Epidemic Projectification: AIDS Responses in Uganda as Event and Process

Abstract

This article explores the responses to the AIDS epidemic in Uganda as events and processes of projectification. AIDS projects became epidemic. Prevention and treatment projects supported by outside donors spread to an extent that made it hard for some to see the role of the Ugandan
state and health-care system. We describe the projectified AIDS landscape in Uganda as projects make themselves present in the life of our interlocutors. We argue that the response in Uganda was syndemic; many different factors worked together to make an effect, and the epidemic of responses
did not undermine the Ugandan state but played a crucial part in rebuilding the nation after decades of civil war. A problematic consequence of the projectified emergency response to epidemics such as HIV/AIDS, which is a long-wave event, is that projects have a limited time frame, and can
be scaled down or withdrawn depending on political commitment.

Full text

Epidemic Projectication
AIDS Responses in Uganda as Event and Process
Lotte Meinert, Aarhus University
Susan Reynolds Whyte, University of Copenhagen
is article explores the responses to the AIDS epidemic in Uganda as events and
processes of projectication. AIDS projects became epidemic. Prevention and treatment
projects supported by outside donors spread to an extent that made it hard for some to see
the role of the Ugandan state and health-care system. We describe the projectied AIDS
landscape in Uganda as projects make themselves present in the life of our interlocutors.
We argue that the response in Uganda was syndemic; many dierent factors worked
together to make an eect, and the epidemic of responses did not undermine the
Ugandan state but played a crucial part in rebuilding the nation aer decades of civil
war. A problematic consequence of the projectied emergency response to epidemics
such as HIV/AIDS, which is a long-wave event, is that projects have a limited time frame,
and can be scaled down or withdrawn depending on political commitment.
Keywords: AIDS, clientship, epidemic, event, process, projectication, syndemic,
Uganda
‘ese days the world is run by projects. If you want to survive, get into a project.’
(Mzee Emojong, retired government employee, advising his
grown children about life, jobs, and treatment options)
e spread of AIDS in Uganda was recognized early on as an epidemic. Uganda was
one of the rst African countries (together with Senegal) to acknowledge publicly the
gravity and urgency of the strange disease that began to appear in the 1980s. When
Yoweri Museveni assumed power in 1986 aer a guerrilla war that ended a protracted
period of political misrule, he took on the new enemy that was ravaging his soldiers
and the citizens of the country they had won. What is much less recognized is that
the epidemic gave rise to a counter epidemic of projects. e rapid multiplication of
projects that addressed AIDS prevention and palliation, social support to those infected
and aected, and later treatment of patients, had characteristics of an epidemic in
the original etymological sense of the word. It was ‘upon the people’. e spread of
projects was not necessarily a danger, as is the spread of disease. Like many responses
to perceived threats, it was sometimes successful, sometimes creative, and sometimes a
Cambridge Anthropology 32(1), Spring 2014: 77–94 © Cambridge Anthropology
doi:10.3167/ca.2014.320107

Lotte Meinert and Susan Reynolds Whyte
78 • Cambridge Anthropology
source of unintended consequences. In this article, we explore the epidemic of projects
that followed in the wake of AIDS in Uganda. We argue that projectication, like the
disease epidemic, can be seen as both event and process. Projectication we take as a
specic way of organizing work (Midler 1995) in delimited packages that has spread
from industrial rms and organizations to international development work. In Uganda
it appeared to reach a high point with the response to AIDS.
AIDS was an event in the sense that it appeared at a distinct time in Ugandan
history. It could be called a critical event in the terms of Veena Das (1995) because it
quickly took on the proportions of a societal crisis, causing deep ruptures, changing
demography, aecting sociality and subjectivities in profound and lasting ways. It was
and is also a process, still unfolding, in which biosocial developments in Uganda form
part of the larger history of the African AIDS epidemic. John Ilie’s book on AIDS in
Africa (2006) shows how the history of the virus intertwines with the response to it.
How do we analyse such a process?
One approach is to examine the temporal structure and unfolding of a ‘plot’ in the
course of an epidemic and the response to it. At a relatively early point in the North
American epidemic, Charles Rosenberg (1989) proposed a dramaturgical frame for
understanding epidemics like AIDS. ere is a rst act of progressive revelation as
recognition takes shape, followed by a second act of managing randomness in which
attempts are made to nd a (moral) pattern in susceptibility. Finally, there is a third act
of negotiating public response through familiar cultural assumptions, ritual actions,
and existing institutions, sometimes exacerbating their chronic insuciencies. is
framework provides a clear plot and emphasizes the stages of the AIDS epidemic. We
will borrow this dramaturgical metaphor in order to distinguish phases in the response,
although we do not adopt his criteria for dening the acts in the AIDS epidemic (his
piece was written early in the epidemic and concerned the drama in the US).
e division into phases or acts should not detract attention from the cumulative
and transformative nature of the epidemic and responses. ey had consequences
and the consequences had consequences within each act and across the entire drama.
Barnett and Whiteside (2006) used the term long-wave event to direct attention to the
consequences of the epidemic, intended and unintended, in the long run.
A second approach to analysing the process of epidemics is to examine the mode
of spread. Attention has been given to the paths of virus transmission through the
movement of traders, long distance truck drivers, and soldiers (Barnett and Whiteside
2006). e pattern of sexual networks in a given society has been related to the speed,
extent, and decline of the epidemic (ornton 2008). As a biological phenomenon,
an epidemic disease oen exhibits synergy with other diseases, a point captured in
the term syndemic (Singer and Clair 2003). HIV ‘worked together’ and ‘worked its
way through’ the population with the help of other health problems, including other
sexually transmitted diseases. e AIDS epidemic was syndemic with a tuberculosis
epidemic, each disease contributing to the gravity of the other. But it is not only a
matter of how rapidly spreading diseases interact with one another. ey are synergetic
as well with ‘harmful social conditions and injurious social connections’ (Singer and
Clair 2003: 429). Poverty and unequal gender relations interacted with the virus. So
too did the chaotic political economy during the Amin and Obote regimes, when the

