Faith matters
Religion and biomedical treatment for hiv/aids in Sub-Saharan Africa
Marian Burchardt, Anita Hardon & Josien de Klerk
AMB Diemen 2009
(isbn 97890-79700-19-6, 44 pp., illustrated, full colour, paperback, € 15,-)
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This document is an outcome of a symposium entitled ‘Prolonging Lives, Challenging Religion: arv’s, New Moralities and the Politics of Social Justice’. The symposium was held in Lusaka/ Zambia in April 2009 and organized by the ‘International Research Network Religion and aids in Africa’.
The main objective of this network is to stimulate social science research on issues surrounding religion and aids in Africa and to facilitate dialogue between researchers, faith-based organizations and development practitioners.
Marian Burchardt is a research fellow in the Department of Development Sociology at the University of Bayreuth. His main research interests are globalization, hiv/aids, and the links between cultural diversity, development and religion. His recently completed PhD thesis is entitled “Religion and aids in South Africa: A Cultural Sociology”.
Anita Hardon is professor of Health and Social Care at the Department of Sociology and Anthropology at the University of Amsterdam. Her main research interests are comparative studies of health care arrangements, focusing on programs to limit the transmission of hiv/aids and sexually transmitted diseases, on the global diffusion and use of contraceptive technologies and modern pharmaceuticals in primary health and family planning programs.
Josien de Klerk is a researcher affiliated to the University of Amsterdam and program manager at WorldGranny. Her main research interests are hiv/aids, Ageing and Care Arrangements in Africa.
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Tabel of contents
1. aids, religion and Art in Africa
2. Religion in ART provision: obstacle or asset?
- Embracing art: institutional growth in mission churches
- Emerging players: engaging (neo-)pentecostal and charismatic churches
- Positive attitudes towards biomedical hiv/aids treatment among religious
leaders
- Critical voices
- Explaining religious responses to biomedical hiv/aids treatment
- Consequences of access to funds for churches and fbos
3. Religious healthcare and public administrations: critical encounters
- Marginalization of public administrations
- Defining eligibility
4. Plural forms of therapy and healing: ART in context
- Treatment trajectories
- Combining prayer, herbal treatment and biomedical drugs
- Religion and general health-seeking behaviour
- How biomedical treatment shapes religious practices
- art, the absence of cure, and spiritual therapy
- Therapies in conflict
- Religion and treatment adherence
- Religion, ART and disclosure
5. New agendas for development and research
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SUMMARY
The importance of faith-based organizations (fbos), religious communities and religious faith for hiv/aids prevention, care and support in Sub-Saharan Africa has long been recognized. With the enrolment of millions of hiv-positive people on anti-retroviral treatment (art) the multiple links between religion and hiv/aids have taken a new shape: As a result of their involvement in art provision and surrounding services such as vct, care and treatment counselling, the role of fbos as recipients of international funds and as healthcare providers has been greatly enhanced. Thus the expansion of art has reshaped relations between fbos and donors but also those between fbos, public administrations and healthcare users. As religious faith shapes people’s perceptions of medicine, these processes have also affected how patients negotiate available therapeutic options.
This document provides ethnographic evidence of these changes and points to emerging conflicts. We argue that while art has undeniably saved and improved the lives of millions of people, it has also introduced new challenges that need to be addressed to safeguard sustained treatment success. We discuss these challenges from the perspectives of fbos, the public administrations they interact with, and art users. Meeting these challenges is critical not only for achieving universal access to art but also for improving service quality and empowering users. The findings can be summarized as follows:
• Biomedical treatment for aids has been firmly embraced by most religious communities and leaders and included in their service structures. However, there are exceptions. Donors need to establish the unequivocal support for treatment programmes amongst their partners if they decide to cooperate with fbos on art.
• Information and knowledge about art is contradictory, uneven and received from multiple sources. In order to enable patients to make autonomous treatment choices public information campaigns need to be strengthened.
• Churches, fbos, and religious communities provide valuable structures and resources for implementing art projects. The wish to attract funds, however, may also lead them to overburden their capacities. Donors should carefully assess existing capacities when making funding decisions.
• Levels of fbo involvement in art programmes depend on church type, infection rates, the political environment and pre-existing institutional structures. The advantages and challenges arising from involving fbos in art programmes thus differ from country to country. Every choice of partners for art programmes should be based on an analysis of the strength of fbo structures in particular countries or provinces.
• There are tendencies towards prioritizing co-religionists in fbo or church programmes, possibly leaving segments of the population unserviced. Donors can play an important role in strengthening coordinating mechanisms thereby ensuring equal access.
• art users rarely see biomedicine and religious forms of healing and recovery as mutually exclusive. Even with art, religion is important in providing for the psychological, spiritual and social needs of hiv-positive people. It is pivotal to ensure that these resources do not ‘dry up’ as a result of the emphasis on treatment.
• Churches1 and fbos are important social actors in African societies and their involvement in development processes is appreciated. Nevertheless, working with them involves ideological messages. Donors need to decide whether they support the missionary tendencies that might come as a corollary of collaborating with religious organizations.
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1. The majority of research projects on which this document draws have been carried out in Christian contexts. As a result, the document is characterized by an overall focus on Christian involvement in art programmes.
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