US Foreign Policy

The convergence of American and Nigerian religious conservatism in a biopolitical shaping of Nigeria’s HIV/AIDS prevention programmes

Jlateh V. Jappah*

Institute for Global Health, University College London, London, UK

(Received 5 March 2012; final version received 27 November 2012)

Nigeria has the largest number of HIV/AIDS cases inWest Africa, with 3.3 million people estimated to be living with the disease. The country remains a fragile democratic state and has allocated insufficient resources to combat the spread of HIV/AIDS among its citizens. The preponderance of President’s Emergency Plan for AIDS Relief (PEPFAR) dollars, expert knowledge, conservative ideology and activities has shaped the direction of HIV/AIDS sexual-transmission prevention programmes in Nigeria. PEPFAR channels significant resources through Nigerian faith-based organisations (FBOs), and considers these organisations integral for HIV prevention strategies. In many instances, HIV/AIDS prevention programmes managed by FBOs reflect their ideologies of morality and sexuality. There is a convergence of religious ideology concerning morality and HIV infectivity between American and Nigerian conservatives; this produces a fertile ground for the influence and expansion of the conservative activities of PEPFAR in Nigeria. The paper highlights this nexus and draws attention to the biopolitical underpinning of PEPFAR in shaping Nigeria’s HIV prevention programmes. The paper further notes both positive and negative effects of PEPFAR activities and attempts by the Obama administration to redirect PEPFAR to a more holistic approach in order to optimise outcomes.

Keywords: Nigeria; religious conservatism; PEPFAR; HIV/AIDS; biopolitics

Introduction

Within the past two decades, African states have been transitioning from autocratic

rule to more representative forms of governance. Bassett and Straus (2011) note that

in 1989, only five states in sub-Saharan Africa had democratic multiparty political

systems. Conversely, they note that by the late 1990s, the trend had changed with

only four countries in the region that had not transitioned to holding multiparty

presidential or parliamentary elections. However, Bassett and Straus attest that the

rise of democratic governance in sub-Saharan Africa has not been flawless, and cite

instances of fraudulent elections and coup d’états. Yet this new trend of representa-

tion has been spreading and has spurred a new wave of civil societies and grassroots

organisations demanding rights and entitlement programmes from their governments

and the international community at large. Further, De Waal (2006) notes that

African electorates have not made HIV/AIDS a top priority despite the havoc the

disease continues to wreak. He argues that despite the conspicuous inaction or

denialism exhibited by many African leaders regarding HIV/AIDS, the disease does

*Email: [email protected]

Global Public Health, 2013

Vol. 8, No. 3, 312–325, http://dx.doi.org/10.1080/17441692.2013.765023

# 2013 Taylor &