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The HIV/AIDS Epidemic in Sub-Saharan Africa in a Historical Perspective Philippe Denis and Charles Becker (Eds) Online Edition, October 2006 Pp The HIV/AIDS Epidemic in Sub-Saharan Africa in a Historical Perspective Edited by Philippe Denis and Charles Becker _____________________ Online edition Réseau sénégalais “Droit, éthique, santé” / Senegalese Network “Law, Ethics, Health” October 2006 The HIV/AIDS Epidemic in Sub-Saharan Africa in a Historical Perspective Edited by Philippe Denis and Charles Becker Online edition Réseau sénégalais “Droit, Éthique, Santé” / Senegalese Network “Law, Ethics, Health” October 2006 Note and acknowledgments The reader will find here an electronic version of a book jointly published by Academia-Bruylant (Louvain-la-Neuve) and Karthala (Paris) in September 2006. The online version is in English, while the printed one is in French. The former comes in the form of twenty-three separate files, corresponding to the subdivisions of the book, and of a single file, which includes the whole book. The editors express their gratitude to the authors for having given their consent and support to this publication. The electronic version was put online by the Senegalese network on “Law, Ethics, Health” and is hosted on the website of the Agence Universitaire de la Francophonie: http://www.refer.sn/rds/article.php3?id_article=245 Links are made to various other websites including: • the Sinomlando Centre for Oral History and Memory Work in Africa, University of KwaZulu-Natal http://www.ukzn.ac.za/sorat/sinomlando • the Health Economics and HIV/AIDS Research Division, University of KwaZulu- Natal http://www.heard.org.za • the Crisis States Research Centre, Department of Development Studies, London School of Economics http://www.crisisstates.com Cover Illustration Musiciens — Miniatures en bronze, Afrique de l’Ouest. Collection privée Musicians — Bronze Miniatures, West Africa. Private Collection Chantez la mémoire des morts par amour le chant qui éblouit le visage des orphelins écoutant une clameur inouïe lumineuse, vivifiante ! Sing the memory of the dead by love, the song which dazzles the face of orphans listening to an unheard, vivifying luminous clamour! © Tous droits réservés pour les auteurs All rights reserved for the authors October 2006 The HIV/AIDS Epidemic in Sub-Saharan Africa in a Historical Perspective Philippe Denis and Charles Becker (eds) Online edition, October 2006 pp. 3-4 Contents Contents 3 Contributors 5 Foreword 9 Part One : Introduction 11 Towards a Social History of HIV/AIDS in Sub-Saharan Africa 13 Philippe Denis (University of KwaZulu-Natal) Part Two : The Dynamic of the Epidemic 27 Twenty years of Intervention and Controversy 29 Michel Caraël (UNAIDS, Geneva) The HIV Epidemics in Sub-Saharan Africa: Why So Severe? Why So Heterogeneous? An Epidemiological Perspective 41 Anne Buvé (Institute of Tropical Medicine, Antwerp) AIDS, a Darwinian Event? 57 Alex de Waal (Harvard University) and Alan Whiteside (University of KwaZulu-Natal) Cattle Breeders and the Spread of AIDS in the Lake Chad Basin 73 Yves Zoa (CNE/MINREST, Yaoundé) Part Three : HIV/AIDS in the History of Epidemics 87 Historical perspectives on HIV/AIDS: Lessons from South Africa and Senegal 89 Myron Echenberg (McGill University, Montreal) Historicising the Unspeakable. Legacies of Bad Death and Dangerous Sexuality in South Africa 97 Benedict Carton (George Mason University, Washington DC) The Search for Healing: the AIDS Epidemic in Gwembe Valley 113 Elizabeth Colson (University of California in Berkeley) Part Four : Facing the Challenge of HIV/AIDS 127 Choosing Between Life and Death: Rationing of Health Care During the AIDS Epidemic in South Africa 129 Gerald Oppenheimer (City University New York) and Ronald Bayer (Columbia University) 4 Contents AIDS in Burundi and South Africa : a Day-To-Day Experience 143 Paul Kocheleff (Greys and Edendale Hospitals, Pietermaritzburg) Historical Trends in the HIV/AIDS Training of Health Care Workers in the Western Cape, South Africa, 1990-2003 155 Stephen van Houten (Consultant) A History of State Action: The Politics of AIDS in Uganda and Senegal 171 James Putzel (London School of Economics) Part Five : Debating HIV/AIDS 185 “Scramble for Cameroon”. Atypical viruses and Scientific Zeal in Cameroon (1985-2000) 187 Guillaume Lachenal (Université Paris 7) Law, Ethics and AIDS in Sub-Saharan Africa. Senegal as a Case Study 207 Charles Becker (CNRS, Dakar) A Oral History of HIV/AIDS in the Congo 219 César Nkuku Khonde (Université de Lubumbashi) Part Six : Bibliography 233 The History of HIV/AIDS in Africa: Bibliography 235 Stephen van Houten (Consultant) and Charles Becker (CNRS, Dakar) Table des matières de la version française 259 Summaries / Sommaires 261 The HIV/AIDS Epidemic in Sub-Saharan Africa in a Historical Perspective Philippe Denis and Charles Becker (eds) Online edition, October 2006 pp. 5-7 Contributors Ronald BAYER is Professor at the Joseph L. Mailman School of Public Health at Columbia University, New York where he is co-director of the history