Didier Fassin

Humanitarianism as a Politics of Life

On March 28, 2003, as on the last Friday of every month, the board of administrators of Medecins sans frontieres (MSF; Doctors without Borders) met between five and eleven o’clock in the organization’s head office on the first floor of a building in the eleventh arrondissement of Paris. On that particular evening a peculiar atmosphere of expectation and excitement reigned. There was of course the customary rapid overview of the situation in a number of “missions” in various parts of the world where the organization intervenes, followed by a more in-depth examination, with discussion of various specific topics concerning the running of the association and its humanitarian activities. The construction of the “international movement” was also raised: it referred to the network of sections in twenty countries, of which six are actually in a position to conduct operations, and which strives to ensure a coherence of identity and policy in the work of each national body beyond the details of local history and culture. The DNDi (Drugs for Neglected Diseases Initiative) program was another issue addressed: this is an original project that the organization had instigated two years earlier in order to establish, in international collaboration with private charitable foundations and public partners, a program of research and development similar

Another Politics of Life is Possible

Although it is usually assumed that in Michel Foucault’s work biopolitics is a politics which has life for its object, a closer analysis of the courses he gave at the Collège de France on this topic, as well as of the other seminars and papers of this period, shows that he took a quite different direction, restricting it to the regulation of population. The aim of this article is to return to the origins of the concept and to confront the issue of life as such. This implies four shifts with respect to Foucault’s theory: (1) Politics is not only about the rules of the game of governing, but also about its stakes. (2) More than the power over life, contemporary societies are characterized by the legitimacy they attach to life. (3) Rather than a normalizing process, the intervention in lives is a production of inequalities. (4) The politics of life, then, is not only a question of governmentality and technologies, but also of meaning and values. The discussion is grounded on a series of empirical investigations conducted in France and South Africa on how life and lives are treated in our world.

The politics of AIDS in South Africa: beyond the controversies

Discussion of AIDS in South Africa needs to move beyond a simplistic “for or against” stance on President Mbekis denial of a connection between HIV and AIDS. The authors propose ways to widen the debate and hence to increase understanding of the epidemic

Beyond good and evil? Questioning the anthropological discomfort with morals

There is a paradox with morals in anthropology: on the one hand, morals are not considered as a legitimate object of study and are looked upon with suspicion; on the other hand, there is an increasing concern for moral issues both in society and within the discipline. Basing my analysis on several empirical studies which I briefly evoke, I call for the development of a moral anthropology. This does not mean that anthropologists should become moralists but that they should study morals as they do politics, religion or medicine. I discuss the two reasons, epistemological and historical, why anthropologists have been reluctant to enter this field of research. I analyse the ambiguities and risks which are effectively inherent to this particular domain. I conclude with two propositions and their two corollaries in favour of moral anthropology, but insist on the heuristic value of the intellectual discomfort aroused by morals among anthropologists.

Denial and defiance: a socio-political analysis of AIDS in South Africa

In May 2000, South Africa’s President, Thabo Mbeki, convened an international panel to consider the causes of and appropriate solutions to AIDS in the African context. Significantly, the panel included representatives from the so-called AIDS dissident community. The willingness of the President to entertain, if not unequivocally endorse, dissident science created an international stir. It resulted in the Durban Declaration, a petition of more than 5000 scientists in support of the ‘orthodox’ views of HIV, launched at the International AIDS Conference in July 2000. However, in October 2000, after several months of intense national and international media coverage on the issue, the President informed his party, the African National Congress (ANC), that he was withdrawing from public debate over the science of HIV/AIDS [1]. Moreover, the government announced that it would make the antiretroviral drug nevirapine available in pilot sites to prevent mother-to-child-transmission (MTCT) of HIV [2], thus meeting a long-standing demand from the AIDS community. It thus appeared as if the national impasse that had characterized much of 2000 was showing signs of ending. In this context, the mobilization of an alliance, led by the Treatment Action Campaign and the Congress of South African Trade Unions, in support of the South African government in its court battle with the pharmaceutical industry, gave the impression of a united front against AIDS. Government and activists jointly celebrated when, in the face of international and local disapproval, the Pharmaceutical Manufacturers Association withdrew its 3-year-old legal action in April 2001. [The court action was instituted against the Medicines and Related Substances Control Amendment Act (90) of 1997, specifically Section 15C, allowing for measures (compulsory licenses and parallel imports) that would allow government to procure essential drugs at cheaper prices.]

