Thesis: A Global Political Ethnography of Mozambican AIDS Treatment

Subject: Ph.D. monograph on the politics and realities of AIDS treatment and malnutrition in Mozambique

Funding agency: Danida (the Consultative Research Committee for Development Research, Danish Ministry of Foreign Affairs)

Project partners: Community of Saint Egídio, DREAM (Drug Resource Enhancement against AIDS and Malnutrition)

Outline of my research:

‘If you give us ARVs, please give us food, just food’

Informed by multi-sited ethnographic fieldwork in Mozambique, my research aims to provide a clear articulation of the relationship between curative AIDS interventions and malnutrition in Mozambique. Supported by international donors, Mozambique and other sub-Saharan African countries are rolling out extensive AIDS treatment interventions. In light of the paramount importance of adequate nutrition for the efficacy of highly active antiretroviral therapy (HAART; commonly ARVs), this project points to a political paradox of the global priorities in funding for nutrition and AIDS treatment that urgently requires analysis; namely that AIDS receives absolute highest priority from international donors while nutrition receives absolute lowest priority. These issues are analysed on two levels: 1) the global political economy of AIDS treatment and nutrition; and 2) the on-site implementation of HIV/AIDS policies and different modalities of ARV drug provision in Mozambique; some including components of nutritional supplementation and home-based care. Documental sources and empirical data are examined within an analytical framework that combines international political economy of health, methodological individualism, and ethnography (‘anthropolitics’). One year of fieldwork is carried out in Mozambique where one renowned international delivery programme (Community of Saint Egídio’s DREAM programme – Drug Resource Enhancement against AIDS and Malnutrition) will be analysed in order to achieve a broad contextualisation of societal processes and factors relevant to ARV drug interventions and priorities in donor policy. Four DREAM centres in Machava (Machava – Maputo), Chókwè (Chókwè – Gaza), Manga Chingussura (Beira –Sofala), and Quelimane (Quelimane – Zambézia) have been selected for qualitative data gathering.

• How do global political priorities and transnational structures govern AIDS treatment in Mozambique? What are the local consequences of a political paradox in funding for AIDS and nutrition?

• How are existing AIDS treatment interventions affected by nutritional deficiency; and how might such insights inform development policies?

• What are the comparative advantages of providing ARV drug patients with a diet convergent with therapeutic requirements as opposed to providing only ARVs; and how do treatment outcomes of these different services differ?

• How do nutritional support programmes most efficiently wed and improve the quality of ARV drug therapy in resource-constrained settings; and how can such provision successfully merge with ongoing AIDS interventions in Mozambique?