Civil Society Reconfigured: Manag(erializ)ing AIDS in Uganda

Marcia Oliver and Stephen Tasson


Once hailed as part of a ‘new breed’ of African leaders, Ugandan President Yoweri Museveni has received much international praise and financial assistance for his early nation building and reform efforts in the aftermath of decades of misrule and political violence in the country. He has been praised for institutionalizing democratic reforms, initiating an effective national HIV/AIDS response, and implementing more ‘inclusive’ liberal reforms emphasizing, in part, ‘good governance’, institution-building, and participatory development initiatives (Craig and Porter 2006). However, recent evidence suggests a significant reversal of the nation’s

M. Oliver (*)

Law and Society, Wilfrid Laurier University, Brantford, ON, Canada S. Tasson

Department of Law and Legal Studies, Carleton University,

Ottawa, ON, Canada © The Author(s) 2017

F. Kurasawa (ed.), Interrogating the Social,

DOI 10.1007/978-3-319-59948-9_6

previous successes combating the spread of HIV/AIDS (Ministry of Health 2006; Masaba 2012) and a growing discontent among international donors, with many Ugandans facing persistent problems of poverty, exclusion, and the consequences of the illiberal and authoritarian state practices of Museveni’s regime (such as economic mismanagement, high-level corruption, and the repression of civil society activity by legal and military means) (Oloka-Onyango 2004; Tripp 2010).

This chapter addresses some of the seemingly contradictory results of Uganda’s development in the last few decades by focusing on the country’s response to HIV/AIDS. In line with the critical sociology elaborated by Kurasawa in the introduction to this volume, we purposefully shift our emphasis from the effects of idiosyncratic political leadership and examine more proximate shifts in structural architecture of development, as such shifts manifest themselves in Uganda’s response to HIV/AIDS today. Specifically, we address the institutionalization of new governance structures and strategies—based on the logics of New Public Management (NPM) and aid effectiveness, as well as their implications for civil society participation, autonomy, and accountability in responding to HIV/ AIDS in Uganda. Both NPM and aid effectiveness are discourses and sets of practices with a global reach and are at the core of development’s ‘good governance’ agenda. Where NPM was designed to transform the public sector through a set of market-based managerial reforms, the principles of aid effectiveness were designed to reflect more ‘inclusive’ discourses of development, such as country ‘ownership’, ‘participation’, and ‘donor harmonization’ with recipient priorities and institutions. The widespread embrace of the ‘good governance agenda’ in development has been accompanied by a range of governing strategies—what we identify as market-based managerialism and ownership strategies—that are used by international donors and national governments to disburse and manage HIV/AIDS financing to civil society ‘partners’. The increasing use of these strategies by donor and recipient countries over the last two decades has posed particular challenges for civil society groups—some- thing that contributors to critical development literature have noted in other settings (Kirby 2004; Cornish et ah 2012; Ebrahim 2003; Foller et al. 2013). Using the US President’s Emergency Plan for AIDS Relief (PEPFAR) and Uganda’s Civil Society Fund (CSF) as case studies, we explore how these governing strategies manifest themselves and practically reconfigure local contexts, give rise to new ways of managing and regulating civil society actors and relations, and potentially produce new challenges for civil society organizations—especially for those ‘lacking’ the technical and professional competences required by today’s donors and for those engaged in HIV/AIDS advocacy work for stigmatized and marginalized populations in the country.

As noted above, like other chapters in this book, our analysis is part of a critical sociology that seeks to provide an analytical-minded critique of established social orders. To this end, our chapter sets out to denaturalize and problematize taken-for-granted truths about development today, specifically by exploring how relations of power operate through regimes of governance, professionalized modes of knowledge, and processes that often impede collective action, participatory self-management, and autonomy in various and diverse ways. Following Kurasawa (this volume), our analysis works within critical sociology’s animating tensions to underscore the generative value of a more reflexive methodology and analysis. Specifically, our approach navigates between a more deterministic structuralism, on the one hand, and a voluntaristic ‘agentic determinism’, on the other, while simultaneously providing an account of contemporary HIV/AIDS governance in Uganda grounded in both analytical rigor and normative critique informed by structuralist and inter- pretivist frameworks.

Our analysis is, in part, based on historical and secondary research of Uganda’s AIDS response and a textual analysis of the following international and Ugandan government policy documents: the United States’ global AIDS policy, known as the President’s Emergency Plan for AIDS Relief (PEPFAR); Uganda’s national strategy frameworks for addressing HIV/ AIDS; Uganda’s legal frameworks concerning HIV/AIDS, sexual minorities, and civil society; and Uganda’s CSF (established 2007). We focus on PEPFAR’s initial authorization under US President George W. Bush, since it occupies a central structural position with the field, significantly shaping the development of HIV/AIDS policies, civil society projects, and governance strategies in the Global South (including in Uganda). Our interest in Uganda’s CSF stems from the emerging global value consensus on ‘aid effectiveness’ and the re-formulation of international funding modalities to disperse and reflexively manage aid to development ‘partners’. ‘Harmonizing’ and ‘aligning’ donor resources and civil society projects with national plans and policies were crucial justifications for establishing the Fund and crucial to its legitimacy as an effective, country- owned development initiative. The CSF exemplifies a global consensus on ‘good governance’, bringing together NPM’s emphasis on efficiency, competitive contractualism, and measurable results with emerging principles of aid effectiveness that stress—aside from results—country ownership, civil society participation, and donor alignment and harmonization with national development plans and priorities (see OECD 2005).

While more structurally informed approaches to ‘formal’ policy and legislation lend insight into the dominant discourses and forms of expertise that shape knowledge and concrete plans for development, they fall short of accounting for the diverse ways that abstract policy texts are translated into development practices and given meaning by development actors. Thus, our analysis is also informed by fieldwork that Oliver conducted in Uganda over an 11-week period between April 2008 and May 2011, which entailed a total of 43 semi-structured interviews with international development partners, government officials, and staff from international, national, and local civil society organizations working in the fields of HIV/AIDS and poverty-related programming. The aim of these interviews was to explore the complex ways in which situated actors, in the context of a constantly changing development architecture, interpret, negotiate, employ, and thus potentially stabilize new development imperatives, justifications, and goals. In what follows, we provide a historical and explanatory account of Uganda’s response to HIV/AIDS, while simultaneously questioning the emergence of new systems of exclusion and mechanisms of power comprising HIV/AIDS governance in Uganda today.

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