HIV and AIDS, Vulnerability and the Governance Agenda: A Critical Perspective on Barbados

• Author: Philip Nanton
• Pages: 277-294

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HIV AND AIDS, VULNERABILITY AND THE GOVERNANCE AGENDA

HIV and AIDS, Vulnerability and

the Governance Agenda

Philip Nanton

Chapter 14

A Critical Perspective on Barbados

In the context of governance and the response to the HIV epidemic,

‘vulnerability’ is predominantly perceived as an outcome of a failure

to avoid the virus and is a term applied to individuals and groups at risk.

As a term denoting a specific process of ‘managing’ HIV, however, it may

also serve both as an instrument of hegemony when linked to governance,

and as a trigger to resistance and resilience at the societal level. These

alternative perspectives on ‘vulnerability’ arise out of the tension between

the state’s response to the risk intrinsic to sexual practice as requiring

some form of regulation, while simultaneously struggling with the

recognition that sexual practice finds expression in a variety of ways,

ranging from the conventional to transgressive eroticism. My chapter

examines how these tensions and blind spots are negotiated in Barbados,

a place with a relatively low incidence of HIV in the wider Caribbean

region, but a number of entrenched social attitudes towards sexuality.

VULNERABILITY AND HIV GOVERNANCE IN THE

BARBADOS CONTEXT

It is now commonplace that the Caribbean region is experiencing an

HIV epidemic that is second only in size to that affecting sub-Saharan

Africa. The characteristics of the HIV epidemic in the Caribbean,

including Barbados, are clearly defined. It is predominantly sexually

transmitted and heterosexual, not easily detected in the early stage, and

affects the most productive members of society. A central problem in

responding to the HIV epidemic is how governance should manage social

change to mitigate its ravages.

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SEXUALITY, SOCIAL EXCLUSION AND HUMAN RIGHTS

Barbados has experienced what has been described by UNAIDS as a

more moderate HIV epidemic than other parts of the region. Between

the years 2001–2006, the average number of people diagnosed with HIV

each year was 184. At the end of 2006, 1,998 people diagnosed with

HIV were known to be alive (Barbados Ministry of Health 2006).

However, based on an estimate of undercounting, this figure is reckoned

to be less than half the total number of people living with HIV in

Barbados. The implication of this, as the Ministry of Health notes, ‘is

that the majority of PLWHA in Barbados do not know they are infected

with HIV’. Two important issues in the management of the epidemic

have been the context in which it is to be managed and the effectiveness

of the strategy to be pursued.

Alongside its relative prosperity and stability, since the late 1990s

Barbados has been experiencing a cultural crisis which has triggered the

need to reassert ‘moral values’. This crisis involves a host of recurring

moral panics, periodically brought to public consciousness by the press

and other media. They include ‘ZR van culture’ (privately owned, mini-

van transport for the general population, identified by ZR number plates),

youth sexuality, homophobia and the spread of HIV and AIDS. In 2000,

an eminent newspaper columnist noted the society was facing ‘a crisis of

moral values that Barbados can’t afford to ignore or rationalize’ (Singh

2000). Since the millennium, Barbados has established two national

commissions of enquiry that focus on issues of national cohesion –– the

National Committee of Eminent Persons to Coordinate National

Reconciliation and the National Commission on Law and Order;

established in 1999. In 2006, a less formal and more widely structured

National Consultation to Address Societal Issues was initiated ( November

27, 2003), inspired by religious leaders and NGOs. Owen Arthur, prime

minister and leader of the Barbados Labour Party for three terms of office

up to January 2008, repeatedly drew attention to this moral crisis. A

sense of moral panic was also expressed in the form of prophetic warnings

of impending calamity and destruction of the society by local religious

visionaries. In 2006, these warnings increased substantially and, on

September 5, Arthur chose to entertain a number of the prophets (Morris