Designing epidemics: models, policy-making, and global foreknowledge in India's AIDS epidemic

This paper examines technical practices, such as epidemiological modeling, used to produce HIV-prevalence estimates within India's national policy establishment. These technical practices are a useful site within which to investigate the shifting politics between India's national government and international agencies such as the World Bank and UNAIDS. The paper argues that international actors, and the technical practices they purvey, carry a ‘foreknowledge’ about the epidemic. This foreknowledge provides a pre-existing template of an AIDS epidemic; it helps the government imagine what an AIDS epidemic looks like, anticipate patterns of risk, and plan public health interventions. However, pre-packaged foreknowledge leaves relatively little room for surprises, and sits alongside a selective silencing of local experiences and public health history.