and ethics of the public health programme. For more than twenty years he has been involved in research into the problems of ethics and public health caused by the AIDS epidemic. Together with Gerald Oppenheimer he has published AIDS Doctors: Voices from the Epidemic (2000), an oral history of AIDS in the USA. Charles BECKER is an anthropologist and historian who lectures in bioethics and the history of the law of health at the Cheikh Anta Diop University, Dakar. He was a member of the scientific committee for the conference “Sciences sociales et sida en Afrique” [Social Sciences and AIDS in Africa] held in Saly in 1996 and was one of the scientific editors of the publication which followed on the conference. Since 2001, he has been the editor of the discussion forum H-West-Africa, which is affiliated to the H-Net network – Humanities on the Net (Michigan State University) of whose scientific council he is a member. He was involved in the creation of the first Francophone teaching (DEA de droit de la santé et de l’éthique) [Diploma of Advanced Studies in the law of health and ethics] introduced in Dakar in 2003. He was one of the founders of the Senegalese network “Droit, éthique, santé” [Law, ethics, health] and participated in the development of its internet site, operative since 2005, which offers many online publications. He is a member of the National Council of research into health and is in charge of ethical matters in Senegal. Anne BUVÉ is a medical doctor. She studied epidemiology in London in 1989 and 1990 after having practiced medicine in Zambia and Sierra Leon for several years. She subsequently joined the Tropical Medicine Institute in Antwerp. Between 1993 and 2001 she made a major contribution to several research projects into AIDS in Africa, including a comparative study of four African towns. Since 2001 she has been the head of the Department of Research and Intervention at the Tropical Medicine Institute. Michel CARAËL has a doctorate in sociology and a degree in journalism from the Université Libre de Bruxelles (ULB) [Free University of Brussels]. From 1968 to 1984 he was a journalist with the RTBF. Since 1985 he has been an international consultant and lecturer in charge of courses at the Faculty of Social, Economic and Political Sciences and at the Institute of Industrial Science at ULB. After several years of research into the state of reproduction and nutrition in Zaire, Somalia and Rwanda, he joined the WHO World Programme for the fight against AIDS when it was formed in 1986. In 1995 he joined UNO-AID as head of the team for prevention and evaluation. Member of numerous scientific committees, he has published more than one hundred and fifty articles, most of which deal with AIDS. Benedict CARTON is Associate Professor in the History department at George Mason University in Washington DC where he contributes to the programme of Afro-American Studies. He is the author of Blood from Your Children: The Colonial Origins of Generational Conflict in South Africa (2000) and the co-editor of Being Zulu: Contested Identities Past and Present (forthcoming). 6 The HIV/AIDS Epidemic in Sub-Saharan Africa in a Historical Perspective Elizabeth COLSON is a social anthropologist and Professor Emeritus of the University of California in Berkley. Since 1986, the bulk of her research has been focused on the Tonga speaking peoples of southern Zambia. Since 1956 she has participated in a longitudinal study of the Gwembe Tonga who were displaced in 1958 with the construction of Kariba dam and Lake Kariba. She is the co-director of this project together with Thayer Scudder, a social anthropologist and ecologist. Philippe DENIS has a doctorate in History from the University of Liège. He has been Professor of the History of Christianity at the University of KwaZulu-Natal since 1993 and visiting Professor of African History at the University of Louvain since 2001. He founded and directs the Sinomlando Centre for Oral History and Memory Work in Africa. He is the author, editor and co-editor of about fifteen books on religious and social history amongst which are The Making of an Indigenous Clergy in Southern Africa (1995), Femmes d’Afrique dans une société en mutation (2004) [African women in a Changing Society] and Never too small to remember. Memory work and resilience in times of AIDS (2005). Alex DE WAAL is a writer and an activist interested in African issues. He is an associate member of the Global Equity Initiative at Harvard, director of the Social Science Research Program on AIDS and Social Transformation and director of Justice Africa in London. Since the mid-90s, he has studied the social, political and medical aspects of hunger, war, genocide and AIDS particularly in the Horn of Africa and the Great Lake region, striving to mobilize the international community in these issues. He has written several books including Famine that Kills: Darfur Sudan (1989, 2004), Famine Crimes: Politics and the Disaster Relief Industry in Africa (1997) and Islamism and Its Enemies in the Horn of Africa (2004).
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