Ancestors and Antiretrovirals: The Biopolitics of HIV/AIDS in Post-Apartheid South Africa

Ancestors and Antiretrovirals: The Biopolitics of HIV/AIDS in Post-Apartheid South Africa. By Claire Laurier Decoteau. Chicago: University of Chicago Press, 2013. Pp. xvi, 324; bibliography, index, 25 b/w photographs. $32.50/£23.00 paper.In Ancestors and Antiretrovirals, sociologist Claire Decoteau examines the biopolitics of HIV/AIDS in the two decades since South Africa's first nonracial democratic election. Despite throwing off the onerous strictures of apartheid, the promise of "a better life for all" remains unrealized for many poor South Africans. In the two Johannesburg-area squatter camps that ground this study, residents' expectations and experiences of liberation collide beneath the overlapping afflictions of poverty and AIDS.Decoteau argues that a "postcolonial paradox" confronts the South African state. She describes this challenge as "the need to respect the demands of neoliberal capital" and global competiveness, while simultaneously shouldering "the responsibility to redress entrenched inequality, secure legitimacy from the poor, and forge a national imaginary" (p. 7). AIDS and healing have been primary sites in the battle to resolve this paradox. Decoteau demonstrates how presidents Thabo Mbeki and Jacob Zuma reinvented and deployed the colonial tropes of "tradition" and "modernity" as ideological tools to marshal legitimacy and exert political power.A series of symbolic struggles shape this book. Decoteau examines the "tricky political maneuvering required of leaders who must represent the interests of the people, while subscribing to the economic policies of global capital" (p. 14). She connects her analysis of policy and discourse with the experience of AIDS in Sol Plaatjie and Lawley, two squatter settlements where Decoteau conducted ethnographic, qualitative, and quantitative research between 2004 and 2009.Thabo Mbeki's denialist stance shaped AIDS policy from 1999 to 2007 andaccording to one study-resulted in more than 350,000 preventable deaths (pp. 81-83). Decoteau sees Mbeki's denialism as rooted in his commitment to independence, autonomy, and a vision of "African Renaissance" (p. 84). Mbeki attempted to resolve the postcolonial paradox and win political support by dismissing international public health's "modem" biomedical approach as racist, imperialist, and driven by pharmaceutical profit-seeking, while promoting "traditional" indigenous healing as an African alternative for an African disease. Decoteau characterizes the Mbeki government as "a thanatopolitical regime" unable or unwilling "to attend to the material realities of poverty and disease" (p. 106).The confrontation between the Treatment Action Campaign (TAC) and the denialist state reinforced what Decoteau terms the "myth of incommensurability"-the idea that "traditional" indigenous healing and "modern" biomedicine are irreconcilably incompatible. The TAC avowed that the scientific promise of "modem" biomedicine would save lives and address entrenched health inequality, while characterizing "traditional" indigenous healing as unscientific, an obstacle to antiretroviral uptake, and a risk for adverse drug interactions. …