THE GOVERNANCE OF AIDS IN CHINA: ASSESSING THE IMPACT OF GLOBAL NORMS BY ROWAN HAGUE A THESIS SUBMITTED IN FULFILLMENT OF THE REQUIREMENTS OF DOCTOR OF PHILOSOPHY SCHOOL OF SOCIAL SCIENCES AND INTERNATIONAL STUDIES UNIVERSITY OF NEW SOUTH WALES, 2008 ORIGINALITY STATEMENT ‘I hereby declare that this submission is my own work and to the best of my knowledge it contains no materials previously published or written by another person, or substantial proportions of material which have been accepted for the award of any other degree or diploma at UNSW or any other educational institution, except where due acknowledgement is made in the thesis. Any contribution made to the research by others, with whom I have worked at UNSW or elsewhere, is explicitly acknowledged in the thesis. I also declare that the intellectual content of this thesis is the product of my own work, except to the extent that assistance from others in the project's design and conception or in style, presentation and linguistic expression is acknowledged.’ Signed ....................................................................... Date ........................................................................ 2 COPYRIGHT STATEMENT ‘I hereby grant the University of New South Wales or its agents the right to archive and to make available my thesis or dissertation in whole or part in the University libraries in all forms of media, now or here after known, subject to the provisions of the Copyright Act 1968. I retain all proprietary rights, such as patent rights. I also retain the right to use in future works (such as articles or books) all or part of this thesis or dissertation. 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Date .............................................................................. 3 ABSTRACT This thesis documents the development of the Chinese government’s response to HIV/AIDS in the context of the global AIDS regime in order to assess when, how and to what extent international AIDS norms have had an impact upon China’s governance of AIDS. Employing an applied constructivist framework, the thesis argues that the impact of global norms at the domestic level has been contingent on a) the socializing actions of norm entrepreneurs, b) the domestic political context and c) crisis. In the case of China and the impact of global AIDS norms, the central argument is that key elements of China’s domestic political context minimized the socializing affects of the global AIDS regime until the SARS crisis in 2003 led to a reappraisal of AIDS in the context of political legitimacy, at which time global AIDS norms began to have increasing salience in China. This thesis begins by identifying the evolution of a global AIDS regime before moving on to an exploration of China’s domestic political context. The thesis then documents and analyses China’s governance of AIDS from 1985 to 2007 through the use of five indicators – political commitment, legislation and policy, representation of AIDS in the media, the participation of civil society, and international engagement. The findings demonstrate that there has been a significant change between China’s pre-SARS and post-SARS AIDS governance with China acting increasingly in accordance with global norms following the SARS crisis of 2003. The thesis proposes that the SARS crisis was catalytic in that it exposed the vulnerability of the Chinese government’s claims to legitimacy, and in so doing, enabled the domestic political context to shift, allowing health, and by extension AIDS, to be reframed as a political issue. Importantly however, when the Chinese government scaled up its response to the epidemic it was able to be guided by the normative framework prescribed by the global AIDS regime. 4 ACKNOWLEDGMENTS The road to completing the PhD thesis is long and sometimes arduous. I could not have done this without my many friends and colleagues. There are too many of you to list individually, but to all of you who read drafts, came to seminars, listened to me vent and celebrated finished chapters over dinner and the occasional bottle of wine, I am very grateful. I am especially thankful of my two supervisors, Dr. Elizabeth Thurbon and Prof. Marc Williams, for sharing their time and knowledge and for the constant reassurance that the research project was viable and valuable. Special thanks to Marc in particular for the daily catch-ups and readings of drafts in the last months - I don’t know what I would have done without you. To my wonderful family, I am so appreciative of the love and guidance you have provided me over all these years. I know you wondered if I would ever get it done but you never wavered in your support. To my mum and dad, thank you for helping me get to where I am today. Lastly and most importantly, my deepest love and thanks to my infinitely patient and understanding partner, Ben, without whom I would have long given up. Thank you for enduring my stress, cooking me dinners, walking our dog, listening to my ideas and fears, telling me that it was ok to have a break and always believing in me. I dedicate this thesis to you. 5 TABLE OF CONTENTS ORIGINALITY STATEMENT.................................................................................2 COPYRIGHT AND AUTHENTICITY STATEMENTS ........................................3 ABSTRACT.................................................................................................................4 ACKNOWLEDGEMENT..........................................................................................5 TABLE OF CONTENTS............................................................................................6 LIST OF ACRONYMS AND ABBREVIATION .....................................................9 NOTE ON CHINESE TERMS.................................................................................14 CHAPTER I – INTRODUCTION: CHINA, AIDS AND GLOBAL NORMS .....................................................................................................................15 1.0 INTRODUCTION ..........................................................................................15 1.1 AIDS IN CHINA..........................................................................................16 1.1.1 SCALE AND CHARACTERISTICS............................................................16 1.1.2 MAJOR ACTORS IN DOMESTIC SETTING ..............................................19 1.1.3 LINKS TO WIDER REGIME...................................................................21 1.2 CENTRAL QUESTIONS AND AIMS …………………………………………22 1.3 CONTRIBUTIONS OF THE THESIS ………………………………………….23 1.3.1 HIV/AIDS GOVERNANCE ..................................................................23 1.3.2 CHINA’S REGIME COMPLIANCE..........................................................25 1.3.3 THE IMPACT OF GLOBAL NORMS........................................................26 1.4 RESEARCH STRATEGIES .............................................................................27 1.4.1 CONSTRUCTIVISM IN INTERNATIONAL RELATIONS ...............................27 1.4.2 APPLIED CONSTRUCTIVISM – A CONCEPTUAL FRAMEWORK ...............33 1.4.2.1 NORM ENTREPRENEURS ...........................................................35 1.4.2.2 DOMESTIC POLITICAL CONTEXT...............................................39 1.4.2.3 CRISIS AND UNCERTAINTY .......................................................43 1.4.3 METHODS .........................................................................................45 1.5 BOUNDARIES AND RESEARCH CHALLENGES ……………………………..47 1.6 STRUCTURE OF THE THESIS ........................................................................48 CHAPTER 2 – THE GLOBAL AIDS REGIME ....................................................50 6 2.0 INTRODUCTION ..........................................................................................50 2.1 THE GLOBAL AIDS REGIME – DEFINITIONS AND KEY FEATURES..............53 2.2 THE PRE-REGIME PERIOD 1981-1986 ........................................................55 2.3 REGIME EMERGENCE 1987-1995 ...............................................................59 2.3.1 NORM EMERGENCE THROUGH GRASSROOTS ACTIVISM.......................60 2.3.2 NORM EMERGENCE AT THE INTERGOVERNMENTAL LEVEL...................67 2.4 REGIME CONSOLIDATION 1996-2007.........................................................75 2.4.1 CONSOLIDATION THROUGH AGENCY AND GEOGRAPHICAL EXPANSION..................................................................................76 2.4.2 CONSOLIDATION THROUGH ISSUE-LINKAGE AND ENSUING ORGANIZATIONAL PROLIFERATION ..............................................84