Carolyn Baylies

The Impact of AIDS on Rural Households in Africa: A Shock Like Any Other?

In areas where HIV prevalence is high, household production can be significantly affected and the integrity of households compromised. Yet policy responses to the impact of HIV/AIDS have been muted in comparison to outcomes of other shocks, such as drought or complex political emergencies. This article looks at the reasons for the apparent under–reaction to AIDS, using data from Zambia, and examines recent calls to mitigate the effects of AIDS at household level. Critical consideration is directed at proposals relating to community safety nets, micro–finance and the mainstreaming of AIDS within larger poverty alleviation programmes. It is argued that effective initiatives must attend to the specific features of AIDS, incorporating both an assault on those inequalities which drive the epidemic and sensitivity to the staging of AIDS both across and within households. A multi–pronged approach is advocated which is addressed not just at mitigation or prevention, but also at emergency relief, rehabilitation and development.

Disability and the Notion of Human Development: Questions of rights and capabilities

From a rights perspective disability has come increasingly to be seen as less a matter of personal misfortune than of societal neglect and obstruction, and as much warranting claims on the state to ensure inclusion and equality as to prosecute a duty of care. This shift resonates with other transitions within international discourse, most notably the increasing prominence of the notion of human development, which emphasises the importance of equity, freedom, and full realisation of human rights and capabilities as central to societal developmental objectives. After briefly examining apparent parallels in discourses relating to disability and to human development, the capabilities approach, upon which the concept of human development is grounded, is examined more closely and its implications for disability considered. It is argued that a capabilities approach may serve alternatively to keep disability partially hidden from view or become a powerful means for identifying the responsibilities of governments and external agencies in genuinely equalising opportunities.

The fall and rise of multi‐party politics in Zambia

The overwhelming electoral victory of the MMD in November 1991 restored multi‐party politics to Zambia and ended the UNIP monopoly of government which had existed since 1964. A coalition of forces disenchanted by economic decline and resentful of authoritarian one‐party rule, the MMD has moved swiftly to reduce the economic and social role of the state and to promote market restructuring in line with IMF conditionalities. An alliance of trade union leaders and local capitalists, the MMD also committed itself to political reform which encouraged hopes that stable democratic institutions can be forged. However, after only a few months in office, criticism of presidential authoritarianism and the widespread use of patronage in appointments raises doubts that such promises will be delivered. The question is posed of whether MMD replaces UNIP or simply reproduces it.

'Political Conditionality' and Democratisation

The use of aid to impose political conditions on recipient countries, to further democratic and government reforms or to punish non‐compliance with earlier demands, is a relatively new feature of the international aid regime. This article evaluates the proliferating donor and academic literature emerging on the subject. At the heart of discussion of democracy/ governance policies are debates about transformation of the state, its relationship to economic development and the decreasing extent to which considerations of sovereignty limit donor interventions. The author argues that, while political conditionalities may assist the development of democratic movements in Africa, there is an irony in that structural adjustment risks undermining the state reforms seen to be essential to them while, equally, democratisation may challenge the processes of economic restructuring being imposed.

The 1996 Zambian elections: still awaiting democratic consolidation

On 18 November 1996 presidential and parliamentary elections were held for the second time under Zambias Third Republic. The first elections, in October 1991, ended the unbroken grip on power enjoyed by the United National Independence Party (UNIP) since 1964 and returned the country to a multi‐party political system after 18 years as a one‐party state. UNIP was heavily defeated by the MMD (Movement for Multiparty Democracy) and Kenneth Kaunda, the countrys president since 1964, was replaced by Frederick Chiluba. The peaceful nature of the changeover in 1991 was applauded locally and internationally. There was a sense of optimism about the countrys democratic prospects. Zambia was widely held up as a model of successful democratic transition and aid flowed in, partly in support of the democratic experiment and partly because of the new regimes commitment to economic liberalisation and structural adjustment. In some cases donor support was specifically earmarked for the promotion of good government and...

Overview: HIV/AIDS in Africa: global & local inequalities & responsibilities

This issue of the Review is devoted to an examination of the HIV/AIDS epidemic in Africa, an emergency which compromises the future of so many on the continent, yet is persistently underplayed. The depth of need it has generated has scarcely been measured and not even begun to be met. Although increasingly acknowledged to be grounded in social behaviour and systemic inequalities, HIV/AIDS is still treated predominantly as a health problem. At the same time, far more attention continues to be paid to the (admittedly crucial) issues of prevention and care than to the economic and social impact of AIDS and the ways it can be addressed and mitigated. This introduction to the issue expands upon general points made in the editorial and reviews some of these issues by exploring two aspects of the multi‐layered context of the AIDS epidemic: • The question of what African governments should and can do in the face of AIDS, and • The viability and potential of the International Partnership on AIDS in Africa.

Social science research on AIDS in Africa: questions of content, methodology and ethics.

An international symposium on the social sciences and AIDS in Africa was held in Sali Portudal, Senegal, in November 1996. English- and French-speaking researchers and AIDS activists came together to consider a broad range of topics, with reference to individual country experience. The authors review some of the issues discussed at the symposium; in particular, the need for more social science research on AIDS to reconsider and re-evaluate methodologies and their role in relation to interventions, the variety of discourses through which AIDS is articulated and understood, and ethical questions relating to confidentiality and disclosure, as well as international disparities in income and access to resources. The shift in perception and understanding about the significance of AIDS, with its implications for the weakening of a former sense of common purpose, makes conferences such as this one all the more important.

The meaning of health in Africa

This briefing demonstrates some of the tensions which arise in trying to define and describe problems of health in Africa: the tension of having available only statistics of known inaccuracy, aggregated across all population groups; the fact that attempts to describe status of health classically rely on describing incidence of diseases. Likewise, in looking at attempts to improve health, there is a tension between, on the one hand states, whose political economy militates against health, and, on the other international agencies who are thus reduced to a progressive rhetoric coupled with, in practice, a set of merely technical interventions of questionable impact.

Editorial: special issue on AIDS

The spectre of AIDS is haunting Africa. If present trends continue, its impact on development and society will be devastating. This issue of ROAPE looks at some of the graphic realities of the situation as faced by those who must cope. It also explores the struggles and the debates around who might take responsibility for delivering programmes of prevention and care, for making affordable drugs available to those in need and for dealing with the consequences of loss wreaked by the epidemic. If families bear the heaviest burden, what role do states, NGOs and international agencies have in managing the crisis and in averting the worst scenarios? These questions have to be considered in context. The epidemic comes at the worst possible time for Africa, already facing economic crisis and indebtedness, the deliberate downsizing of national governments through externally-imposed neo-liberal policies, as well as riven by more armed conflicts than any other region of the world.

Setting an agenda for change in Africa

This issue of ROAPE takes up a number of themes which have been a recurring concern of our contributors in the past. The pressures imposed by external forces and imperialist agencies, especially through the structural adjustment policies of the international financial institutions, are pervasive and inexorable, forming the context in which policy or political change must occur. But the internal impetus towards political change of state structures on the continent is also strong, particularly with regard to demands for popular participation. If external forces continue to take their toll, ongoing processes of change, particularly in the political realm, offer some room for cautious optimism.