Structures of Stigma: Diagonal AIDS Care and Treatment Abandonment in Mozambique

project summary

From a predominantly political standpoint, informed by a multi-sited ethnographical case study in Mozambique, this project aims to provide a clear articulation of the relationship between curative AIDS interventions and malnutrition in Mozambique. Supported by international donors, Mozambique and other Sub-Saharan countries are in the process of rolling out extensive anti-retroviral (ARV) drug interventions. In light of the paramount importance of adequate nutrition to the efficacy of AIDS treatment, this project points to a political paradox of the priorities in funding for nutrition and AIDS treatment that urgently requires reorientation: that AIDS receives absolute highest priority from international donors while nutrition receives absolute lowest priority. These issues are analysed on two levels: 1) the international political economy of AIDS treatment and nutrition; and 2) the actual on-site implementation of these policies and different modalities of ARV drug provision in Mozambique; some which include components that also address nutrition (nutritional support schemes, home-based care, etc). Documental sources and empirical data are examined within an innovative analytical framework that combines international political economy of health, methodological individualism, and ethnography. A full year of fieldwork is planned in Mozambique. National ARV provision services and a successful international ARV delivery programme (DREAM – Drug Resource Enhancement against AIDS and Malnutrition) are analysed comparatively in order to bring about a broad contextualisation of societal processes and factors relevant to ARV drug interventions and priorities in donor policy crucial to the effectiveness international development aid.