AIDS Responses in Uganda as Event and Process
Cambridge Anthropology • 79
economy collapsed and illegal trading across international borders, created a fertile
ground for HIV to spread, together with the mobility of soldiers and guerrilla ghters
during Amin’s war with Tanzania, and the insurgency that nally brought Museveni
to power. us the AIDS epidemic was characterized by several syndemic dynamics.
For infected individuals and their families, synergy was also at work. HIV masked
itself in a whole range of symptoms such as weight loss, rashes, and diarrhoea. It
coexisted with common diseases such as malaria and respiratory infection and
tuberculosis. What was HIV and what was some other sickness? Beyond the multiplicity
of health problems, HIV and its demands were intertwined with all kinds of other
diculties and worries: family crises, nancial needs, work demands, and children’s
complications (Whyte, in press).
Given these perspectives on the HIV epidemic as event and process, unfolding drama
and syndemic process, we wish to consider the intertwined processes of projectication.
Like the disease epidemic, the proliferation of projects was a chain of events and
consequences, foreseen and unforeseen. And just as the spread of AIDS is syndemic,
so also the expansion of projects interacts synergistically with political, economic, and
social developments. At the level of individuals and families too, projects intertwine with
other concerns. In the course of our research, we became aware that our interlocutors
were living in a projectied landscape. Ivan’s story illustrates this very well.
Ivan
One of the people we followed was Ivan, thirty-ve years old at the time and living
in a rural area in Eastern Uganda. Ivan was the second son in a large polygynous
home, where he lived with his wife, his mother, some sisters and their children. He
had nished secondary school, and like most school leavers did not have a permanent
job. Lotte had known Ivan and his family since 1997 when she lived in their village and
did eldwork there. Ivan was known to be a frustrated young man who had resorted
to drinking and smoking, and parents in the area told their children to stay away from
him. But Ivan was very enterprising and had been active in the cross-border trade to
nearby Kenya, even while he was studying. He was selected for training as an HIV/AIDS
counselling aide, probably because of his level of education and his family connections.
e opportunity came through the NGO Plan International, which ran a project at a
nearby health centre. It included a stay at the Mildmay HIV/AIDS organization in
Kampala, and eventually led to working as a community-counselling aide under Plan
International for a short period.
Ivan and his wife lost two children shortly aer they were born, which contributed
to the diculties in their marriage and in their relationship to Ivan’s mother, who lived
in the same compound. Ivan did not know for sure that he had the virus until early
2003. His wife was admitted to hospital, they tested her, and she told Ivan she was
positive. He was not shocked, because he had started suspecting HIV since the children
had died and his wife had been sick on and o. Ivan had drawn the conclusion about his
own test before he got the results. For some people in our study getting the test results
was a shocking event, but for many like Ivan it had been a long process of suspecting
and calculating, which led up to the realization and a positive test result. Ivan said the

Lotte Meinert and Susan Reynolds Whyte
80 • Cambridge Anthropology
counselling training helped him through the process: ‘It gave me courage and I became
strong about it. But of course it was not good news. I started looking at ourselves having
a short-lived life’.
Immediately aer Ivan and his wife were tested, they were given forms to ll for
enrolment in TASO (e Aids Support Organization). ey had decided to keep their
status a secret, but soon aer the wife was discharged from hospital, a friend and
neighbour, who worked for CDC (Centers for Disease Control) in the district town,
contacted them and told them about a new treatment study. e new project called
HBAC (Home-based Aids Care) enrolled Ivan’s wife in the study and she started on
ARVs (antiretroviral medicines). Ivan was not eligible to join at that time, because his
CD4 count was over the threshold set by the project.1 When Ivan initially decided to
start treatment on a private basis, it was at the regional branch of Joint Clinical Research
Centre, a para-statal organization, which was oering fee-for-service treatment. Ivan
started buying drugs, but as he said ‘it was a gambling situation, because they could
only give me the tablets I could aord’. Once he lost the four expensive tablets he had
just bought and aer that, he said: ‘I lost hope and gave up and said let me just ignore
and pack’. e neighbour working at CDC came back and told him they were recruiting
another lot of people for the HBAC project to make 1,000 cases. Ivan was very sick
by then with a low CD4 count, and perhaps ready to be ‘public’ about his HIV status.
It was his good fortune to join the treatment programme with the highest standard
of service in eastern Uganda. His medicines were delivered to his home weekly by
a eldworker, who checked to see if there were any problems, and referred him for
counselling or medical treatment if necessary. Ivan’s health improved, but he still had
troubles of various kinds, as did everyone else we visited.
e second time we visited Ivan, he had just joined the local Post-test Club,
explaining that he had not been a member earlier because it consisted mostly of women
‘and you know how women can manage things when they are the majority in a club’.
Many men had then joined and Ivan was elected vice chairperson. e Post-test Club
was in principle open to anyone who had taken an HIV test, but in practice consisted
of people who had tested positive. It served as a platform for HIV activities sponsored
by various organizations. On ursdays, Plan International provided cooked food
for children of members. An NGO called Africa 2000 provided planting materials
for members. ey wanted a demonstration garden and Ivan provided the land for
it. However, the demonstration garden developed into a conict with the neighbour
whose ducks ate the crops. Ivan pursued the case with the Local Council and then with
the police. When the Ocer in Charge demanded a bribe, Ivan avoided paying it by
saying she should be ashamed to ask for money from sick people like him. He seemed
quite pleased with his success as key stakeholder in the farming project. Sometimes
the Post-test Club was also a point of contact for well-wishers, such as a Swedish group
bicycling from Malawi to Nairobi to Kampala. ey visited the Club, and at the end of
their tour, gave a bicycle (‘a very good one’) as a gi. Ivan was the one who picked it up
at Busia on the Kenya border.
Whenever Ivan fell sick with malaria and other infections he went to the newly built
and eective CDC department of the district hospital where the HBAC project would
care for him. e medicine was free, and he would be provided money for food and

