You wouldn’t have to go far to envision such a place. The phenomenon of globalization has turned this imagination into a reality and now all peoples are finding themselves included in this “imagined world”. There have been numerous attempts by authors, theorists, journalists, political activists and modernists to explain this new modern world system and the phenomenon of globalization.
Every explanation endeavors to grab a hold of the root of what the modern world system implies, how it came to be, and how one can decipher the many factors that make up such a complex idea and reality. Contemplating and analyzing these endeavors are important for explaining the world we live in and for understanding one of the most vicious diseases, or as Stephanie Nolen labels it, “unique and savage phenomenon in Africa.”
Acquired Immunodeficiency Syndrome has already claimed over twenty million lives alone and kills close to 5,500 people every single day in Africa. The disease has not only stolen people’s lives but their livelihood, friends, loved ones, dignity, and ultimate humanity, leaving little hope for some of the world’s poorest.
One can understand how the development of the AIDS epidemic is directly related to the nature of the modern world order. AIDS accentuates all that one knows about two important forces: capitalism and the complex entity of the nation-state. These forces are not the only ones that can be revealed when discussing AIDS but they are the ones discussed by Ellen Woods and James C. Scott and are powerfully persuasive in their ability to shape, and more specifically, to hasten the progress of the AIDS epidemic in Africa.
In her book The Origins of Capitalism, Ellen Wood defines the economic order of capitalism. Capitalism, she states, is a social form with a specific set of property relations generated by market compulsion with a certain set of market imperatives. These include labor productivity, competition, accumulation, profit maximization, and the commoditization of land.
One of the most prominent characteristics of the economic order is the act of exchange. Capitalism acts a trade vector, a means by which goods and peoples are constantly on the move. Woods argues that in 16th century South East England, capitalism emerged as a means of exchange that changed the property relations between the landowning class and the peasantry class.
After farm workers were no longer working the land of the English elite, due to a change in customary land laws, they migrated to the urban center of burgeoning London. Here they involved themselves in the marketplace of capitalism. Thus, a property less mass emerged, turning land into a commodity which created a market in leases.
Today, capitalism has commodified not only land but education and health care , adding to the difficulties facing many in the Third World. The commodification of education has made it difficult for those in Africa to achieve—or even access-- adequate education.
The complication of achieving an education has made it a struggle for youth of third world nations, like those in Africa, to rise above their impoverished circumstances and to fight the pandemic of AIDS. For example, in 28 Stories of AIDS in Africa, Nolen writes of two siblings in the impoverished country of Ethiopia, Tigists and Yohannes. Tigists, the older sister, must take care of her brother and plan for both their futures because AIDS killed their young mother.
Both children knew how important it was to receive an education and thus, when prompted by relatives to stay in the rural region of Africa, Tigists decided that “it was not in our interest to stay there---there is more education and more prospects in the city.”. An education is one of the only hopes available to those of the Third World in order to improve their circumstances, but with the commoditization of such a valuable entity, it isn’t always accessible or easily achieved.
As Nolen suggests, education in Ethiopia is free until the tenth grade but there is still the cost of development fees and uniform all accumulating to 360 Birr a year, a hefty fee for the two children. One could suggest that the commoditization or “pricing” of education causes the inability or extreme difficulty for children in Third World nations to become educated. They are unable to receive the only thing that might lift them out of their impoverished conditions.
Capitalism has also acted to commodify healthcare leading to a lack of proper medical funding in Africa. In fact the lack of such funding to fight AIDS is the very reason they are motherless. Without the ability to purchase or receive health care, Tigists and Johannes’s mother died of a disease that could have at least been treated. The two were left without a mother figure and to fend for themselves. Essentially, the commoditization of goods and resources that capitalism entails can cause deaths from AIDS and a challenge to attaining knowledge and medical attention for many in the Third world.
Capitalism is not the only force that has played into the progression of AIDS. The power of the state, and the lack thereof in Africa, also plays an influential role in the epidemic’s ability to ravage the Africa population. James C. Scott defines the state as “a vexed institution that is the ground of both our freedoms and our unfreedoms.”.
This “vexed” institution is supposed to help to administer such “commodities” as accessible education in Ethiopia, medical supplies in Zimbabwe, or better roads in Kenya. The modern state structure of many developed nations provides a means of distributing such essentials. As Scott argues in his book, Seeing Like a State, the modern nation-state, with its greater centralized system of order and legibility, developed out of necessity for power, the extraction of wealth, and for the benefits of its citizens.
However, Scott also argues that complex schemes implemented in the Third World to encourage modernization have often been unsuccessful, leaving a weakened state with no central structure and no means to address the needs of the people. This failure, along with corrupt leadership, lack of wealth, and codified laws that regulate the civilian population, has left many in the Third World in the dark in the fight against AIDS.
Stephanie Nolen gives an example of lack of government centralization and assistance in her story about Siphiwe Hlophe. Siphiwe is from the village of Lundzi in the northern part of Swaziland. Infected with HIV herself, Siphiwe understands the meaning behind living with the disease. Lacking government assistance, Siphiwe often carries out duties that the state, or the “ground of both freedoms and unfreedoms”, should be able to facilitate.
For example, Siphwe makes many trips to impoverished communities of Africans living with AIDS. In one story, Siphiwe was summoned by a village an hour outside of Manzini to assist the community living there. When she arrived, she found that out of a small village of three hundred people there were fifty one orphans and many people plagued with the virus.
There were those dying on grass mats without proper treatment or government aid. To help Siphiwe, by herself, assisted the community in planting a garden near a stream in the village; the community used the profits for seeds, fertilizer, fences for livestock, and the like. Nolen argues that Siphiwe’s assistance not only provided an invaluable source of pride but also a means of income for the community.
In a developed nation such assistance is often provided by government institutions or groups of non-profit workers and then, should such assistance fail, by individuals, not the other way around. Scott would argue that the centralized state institutions are severely lacking in many African nations and spurs on the vicious progression of the AIDS epidemic. Tigists of Ethiopia speaks for many Africans affected by the AIDS epidemic when she says, “I shouldn’t be worried about this. It should be for others to worry”
In general, this ability of the government to structure itself legitimately for administration to the civilian population is essential in combating some of society’s most difficult problems. In many African nation-states the lack of legitimization has made the battle against AIDS very difficult. This obsolete presence has left Africans like Siphwe to fend for themselves and others, in hopes that their efforts will have some sort of influence in slowing down the progression of a very determined and vicious disease.
The forces discussed by Ellen Woods and James C. Scott, have nurtured the mass proliferation of the virus throughout the continent, turning AIDS into one of the worst epidemics in contemporary history. Capitalism has acted to commodify education and healthcare, two essential weapons for fighting the iniquitous virus but which are difficult to obtain.
Large schematic state plans to modernize countries like Africa have failed and created insubstantial internal structures in African nations that are unable to combat the epidemic. This enemy of the masses will not stop until these symptomatic forces are greatly considered, dealt with, and understood as the underlying forces in the vicious cycle of AIDS.
Written by Mark Riegel, MD
Here’s what we've been up to recently.