ABSTRACT
Current ethnographies of the antiretroviral therapy (ART) rollout, focusing on providers' perspectives, address the ethical and practical dilemmas surrounding issues of patient confidentiality that have been part of AIDS care from its first days. Many current ethnographic accounts focus on a specific policy, an implementation attempt, or a certain level of analysis. This chapter uses the ART rollout in Malawi to illustrate some universal problems in healthcare delivery. Individual stories will demonstrate the challenges inherent in delivering healthcare in resource-limited settings. Furthermore, the HIV crisis hit healthcare workers particularly hard, magnifying an already severe shortage of personnel. Even within the context of sub-Saharan Africa, the epicenter of the crisis, Malawi's healthcare workforce shortage was striking. HIV/AIDS care is an expensive and complex endeavor by any means. Finding the resources to pay for medications, chronic care, and management and to train healthcare providers specializing in long-term AIDS care requires a concerted effort.
