The Politics of the Idea of Partnership: From contemporary aid policy to local health governance in practice in Zambia

This thesis explores the idea of partnership in contemporary aid policy and practice. Drawing on a multi-disciplinary body of literature that is broadly ‘constructivist’ in orientation, and using the Global Fund to Fight AIDS, Tuberculosis and Malaria, the health Sector-Wide Approach (SWAp) and the health sector in Zambia as case studies, the research uniquely explores how (and why) the idea of partnership is a pervasive feature in aid policy, and how this relates to and shapes local practice, including the practice of politics that this enjoins. Drawing on textual analysis of policy documents and on qualitative field research conducted in Zambia between November 2008 and July 2009, the thesis provides a number of important and novel insights. Firstly, it shows how the idea of partnership began its contemporary life in the socio-political relations of aid institutions and in the context of an aid crisis in the 1990s. Secondly, it shows how the idea travelled ideationally and geographically, through an elite network of aid agency actors (cf. Mosse, 2007), eventually becoming an expected and symbolic motif of aid policy. Thirdly, the thesis suggests why partnership remains a pervasive policy idea; featuring in SWAp and Global Fund policy because it symbolically conceals the existence of different perspectives about the right relations of health and developmental governance. Fourthly, and at the same time, the thesis shows how partnership is dominantly constructed in aid policy in a depoliticised way – as a technical and economic way to organise action – due to the prevailing power of donor governments and aid agencies in the socio-political processes that produce aid policy and the context of inequality in which aid is governed. Finally, the thesis shows how the depoliticisation of policy is ‘unravelled’ in the health sector in Zambia as partnership is translated, in and through the politics of collaboration, contestation, and compromise (Mosse, 2007, p.2, 2005a p.645; Rossi, 2006; Bending and Rosendo, 2006). This shapes, contorts and constrains local health governance in diverse and unexpected ways