AIDS Responses in Uganda as Event and Process
Cambridge Anthropology • 81
transport. If admitted to hospital, HBAC clients were given a daily allowance to cover
food and other expenses. But if he fell sick on weekends when the CDC department
was closed, Ivan had to go to the main hospital ward, and ‘treat himself’: nd health
workers, nd medicine, pay for treatment, food and transport. e dierence in the
quality of health care in the HBAC project and the public health system was stark.
In Ivan’s village Plan International started a nursery school and wanted to employ
some Post-test Club members as teachers. Ivan’s wife was recruited to teach, but aer
some time Plan International stopped paying her salary because sustainability required
contributions from the pupils’ parents. When they failed to pay anything, she quit.
Later however, she joined a Drama Group organized through the Post-test Club, which
practised three times a week (and presumably paid her some allowance). Ivan himself
got a further opportunity for training in counselling, when trainees were picked from
the Post-test Club.
Securing an income for the family was a constant problem and Ivan said ‘People
have frustrated me even with this disease. You know when you are poor, not eating
well and all the time worried about what follows next, ahh, you go very fast! But I am
trying hard to survive!’ In other words, Ivan was aware of the syndemic dynamics at
the individual and social level: if you are HIV-positive, have low socioeconomic status,
get poor nutrition, are stressed and depressed, you die faster. But Ivan knew he had to
ght and said: ‘I have tried to forget those problems because what matters now is my
health and eating well’. Ivan’s transformation was indeed impressive. He made a ‘life
project’ out of the struggle to survive with his wife. He stopped drinking and smoking,
stuck to his wife and his medicine and was eager to get into new projects that provided
some kind of opportunity.
When the HBAC study was about to end, Ivan, his wife and many other clients were
worried. First they heard that they would have to go to TASO. en they were told that
the project would continue as long as CDC had the funds. Ivan did not trust TASO to
maintain a good standard of care. ‘At least there is hope for us [with the HBAC project]
that we shall live longer – otherwise we were worried of going to join TASO’. A couple
of years later, the HBAC project did end and TASO took over. We did not talk to Ivan
aer this, but to other clients who had transferred to the TASO project. ey said that
the provision of medicine was still stable, but the regimen had changed. Now their
worry was what would happen if the TASO project ended.
An Epidemic and Its Projects
Even this brief summary of Ivan’s situation, as we came to know it through eight
visits to his home, gives a good picture of the intertwining of an epidemic disease and
the projects that responded to it. In talking about his illness and current situation,
he mentioned seven dierent projects or organizations, some of which had several
activities. ere were prevention eorts exemplied by the drama group that Ivan’s
wife joined. ere were organizations and activities that provided material support to
people infected or aected, such as the farming initiative and the feeding programme
for children. And there were organizations providing treatment, for fee or free, with
various kinds of associated activities such as home visits or counselling. ere were

Lotte Meinert and Susan Reynolds Whyte
82 • Cambridge Anthropology
research projects with large budgets, such as the Home-based AIDS Care project
implemented by the US Centers for Disease Control. And there were small ones like
our own that brought only visits with gis of sugar.
e projects of which Ivan spoke had in common that they were organized
enterprises planned to achieve an aim. ey had a life course: an inception, beginning
and end. While the organizations and institutions that undertook projects were
relatively enduring, the projects themselves were not meant to last for decades. eir
limited time frame was obviously a problem in relation to the long-term duration of
the AIDS epidemic, and to the life-long perspective of antiretroviral therapy. Moreover,
projects included and excluded, and thus created inequality, which could reach right
into households when one member (like Ivan’s wife) was eligible for a project that
excluded another (like Ivan, who was only included later).
We want to understand the consequences of projectication for people like Ivan,
but to do so we must also attend to its consequences for the state and the health care
system. In the following sections, we consider each of these. First, however, we need a
rough historical background for Ivan’s experience of the intertwined epidemics.
Ivan was born about 1970 and would have been in his mid teens when Museveni
began his campaign against the new enemy, ‘slim’ disease. As a schoolboy and aer,
he would have been exposed to AIDS education messages: the traditional drumbeat
warning of danger broadcast on the radio, the touring drama groups, the popular songs,
the information conveyed in schools, at health centres, and at meetings of all kinds. In
what might be called the First Act of the projectication drama, the plot was in large
part about prevention, since there was no eective treatment. But it was also about
support and palliative care for the sick and dying, and their families. Organizations and
projects emerged to distribute food supplies, medicines for opportunistic infections,
blankets, and comfort to those known to be positive. Despite the establishment of AIDS
Information Centre (in 1990), a US-supported NGO that oered HIV testing at many
hospitals and health centres, people were oen reluctant to be tested, thinking that
uncertainty was better than an inevitable death sentence.
In the Second Act the plot shied toward treatment, slowly and with some reluctance
at rst. Antiretroviral erapy (ART) was available in Uganda, but at such a high price
that most people could not aord it. ose who tried, like Ivan, usually had to stop for
want of money. Some projects, like the Joint Clinical Research Centre (JCRC) whose
regional branch Ivan patronized, carried out research as well as providing treatment
for paying patients. Other research projects, like the CDC-sponsored HBAC that he
eventually joined, gave treatment for free to study participants. Still other projects,
such as Uganda Cares and the Médecins Sans Frontières project in Arua, were not
involved in research, but had an exemplary function in showing that provision of free
ART was a feasible strategy. e critical event that occurred in this Second Act was the
advent of a national rollout (or scale-up) of free ART at sites all over the country in
the years 2004–2006.2 Funded by the President’s Emergency Program for AIDS Relief
(PEPFAR) and the Global Fund for AIDS, Malaria and Tuberculosis, this development
made ART accessible through a multitude of treatment sites, both in government
health facilities and beyond. A whole generation of HIV-infected people became clients
of these treatment sites and got a second chance to live, on condition that they accepted

AIDS Responses in Uganda as Event and Process
Cambridge Anthropology • 83
to take their medicine regularly and try to ‘live positively’. For patients and families,
the management of medicine and lives with HIV turned into various kinds of chronic
homework. (Mattingly et al. 2011; Meinert 2014).
e ird Act is still veiled behind curtains of uncertainty. To consider some
possibilities we must bear in mind what projects and projectication actually meant.
By their nature, projects resemble events. ey start, have duration, and stop. Many
might continue through multiple phases, but they are not permanent in the manner
that government institutions are meant to be permanent. ey mobilize resources,
including personnel, in order to realize objectives through planned activities. If those
activities and personnel are ‘mainstreamed’ into enduring organizations, then they are
no longer projects. In the ird Act of the projectication drama, people like Ivan
wonder what will happen if (when) the project ends. us far, projects have pulled more
projects. Some have even built on others, as HBAC recruited study participants from
TASO. But if fewer new projects and organizations enter the scene, and if PEPFAR, the
biggest funder of projects, fails to win continuing support from the US Congress, then
treatment tasks would fall to government and private health facilities, whose capacity
would be sharply diminished without external funding. e prevention and social
support projects, which spread with such vigour in the First Act, might not continue
to mobilize such enthusiasm as the epidemic itself and the political situation change.
e sense of emergency that fuelled them has diminished, and energy would have to
be mustered and marshalled in other ways.
We have followed this drama from several vantage points over the years. Susan
began working in Uganda long before it started and saw the rst cases of AIDS among
friends and neighbours and the rst locally initiated prevention projects in eastern
Uganda. In the beginning of the 90s, Lotte studied HIV prevention initiatives in
Uganda by UNICEF, the School Health Education Programme, and Straight Talk, a
communication project for teenagers. When ARVs started to enter the Ugandan scene,
we did an explorative study of treatment access focusing on the dierences between
those who had to buy the drugs, which were very expensive at that time, and those
who could access ARVs freely through research projects and other channels (Meinert
et al. 2004; Whyte et al. 2004). en when ART became widely available, we undertook
a study of the rst generation that learned to live with the treatment regime As part of
a collaborative research project, we and other colleagues followed twenty-three people
on ART over a year and a half from late 2005 to 2007. ey were receiving treatment
at seven dierent facilities in Kampala and eastern Uganda, thus giving us insight into
the landscape of projectication (Whyte, in press). It is mainly from this last study that
we draw material for the present article.
The Politics of Projects
e prologue to the AIDS drama in Uganda began in 1980, just aer Tanzanian troops
had put an end to Amin’s murderous regime. Cases of a mysterious disease were rst
reported from Rakai District; physicians at the national hospital Mulago quickly took
an interest, and the rst publication about the condition dubbed ‘slim’ appeared in
1985.3 But it was not until 1986 when Yoweri Museveni had assumed power that the

