Research

 

You will find a complete range of our monographs, muti-authored and edited works including peer-reviewed, original scholarly research across the social sciences and aligned disciplines. We publish long and short form research and you can browse the complete Bristol University Press and Policy Press archive of over 1,500 titles.

Policy Press also publishes policy reviews and polemic work which aim to challenge policy and practice in certain fields. These books have a practitioner in mind and are practical, accessible in style, as well as being academically sound and referenced.
 

Books: Research

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This chapter introduces the conceptual framework of the book, followed by a short summary of each of the three main countries discussed in the book and the methods that were used in conducting primary and secondary research across these countries. The first section, on concepts, traces the theoretical trajectory from biopower to the politics of life linked to recent technological advances and their implications for governance. Thereafter, the chapter critiques this trajectory in light of two sets of literature that engage specifically with the two dimensions of the research focus – the embodiment and politics of HIV medicine. It proposes that feminist new materialism, science studies and anthropological theory around actor networks and assemblages might enable an integration of these sets of literature. Following the introduction of key concepts pertinent to the book, the second section locates the relevance of these concepts by providing contextual background to South Africa, Brazil and India. The chapter then turns to an outline of the research methods – both primary and secondary – that were used in each country. The methods include participant observation, ethnography, participatory photography and film, key informant interviews and policy analysis.

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The final chapter draws the findings of the five substantive chapters together and considers the implications of the shifting political landscape in which this multi-sited ethnography was located. In doing so, it explores the limits of agency for both governments and individuals to exert autonomy over their vitality within a global assemblage that draws actors that shape life under the skin – like HIV and antiretrovirals (ARVs) – into a network with actors – like South Africa, India, Brazil, the EU and the World Trade Organization – that govern the development and distribution of essential HIV medicines. In considering these implications, the conclusion reflects on the value of two overarching contributions of the book in researching the intersection between women’s embodied experience of medicine and their political engagement with the state. First, the concept of diffracted biosocialities reflects emergent biopolitical struggles that fan out from a narrow focus on illness to include and integrate struggles that happen ‘inside’ the body (linked to HIV and ARVs) with the context ‘outside’ the body (linked to violence, unemployment, sanitation). Second, the related concept of biopolitical precarity shows the entwined relationship between the state of the body and the body of the state and highlights the value of locating this historical biopolitical relationship in a global terrain.

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Chapter 3 is the first of this book’s five substantive chapters. This chapter zooms into the intimate worlds of women living in Khayelitsha, South Africa. Based on fine-grained ethnographic research, it brings to light the nuanced struggles that women encounter in their sexual, social and economic worlds. These struggles are articulated, too, in relation to the history of South Africa’s failure to provide essential medicines and the subsequent increase in vertical transmission of HIV from parents to their children through birth and breastfeeding. This has had lasting implications for the women in this study, and for their children, and these implications are detailed in the first section of this chapter. The second section, on ‘horizontal pathways’, looks at the evolution of sexual and reproductive rights and women’s experiences of gender-based violence in South Africa. The final section of the chapter explores women’s strategic negotiation of these forms of harm and underlines the value of thinking more critically around the ways in which women act strategically to navigate their lives in highly complex and often violent contexts.

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Chapter 7 moves further out in scale to articulate some of the regional axes of power, linking Brazil, India and South Africa, that have challenged global forms of governance that limit access to essential HIV medicines. The first section of this chapter extends the discussion on patent regulations introduced in Chapters 1 and 2, with a detailed focus on the politics surrounding the World Trade Organization’s early role in governing access to essential HIV medicine through the Trade-Related Aspects of Intellectual Property Rights Agreement. It then turns to consider some of the ‘patent wars’ that were waged by countries like South Africa, Brazil and India. And it explores the crucial role played by India in reverse engineering HIV medicines that would otherwise have been inaccessible to most governments in the Global South due to their pricing (protected by patents) in the Global North.

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Chapter 5 traces changing citizenship practices as they are embodied by HIV-positive women in South Africa, and as they coalesce around emergent political concerns that fan out from the historic assertion of the right to life linked to HIV medicine. The chapter explores multiple dimensions of South African citizens’ imaginaries as they ‘saw’ and ‘spoke’ to the state; these imaginaries reflect on and develop the set of ‘new generation struggles’ that are detailed in the previous chapter and that, I argue, reflect South Africa’s shifting medical and political landscapes in the wake of the antiretroviral rollout.

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Embodied Democracy in the Global South
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This book centres on women living with HIV in South Africa who have navigated affective relationships, activist networks, government institutions and global coalitions to transform health policies that govern access to HIV medicines. Drawing on 20 years of ethnographic and policy research in South Africa, Brazil and India, it highlights the value of understanding the embodied and political dimensions of health policy and reveals the networked threads that weave women’s precarity into the governance of technologies and the technologies of governance. It illuminates the entwined histories of health policy evolution, systemic inequality and everyday life and calls for a recognition of the embodied ramifications of democratic politics and global health governance.

By integrating medical anthropology with science studies and political theory, this book traces the history of the struggle to access HIV medicines in the Global South and brings it into the present by articulating the lessons learned by activists and policy makers engaged in shaping these vital health policies.

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Chapter 4 traces a set of ‘new generation struggles’ that have emerged following the large-scale provision of HIV medicines through South Africa’s public health system. Just as HIV precipitated forms of embodied vulnerability when medicines were not readily available, so too have HIV medicines generated new forms of embodied vulnerability, including side effects, treatment fatigue and viral resistance. These struggles are less frequently discussed or considered when looking at the history of the struggle for HIV medicines, but they are increasingly important as they often lead to poor treatment adherence and sometimes death. The economic context in which people navigate their treatment regimens has also been shown to affect whether or not people are able to adhere to their medicines: some medicines need to be kept refrigerated, and without money for electricity or access to electricity, this renders medicines ineffective. These linked struggles, around the embodiment of HIV medicines and the socio-economic context in which these medicines are taken, are foregrounded through ethnographic accounts drawn from my own research in South Africa and also from current research elsewhere in Africa, Latin America and South East Asia.

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With the provision of HIV medicine in South Africa, emergent concerns around access to newer medical technologies that have fewer side effects call a set of global actors into focus. These actors include Brazilian activists who have a long history of mobilizing the government for access to emerging medical technologies. Chapter 6 draws South Africa’s and Brazil’s history of activism into dialogue, debunking the notion that Brazil can be solely understood as an ‘activist state’ and exploring some of the current challenges facing people living with HIV in both countries.

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The Ethiopian strand of our cross-national research took place in Tigray during a devastating civil conflict. This supplementary chapter draws on testimonies and artefacts shared by teachers as part of fieldwork in 2021, and reports on their experiences of trauma, displacement, the destruction of lives and schools, and the implications for the teaching profession in the years ahead.

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This chapter provides a rationale for viewing teacher professionalism in the global South in its wider sociocultural and economic context, with due attention to the colonial experience and ongoing condition of ‘coloniality’ which continues to shape education. In the global education policy space, dominant models of teacher professionalism are grounded in the assumptions and agendas of Northern actors and institutions. It is argued that understandings of teacher professionalism should be grounded in the perspectives, experiences and conditions of teachers in low- and middle-income countries in the global South. The chapter introduces Ndlovu-Gatsheni’s understanding of ‘coloniality’, which will be used to frame the analysis and arguments in later chapters.

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