Title: Cure interrupted: Life and values during the HIV epidemic in Ethiopia

Abstract

This presentation examines how the pharmaceutical-driven model of public health has altered forms of HIV care in Ethiopia during the past decade. First, it examines how the efforts to “cure” the lives of some people affected by HIV have been marginalized through the process that some medical anthropologists referred to as the exercise of “triage.” Second, it considers how the process was facilitated by narrowly defined concepts of life and value in mainstream global health discussions by comparing them with the anthropological theory of values. In my ethnographic research in a provincial town in Ethiopia, I examined how the expansion of the antiretroviral treatment program interplayed with local actions through which suffering inflicted by the epidemic was cared for.1 Local health institutions served the town’s population by disseminating antiretrovirals free of charge. However, they referred patients whose problems were too complicated to be solved by the drugs to a local association of people with HIV. I regarded this as an exercise in “triage” because the association was systematically deprived of the resources required to address its members’ needs. Pharmaceutical agents are valuable because of their power to improve life. However, what it means to “make life better” needs clarification. Medical anthropological theory assumes that for all living entities, value arises from life, meaning the value is always embodied.2 The embodied value enhances life to become more relevant to its social and biological environments. However, healthcare theories and practices that do not entertain embodied values fall short of “curing” the lives of persons.