Add to bookbag
Author: Ahmed C. Bawa
Title: Science, Power and Policy Intersecting at the HIV/AIDS Pandemic
Publication info: Ann Arbor, Michigan: MPublishing, University of Michigan Library
passages
June 2005
Rights/Permissions:

This work is protected by copyright and may be linked to without seeking permission. Permission must be received for subsequent distribution in print or electronically. Please contact mpub-help@umich.edu for more information.

Source: Science, Power and Policy Intersecting at the HIV/AIDS Pandemic

no. ns 2, June 2005
URL: http://hdl.handle.net/2027/spo.4761530.0010.010

SCIENCE, POWER AND POLICY INTERSECTING AT THE HIV/AIDS PANDEMIC

Ahmed C. Bawa

Professor of Physics, Hunter College, City University of New York, New York [1]

Introduction

The HIV/Aids pandemic is firmly threaded into the fabric that is South Africa and it has many diverse and complex influences on the texture of that fabric. These influences drive new sets of social and political dynamics that have severe long-term implications. The first democratic election late in April 1994 took South Africa across a threshold with popular hopes and promises of justice, peace, human rights and social development. South Africa is a theatre with a myriad stages each shaping new imaginations of a society in creation, a society in transition, a society in transformation. These imaginations find expression in discourses of various kinds, including the development of policy frameworks and the creation of new social institutions or the transformation of existing ones. These discourses are constrained by local and global conditions that are constantly evolving. The HIV/AIDS pandemic is perhaps the most powerful of all of these as it brings enormous stresses to bear on South Africa's delicate and fragile processes of democratic construction, nation building and social and economic reconstruction. Reframing Infectious Diseases at the Institute of the Humanities at the University of Michigan is an interesting opportunity to reflect on and rethink the way in which infectious diseases are socially constructed and how they impact on nature and essences of democracies.

As I planned this talk, I thought that I would simply tell the tale from the point of view of science even though this would be a preferred reference frame. As my thoughts unfolded yet again, it was clear to me that we had to do better at allowing diverse South African voices to somehow intersect and interact with each other. While the science tale is briefly told in this paper, it is supplemented through an approach based on the multitude of metaphors [2] that are used to talk about the pandemic.

The Social Expressions of the HIV/Aids Pandemic in South Africa

The social expressions of this pandemic are many. (Kauffman, Lindauer, 2004) The most vivid are the pure devastation of individual lives - not just death and destruction but also the complex psychosocial alienation of infected individuals who live in communities that see the disease through the lenses of various kinds of moral certitudes. The impact of this localized devastation on the nature of community, its structure and its cohesion, has long-term implications in the context of a society that has only begun to just emerge from the devastation to community of the Apartheid system. Claude Ake, the late Nigerian political scientist, visited South Africa in the early '90s and after traveling through rural and urban KwaZulu-Natal and sharing thoughts with people, shared his thoughts with students and faculty in Durban. His main observation was that while he had seen greater poverty and depravation in other parts of Africa, he had not ever seen the utter breakdown of community that he witnessed as he traveled through rural villages and urban townships. This was due to the impact of apartheid South Africa's deeply racialized migrant labour system, the lifeblood of South Africa's capitalist system. How would these already depleted communities respond to the challenges of the pandemic? And notwithstanding the wonderful strides made by the new democracy in shaping a strong culture of human and civil rights, how would they emerge from it? What impact would it have on the future coherence of the broader society? For instance, with all the advances made in constitutionally securing gender rights, how would the pandemic impact on gender relations within households and in communities?

