This dissertation is about the side effects of HIV/AIDS treatment activism, its dysfunction and legacy in Mozambican everyday life. Working with AIDS support groups in northernmost Cabo Delgado Province, I problematize the utopian depiction of patient groups as a forum for infusing political subjectivity. Prone to internal conflict and hijacking by careerists, members compete for resources and inclusion in formal development projects. This antagonizes the relationship between civil society and the communities it presumes to serve, fostering distress and instability between and among groups. Poor treatment adherence and biomedical skepticism, alcoholism, and economic desperation pose serious obstacles to social solidarity and progress. In the name of “health systems strengthening” and the “decentralization” of clinical services, AIDS-specific treatment centers known as “day hospitals” were closed down nationwide. The discouraging state response to organized protests exposed the fragility of a rights-based approach to political oppression, suggesting that the broadly resonant “master frame” associated with AIDS activism—more treatment, for more people, in more places—has been successfully absorbed into wider governance structures. No longer victims in global health parlance, the patient voice has become diluted and devalued. Allowing itself to be defined by political process theory, I argue, AIDS activism has become unmade. A focus on its emergence, rather than the viability of its forms and strategies, has created an academic blindspot, contributing to activism’s obsolescence, and relocating it from streets and communities into multinational institutions and the offices of government contractors. Due to selection bias and a poor diversity of case studies, anthropology finds itself enamored with sweeping and invariant models of social movements. Ethnographic data presented here suggest that political involvement and demands for treatment alone are insufficient for sustainable patient mobilization, and that we may not be learning about biosociality from enough sources. Creating a safe haven for the common HIV/AIDS patient begs renewal of the concept of therapeutic community, and a reformulation of patient rights that is more practical than radical, and more local than transnational.
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