This article critically examines the fight against HIV/AIDS in Sub-Saharan Africa. As the epidemic revealed its devastating power when neoliberalism emerged as a dominant force in economic and development thinking, it investigates how policies like SAPs have affected the severity of the epidemic in a country like Zambia. Moreover, the article examines how the dominance of medical and private actors has influenced the fight against HIV/AIDS. By, for example, tracing the influence of the pharmaceutical industry and conservative Christian forces in PEPFAR, it is argued that the epidemic has been largely conceptualized in biomedical and behavioural terms – placing too much emphasis on African sexuality and culture – while ignoring structural factors like poverty and inequality. As a result, inhumane conditions for millions persist and solutions that would be unacceptable for the affluent are still implemented. Inspired by the work of Farmer (2005) and Pogge (2008), a more inclusive development agenda is outlined that involves structural democratic reforms of global institutions.
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