These lead to macro social expressions that relate to the long-term behaviour of the social and economic health of the society in general. And economists have done extensive studies of the impact of the pandemic on the state of the economy and in particular, its impact on capacity of the economy to grow - a requirement for post-Apartheid reconstruction. (Sachs and Sachs, 2004; Poku and Whiteside, 2004)

Yet another form of social expression of the pandemic is represented by the stresses it brings to bear on the project of nation building. Like much of social discourse in South Africa, the racial and gender expressions of the pandemic threaten to unravel any attempt to build a rational approach to it. The scars of Apartheid are deep and complex. (Herwitz, 2002) While race and gender are seriously discussed, neither racism nor sexuality has yet been properly examined in terms of their place as fundamental underpinnings of this nation's past or its future. (Posel, 2003)

The impact of the pandemic on social institutions in the particular context of a developing nation is yet another social expression. The most direct impact here are the stresses placed on the health system and its capacity. The impact of the pandemic reaches into the education system through its impact on teachers and the teenage population. It plays itself out systemically on all public, private and non-governmental institutions, many of which had plotted out post-Apartheid reconstructive agendas that have had to give way to the containment of a crisis. (Kauffman, 2004)

Perhaps most serious of all of these social expressions is the impetus of the pandemic to destroy the imagination of liberation as it spawns complex and often terrifying interpretations of itself - often drawing on superstition, outlandish conspiracy theories, religious bigotry and various kinds of political bullying. In particular, it may threaten the project to construct a complex multilayered democracy. One startling indication of this is the fact that the pandemic has unraveled an earlier optimistic consensus about the role of science in development. It has brought to the fore a set of contestations around the social construction of knowledge and how this plays itself out in the terrain of policy construction and implementation. It is this that is the subject of this paper.

Much has been written about the pandemic. This paper attempts to explore what happens at the nexus of science, power and policy as they intersect at the pandemic. This is a lens to observe their interweaving.

Science and the Pandemic

Biomolecular science tells us what the genetic material of HIV is and that it encodes 15 proteins and that considerable insights have been gained into the function of these different products. The science also explains the way that the retrovirus penetrates the cell membrane and what it does inside the cell. With regard to this there does not appear to be any discord among researchers.

Diseases related with HIV result from a gradual deterioration of the immune functions of the infected human system. Crucial immune cells called CD4+ T cells are disabled and cease functioning during the typical course of infection. These "T-helper cells" are central players in immune response systems. They signal other cells in the immune system to perform their special functions. About this there is discord. According to the established dominant biomolecular position there is incontrovertible experimental evidence and a sufficient theoretical framework to understand the causation pathway and the phenomenology. A minority group does not agree with this - and in particular with the findings on causation. While the arguments within this group do not appear to be uniform, Peter Duesberg, its most consistent spokesperson, captures it in the following way. He puts forward the hypothesis that the various American/European AIDS diseases are brought on by the long-term consumption of recreational drugs and/or the use of antiretroviral drugs and in the case of the African pandemic, he hypothesizes that this is an outcome of malnutrition. [ http://www.duesberg.com/ ]

The single voice of the establishment is that there is no evidence to support the Duesberg hypothesis. It identified Duesberg's arguments as largely rhetorical and unsupported by the data that was available. Initially, it did not altogether rule out this theory but after further investigation the hypothesis was rejected as untenable. Today, it is argued more formally, that there are overwhelming epidemiological and experimental data to satisfy all three of Koch's postulates, establishing to a virtual certainty that HIV causes AIDS. In essence, for scholars holding the dominant view, all formal routes to test the Duesberg hypothesis have now been tried. And it is argued that in terms of the usual validation procedures in formal scientific practice this points towards a consolidation of the dominant view as the correct one, unless and until new experimental or theoretical evidence arises which contradicts that view.

Discord amongst groups of scientists is common, expected and sometimes remains unresolved. The problem with this particular discord is that it plays itself out in the approach of the two groups to the principles underpinning the treatment regimes for AIDS sufferers. It has an impact on the lives of millions of people. The group that we refer to as the dominant group sees a three-pronged attack as the best approach: education, prevention (use of condoms, better nutrition, etc.) and treatment (such as the administration of antiretroviral drugs and microbicides, nutritional enhancements, etc.). In terms of the African pandemic, the minority group is clear that the pandemic is really related to malnutrition and opportunistic infectious diseases such as tuberculosis and that it is best treated by treating the symptoms and by treating the malnutrition.

