BETWEEN BEDROOMS AND BALLOTS: THE POLITICS OF HIV'S ...

process (which utilizes rhetoric about ‘human rights’) mean there is now less autonomy between
the state and civil society than what we’ve seen in the past in African countries. In short,
HIV/AIDS has propelled some individuals to move from subjects to citizens, voice demands on
formal and/or informal institutions, and shift boundaries by pulling this disease from the private
into the public realm.
Location, Location, Location
Having worked on HIV/AIDS in a number of African countries, I chose Mozambique as
the case study for several reasons. First, its role as a major international aid recipient allows for
an examination into the gaps between assumptions and arguments of the international donor
community, on the one hand, and those of local Mozambicans, whether they are volunteers or
not, on the other. Donor health programs are often conceptualized by elites outside of the
country who do not fully understand the nuances of local systems and accountability is external
rather than internal to the communities themselves. What the community wants and what it
receives are often two very different things.
Second, the lack of infrastructure makes it difficult if not impossible for the more than
200,000 Mozambicans who need ARVs but don’t have access to them; the lack of adequate food
and medical resources and the long distances to water sources equate to poor health. Even in
countries with a privatized system, high employment and the ability to access resources, health
care is a salient political issue (particularly evidenced by the 2008 presidential campaigns in the
United States). In a country with an incomplete national public health care system, low
incentives for doctors and nurses, millions of unemployed and impoverished, difficulties with
transportation, and the prevalence of untrained curandeiros (traditional healers) with poor
medical information, it is not surprising that a sexually transmitted disease that kills constitutes
nothing short of a disaster. Add on top of this a poverty that is so insidious that 15 years after the
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