2010Number of visits: 1693
The 2010 Session: HIV and AIDS and the discourse of the “outsider” in Africa
The central question to HIV and AIDS and identity addresses issues about the extent to which
Africans and African governments have taken ownership and control of the HIV and AIDS
pandemic. To take ownership of a problem means taking control of the various aspects of the
pandemic, understanding the dynamics of transmission, putting in place measures to protect
citizens from infection, providing care to the inflicted and affected, taking responsibility and
providing realistic resources toward alleviating the problem. Ownership of the HIV and AIDS
pandemic means that Africans and their governments will drive the process towards finding
working and workable solutions for all populations.
Why have African governments taken so long to take leadership in the control of the
pandemic? Perhaps one of the main reasons is that from its inception, the discourse surrounding
HIV and AIDS has been one which focused on the outsider both as the cause and sometimes the
perceived victim of the disease. This externalization of the problem has been critical in shaping
both the global and local responses to the pandemic. Associated with this denial of ownership
by African governments, has been the “distorted” claim of ownership of knowledge of the
pandemic by self proclaimed experts in the field of health and social sciences who have been
able to influence national and international responses to the pandemic because they have
claimed ownership of expertise on the disease. This selective ownership has in most cases
created North-South networks on experts supported by “epidemic logic” who have mostly
enriched themselves on research grants while making very little impact on alleviating the HIV
and AIDS problem in Africa.
In the epidemiological discourse on the origin and causes of HIV and AIDS, the theme of the
outsider began early with western notions of the disease as African (whether through African
monkeys or sexual practices), or as a disease affecting mostly members of the gay community,
prostitutes, and intravenous drug users. Most of those suffering from the disease were
perceived as being foreign in one way or another either because of nationality or citizenship,
sexual preference (homosexuality), spatial location, geography or race. The “otherness”
identity provided the explanation why a person became the affected or infected. An examination of the evolution of the discourse as well as the history of the disease and the
changing faces of this discourse provides an interesting starting point to this debate.
Within the African continent, the discourse of the outsider has emerged in studies that focus on
migrants, prostitutes, mine workers, soldiers, foreigners and other perceived outsiders. This
focus has allowed governments and policy makers to invest very little in dealing with the
pandemic at national level and has lulled a lot of “citizens”, (insiders) into a false sense of
security where they no longer perceive themselves as at risk. With new HIV infections still on
the increase on a daily basis in many African countries, this approach to the pandemic is
tantamount to a deliberate neglect by governments.
At both global and local contexts, immigrants, migrants, travellers, tourists, refugees, soldiers
and many people experiencing spatial relocation and dislocation have been the focus of
studies on HIV/AIDS. The underlying theme reflects that researchers and scholars still grapple
with the idea of HIV/AIDS as a mainstream disease and are more comfortable treating it as a
disease for those on the fringes of society. This externalization of the problem to the outsider
has provided excuses for many African governments not to play their roles in the prevention,
provision of care and treatment and protection for all populations. It has created a fertile
ground for all sorts of experts some of whom have neocolonial agendas while others simply
use the pandemic to enrich themselves or to disempower poor Africans.
Why, in spite of all the knowledge gathered and the expertise housed in Africa and the ever
increasing death toll of Africans from the pandemic, has no multi country powerful team of
Africans dedicated to finding solutions to the HIV and AIDS pandemic been set up, housed in
the African Union and funded by various African governments to spearhead the finding of a
vaccine, challenge drug patents and provide sustained research on African AIDS medicines?
Why is Africa lagging behind in finding solutions to a pandemic which is devastating the
While the focus on the outsider continues, the disease is killing “mainstream” Africans, many
uninformed, or misinformed into believing themselves not to be at risk. With the disease
externalized to a few pockets of deviant outsiders, African governments are finding
justification not to put enough resources to face the problem, own it and find solutions for it.
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