South Africa generated other scientific approaches. A group of transplant researchers at an academic hospital in Pretoria produced a potential 'cure' for AIDS; a drug was called Virodene. The research group had sought permission from the Medicines Control Council to carry out clinical tests and this was rejected. But the group continued its trials under the protection and sponsorship of then Minister of Health, Nkosazana Dlamini-Zuma and then Vice President Thabo Mbeki. [3] To achieve this line of patronage, the Minister of Health disbanded the MCC and restructured it. According to a Mail and Guardian report in March 1998, "The Virodene researchers had so little respect for the humanity of the subjects of their trial—11 seriously ill AIDS patients—that they did not even bother to submit themselves to a committee. Subsequent attempts by the researchers to construct trials have not passed the ethical standards required."

The South African Science System and HIV/Aids

The science system comprises of the universities, the state-supported science councils (such as the Medical Research Council (MRC)) and private sector laboratories.

In 1994, significant policy exercises were undertaken to study and reshape the science system to resonate with the new realities of a free but deeply divided South Africa. Many structural problems and questions of ethos were identified. Relevant for this discussion, three are important. The first is that the system was hopelessly disarticulated from the challenges facing a nation in reconstruction. Here was a system that produced the world's first heart transplant but was unable to deal effectively with the usual diseases of the developing world: malaria, tuberculosis, cholera, etc. The second is that the system suffered from severe race and gender imbalances - overwhelmingly white and male. The third was that this system was underpinned by western scientific norms and knowledge systems and that it positively discriminated against other knowledge systems, in particular what have come to be known as indigenous knowledge systems.

Each of the medical schools and the MRC had established large research projects on HIV/Aids, many of them in collaboration with groups elsewhere in the world, largely as a result of the need to tap into the HIV/AIDS expertise and research budgets available to the research institutes of the global North.

The so-called dissident voice in this system is very small and very weak and its views were quickly and comprehensively dispelled on the basis of the scientific details. The purpose for a rapid response was to prevent confusing messages relating to the education and prevention regimes that were so crucial to bring the pandemic under control.

The Government and HIV/AIDS

The Virodene issue raised the spectre of high-level government intervention in matters that were referred to the MCC, a state-appointed independent institution. The decision of the MCC was regarded as inappropriate - too bound by the dictates of a science model that reached back into Apartheid's past. The researchers involved were invited to present the wonder drug to cabinet and it was reported that cabinet gave them a standing ovation with the promise of research money since the MRC, which was responsible for distributing funding from the national budget for medical research had also turned down their application on scientific grounds. This was an early indication that the government was prepared to intervene in and subvert the scientific process if the process appeared to them to be discriminatory. The response of the science system was that the science process was indeed designed to discriminate and that the process followed was self-consistent.

It is a global phenomenon that governments in the South take a long time to acknowledge the fact that they face an HIV/Aids epidemic. In South Africa too this was the case but there was an additional factor in this case. Quite soon after becoming President, Mbeki acknowledged the existence of the Aids pandemic but questioned the closure on causality - he questioned whether the retrovirus was responsible for the development of Aids. It has been reported that his curiosity arose out a session of internet surfing which pointed him towards the alternative views of the minority group mentioned above. (van der Vliet, 2004)

Mbeki's curiosity did not lead him to convene a meeting of the leading local scholars to help him work through the issues. Nor did he ask the National Advisory Council on Innovation which is tasked to advise cabinet on science issues to convene the necessary meetings to address the questions. He sent a substantial body of literature to President of the MRC, Dr Malegapuru Makgoba who responded to Mbeki that this information was not founded on scientific grounds. This advice was not adopted. When his concerns with the causation argument were publicized the unfolding discourse located him as a preeminent spokesperson of the minority group. While the South African science system was funded by the government to work on an HIV vaccine, on a large number of antiretroviral tests, etc., the leader of that government had decided that he wasn't sure that the causation debate was closed - in fact, he thought that the retrovirus was incapable of producing a disease as complex as AIDS. Members of the minority group were then invited to serve on various advisory panels.

