Process experiences. limitations, and politics of ARV treatment in Mozambique.

I argue in this thesis that successful access and delivery of antiretroviral treatment essentially depends on the interrelatedness between individual, social, and political processes. It takes the case of Mozambique, a hard-hit poor country in Southern Africa, which offers free ARVs on a 'first come first served' basis, supported by all major international donors. The HIV epidemic will be analyzed in a time perspective to show this interrelated process. This entails a move between experience and politics using classical anthropological perspectives on power, politics, social order, taboo, rites of passage, risk environment, and structural, symbolic, cultural, social, and everyday violence. Life story interviews, ethnographic interviews, participant observation, and focus groups are key methods that lead the descriptive and analytical narrative of this particular landscape, which was pieced together by multi-site fieldwork in Maputo City, where all major government, international community, civil society, and treatment implementing actors reside. The outcome is unique and detailed accounts of the reality of ARV rollout in Mozambique, which relates experience living with ARVs, epidemiology, consequences living without ARVs, health worker experience delivering ARVs, health system capacity, advocacy, history, and politics of ARVs, health care, and nation-building. This will show how the individual level of access relates to the macro level of the political struggle for independence and sovereignty, intertwined by ever-changing social constraints that feed on the delicate (im)balance between experience and politics. The study thus deviates from classical adherence, stigma, civil society, and governance studies, which tend to focus exclusively on the patient, society, or political institutions. Such micro-macro anthropology invariably recognizes two sides of the coin: success and failure, which is a constant struggle between the state of endemic socio-structural crisis and (dis)order, political leadership, and international solidarity, against the creeping and concrete reality of normalization of life and death