Rethinking global health governance: South African biotechnology initiatives and civil society networks buildingresilience against AIDS epidemics

Upton, Mary (2011). Rethinking global health governance: South African biotechnology initiatives and civil society networks buildingresilience against AIDS epidemics. In: EADI-DSA 2011 Conference, 19-22 Sep 2011, University of York, UK.

URL: http://eadi.org/gc2011/upton-372.pdf

Abstract

South Africa remains at the epicentre of the HIV and AIDS epidemics with its far-reaching impact on socio-economic and political development. New strategies in health biotechnology aim to develop multi-level health governance equipped to rise to such challenges, but there has been limited attention to the social and political aspects of these innovations. A multi-level approach to health governance attends to both the institutional structures and the opportunities and constraints on health access for the intended beneficiaries. This paper focuses on: i) the role of biotechnology innovations in global health governance and; ii) the voices of marginalised and vulnerable people in bringing their concerns to enhance health governance. New voices and alliances offer insight into the complex power relationships and disconnections between global and national health governance and local health agency. Qualitative data on community engagement in two South African HIV vaccine clinical trial sites reveal the political and social and complexities of HIV and AIDS, where interlinked political controversy and social norms have influenced health activism. Community engagement in trial site activities is fraught with difficulties which limit capabilities for communities to play meaningful political roles. However, some are using HIV prevention and vaccine science information to aid decision-making over health and to develop health agency through knowledge exchange across South African civil society networks involved in national and global health governance. In doing so, they are increasing the potential to respond to issues of representation and accountability on behalf of those whose health resources are limited and whose variable and specific health needs contribute to more inclusive health governance. That knowledge contributes to building resilience against HIV and AIDS epidemics and other health interlinked health and development challenges.

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