What must have been an attempt to preempt global fall-out from this public announcement, Mbeki wrote a letter to various world leaders including Bill Clinton and Kofi Annan detailing the logic of his exploration. This is a complex letter and I refer to just two points of relevance. The first was that dissent in the scientific community was being prohibited. He went on to say: "We are now being asked to do precisely the same thing that the racist apartheid tyranny we opposed did, because, it is said, there exists a scientific view that is supported by the majority, against which dissent is prohibited....The day may not be far off when we will, once again, see books burnt and their authors immolated by fire by those who believe that they have a duty to conduct a holy crusade against the infidels." It was clearly the case then as it is now, that Mbeki had not actually understood the scientific process or actually engaged with it to determine what processes of contestation and discrimination had occurred. Vice President Jacob Zuma amplified this further. On a radio news programme, he made a statement to the effect that he didn't quite understand what the fuss was about since all the government was doing was providing mediation between two groups of scientists who had different views on a scientific matter so that they could arrive at a consensus. The second point of relevance in the letter was that this pandemic was a particularly African problem and that the solutions to it will be found in Africa. This placed this pandemic at the centre of an African-essentialist thesis.

Mbeki's anxiety about the science system expressed itself most emphatically at the inaugural ZK Matthews Lecture that he gave in November 2000 at the University of Fort Hare. He referred to the nation's medical schools as places where black South Africans were "reminded of their role as germ carriers". He went on to say: "Thus does it happen that others who consider themselves to be our leaders take to the streets carrying their placards, to demand that because we are germ carriers, and human beings of a lower order that cannot subject its [sic] passions to reason, we must perforce adopt strange opinions, to save a depraved and diseased people from perishing from self-inflicted disease." And slightly later on in the talk he addresses what must be a deeply held and abiding concern about 'western science' when he says "Convinced that we are but natural-born, promiscuous carriers of germs, unique in the world, they proclaim that our continent is doomed to an inevitable mortal end because of our unconquerable devotion to the sin of lust."

In another response to an article on the discord, members of the cabinet refer to South African scientists as 'village boys returning from the city' as defending their global counterparts and being dependent on science at the metropoles in the global North.

What does one gather from this? Firstly, it is clear that there is a deep distrust amongst South Africa's politicians of its establishment scientists and science system. The system (including white and black scientists and science managers) was seen to shape its science around deeply colonial and offensive interpretations of the lives of the majority of South Africans. The politicians were happy to gamble with the Pretoria group (all white scientists) that produced Virodene but this was presumably because that had been turned away for research funding by the establishment and were putting forward an 'African' solution. The politicians were happy to tap into the work of the minority group involving people like Duesberg even though it was international. The local scientific establishment was seen to be in cahoots with the global one - an uncritical, subservient branch of it.

Secondly, there appears a broad thrust around the need for Africa to find a solution to what was deemed to be an African problem. The Department of Health and other governmental agencies have focused much attention on possible indigenous solutions through the incorporation of traditional health systems in the overall strategy, the use of particular nutritional regimes and the use of herbs and other medicinal plants.

Thirdly, it is clear that there are deep suspicions of the role of the multinational pharmaceuticals in establishing and progressing the establishment position - as a means to build up the markets for antiretroviral drugs. And of course, what we might refer to as the 'industrialization of science' increases the suspicion that the scientific establishment has carved out a niche for itself in the sordid money business.

Fourthly, and perhaps most controversially, issues related to the sexual behaviour of South Africans, unresolved issues around sexuality and the fact that most of the education and prevention programmes are focused on sexual behaviour change appears to be a recurring theme. In particular, the focus of the attack spans the entire spectrum: the educators, the people working on prevention and the scientific fraternity that seeks to establish ARV treatment regimes of Aids sufferers.

As was pointed earlier, this state of distrust occurs while the state sponsors large research exercises in the search for a vaccination, in major tests related to ARV treatments, in major epidemiological studies, in social science enterprises to address the needs of behaviour changing education and prevention programmes, etc. How is one to understand this?

The Policy Development Process

The policy development processes relate to the science system and to the government in complicated ways. Policy development is the responsibility of government departments, the bureaucracy. The responsible minister gives the department the go-ahead to set in place a process. In a context like South Africa's this usually entails creating teams of people that usually draw on mainstream scientists, usually researchers who have a history of working with the liberation movement and with the new government.

