Miller Casey James
Department of Anthropology, Bryn Mawr College.
Med Anthropol Q. 2016 Sep;30(3):414-30. doi: 10.1111/maq.12300. Epub 2016 Jul 6.
Drawing on 17 months of ethnographic fieldwork (2007-2011), this article critically examines the consequences of two global health initiatives (GHIs), the Global Fund and the Gates Foundation, on NGOs engaged in HIV/AIDS prevention and treatment among gay men in northwest China. I argue that a short-term surge in funding provided by GHIs between 2008 and 2010 exacerbated preexisting conflicts between NGOs by promoting a neoliberal process in which the state outsourced public health services to civil society organizations, deliberately encouraging a climate of competition among NGOs. I also show how GHIs encouraged the bureaucratization and medicalization of one grassroots gay NGO, channeling its activities away from broader political and social objectives and compelling the group to develop a narrower and more entrepreneurial emphasis on HIV testing and treatment. This article contributes to a deeper ethnographic understanding of the complex and perhaps unintended consequences of GHIs.
本文基于17个月的民族志田野调查（2007 - 2011年），批判性地审视了两项全球卫生倡议——全球基金和盖茨基金会，对中国西北部从事男同性恋者艾滋病毒/艾滋病预防和治疗工作的非政府组织所产生的影响。我认为，2008年至2010年间全球卫生倡议提供的短期资金激增，通过推动新自由主义进程加剧了非政府组织之间原有的冲突，在这一进程中，国家将公共卫生服务外包给民间社会组织，蓄意营造了非政府组织之间的竞争氛围。我还展示了全球卫生倡议如何促使一个基层男同性恋非政府组织走向官僚化和医学化，使其活动偏离更广泛的政治和社会目标，并迫使该组织将重点更狭隘地转向创业型的艾滋病毒检测和治疗。本文有助于通过民族志更深入地理解全球卫生倡议的复杂且可能意想不到的后果。
