphasis of this project on drawing out the main works of Spivak, we are not engaging with these very important theorists in this essay.

²By the term “other,” here we refer to the recurring leitmotif of much postcolonial scholarship and theorizing. Processes of colonization and imperialism have always relied on a bifurcated view of the world; of “us” versus “them,” the “modern” versus the “primitive,” the civilized versus the uncivilized. Culture, civilization, modernity, and even humanity are attributed to the “Western” mainstream while the colonized worlds are “othered,” in that their existence is conceptualized as the negation or the antithesis of what the colonizer comes to represent. For a more detailed explanation on the concept, see Said (1978), and Fanon (2007).

³The role played by international agencies in protecting and pushing agendas that serve to continually secure the interests of advanced capitalist economies (as exemplified by the G-8 countries) cannot be explicated in detail in this effort, but for a detailed analysis, see Harvey (2005) and Zoller (2008).

⁴David Harvey defines neoliberalism as “a theory of political economic practices that proposes that well-being can best be advanced by liberating individual entrepreneurial freedoms and skills within an institutional framework characterized by strong private property rights, free markets, and free trade. (Harvey, 2005, p. 2). Applied to global health policy, neoliberalism refers to the configuration of dominant global actors including transnational corporations, nation states, global organizations such as the United Nations (UN) and the World Bank, and local elites that work to “privilege the private market and undermine the language of public investment and protection we associate with public health promotion” (Zoller, 2008, p. 390). As pointed out by Farmer (1993), structural adjustment programs under neoliberalism have fostered the spread of HIV/AIDS through the displacement of people, contributions to unemployment and migration, and putting subaltern communities at greater risks of contracting the disease.

⁵But perhaps the most problematic aspect of constructing India as a “premedicinal” site is the complete ignorance of the role of India as a global pharmaceutical procurement hub. Under the aegis of PEPFAR (U.S. President's Emergency Fund for AIDS Relief), the U.S. government took advantage of the relative cost advantage of antiretroviral drug production in India to supply worldwide. As mentioned earlier in this article, India, with its relative proliferation of pharmaceutical companies and advanced scientific research, has become the hub for AIDS-related drug testing. A detailed explication of the relationship of India's pharmaceutical industry to U.S. agencies like the Food and Drug Association, while being outside the scope of this article, is definitely worth examination as a case study in politics of control with regard to transnational cash flows. The case of the Indian pharmaceutical company Ranbaxy and its tussle with the FDA has been the subject of much mainstream U.S. print coverage. See Fagan (2008) and Cohen (2008).

⁶The remoteness of India is a recurring theme in the dominant imagination, and excerpts like this one from the Los Angeles Times are testimony: “The Dolls of Hope project was continued indefinitely, and Davis has since partnered with agencies as far away as South Africa, India, Tanzania and Malawi” (Bloomketz, 2008, p.3).