We begin by looking at the science-policy nexus in the policy development process. The relationship between the university-based researchers and the government departments result in policy discussions, debates and papers which take into account a set of national constraints: the macroeconomic plan, existing policies, the state of the human resource pool, etc. Once the various papers have been produced the process enters the political phase and finds its way through cabinet, to parliament and its various committees and then back to cabinet. Along the way changes are inscribed on the document. Most researchers who were allied with the liberation movement see this kind of engagement as an opportunity to maintain social and political engagement as a means to continue to contribute to the 'struggle' for reconstruction and development. (Padayachee, 2000)

There are several sources of tension in the science-policy nexus. In areas such as HIV/Aids there may well be deeply divisive chasms that arise from disagreements on the basic science between the researchers and the bureaucrats. This may be exacerbated if there is an executive arm of government that directs the construction of the basic science discourse. The second is that policy development is always about choices and the priorities of government may not coincide with those that emerge in the process of research. Very often these choices are difficult in resource-constrained conditions. The third is the concern of engaged, university-based researchers that they are seen, on the one hand by peers to have sold out to and on the other hand, by the government to belong inside the domain of policy construction. This is to say that in this still very young and fragile democracy, there isn't yet a clear understanding of the role of university-based intellectuals in such processes. These researchers are therefore constrained in their ability to be critical of government policy and implementation and constrained in their ability to be seen as free agents in policy discourse outside of the policy development process. Fourthly, there is growing concern that the use of knowledge emerging out of scientific practice is being systematically eroded. And this arises out of a conflict in the understanding of how knowledge is socially constructed and how it is diffused into social processes of policy development.

The power-policy nexus is also extremely interesting since it brings to the fore a different set of tensions. There are various forces at play in the development of policy. We have concentrated on the role of the executive and the cabinet thus far. The South African parliament is constructed to play a counterbalancing role through its portfolio committees that are expected to draw as much public input as possible. The highest court in the land, the Constitutional Court is asked, from time to time to adjudicate the constitutional validity of policies and implementation strategies that are adopted by the government. Civil society organizations flex their muscles from time to time and one of the most potent has been the mobilization of the Treatment Action Campaign for the introduction of broad-based antiretroviral treatment regimes. This campaign is one of several that have helped to reinvent a national imagination about the role of civil society in post-Apartheid society, building on an extraordinarily rich history during the anti-Apartheid struggle. While opposition political parties are weak, organizations in the governing alliance are strong and influential and often take on opposing positions relative to the ruling party. Finally there is the powerful and ever-present private sector. Each of these influences the policy processes by exerting power in some form or other.

What kinds of tensions are these? First and foremost, the executive has a powerful hand in that it lays the backdrop of powerful superceding frameworks that act as the underpinning for all other policies. Very often these have not been adopted or agreed to by the other players in the policy generation game, hence this is a source of deep tension. The extra governmental players referred to above form interesting relationships with science to help shape their policy arguments. This applies to the alliance partners (the trade union movement and the South African Communist Party but not the ruling party), the civil society organizations and the private sector. The policy processes are required to take into account the many voices that constitute South Africa and often this entails building bridges where bridges may not be built.

Lessons for Building a Democracy

The issues that are laid out above indicate that the HIV/AIDS pandemic is a powerful lens to consider what elements are required to generate frameworks and institutions that are critical for the building of a democratic system. It allows us to use a host of deeply probing social expressions to drill down to the way in which such complex systems may be constructed. The science-policy-power nexus, suggests a range of rather important points.

The strained relationship between the science establishment and the cabinet has its roots in different understandings of how scientific knowledge is produced. This is vividly portrayed on the one hand by the anger and frustration of the scientific establishment that came to the fore once Mbeki's announcements made him a spokesperson for a set of discredited set of ideas. On the other hand it is highlighted by Mbeki's frustrations that scientific views put forward by reputable scientists had simply been rejected and isolated.