Exclusion, underclass, marginalidad: Figures contemporaines de la pauvreté urbaine en France, aux Etats-Unis et en Amérique latine

Didier Fassin : Exclusion, underclass, marginalidad. Zeitgenossische Darstellungen der stadtischen Armut in Frankreich, in den Vereinigten Staaten und in Lateinamerika. ; ; Im Verlauf der letzten Zeit brachte die Erscheinung von neuen Armutsformen, die besonders durch ihren stadtischen Charakter gepragt waren, spezifische Bezeichnungsarten hervor : exclusion in Frankreich, underclass in den Vereinigten Staaten und marginalidad in Lateinamerika. Wenn einerseits die Grunde und Mechanismen dieser sozialen Gegebenheit zu zahlreichen Arbeiten Anlass waren, so wurden andererseits das Erarbeitungsphanomen, durch das diese Begriffe sich durchgesetzt haben, die Darstellungen des sozialen Raums, die darunter liegen und die daraus entstehenden politischen Auswirkungen nur wenig untersucht. Zweck ist hier, auf der Grundlage einer vergleichenden Naherungsmethode zwischen den drei sozialen und intellektuellen Kontexten, die Entwicklung darzulegen, des diesen Begriffen zugeordneten Sinnes, der von diesen Begriffen bezeichneten und qualifizierten Fakten, des Einsatzes der auf dem Spiel stand und den sie zu verdunkeln beitrugen. Es handelt sich also dazu, die neue soziale Topologie zu analysieren, die diese Begriffe darlegen wollen und die sie mit produzieren. geordneten Sinnes, der von diesen Begriffen bezeichneten und qualifizierten Fakten, des Einsatzes der auf dem Spiel stand und den sie zu verdunkeln beitrugen. Es handelt sich also dazu, die neue soziale Topologie zu analysieren, die diese Begriffe darlegen wollen und die sie mit produzieren.

The embodiment of inequality. AIDS as a social condition and the historical experience in South Africa.

The Thirteenth International AIDS Conference, which took place in Durban from 9 to 14 July 2000, was the first to be held in a city in the developing world. It showed that the international scientific and political communities are now ready to face the serious situation in developing countries, first and foremost those in Africa. And, as the title proclaimed, the conference sought to ‘break the silence’ surrounding such crucial issues as infection statistics and the social exclusion of patients, and also the lack of mobilization among rich nations on access to drug treatment. In this context, the choice of South Africa, which had only returned to democracy six years before from the apartheid regime, was highly symbolic. However, as the event approached, the tension mounted among the medical world and advocacy groups. For several months, South Africas President, Thabo Mbeki, had been open to the theories of some Western researchers who denied the causal relationship between viruses and infection. He had even invited some of them to a panel and had temporarily stopped all mother‐to‐child transmission prevention programmes on the grounds that the medication used was harmful (Schneider, 2002; Fassin, 2002a). In response to Mbekis actions, some participants considered not attending the meeting, fearing that their presence would seem to condone this dissident assessment. The conference did finally take place, but Thabo Mbekis opening speech was given to a half‐empty auditorium after most participants had ostensively left. Hans Holbein the Younger (1497–1543) Die Abtisinn (The Abbess) from the Bilder des Todes (Pictures of Death) series; woodcut by Hans Lutzelburger and Veit Specklin; 6.5 × 4.8 cm; with permission from Public Art Collection Basel, Switzerland. ![][1] The South African President declared that he had wondered long and hard about what could explain the virulence of the AIDS virus that was … [1]: /embed/graphic-1.gif

Embodied history. Uniqueness and exemplarity of South African AIDS

The exceptionality of AIDS in South Africa, both for its epidemiological features and public controversies, seems to have its correspondence in the exceptionalism of South African history, with its unprecedented regime of apartheid and its unexpected turn to democracy. The article shows that AIDS in this country can simultaneously be seen as unique (because of the historical context in which it is inscribed) and exemplar (of social determinants observed in other countries characterised by similar past or present of domination). As an alternative to cultural and behavioural models of the epidemic which have been widely spread on the African continent, the concept of embodiment of history is proposed in order to account for both the structural facts underlying the epidemic (inequality, violence, migration) and the construction of collective as well as individual narratives of the disease (including victimisation and accusation).

An anthropological hybrid : The pragmatic arrangement of universalism and culturalism in French mental health

As in most European countries, the mental health of immigrants in France has recently been the subject of scientific scrutiny. Since the end of World War II voluntary special mental health services for migrants and refugees have been created in France and especially in Paris, but none has been based on epidemiological data. Generally, this lack of objective data gave rise to the assumption that many immigrants might not be getting the type of services they required. The birth of a new type of service (e.g. for migrants, refugees, ethnic groups, trauma and torture victims) was a political reaction to what was, at the time, expressed as an essential unmet need regarding this very specific population. In this article we review, from an anthropological point of view, the different paradigms that have prevailed over the last 50 years.

A contribution to the critique of moral reason

Responding to Carlo Caduff’s comments on an earlier paper of mine provides me with the opportunity to refine my defense and illustration of moral anthropology. After having recalled that my personal encounter with moralities and ethics was of the kind of Monsieur Jourdain’s discovery of prose, rather than a deliberate effort to apply moral philosophy to social science, I attempt to clarify my positioning in terms of critical thinking and my reformulation of the concept of moral economies, using my research on the intolerable and on humanitarianism. My explicit intention is to go beyond or rather, more modestly, to veer away from the alternative between the Durkheim-Kant legacy and the Foucault-Aristotle tradition, and from the dialectic between morality as code and ethics as freedom. It is to explore two epistemological frontiers: one related to the place occupied by the anthropologist, which I suggest should be on the threshold of rather than inside or outside Plato’s cave; the other one linked to the separation of a moral and ethical matter from the social gangue of human lives, which I find problematic because of the loss of history and politics it implies. I contend that both frontiers engage what it means and implies to be doing social science in the contemporary world.