Lotte Meinert and Susan Reynolds Whyte
84 • Cambridge Anthropology
rst act of the intertwined AIDS and projectication epidemic opened. He immediately
addressed the danger, established the world’s rst AIDS Control Programme, and
called for action. AIDS education was to be part of all activities; under the multi-sector
approach concern with the epidemic was not restricted to the Ministry of Health.
e economy was in ruins aer een years of misrule and the government itself
had few nancial resources to put into the AIDS campaign, so the mobilization of
other sources was necessary. Reviewing HIV/AIDS policy documents from this critical
period, Parkhurst (2005) shows that the new government explicitly tried to involve a
wide range of NGOs, religious organizations and international donors. It also welcomed
dierent approaches to the tasks. ‘Rather than attempting to undertake HIV prevention
campaigns in one set model across the country […] the government adopted an indirect
approach in which one of its key responsibilities would be to support the wide range
of non-state actors involved in HIV activities’ (Parkhurst 2005: 583). e call to action
was answered in part by indigenous organizations that later went on to gain funding
from abroad, and in part by external agencies attracted by the open and welcoming
attitude. While neighbouring countries were still ignoring or denying the epidemic,
projects were streaming into Uganda. Kinsman (2008: 99) notes that by 1997, Uganda
already had 1,200 registered organizations carrying out AIDS related activities. By 1999
when Kenya’s president Moi nally declared the epidemic an emergency in his country,
Uganda had already received about $180 million worth of funding for ghting AIDS
(Kinsman 2008: 74–75, citing Hogle et al.).
Homegrown initiatives soon began to appear. TASO, The AIDS Support
Organization, started in 1987 as a pioneer patient organization. It implemented projects
for prevention and for material and social support to patients and their families. Later,
when ART became available, it was already in place, ready to begin providing treatment.
e Joint Clinical Research Centre was established in 1990 as a collaboration between
the Ministries of Defence, Health, and Makerere University. It too was an indigenous
enterprise that went on to become a platform for projects and funding from outside.
Soon, NGOs funded by external donors began to stream in. In 1990 the US-funded
AIDS Information Centers began to oer HIV testing at an expanding number of sites,
usually in connection with hospitals and health centres. Bilateral donors like Danida
supported the Uganda AIDS Commission (established in 1992 as successor to the AIDS
Control Programme), which had the task of coordinating the many AIDS activities.
In this rst period, research projects owed in as well. Two large epidemiological
projects had their beginnings in 1988: the British Medical Research Council developed
a project in Masaka District and a US-funded research group worked in neighbouring
Rakai District. Together with other research initiatives, these two contributed a ra of
scientic papers, which made Uganda’s epidemic one of the best documented in Africa
and familiarized a section of the population with HIV research projects.
e orescence of AIDS projects in Uganda can clearly be traced to Museveni’s
initial openness. Various explanations for his stance are possible. Perhaps his military
campaign through the Ugandan epicentre in the southwest of the country brought him
face to face with the reality. Perhaps he was concerned about the toll the disease was
taking in the army that had brought him to power. Perhaps he simply saw that he had
nothing to lose (no tourist industry, no foreign investors) and much to gain. Whatever

AIDS Responses in Uganda as Event and Process
Cambridge Anthropology • 85
the reason, the consequence in political terms was to increase his legitimacy at home
and abroad. Just as the government of newly independent Ukraine gained recognition
internally and externally by its eort at transparency and compensation in the wake of
the Chernobyl disaster (Petryna 2002), so did the young National Resistance Movement
win political capital by its progressive stand (Putzel 2004).
In some ways, the response to the epidemic undermined the sovereignty of the
state in many African countries, as pointed out by Vinh-Kim Nguyen (2010). Yet the
projectied response in Uganda also helped President Museveni’s nation-building
process; many clients and citizens conated government and donor eorts. One of
our interlocutors captured it by saying: ‘I really thank this government – or whoever
brought these drugs’. It seems that the relationship between the many AIDS projects
and the Ugandan state was symbiotic.
e proliferation of AIDS projects in Uganda was part of a general trend across the
continent. Since at least the 1980s, African states were more and more dependent on
non-state agencies in matters of governance. Geissler (in press) uses the term ‘para-
state’ to describe the ambiguous construction in which research and health activities
are parcelled out among non-state, oen foreign-funded, actors. e interdigitation of
state forms and non-state resources is oen so intricate that it is dicult to separate
the one from the other. Uganda’s projectication can be seen in this light; in fact it
is a prime example. But the Uganda drama was more than a simple illustration of a
widespread pattern. ere was a particular conjuncture of persons, timing and history
aer the years of misrule and a civil war, which had split Uganda into several fractions.
AIDS was made into the new enemy, which could unite the nation and attract donors.
e framing of the epidemic helped create the new times of peace in Uganda and the
response brought it international recognition as ‘a success story’ aer a discreditable
period. e relationship created by the response between projectication and state
building was synergetic.
The AIDS industry in Uganda was well established in the 1990s. It grew
exponentially in the 2000s as ART became a realistic possibility. With the advent of free
ART, the pattern of projectication gained momentum. PEPFAR was by far the biggest
source of funding, and its policy was to support a multitude of NGO organizations to
carry out AIDS projects, including provision of ART. PEPFAR money found its way to
projects that had started with prevention, social support and treatment of opportunistic
infections, such as TASO and faith-based organizations like Mbuya Reach Out and
Kamwokya Christian Caring Community. rough JCRC’s TREAT collaboration,
PEPFAR resources also found their way into government health facilities. Baylor
Medical School received PEPFAR funding to make ART available for children at
government health facilities.
Projectication seemed to be a self-reinforcing process. Although he does not use
the term projectication, Kinsman (2008: 204) notes this cumulative phenomenon:
‘openness […] served to attract ever more foreign agencies and nancing into the
country over the 1990s and 2000s. By thus continually reinforcing this particular
“institutional pattern”, success has fed success, and President Museveni’s early pragmatic
recognition of the need to act against AIDS has paid o handsomely’.