The status of scientific knowledge has different meanings for the different roleplayers. The health minister has said on several occasions that she cannot tolerate the situation where the views of a few people (meaning scientists) can affect the way in which a society relates to the pandemic. This points towards the need for the development of a consensus on how scientific knowledge relates to policy processes and public discourses.

Perhaps the way to think about this is to assess how it is that knowledge is socially constructed and how scientific knowledge might hold its integrity in such a process.

And this leads to the need for the development of an integrated knowledge system that admits the role of experts into processes that are broader in participation and which deal with large cross-cutting issues.

The undefined concept of an indigenous knowledge system that had forcibly been permeated into the national science system opens the way for interesting new approaches to the production of knowledge. It also however, strengthens the emergence of superstition, quackery and obscurantism, all of them trying to find a home within the national system.

The danger is that unless leadership emerges to find exciting and interesting ways to bring together these strands, this state of discord might form the basis for the emergence of an anti-intellectualism that simply disregards scientific knowledge in part or in whole because it falls foul of a political agenda.

Need for a New Framework! Why Metaphors?

To describe the potentially catastrophic relationship between science, policy and power is not enough. Is it possible to resolve these tensions through rational debate? This is not likely. There isn't a common medium through which such a discursive debate might occur. And the question is how might a more fluidized situation arise so as to permit engagement and interaction. In the rest of this paper we attempt to describe the use of metaphors in metaphor spaces (as means to provide structure) as one approach that might permit this.

Why has this occurred at a time when there was such hope and exuberance and euphoria? Transitions of the magnitude undergone by South Africa are complex. This particular one was arrived at through a process of broad-based struggle and negotiation. The struggle papered over deep divisions amongst the organizations and the people in the broad church that was the movement against Apartheid. The negotiations involved parties that really did not trust each other but who were driven by internal and external factors to arrive at suitable settlements on a range of very important social, political and economic parameters. Both before and after 1994, we found a way to talk to each other in multiple tongues that carried multiple meanings to veer away from impasses that would jeopardize a united front against Apartheid and then a negotiated settlement. Metaphors proliferated.

The Truth and Reconciliation Commission was neither about truth nor about reconciliation. The Reconstruction and Development Programme was neither about reconstruction nor about development. It was not even a programme. This is a time generating strategy - time to find a common tongue while the transition finds its way. Scientific metaphors are used all the time as a means to build models. And metaphors are used all the time in policy discourse as a means to mediate the very substantial uncertainties in the construction of policy in such a divided society. The question is whether there is a way to allow these metaphors to exist in common spaces and to interact in those spaces.

Conceptual conventional metaphors might provide the basis to capture the essence in these engagements. Using Lakoff's typology we consider, amongst others, the use of words with a number of related meanings and the use of patterns of inferences from one conceptual domain that are used in other domains. These might help us to expose the richness in diversity and in texture in these discourses related to the science of HIV that we are interested in and thereby release large amounts of contiguous information that may (ought to) help us to arrive at new approaches.

What I argue here is that we could have used the usual scientific analysis to understand the multiple discourses. The problem with this is that the multiple discourses are in different voices, largely running parallel to each other, failing to intersect at space-time points that are suitable for the kinds of analysis that we are used to doing. Studying the interaction of metaphors to explore the relationships in the power-science-policy triangle is an alternative approach. The metaphors speak in their own voices and are understood in their own voices.

What follows is a fanciful attempt to construct a model for such an approach. It begins with the construction of a space that permits these metaphors to play themselves out without entrenching the power relations that underpin the current contestations. We also look at ways in which these relevant metaphors interact with each other and what kinds of outputs may results from these interactions. The challenge of this approach is to build in mechanisms that allow the multiple voices to retain their integrity even as they interact. How would this be done in the context that hegemonic voices exist?

The Metaphor Spaces

Our interest here is to find ways to understand the way in which the domains of science, policy (research, development, implementation) and power relate to each other and how the different role-players (government, state/bureaucracy, civil society, scientists and the science system) interact in terms of these domains. This experimental approach begins with the creation of metaphor spaces. One can think of each of these spaces as containing the metaphors relating to a particular domain, which emanate from each of the roleplayers that are relevant. The spaces given below are not necessarily the correct ones or the only ones. They are chosen for illustrative purposes. It will be require much skill and understanding to choose the spaces that provide for the important interactions.

