Negotiating Development through AIDS: Contesting the Post-Liberalisation Indian state in Disease Control and Health, 1983 to 2017

Author: 

Reiko Kanazawa

PhD defended at: 

University of Exeter

Summary: 

This dissertation explores why, in an era of state retreat following India’s economic liberalisation in 1991, many wide-ranging ideas about social and economic development were expressed through AIDS. It takes a historical approach, tracing the entangled trajectories of international, governmental, and NGO actors from the early 1980s to 2017. It consults interdisciplinary primary source bases of grey literature of international institutions and oral history interviews conducted with key actors in the AIDS field in New Delhi in spring 2017.

The main objective of the thesis is to draw out specific case studies of partnerships, as well as disagreements, between individuals representing various international, national, and non-governmental organisations (NGO), each pushing their own ideas about the appropriate role of the Indian state in providing health and development. In a broadly chronological manner, the chapters cover the impact of the India’s debt crisis and structural adjustment on the first World Bank-funded National AIDS Control Programme (NACP) in 1992; an alternative funding stream from Ford Foundation that encouraged an era of ‘watchdog’ NGO activism during the 1990s to the early 2000s; the rise to prominence of the UK’s Department for International Development, working with the pro-poor social justice politics of the Indian National Congress-led United Progressive Alliance government and the assertiveness of Sujatha Rao in NACP’s third phase (NACP-III) from 2007 to 2012; and finally, the inclusion of opioid substitution therapy for injecting drug users under NACP-III in 2007.

While speaking mainly to the emerging discipline of history of global health, the thesis draws concepts and approaches from the history of postcolonial medicine, as well as incorporates an understanding of contemporary international development and Indian politics. In doing so, the main finding of the thesis is to re-position the state as the fundamental decision-maker and agenda-setter for the social sector in India after liberalisation. Thus, each chapter shows how international donors and NGO actors negotiated their visions for development with the Government of India, using AIDS as a platform.

Defended: 

2018