Lotte Meinert and Susan Reynolds Whyte
86 • Cambridge Anthropology
From a political point of view, indeed from any point of view, dependence on
foreign-funded projects is highly contingent. e unpredictability became clear when
PEPFAR was aected by a ceiling on funds in connection with the nancial crisis. From
the end of 2008 until the second quarter of 2010, PEPFAR projects were not allowed to
take on any new patients and the spectre of AIDS as a fatal disease emerged once more
(Mugyenyi 2012). at is one of the serious consequences of projectied emergency
responses to epidemics that are in fact long–wave events: projects can be scaled down
or withdrawn; they only entail commitment for a certain time period. Yet, under the
current political situation, many of the involved people in Uganda do not really see
any other option than to try to continue the epidemic projectication (with whatever
it takes and brings).
Projectication and the Health Care System
Epidemic projectication spread into the health-care system with ambiguous eects.
In some ways, it strengthened the government and not-for-prot part of the system,
weakened by the years of misrule and civil war. Indeed other kinds of donor-funded
health-care projects were already appearing. e Essential Drugs Programme, leprosy
control, Integrated Management of Child Illness, and Safe Motherhood were also
time-limited donor-funded enterprises aimed at specic improvements, rather than
an all-round li, in health care. But AIDS projects were multiple, even within the same
facility, and the resources they brought for one disease were seen by many to introduce
an imbalance into health services. AIDS exceptionalism, a response that treated HIV
as dierent from all other diseases and requiring extraordinary measures, had both its
supporters and critics (Whiteside and Smith 2009; Smith and Whiteside 2010).
In the early days, most projects were about prevention, support for positive people,
and to some extent treatment of opportunistic infections. Prevention through information
and education, as well as much patient support, took place outside the domain of the
formal health care system. But even before the advent of ART, projectication began
to be felt in district hospitals and upper-level health centres. AIC testing sites were
usually located on the premises of health units and manned by health-facility personnel.
Testing required counselling, and projects provided training in the skills of counselling.
Such short courses were highly valued by health workers, for the new knowledge, the
allowances provided, and the certicates received. Laboratory technicians were trained
in processing tests. Record-keeping and reporting skills were honed.
World Vision ran AIDS projects that were community-orientated but aliated with
government health units. It distributed food supplies to positive people from hospitals
and health centres, and ensured medicines for the treatment of opportunistic infections
were available in the dispensary. us storekeepers and dispensing assistants, as well as
clinical ocers who treated those registered, took on tasks for the project in addition
to their regular duties.
By the year 2000, Prevention of Mother to Child Transmission (PMTCT) was
becoming standard in antenatal care at all health units. It was supported by dierent
donors (UNICEF, Plan International, and others) at dierent health units, which gave
it the aura of a project. Since it involved HIV testing, training in counselling was a

AIDS Responses in Uganda as Event and Process
Cambridge Anthropology • 87
project activity, as were the supply of test kits and a dose of antiretroviral medicine for
HIV-positive mothers and their babies.
e biggest impact in the formal health care system came with the 2004–2006
rollout of free ART to district hospitals and upper-level health centres. is meant the
establishment of HIV clinics (a designated time and venue within the unit) manned
by the existing sta. For years, health workers had been overwhelmed by grievously
ill patients for whom they had no eective treatment. When ART was rolled out, they
nally had something that could reverse the dreadful advance of the disease and give
real meaning to the term ‘living positively’. en they had to deal with the need for
continuous treatment, the increasing chronicity of HIV and the various challenges and
disabilities accompanying it (Nixon et al. 2011). at required radical innovations in
health care.
Patients on ART joined a treatment programme and went for regular monitoring
and medicine rells where they were members. is was very dierent from the usual
pattern of health care in Uganda, where people get treatment here or there as they
feel the need. In this transformation patients became clients, and in eect members of
projects, since dierent donors sponsored treatment at dierent facilities on a time-
limited basis. Projects provided possibilities for patron–client relationships, such as that
between Ivan and his neighbour who acted as a mediator between the project and Ivan’s
family. Public health care in this situation did not mean rights and equal opportunities
for citizens of Uganda. Rather it meant building patron–client relationships locally,
nationally, and internationally.
Health workers in government service learned to navigate the diculties and
possibilities of ART projects. Each donor had slightly dierent procedures and
requirements for paperwork. At Mukuju Health Centre IV, where the Plan International
project that involved Ivan was located, there were three dierent projects providing
ART – each with its own paperwork. e projects provided opportunities for training
and outreach, which oered allowances to health workers. With greater resources,
they drew sta away from other duties (indeed some le government service for more
lucrative posts with NGOs). But they were also motivating for health workers, because
of the new knowledge and skills, the contact with a wider world, and of course the
extra money.
With their resources, and their attention to each member/user of services, the AIDS
projects represented another kind of care. One new principle was the importance of
counselling – when testing, when starting ART, and to maintain adherence to treatment.
Projects required that each client have a journal, maintained at the clinic – something
unknown in ordinary outpatient care. Although not perfect, the supply of medicines
was much more reliable in AIDS projects. In these and other ways, AIDS projects have
been inspirational. In the district hospital, which hosted the HBAC project that Ivan and
his wife joined, one of the doctors said: ‘CDC has set another standard of health care.
We also want to reach that standard at the hospital’. e problem was that resources for
development of that quality of care were only channelled to AIDS projects.
AIDS projectication resembled many of the old vertical eradication programs
in Uganda dealing with one disease or epidemic at a time, such as sleeping sickness,
leprosy, river blindness, and now Ebola. is may be necessary and justied for some

