Power Over Life, Power Over Populations
Lukasz Swiatek examines power between global players in the HIV/AIDS pandemic.
In a New Delhi hospital, Loon Gangte was waiting to collect HIV medication. The queue was long; the wait had lasted over an hour. When he finally reached the window and presented his prescription, the nurse on duty ordered him back to the end of the line. At first, Gangte could not understand why he was being discriminated against. “Much later I realized that my HIV-positive status compelled her to single me out and treat me differently,” he explains in an interview for UNODC. “During those days, if you were living with HIV, it [the prescription paper] was stamped prominently ‘HIV – Positive’.”
Such scenarios of discrimination are common around the world. They also reveal a unique form of power – ‘biopower’ – in action. Michel Foucault, the French scholar who developed this concept, contended that the politics of biopower regulate life itself. One of the issues in which this idea is most prominent is the global HIV/AIDS pandemic.
Rethinking Power
HIV/AIDS now affects an unprecedented number of people worldwide. At a September World Health Organization Sub-Regional workshop in Gaborone, it was revealed that the number of AIDS-affected victims had dramatically risen from eight million in 1990 to 33 million today.
The pandemic has also become a crucial issue for international actors. Its importance was underscored on 10 January 2000, when the United Nations Security Council put aside traditional conflict and security issues to consider the implications of the spread of the disease. As international relations scholar Stefan Elbe notes, “the Council had never before considered an illness to pose a threat to international peace and security”. The meeting was therefore “unprecedented”, made even more symbolic by being the first sitting of the Council in the new millennium.
Political leaders and organisations have clearly grasped the significance of issues such as HIV/AIDS for international peace and security. This, in turn, has signalled a shift in the way in which the concept of power is understood.
Political leaders and organisations have since clearly grasped the significance of issues such as HIV/AIDS for international peace and security. This, in turn, has signalled a shift in the way in which the concept of power is understood. In international relations, power has traditionally been understood – or is commonly understood – in realist and neorealist terms. From this perspective, it operates at the level of the state, and states – as sovereign entities – seek to maximise their power. They do so through self-help, due to the fact that they operate in an anarchic system.
“In this model, power is something that is possessed and wielded,” notes international relations scholar Andrew Neal. “If a state has more power, it is more free to act, if it has less power, it is more constrained. Military capabilities and economic strength are often taken as measures of this kind of state power. However, this particular explanation of power is limiting. Foucault understood this, and instead posited a radical alternative.
Foucauldian Power
Power, Foucault suggested, might be better understood as a set of relations, inherent in all social interaction and, indeed, society’s construction. Power, he indicated, “reaches into the very grain of individuals … and inserts itself into their actions and attitudes, their discourses, learning processes and everyday lives”. For Foucault, relations of power transform the individual into a controllable body, or ‘subject’. This occurs through the twin processes of disciplining and surveillance, which normalise subjects, and compel them to behave in socially acceptable ways. Where deviance is exposed, correction is applied.
This notion of power also contains another important dimension: that of biopower. The term, coined by Foucault in his lectures at the Collège de France in the 1970s, extends these notions to the regulation of life itself. Foucault explained that, in the eighteenth century, starvation and plagues – the most common causes of death at the time – became less of a concern for populations, thanks to advances in agricultural productivity. Because of this, the “randomness of death” disappeared, and society was able to concentrate more on developing better conditions for living. Consequently, with its concern for life, biopower became the “acquisition of power over man [sic] insofar as man is a living being”.
At the same time, this regulation of life became ‘governmentalised’, that is, it became “elaborated, rationalised, and centralised in the form of, or under the auspices of, state institutions”. By developing techniques and methods to study the health of its populations, governments were able to enact policies that benefited life. These policies made their populations healthier and more productive. For this reason, Foucault scholar John S. Ransom conceives biopolitics – the governance of populations through biopower – as the “science of policing”. It can also be a productive tool; indeed, it has proven to be positive in dealing with HIV/AIDS.
Beneficial Biopower
The positive side of biopower is readily evident in many efforts to deal with the pandemic. In particular, the “science of policing” has led actors to collect and manage data about the extent and spread of HIV/AIDS. As Stefan Elbe notes, national governments and international organisations have made “the health and longevity of their populations a matter of highest governmental priority”. The World Health Organization and the Joint United Nations Programme on HIV/AIDS have been particularly active in their monitoring efforts.
It is also no coincidence that a whole host of organisations is combating the pandemic. As Foucault explained, the health of all becomes a priority for all, and biopower is consequently “exercised through a net-like organisation”. This too is evident internationally, with non-governmental organisations, policy institutes, transnational corporations, foundations and universities uniting to fight the disease.
