Republic of Therapy

Vinh-Kim Nguyen is Associate Professor of Social and Preventive Medicine in the School of Public Health at the University of Montreal.

“Neither activist, nor politician, nor patient, nor pharmaceutical provider, Nguyen brings a more objective perspective to the AIDS crisis, even as he gives a first- hand account and conveys his close relationships with HIV-positive patients. A telling and provocative study of AIDS treatment in Africa, The Republic of Therapy offers no prospective solutions, but highlights the complexities and power dynamics inherent in the process of intervention.” - Sarah Fletcher, Montreal Review of Books “[A] book that can and will be read by audiences far beyond the domain of medical anthropology. The resultant volume captures the evanescent history of a slowly developing crisis within the rapidly changing landscape of postcolonial health in sub-Saharan Africa. In this unsparing and clear-eyed account, Nguyen admirably sets forth the difficult but necessary task for contemporary social scientists in the critique of global health practices.” - Jeremy A. Greene, Journal of the History of Medicine and Allied Sciences “[P]ath-breaking. . . . Nguyen’s strengths as an ethnographer are his capacity to move among different organizations and institutions, his sensitivity to the roles he plays in these contexts, and his long-term engagement with local activists and other informants, and he parries these strengths into a nuanced account of the urban politics of triage and HIV in West Africa.” - Betsey Brada, Somatosphere “This work is notable not only for the quality of its craft but also the degree to which it lends a personal face to political and economic crisis.... Written in lucid, largely understated prose and drawing on the author’s long experience as both physician and anthropologist, the result is sure to provoke discussion and reaction well beyond the discipline.” - Peter Redfield, American Anthropologist “The activist, physician, and anthropologist Vinh-Kim Nguyen has written an engaged, rigorous, and compelling account of the years when, in West Africa, AIDS treatment started to become available and persons living with HIV began to organize. With insight and sympathy, he explores how new political forms were thus invented in CÔte d’Ivoire and Burkina Faso, combining therapeutic sovereignty and health democracy, triage of patients and empowerment of communities, confessions and accusations.”-Didier Fassin, author of When Bodies Remember: Experiences and Politics of AIDS in South Africa “[A] book that can and will be read by audiences far beyond the domain of medical anthropology. The resultant volume captures the evanescent history of a slowly developing crisis within the rapidly changing landscape of postcolonial health in sub-Saharan Africa. In this unsparing and clear-eyed account, Nguyen admirably sets forth the difficult but necessary task for contemporary social scientists in the critique of global health practices.” - Jeremy A. Greene (Journal of the History of Medicine and Allied Sciences) “[P]ath-breaking. . . . Nguyen’s strengths as an ethnographer are his capacity to move among different organizations and institutions, his sensitivity to the roles he plays in these contexts, and his long-term engagement with local activists and other informants, and he parries these strengths into a nuanced account of the urban politics of triage and HIV in West Africa.” - Betsey Brada (Somatosphere) “Neither activist, nor politician, nor patient, nor pharmaceutical provider, Nguyen brings a more objective perspective to the AIDS crisis, even as he gives a first- hand account and conveys his close relationships with HIV-positive patients. A telling and provocative study of AIDS treatment in Africa, The Republic of Therapy offers no prospective solutions, but highlights the complexities and power dynamics inherent in the process of intervention.” - Sarah Fletcher (Montreal Review of Books) “This work is notable not only for the quality of its craft but also the degree to which it lends a personal face to political and economic crisis.... Written in lucid, largely understated prose and drawing on the author’s long experience as both physician and anthropologist, the result is sure to provoke discussion and reaction well beyond the discipline.” - Peter Redfield (American Anthropologist)

• Acknowledgments ixIntroduction: Côte-d'Ivoire and Triage in the Time of AIDS 11. Testimonials That Bind: Organizing Communities with HIV 152. Confessional Technologies: Conjuring the Self 353. Soldiers of God: Together and Apart 614. Life Itself: Triage and Therapeutic Citizenship 895. Biopower: Fevers, Tribes, and Bulldozers 1116. The Crisis: Economies, Warriors, and the Erosion of Sovereignty 1377. Uses and Pleasures: The Republic Inside Out 157Conclusion: Who Lives? Who Dies? 175Notes 189References 205Index 229