The Politics of Development and the Politics of Health
This article takes an AIDS prevention program in Nepal as a case study for reflection on the intersection between international social welfare agendas and local politics of development. It examines how a progressive model emphasizing social conditions that foster HIV infection was transformed, in practice, as it was implemented by non-governmental organizations through the familiar rationalities of the Nepali development apparatus. Far from challenging the power relations that perpetuate patterns of ill-health, the response to AIDS that emerged from NGO practices further stigmatized marginal groups, especially low-caste and ethnic minority sex workers, by targeting them as people who “need” AIDS prevention interventions. To understand how and why this occurred, it is necessary to look at the development practices of NGOs within the political context in which they operate. Analyses of social responses to AIDS in countries of the South must take into account the ways local politics of development infuse even the most progressive AIDS prevention strategies.