When ‘development’ devastates: donor discourses, access tohiv/aidstreatment in Africa and rethinking the landscape of development

If globalisation is the mighty tremor shaking the landscape of the ‘project of development’, then, in certain regions of the world, hiv/aids is surely its epicentre. Nonetheless, for all the burden of the disease, Western donor policy on hiv/aids still remains largely silent about the provision of anti-retroviral treatment. This paper seeks explanations for this pervasive medical neglect and donor preference for prevention programmes over treatment. The postcolonial approach taken in the paper is to regard donor policy on hiv/aids—as illustrated by the UK's Department for International Development and the Norwegian Agency for Development Co-operation—as cultural and political exchanges framed by prevailing representations of Africa. The different ‘logics’ which skew policies towards prevention are identified. For donors and African states alike, hiv/aids policies—like development interventions more generally—would benefit immensely by foregrounding the human right to health, including, critically, promoting treatment within a genuine ‘prevention–care–treatment’ policy continuum.