Lotte Meinert and Susan Reynolds Whyte
88 • Cambridge Anthropology
epidemics, but the habit of organizing health care around attention to epidemic crises
led to a fragmented, unequal and unpredictable version of health care in Uganda.
AIDS exceptionalism created scenarios where you could get treatment if you were
HIV-positive, but if you had diabetes, breast cancer or clinical depression there were
only meagre options for health care. Moreover, even those benetting from ART
projects experienced inequalities among projects and vast dierences between the care
available through the project, and the ordinary care they had to use on weekends or for
conditions not covered by the project, as we saw with Ivan.
Like many African countries, Uganda had long had a peculiar public–private mix,
where formal sector non-prot health care was supplemented by, indeed intertwined
with, private for prot enterprise (Van der Geest 1988; Whyte and Birungi 2000). e
AIDS response added another ‘P’ to make it a public–private–project mix. e response
– like the epidemic – was syndemic; many dierent factors and actors worked together
to create an eect and they were mutually reinforcing.
Projects and Subjects
e AIDS epidemic created patients, death, and mourners, but the response to the
epidemic also created survivors and clients, volunteers, counsellors, jobs, and structures
of care (in families and the health system) that spread widely, oen through personal
connections. ese various emerging subjectivities of clients, counsellors and carers
in the projectied landscape of response were also evident in Ivan’s transformation.
Prior to the epidemic, Ivan was a child, a schoolboy, student and then a trader. During
the epidemic, Ivan became a (sexual) ‘partner’, a ‘patient’, ‘drunkard’ and a ‘bereaved
parent’. But concurrently the epidemic provided opportunities; he also appropriated
identities as a ‘counsellor’ in a development organization and went for training in the
capital. Ivan and his wife became ‘members’ of TASO and were part of the category
‘PLWAs’ (People Living With AIDS). Ivan became the ‘vice-chairman’ in the local Post-
Test Club and played a role in the management of food distribution to the members’
children. Ivan’s wife became an ‘actress’ in the drama group and a pre-school ‘teacher’
in one of the AIDS-funded projects. With the CDC-initiated HBAC project Ivan’s wife
became a ‘client’ and what the CDC categorized as an ‘index-person’ – the rst person
receiving treatment in a household. For a period Ivan was ‘not eligible’, and in his own
words he was a ‘gambler’ trying to buy his own medicine. Aer a while, because Ivan
was living in the household of an index-person, and fell below a 250 CD4 count, he
was also recruited for the HBAC study as a ‘client’. Being a client, Ivan transformed
himself from being a drunkard and smoker to someone who followed the rules of the
project and the regimen of the medicine. Other people in our study devoted themselves
completely to their projects as clients – and told us, as Robinah did: ‘I am their person
now’. Registers in ART projects and their various forms of paperwork became proof of
this new kind of belonging.
e transformation of HIV subjectivities from ‘patients’ to ‘clients’ was perhaps the
most remarkable change in the period of projectication. Health workers began to speak
about patients as clients and the clients also started referring to themselves as such. e
relationships between patients and projects took contractual forms with expectations

AIDS Responses in Uganda as Event and Process
Cambridge Anthropology • 89
and entitlements characteristic of patron–client relations. is transformation included
abiding by the rules of the projects and being active in carrying out the activities or
‘homework’ expected by the project. Projects spread into the details and routines of the
everyday lives of both clients and their families.
Clients were oen schooled by their projects. HBAC took Ivan, his wife and other
clients for a series of trainings on how to understand the virus, themselves and their role
in the management of the disease. A counsellor from HBAC also came to their home
to teach the clients and the families about the importance of care, being compliant and
living up to their obligations towards the project. Anna, one of the other HBAC clients
was quick to list the ‘homework’ assigned by the project:
1. Take the medicine strictly every day on time, in the morning and evening, 2. Only
drink chlorinated water, 3. Eat a healthy and varied diet, 4. Seek to have ‘peace of mind’,
5. Socialize with people in your surroundings, 6. If you have sex only practice safe sex,
7. Do not get pregnant, 8. Be available at home for the research team when they come to
carry out their studies. (Meinert, in press: 125–126)
Even though this homework regime turned out to be cumbersome and less realistic
with time for many clients, it also provided a frame for being a kind of person who was
not a mere AIDS patient swallowing pills, but a person with psychological qualities,
emotions and discipline, a socially recognized person, and a responsible client trying
to full her obligations to a project.
We have suggested the term ‘therapeutic clientship’ (Whyte et al. 2013) as a way
to explore these emerging forms of sociality and subjectivity. erapeutic clientship
acknowledges the new quality of the healthworker–patient relationship and at the same
time draws attention to aspects of interdependence and inequality in patron–client
relationships. Technical know-who is a well-known phenomenon in most corners
of Ugandan society. All know that resources and avenues to ‘belonging’ are most
easily accessed through social relations. is dynamic was also very pronounced in
the networks created and stabilized through the epidemic response. Ivan and many
other clients got linked to projects through personal connections, which in turn also
encompassed a relationship of mutual obligations. Pitt-Rivers’ description of patron–
client relationships as ‘lop-sided friendship’ (in Wolf 1966: 16–17) ts well here.
Patronage and neo-patrimonialism have also been discussed more recently among
scholars of governance in Africa as forms of sociality that make systems work despite
the fact that they seem to be in contradiction with the spirit of rational bureaucratic
and democratic systems (Chabal and Daloz 1999; Swidler 2009).
To be a client in a project meant that you had your le with that project, perhaps
even your photo, and you were ‘someone’ visible to a powerful organization. To belong
to a project was to be recognized as a person with needs, and to be respected as a person
who had expectations of benet. Clients did not always receive what they expected, nor
were they always treated with the kind of respect they hoped for, but they had a status
within projects that was remarkably dierent from the position patients held vis-à-vis
the Ugandan health care system. In the beginning of Ivan’s inclusion in the HBAC
project he complained about the counsellor, who came to his home to tell him how to
live his life, what to eat, drink, how to relate to his wife and family. Ivan thought it was

Lotte Meinert and Susan Reynolds Whyte
90 • Cambridge Anthropology
particularly disrespectful when the counsellor reported him for not being present at
his home during the time of medicine delivery and counselling, when he was actually
looking for food for his family. Ivan eventually got another counsellor and settled well
into the project routines. Other clients in the HBAC project reminded him that this
particular project provided ‘excellent care’ compared to other projects in the area or the
public health care system.
e dierences among the projects that made up the response to the AIDS epidemic
were obviously of great concern to potential clients and to others who were worried
about the very unequal provision of care on a national as well as on a local scale. Ivan
was a case in point when he was rst excluded by the HBAC project criteria. Joyce
and Robinah were sisters, who did not live far from Ivan. When the HBAC project
started, Robinah was recruited as a client, but Joyce’s CD4 count was such that, like
Ivan, she was not eligible for participation in the HBAC project. Instead Joyce started
receiving her medicine from TASO. e sisters living in the same house with the same
virus and problems experienced what it meant to belong to dierent projects. Robinah
had her medicine delivered in their home on a weekly basis in pre-packaged day-
doses by a eld worker who enquired how she was and could help in case she needed
additional medication or care. Joyce had to pick up her medicine from TASO for two
months at a time. Her sister helped to repack the tablets in a small container with day-
dose compartments like the one Robinah had from the HBAC project, so that Joyce
felt she also received good quality of care. While Robinah kept getting reports about
her rising CD4 counts and gained kilo aer kilo, Joyce did not have any CD4 tests
done because her project did not provide this service. Oen coincidences seemed to
determine whether a person became a client in one project or the other, or would be
excluded altogether. From a project perspective clients were included or excluded based
on rational criteria (such as the HBAC criteria of residence in the area, membership of
TASO, CD4 count below 250), but to the potential clients it appeared that timing and
connections were crucial to getting into a project. Both Robinah and Ivan’s wife were
contacted by personal acquaintances who were project employees, and they happened
to have the ‘right’ CD4 count at the right time, when the project was recruiting clients.
Ivan was also contacted later and was lucky to reach the needed CD4 count during the
next window of opportunity when the project was recruiting patients again. Joyce did
not t the HBAC criteria at the right time, but got into another project with a dierent
standard of care.
e projectied landscape of response to the AIDS epidemic spread new possibilities
of being a client. Given the vital resources at stake, it is not surprising that the idea of
being a client and belonging to a project was desired and therefore contagious. Equally
attractive to people living in this landscape were the job opportunities that projects
oered.
Projects as Occupations
e neighbour and friend who initially contacted Ivan and his wife to be included in
the HBAC project had been given a job in CDC as a eldworker. His sister was also
employed as a counsellor in the project. ey were both highly qualied to do these

