Ethnographing Public Health Policies:

The Production of a Local Response to HIV/AIDS

Abstract

Drawing on debates within the anthropology of public policy, this article analyses the local response to the HIV/AIDS epidemic. Adopting an ethnographic perspective, it traces the history of a municipal programme in the Buenos Aires metropolitan area. It analyses how the personal and professional trajectories of health team members, their networks of personal and institutional relationships, the characteristics of local healthcare demand, national and global guidelines for epidemic governance, and the availability of biotechnologies and specific funding intertwine in the production of a local response. In today’s global governance of HIV/AIDS, which is characterised by the growing universalisation and standardisation of interventions based on the deployment of biotechnologies with little or no attention paid to local contexts, we highlight the historical and situated nature of health policy making in order to understand it in all their complexity. Firstly, we demonstrate that the local production of policies involves complex, messy, and ambiguity-ridden processes. Secondly, we address the ways in which state agents deploy creative capacities and relative autonomy, allowing them to create novel forms of state policy despite institutional constraints.

Keywords: Global health. Public policies. Biotechnologies. Epidemics.