Public policy and AIDS in Africa: building an interdisciplinary’, empirical, and theoretical contribution to public policy analysis

Along with a multidisciplinary team mostly trained in anthropology and political science, I suggested questioning some of the notions and theories of public policy in light of the fight against AIDS in Africa. Our aim was to draw on the experience of researchers from both fields to examine an area of intervention that represented one of the major political challenges for both international relations and contemporary Africa. The project’s two main concerns, theoretical and empirical, led to a series of important questions. Why has political science research on Africa, both French and American, barely addressed public policy? Knowing that anthropology is the social science that has made the most significant contribution to understanding AIDS in Africa, what might it contribute if placed in dialogue with political science? Which public policy concepts and approaches can be reformulated or even enriched by analysing the fight against AIDS in Africa? At an empirical level, why is the case of Cameroon a relevant example for our topic of study? Why does policy analysis teach us about politics?

To address these questions has required revisiting the initial anthropological studies on AIDS in Africa, so as to identify what political science can contribute to the AIDS research field. I thus created a new framework by bringing the more conventional concepts and thinking of political science, at least as they are used in the analysis of public policy, to those landmark studies.

Rather than enforcing the interests of political science as a corporation, I reconstructed the process by which anthropological research and the critiques it had addressed to the biomedical sciences had become incorporated into a history that reveals as much about the evolution of an epidemic as about the epistemology of the social sciences in research on sub-Saharan Africa. The published and unpublished work of French anthropologists like Laurent Vidal (1996, 2000), Didier Fassin (1996,1999. 2002a, 2002b), Jean-Pierre Dozon (Dozon and Fassin, 1989; 2001), Marc-Eric Gruénais (1999, 2001b) and many others have inspired this effort. I have drawn on their work to help me articulate the need for a new building block for the edifice of “AIDS anthropology”, moulded from the novel perspective of political science.

The AIDS field has undoubtedly been most radically challenged by classic anthropology. In this book, I elucidate this by confronting Laurent Vidal’s research (1996, 2000), in which he moves from the analysis of patient trajectories to a more general anthropology (1996, 2000), with political science studies of policy that did not inform Vidal’s work.

From a heuristic point of view, AIDS research is becoming a prism through which it is possible to understand the essential modalities of public policy implementation in sub-Saharan Africa. What one researcher has observed for Central African countries can be generalised to other African countries:

What is at stake is how the transformations and tensions currently affecting Central African countries in “transition” are understood. That understanding touches on new paradigms of public action and new mechanisms of citizenship at the intersection of the new ways in which those societies conceive of their relationship to the world.

(Enguéléguélé, 2002, p. 249)

In this light, the example of Cameroon can serve as an empirical reservoir for international debates and case studies. These have allowed me to reflect on 20 years of social science progress in AIDS research in Africa, while emphasising the novel contribution of political science (Eboko, 2005a, 2005b).

Public policies in Africa: multidisciplinary sequences

Public policy analysis (PPA) draws mainly from political science. PPA gradually migrated from the United States, its birthplace, to Europe, and particularly to France, where it became a key sub-field from the 1980s onwards. Its choice sites

International policy response in Africa 19 for empirical study were mostly Western countries, where most of its research was ultimately conducted. As for the themes social scientists explored in Africa, they were limited, albeit indirectly, by the policies of international institutions, transmitted by programmes and projects aimed at improving the standard of living of "populations”. Researchers working in Africa nevertheless elaborated their own epistemological and heuristic proposals in response to the issues arising from the implementation of so-called development projects. Their epistemological framework took into account the social, economic, and cultural stakes generated when international policies intersected with the local dynamics these researchers had already been studying.

From the 1990s on, Africanist political science prioritised phenomena related to the construction of the newly independent States. As Darbon (2008) notes,

Whether because of their tradition or historical heritage, “Africanists” have hardly been concerned with the sociological analysis of administrations, organisations and institutions or with the study of sectorial decision-making processes and procedures. Some exceptions can be found among Anglophone academics [...]. For the most part, however, these approaches have remained “peripheral” and strongly rooted in the consulting field and the development of intervention models. As a result, these academics tend to be marginalised in intellectual debates. They tend to show up in management and public administration journals and areas, rather than in the more "legitimate” domain of policy analysis in Africa.