AIDS Responses in Uganda as Event and Process
Cambridge Anthropology • 91
jobs due to their earlier experience in other organizations and projects. e project
employees in the HBAC project were equipped with American Embassy identity tags,
motorcycles, helmets, and other equipment, which made them highly visible when
they moved through the landscape. ey were given additional education, they signed
contracts of condentiality, project regulations and codes of conduct. Lastly, but most
importantly, they received a relatively generous salary, from which they could live and
support parts of their family networks. Other members from the same family also
applied for positions at the HBAC project, but did not qualify or were not lucky enough
to get a job, and instead became dependants of those family members who were hired.
e pre-existing (and continuing) relationships between the project employees and the
clients made the relationships multiplex. Ivan knew his counsellor because they were
‘from the same village’ and he did not make an ocial complaint when she reported
him, but complied with the project rules, because he knew that for counsellors and
eldworkers, ensuring the clients’ compliance with project rules was important for their
positive job evaluation and job safeguarding (Meinert 2014).
Clients also hoped for jobs in the projects. Anna, who was one of the very rst
clients enrolled in the HBAC project, was desperate to get any kind of work within
the project, so she applied for a cleaning job, even though she was over-qualied for it.
e project did not employ her. ey told her they had received her application aer
the deadline. Perhaps they hesitated because it would then be unclear what kind of
person she would be in the project. Client or employee? Anna was very upset about the
rejection, whatever reason was given. She longed to have the kind of recognition she
imagined she would get from being employed – a full person and citizen contributing
to the economy. Morris (2008: 205) describes a similar sentiment from South Africa
where a young man involved in an HIV project said: ‘You are saving us for dying. We
want to make a living’. To make a living is more than merely surviving on medicine
and food aid. In Anna’s longing for a job and for others who were also trying to get
inside a project – not as a client but as an employee – there was an implicit demand for
recognition of a fuller kind of personhood.
Projects did oer job opportunities and positions for a signicant number of
people over the years. In fact, people would joke and talk about the AIDS industry as
a new sector with job prospects in society. e industry not only held possibilities for
salaried jobs, but also for positions as volunteers, expert clients and dierent kinds of
group members, who would sometimes receive an allowance. Ivan and his wife held
several AIDS-project-related volunteer and group member positions, which may not
have provided an income, but occasional allowances, something to identify with and
something to guide them through the diculties they faced. As described by Prince
(2012) for Western Kenya, practices of volunteering spread rapidly with AIDS projects
and became important ways of trying to create a livelihood. People – like Ivan – were
trained as counsellors and acquired skills from projects that they could apply in other
walks of life.

Lotte Meinert and Susan Reynolds Whyte
92 • Cambridge Anthropology
Uncertain Endings
e AIDS epidemic is a continuing process with uncertain endings. What will happen
in the ird Act of the drama we have described? e First Act of response focused
on prevention and support interventions, when the basic pattern of projectication
was established. e Second Act, which we have described in some detail in this
article, was characterized by an epidemic of projects centring on treatment. We now
seem to be at a turning point, when many projects are closing down and patients and
employees are wondering and worried about the future. e sense of emergency around
the AIDS epidemic in Uganda has diminished as the illness and its management have
become familiar. Clients of treatment projects are managing their homework of ‘living
positively’ in everyday routines. But the situation is extremely fragile. When there is no
sense of emergency around an epidemic, it is likely to be more dicult to mobilize the
enthusiasm and nancial support needed to carry on the long-term work of setting up
permanent systems that are sustainable beyond time frames of ‘projects’.
When Mzee Emojong, whose words opened this article, advised his children to get
into a project if they wanted to survive, because ‘these days the world is run by projects’,
he was referring both to the treatment options and to the job opportunities created by
the AIDS projects. Emojong was retired, but had a long history in government work,
including senior ministerial positions in former regimes, and he was part of a longer
family trend of being involved with government and colonial administration. When
he reected upon the recent developments towards projects and away from state-run
health care and government work, he was somewhat resentful and nostalgic, because
he still believed in the idea of a modern state governing the development of the nation
and distributing resources and opportunities according to principles he understood
and felt were democratic and transparent. Yet he was also pragmatic and realized that
projects had advantages; they were exible and were backed by heavy donors who could
make things happen in a way that government bodies oen failed to do. Most of his
children followed his advice. One of them became a client in an AIDS project. ose
who had the qualications applied for jobs with projects and two of them were lucky.
One of them became Ivan’s counsellor and the other got Ivan into the project and
delivered his medicine by motorbike to his home. Mzee Emojong was grateful that one
of his children had been accepted onto a treatment project and appeared to survive
and thrive. He had lost two other children to AIDS and knew what it meant to be
ghting for public health care, and trying to pay for the medication privately. He was
also relieved that two of the children had secured salaried jobs though projects, which
took some of the nancial burdens o his shoulders. Yet before Mzee Emojong died he
also expressed his worry that ‘these projects never last’. Where would his daughter get
medicine when the project closed? How would the counsellor and the eldworker earn
a salary when the project ended? Would new projects oer opportunities?
Notes
1. CD4 is a type of white blood cell that helps ght infection.
2. A critical event that preceded the national rollout was the court case in South Africa that resulted in
the abandonment of the patent on ARV medicine, making it far more aordable.
3. For a description of this early period, see Kinsman (2008) and Mugyenyi (2008).

