“A Test of Governance”: rights-based struggles and the politics of HIV/AIDS policy in South Africa

Abstract

Abstract Debates concerning democratisation and development increasingly engage with what are termed as ‘human rights-based approaches’. As such, whilst critical accounts are correct in cautioning against Rights-Based Development (RBD) in an era of rampant neo-liberalism and donor-driven agendas, the paper proposes that not only are more progressive and political readings of RBD necessary, they already exist ‘on the ground’. The dramatic u-turn in the South African government's policy concerning HIV/AIDS treatment, for example, is, arguably, situated at the confluence of rights-inspired struggles and the politics of governance. The policy shift therefore provides an opportunity to assess how rights-based approaches to development (RBD) can, under specific conditions, widen critical ‘political space’ and enable more inclusive governance. The key issues posed in the paper are, first, how the South African government's HIV/AIDS policy can only be properly understood when placed in the context of the broader rhythms of post-apartheid transition and discursive fault-lines underpinning understandings of the epidemic. Second, as embodied through the Treatment Action Campaign – a social movement in South Africa – the paper seeks to explore how human rights principles deployed in a context of social mobilisation and people-driven access to institutional channels, have the potential to impact upon policy-making. Third, setting out the guiding principles of one particular right, the right to health, allows better understanding of RBD more generally. Finally, and by way of conclusion, RBD's contribution to widening inclusive political space does not have to end at policy-making but can also impact upon rights-based approaches to service delivery. Above all, this case study offers more general theoretical and practical lessons for conceptualizing both RBD and the role of alternative social actors and movements in this.