HIV/AIDS, globalisation, and the international women's movement

Sisonke Msimang

HIV/AIDS and globalisation

Globalisation has been described as 'the drive towards an economic system dominated by supranational trade and banking institutions that are not accountable to democratic processes or national governments' (Globalisation Guide, www.globalisationguide.org /01.html). It is characterised by an increase in cross-border economic, social, and technological exchange under conditions of (extreme) capitalism. As human bodies move across borders in search of new economic and educational opportunities, or in search of lives free from political conflict and violence, they bring with them dreams and aspirations. Sometimes, they carry the virus that causes AIDS, and often, they meet the virus at their destinations.

As corporations increasingly patrol the planet, looking for new markets, and natural and human resources to exploit, they set up and abandon economic infrastructure – opening and closing factories, establishing hostels. In so doing, they create peripheral communities hoping to benefit from employment and the presence of new populations where previously there were none. And when they move on, once they have found a cheaper place to go, they leave in their wake communities that are extremely susceptible to HIV/AIDS.

This is because the virus follows vulnerability, crosses borders with ease, and finds itself at home where there is conflict, hunger, and poverty. The virus is particularly comfortable where wealth and poverty co-exist – it thrives on inequality. It is not surprising, then, that Southern Africa provides an excellent case study of the collusion between globalising processes and HIV/AIDS.

The economy of the region has been defined in the last two centuries by mining: gold and diamonds. In an era of plummeting gold prices, and an increasing shift towards the service industry, Southern Africa is shedding thousands of jobs. Yet the last century of globalisation has provided a solid platform for the current AIDS crisis.

If there was a recipe for creating an AIDS epidemic in Southern Africa, it would read as follows: 'Steal some land and subjugate its people. Take some men from rural areas and put them in hostels far away from home, in different countries if need be. Build excellent roads. Ensure that the communities surrounding the men are impoverished so that a ring of sex workers develops around each mining town. Add HIV. Now take some miners and send them home for holidays to their rural, uninfected wives. Add a few girlfriends in communities along the road home.

Add liberal amounts of patriarchy, both home-grown and of the colonial variety. Ensure that women have no right to determine the conditions under which sex will take place. Make sure that they have no access to credit, education, or any of the measures that would give them options to leave unhappy unions, or dream of lives in which men are not the centre of their activities. Shake well and watch an epidemic explode.'

There's an optional part of the recipe, which adds an extra spice to the pot: African countries on average spend four times more on debt servicing than they do on health. Throw in a bit of World Bank propaganda, some loans from the IMF, and beat well. Voilà. We have icing on the cake.

As the gap between the rich countries of the North and the poor countries of the South grows, we are beginning to see serious differences in the ways that states can afford to take care of their citizens. Access to technology, drugs, and strong social safety nets in the North, mean that HIV/AIDS is a manageable chronic illness in most developed countries. Yet there are pockets of poor, immigrant, gay, and otherwise marginalised communities within these countries, where HIV prevalence is on the rise. An analysis of the complex intersections between inequalities tells us that it is not enough to belong to a rich country – that alone does not protect you from vulnerability to HIV infection, nor does it guarantee treatment. Where you sit in relation to the state is equally important – whether you are a woman, a poor woman, a black woman, an educated woman, a lesbian, a woman with a disability who is assumed not to be having sex, an immigrant who is not entitled to many of the social security benefits of citizens. All these factors determine your vulnerability to HIV/AIDS.

Now what does this mean for a 25-year-old woman living in Soweto? Jabu works as a security guard at a shopping centre in Johannesburg. Every day she spends two hours travelling to work because of the distances the architects of apartheid set up between city centres and the townships that serviced them. Jabu is grateful to have a job. Her two little ones are in KwaZulu Natal with their grandmother until Jabu can get a stable job. She is on a month-to-month contract with the security company. She watches expensive cars all day, protecting their owners' investments while they work. The company doesn't want to take her on as staff so each month she faces the uncertainty of not having a job the next month. Joining a union is not an option – she's not technically a staff member and she can't afford to make trouble. Jabu's boyfriend Thabo drives a taxi. Their relationship saves her cash because he drives her to and from work every day – a saving of almost one-third of her salary each month. She has another boyfriend at work, who often buys her lunch. She has to be careful that Thabo doesn't find out.

In addition to race, class, and gender, Jabu's life is fundamentally shaped by the forces of globalisation – where she works and how secure that work is,...