The Biomedical Metaphor Space. It contains all metaphors that relate to the bioscience of HIV and AIDS, the biomedical constructions, the epidemiological findings, the role of malnutrition in the construction of the pandemic and so on.

The Demographic Metaphor Space. We can think of this as the space that contains all the metaphors about the dynamics of the pandemic - its spatial and temporal spread, its dynamics within populations, its impact on economies, on health and education systems and so on.

The Science and Science System Metaphor Space. This space contains metaphors that relate to ways in which the roleplayers have depicted the science and the science system. There ought to be a particular emphasis here on the way in which the history of the system plays itself out in current interpretations, together with the perceived relationship between science and big business.

The Policy Development Metaphor Space. Policy construction is extremely contentious in post-Apartheid South Africa, balancing a variety of contending forces but forced in the end to synthesize approaches that must be implementable.

The Power Metaphor Space. How do the different roleplayers talk about power and how do they relate power to their notions of a young, vigorous, evolving democratic system?

It may well be that the choices made in terms of which metaphor spaces should be populated are not so crucial as long as the available metaphors find a home in which they can interact with other metaphors originating from all the roleplayers.

What might the properties of these spaces be? This is not clear yet but one can imagine properties of the following kinds that shape the way in which these metaphors might interact with each other.

These spaces might be completely empty. In other words it is fully possible that none of the roleplayers has anything to say about one or other of the key topics. There may be various reasons for this. One is that the roleplayers have no value for such metaphors. Another is that the complexity of the situation hampers the engagement of the roleplayers.

There may be just one metaphor in a space. That is, while each of the role-players has a metaphor for one of the topics, these metaphors may collapse into a single metaphor on the basis of a consensus.

There is no limit on the number of metaphors that each of the spaces might contain. Thus each of the role-players may have any number of metaphors for each domain.

It will be important for the metaphors to be space-time labeled in terms of origin and development so that their transformation and transformation rates might be recorded.

These metaphor spaces appear therefore to be open ended in a temporal sense. The rate of creation of new metaphors and the transformation of existing ones is a measure of the dynamism of the space. But would they also be open ended in a spatial sense? This depends on the way in which the role-players are defined. For instance, if we refer to the scientific community, not as the South African one, but as the global one then this guarantees open-endedness in spatial terms as well. One way of thinking about this is that these metaphor spaces may well migrate through different problems.

Interactions Between Metaphors

In terms of the usefulness of this kind of model as a discursive tool, it would be important after one sets up the metaphor spaces to define the rules relating to the interactions between the metaphors. The challenge is to understand how to introduce dynamics into the model. Perhaps the best way to approach this would be probably be to adopt an experiential model. However, I take this opportunity to introduce just two additional definitions for the metaphors, relating to the way that they may transform and therefore hint at the dynamics.

A metaphor contained in a space might transform into a new metaphor that will also exist in the space. The original metaphors remain in the space since they represent a set of metaphors that are a part of the diversity of the situation since they are a product of both space and time and would be labeled as such.

A metaphor might transform into an existing metaphor in that space and this alters the labeling of the transforming metaphor and the metaphor into which it transforms.

This transformation of metaphors might depend on one or more of a variety of different factors: the tensions within a single metaphor might propel it towards change, the interactions between a metaphor and other metaphors within a common metaphor space might cause it to shift, the connections between a metaphor and metaphors in other spaces could cause it to change and completely external factors might impact on it.

Watching the transformation of a metaphor that occurs as a result of interactions within a particular space would provide insights into the dynamics within a domain. For instance, is there a convergence in metaphors emerging between the different roleplayers relating to the biomedical interpretations of the pandemic? Or are the dynamics pointing towards greater divergence? What can we tell about the rate of change? Are the metaphoric representations in one of the domains of one of the roleplayers moving towards a state of tension or towards a state of cohesion? Is there a convergence in metaphors about the role of scientific knowledge in society?

