Accepted paper:

Risk and responsibility in the era of global health: public health interventions and HIV-discordant couples in rural Ethiopia

Authors:

Makoto Nishi (Kyoto University)

Paper short abstract:

This paper addresses the complex realities of HIV-discordant couples living in Ethiopia. It identifies three realms of realities these couples face: epidemiological reality, reality of the locality, and reality of relatedness. Each realm involves a certain set of knowledge and ethics.

Paper long abstract:

Controlling the disease of the poor has become one of the central issues of global governance. Infectious disease epidemiology provides the fundamental knowledge underlying efforts of public health interventions to contain the spread of intractable viruses. Epidemiologists and public health experts are increasingly confident that they are developing efficient and inclusive mechanisms to control the global epidemic of HIV infection. What is less clear is how individuals living with HIV can maintain or develop affirmative relationships with the others and comprehend their lives as consistent and meaningful ones. This paper addresses the complex realities of HIV-discordant couples living in rural Ethiopia. The experiences of these couples are often complicated because each individual faces questions simultaneously as a rational self, a moral person, and a lived body. This article identifies three realms of realities these couples face: epidemiological reality, reality of the locality, and reality of relatedness. Each realm involves a certain set of knowledge and notions of responsibility to others. Such responsibilities are indispensable to secure the continuity of certain realities, namely the health of the population and the reproduction of the locality. Yet these realities are hard to live with for a discordant couple whose relationship involves persistent health risk and moral questions. What makes the experiences of these couples more complicated are the ways in which the individuals' lives are interrelated, which often cannot be understood by referring to any existing category of morality or justice.

panel P062
Biomedicine in Africa: changes in knowledge, practice, and sociality