ABSTRACT
The World Bank has set and sustained the current agenda for the global HIV/AIDS response. It has done so through a combination of timing, labelling the problem of HIV/AIDS a development one and, crucially, developing specifi c partnerships with states, CSOs in sub-Saharan Africa and intergovernmental organisations. Yet the role of the World Bank in the fi eld of HIV/AIDS continues to receive scant attention. This is not surprising, as the Bank has deliberately organised its agenda in such a way as to obscure its role and responsibility for it. However, it is problematic if the structures, actors and money channelled to the HIV/AIDS response are to have any progressive affect. The contradictions in the response arising from the predominance of neoliberal incentive as a means of pursuing liberal outcomes have undermined the ability and success of the global response to HIV/AIDS. These problems have become inherent to the system of HIV/AIDS governance at the individual, community, state and global level. The founding principles, ideology and structures of the response thus need to be unravelled to see where the problems of addressing HIV/AIDS lie. Hence, this chapter draws together the main fi ndings of the book to answer the initial concern of what the Bank’s agenda for HIV/AIDS looks like and how it has set it. To fully understand this agenda, the chapter revisits the governance Bank debate outlined in Chapter 1 in regards to how we can now understand the Bank’s relationships with the state, civil society, the individual and global decision-making. The chapter addresses the implications of the Bank’s HIV/AIDS agenda for its wider role in health, and what it begins to suggest about the relationship between East Africa and the international, before focusing upon the wider normative concern of criticising the HIV/AIDS response. It does so by unravelling the political implications of criticising the global response to the disease, why it matters and what could be done. As such, in conclusion it confronts the normative question of such an argument: is a problematic agenda for HIV/AIDS better than no agenda at all?