But in such a scheme there may be yet another kind of interaction. Metaphors in one space might interact with metaphors in another space. So for instance one can think of the interaction between the biomedical metaphors of one of the role-players influencing the metaphors in the policy space either of that role-player or another role-player. This kind of interaction sets in place a new dynamism that may lead to unintended consequences - increasing or decreasing the systemic coherence. It opens up the possibility of a complex and cascading influence not just through metaphors but also through metaphor spaces. In some respects this kind of interaction might lead to outcomes that might be wholly trivial or extremely complex. And in terms of the latter the complex outcome might be beautifully complex or catastrophically complex.

Conclusion

This pandemic that rages through the bodies and minds of individuals, through whole communities, through whole societies has powerful and irreversible consequences through its ravages. In addition to the impact on the socio-economic conditions of its hosts at all these levels, it tears away at the fragile fabric of these societies by undermining the human rights and the democratic traditions of societies. It will force a reversal on the gains made through the struggles in all societies in terms of these. It is a challenge therefore to unravel these consequences from the pandemic and to understand how to optimally manage the pandemic and its consequences so that these societies are able to stay whole through the pandemic and after it. Special mechanisms may evolve to allow idea interactions to take place in their own voices so that they open the way for interesting convergences. To fail here might place these societies at the risk of anti-intellectual imaginations. The use of metaphors, metaphor spaces and metaphor interactions is perhaps one way of allowing these idea interactions in their own voices.


Ahmed Cassim Bawa is a theoretical physicist and is currently in the Department of Physics and Astronomy at Hunter College, City University of New York. He was recently program officer for higher education and scholarship at the Ford Foundation. He worked previously at the University of Natal, where he was the Deputy Vice Chancellor of Academic Affairs. He is Fellow of the Royal Society of South Africa as well as the Academy of Science of South Africa and served as Vice President for the latter from 1999-2000.

Literature Cited

Herwitz, Daniel. 2002. Race and Reconciliation: Essays from the New South Africa. Minneapolis: University of Minnesota Press.

Kauffman, Kyle D. 2004. "Why is South Africa the AIDS Capital of the World? An Institutional Analysis of of the Spread of the Virus." In Kyle D. Kauffman and David L. Lindauer, eds. AIDS and South Africa: The Social Expression of a Pandemic. New York: Palgrave Macmillan.

Kauffman, Kyle D. and David L. Lindauer, eds. 2004. AIDS and South Africa: The Social Expression of a Pandemic. New York: Palgrave Macmillan.

Padayachee, M. 2000. Professorial Inaugural Lecture, University of Natal.

Poku Nana, K and A. Whiteside, eds. 2004. The Political Economy of AIDS in Africa. Aldershot: Ashgate.

Posel, Deborah. 2003. "Getting the Nation Talking about Sex: Reflections on the Politics of Sexuality and 'Nation-Building' in Post-Apartheid South Africa." Manuscript.

Sachs, S. E., and J. D. Sachs. 2004. "Too Poor to Stay Alive". In Kyle D. Kauffman, and David L. Lindauer, eds. 2004. AIDS and South Africa: The Social Expression of a Pandemic. New York: Palgrave Macmillan.

van der Vliet, V. 2004. "South Africa Divided Against AIDS." In Kyle D. Kauffman and David L. Lindauer, eds. AIDS and South Africa: The Social Expression of a Pandemic. New York: Palgrave Macmillan.

NOTES

1. A version of this paper was earlier presented at the "Reframing Infectious Disease" conference, Institute for the Humanities, University of Michigan, December 2-4, 2004. The editors appreciate the Institute Director Danny Herwitz's assistance.

2. Susan Sontag has used metaphors as a way of talking about diseases and public health. In this paper we use metaphors to allow different voices to talk about diseases, the science, the policy development and the politics.

3. The Virodene issue has been covered extensively in the South Africa media. One example is Mail and Guardian, March 13th, 1998.

passages | http://quod.lib.umich.edu/p/passages/