In regulating the wellbeing of whole populations, governments and international organisations necessarily make certain groups and individuals into ‘problem’ cases.
In some countries, biopolitical actions have yielded dividends. Brazil is a case in point. Its former president, Fernando Henrique Cardoso, instigated numerous social reform policies between 1995 and 2003, including an HIV/AIDS Prevention Program. The government guaranteed access to antiretroviral medicines, introduced prevention campaigns, and increased communication with non-governmental organisations. Cardoso’s successor, the current president Luiz Inácio Lula da Silva, has maintained these policies.
In some countries, biopolitical actions have yielded dividends. Brazil is a case in point. Its former president, Fernando Henrique Cardoso, instigated numerous social reform policies between 1995 and 2003, including an HIV/AIDS Prevention Program. The government guaranteed access to antiretroviral medicines, introduced prevention campaigns, and increased communication with non-governmental organisations. Cardoso’s successor, the current president Luiz Inácio Lula da Silva, has maintained these policies.
“Two decades ago, it would have been hard to imagine finding an upside to an HIV crisis of the scope that Brazil had on its hands. The World Bank estimated that 1.2 million Brazilians would be infected by the turn of the century – by far the highest number of any country in the region,” notes public policy scholar Eduardo J. Gómez in a Foreign Policy article. “Today, there is plenty of good news to go around. Thanks to aggressive intervention, Brazil has only about half as many HIV cases as predicted.” Brazil’s story, unlike other nations’, has been one of progress and hope. Yet in every country, negative biopolitical forces are also at work, and have sometimes produced sinister results.
Detrimental Biopower
In regulating the wellbeing of whole populations, governments and international organisations necessarily make certain groups and individuals into ‘problem’ cases. As Elbe explains, government policy “constitutes disease – and by extension the diseased – as a social and political problem that needs to be addressed”. Often, however, no indication is provided about how best to address such problems.
For example, former South African President Thabo Mbeki was widely criticised over his government’s handling of the AIDS virus in his country. A 2008 Harvard University study revealed that as many as 365,000 South Africans had died prematurely because antiretroviral drugs had not been provided to AIDS patients and pregnant women.
Biopolitics also fosters normalisation. Elbe notes that “by subtly directing the behaviour of individuals and populations towards a determined ‘healthy’ norm”, societies identify deviants, who are consequently subjected to discrimination. In the United States, these deviants include groups such as haemophiliacs, heroin addicts, Haitians and sex workers. In Muslim countries, any individual who contracts AIDS is likely to be stigmatised. In a 2005 Foreign Policy article, Laura M. Kelley and Nicholas Eberstadt reported that in Muslim countries, AIDS victims find little community support, even from their closest friends and family. In Iran for example, “nearly 60 percent of HIV-positive citizens take their own lives within the first year of their diagnosis”, as they face little chance of acceptance.
Another negative aspect of biopower is ‘new racism’. Foucault reasoned that, after identifying deviants to the norm, societies would separate those who should live from those who should die. In essence, as Elbe explains, biopower “pits the ‘healthy’ members of the population against the ‘unhealthy’ who are deemed to sap the strength and vitality of the population as a whole”. Many reports document cases of immigrants with HIV/AIDS who have been denied entry into certain countries; of others who have been quarantined; and of hopeful military recruits who have been denied entry into armies on the basis of their HIV-positive status.
However, biopolitical racism is not particular to the AIDS pandemic. In past centuries, it has been sanctioned as a method of population control, formalised through eugenics. Nazi Germany’s elimination of populations that did not conform to its vision of a ‘pure’ Aryan race – including Jews, Roma, communists, criminals, homosexuals and the handicapped – was perhaps the acme of such biopolitical racism, and the most dangerous and haunting testament to such policies.
The Limits of Biopower
Foucault’s theories of power have always been contested. Biopower is no exception. Sociologist Craig Calhoun has argued that Foucault’s theories relating to power contain no criteria for “distinguishing legitimate from illegitimate power”. Equally, he contends, they are too general, unable to “achieve historical specificity” or grasp the particular traits of different cultures.
Nevertheless, Foucault’s ideas provide insightful explanations for many political issues, such as the international HIV/AIDS pandemic. And when it comes to power, international relations scholar Cynthia Weber emphasises that states are no longer the only – or most significant – actors in international politics. Power operates as much ‘from above’ as it does ‘from below’, recognising that “individuals, too, end up constructing the very orders that construct them”.