AIDS Responses in Uganda as Event and Process
Cambridge Anthropology • 93
References
Barnett, T., & A. Whiteside. 2006. AIDS in the Twenty-rst Century: Disease and Globalization
(2nd edition). Basingstoke: Palgrave Macmillan.
Chabal, P., & J.P. Daloz 1999. Africa Works: Disorder as Political Instrument. Bloomington:
Indiana University Press.
Das, V. 1995. Critical Events: An Anthropological Perspective on Contemporary India. Delhi:
Oxford University Press.
Geissler, P.W. In press. Introduction: Life-science in its African Para-state. In Para-states of
Science: Ethnographic and Historical Perspectives on Life-science, Government and Public in
21st Century Africa (ed.) P. Wenzel Geissler. Durham: Duke University Press.
Ilie, J. 2006. e African AIDS Epidemic: A History. Athens: Ohio University Press.
Kinsman, J. 2008. Pragmatic Choices: Research, Politics and AIDS Control in Uganda. PhD
thesis, University of Amsterdam.
Mattingly C., L. Grøn & L. Meinert. 2011. Chronic Homework in Emerging Borderlands of
Healthcare. Culture, Medicine and Psychiatry 35(3): 347–375.
Meinert, L. 2014. Regimes of Homework: Questions of Responsibility and the Imagination
of Lives in Uganda. In Making and Unmaking Public Health in Africa: Ethnographic and
Historical Perspectives (eds.) R.J. Prince & R. Marsland, 119–139. Athens: Ohio University
Press.
Meinert, L., M. Whyte, S.R. Whyte & B. Kyaddondo. 2004. Faces of Globalization: AIDS and
ARV Medicine in Uganda. Folk 45: 105–123.
Midler, C. 1995. ‘Projectication’ of the Firm: e Renault Case. Scandinavian Journal of
Management 4: 363–375.
Morris, R.C. 2008. Rush/Panic/Rush: Speculations on the Value of Life and Death in South
Africa’s Age of AIDS. Public Culture 20: 199–231.
Mugyenyi, P. 2008. Genocide by Denial: How Proteering from HIV/AIDS Killed Millions.
Kampala: Fountain Press.
Mugyenyi, P. 2012. A Cure Too Far: e Struggle to End HIV/AIDS. Kampala: Fountain Press.
Nixon, S.A., J. Hanass-Hanock, A. Whiteside & T. Barnett. 2011. e Increasing Chronicity
of HIV in Sub-Saharan Africa: Rethinking ‘HIV as a Long-wave Event’ in the Era of
Widespread Access to ART. Globalization and Health 7: 1. Available at <http://www.
globalizationandhealth.com/content/7/1/41>.
Nguyen, V.-K. 2010. e Republic of erapy: Triage and Sovereignty in West Africa’s Time of
AIDS. Durham and London: Duke University Press.
Parkhurst, J.O. 2005. e Response to HIV/AIDS and the Construction of National
Legitimacy: Lessons from Uganda. Development and Change 36: 571–590.
Petryna, A. 2002. Life Exposed: Biological Citizens aer Chernobyl. Princeton: Princeton
University Press.
Prince, R. 2012. HIV and the Moral Economy of Survival in an East African City. Medical
Anthropology Quarterly 26: 534–556.
Putzel, J. 2004. e Politics of Action on AIDS: A Case Study of Uganda. Public Administration
and Development 24: 19–30.
Rosenberg, C.E. 1989. What is an Epidemic? AIDS in Historical Perspective. Daedalus 118:
1–17.
Singer, M., & S. Clair 2003. Syndemics and Public Health: Reconceptualizing Disease in Bio-
Social Context. Medical Anthropology Quarterly 17: 423–441.
Smith, J.H., & A. Whiteside. 2010. e History of AIDS Exceptionalism. Journal of
the International AIDS Society 13: 47. Available at <http://www.jiasociety.org/
content/13/1/47>.

Lotte Meinert and Susan Reynolds Whyte
94 • Cambridge Anthropology
Swidler, A. 2009. Dialectics of Patronage: Logics of Accountability at the African AIDS-NGO
Interface. In Globalization, Philanthropy, and Civil Society (eds.) D. Hammack & S.
Heydemann, 192–220. Bloomington: Indiana University Press.
ornton, R.J. 2008. Unimagined Community: Sex, Networks, and AIDS in Uganda and South
Africa. Berkeley: University of California Press.
Van der Geest, S. 1988. e Articulation of Formal and Informal Medicine Distribution
in South Cameroon. In e Context of Medicines in Developing Countries: Studies in
Pharmaceutical Anthropology (eds) S. van der Geest & S.R. Whyte, 131–148. Dordrecht:
Kluwer Academic Publishers.
Whiteside, A., & J. Smith 2009. Exceptional Epidemics: AIDS Still Deserves a Global Response.
Globalization and Health 5: 15.
Whyte, S.R. (ed.) In press. Second Chances: Surviving AIDS in Uganda. Durham: Duke
University Press.
Whyte, S.R., & H. Birungi. 2000. e Business of Medicines and the Politics of Knowledge in
Uganda. In Global Health Policy, Local Realities: e Fallacy of the Level Playing Field (eds)
L. Whiteford & L. Manderson, 127–148. Boulder, CO: Lynne Rienner.
Whyte, S.R., M.A. Whyte, L. Meinert & B. Kyaddondo. 2004. Treating AIDS: Dilemmas of
Unequal Access in Uganda. Journal of Social Aspects of HIV/AIDS 1: 14–26.
Whyte, S.R., M.A. Whyte, L. Meinert & J. Twebaze 2013. erapeutic Clientship: Belonging in
Uganda’s Projectied Landscape of AIDS Care. In When People Come First: Critical Studies
in Global Health (eds) J. Biehl & A. Petryna, 140–165. Princeton: Princeton University
Press.
Wolf, E.R. 1966. Kinship, Friendship and Patron–Client Relations. In e Social Anthropology
of Complex Societies (ed.) M. Banton, 1–22. London: Tavistock.
Lotte Meinert is a Professor of Anthropology at the Department of Culture and Society,
Aarhus University, Denmark, and currently a visiting scholar at the Department of
Anthropology, Johns Hopkins University, USA. She has recently co-authored ‘Tests
for Life Chances: CD4 Miracles and Obstacles in Uganda’, Anthropology and Medicine,
2009, 16(2): 195–209; and ‘Creating the New Times: Reburials aer War in Uganda’, in
Taming Time, Timing Death. Social Technologies and Ritual (eds) D.R. Christensen &
R. Willerslev (2013).
Susan Reynolds Whyte is a Professor at the Department of Anthropology, University
of Copenhagen. She is co-author of ‘erapeutic Clientship: Belonging in Uganda’s
Projectied Landscape of AIDS Care’, in When People Come First: Critical Studies in
Global Health, (eds) João Biehl & Adriana Petryna (2013) and the editor of Second
Chances: Surviving AIDS in Uganda (in press).