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Mitigating South Africa’s HIV Epidemic: The Interplay of Social Entrepreneurship and the Innovation System

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Abstract

With the struggle against apartheid achieved, South Africa faced the new struggle of overcoming the HIV/AIDS pandemic. This paper examines the response of government, the innovation system and civil society in rising to the challenge. The response included a fatal denialism concerning the etiology of AIDS, a fatalism that constitutes political market failure. This political market failure was counteracted through the emergence of social entrepreneurship in the form of the Treatment Action Campaign (TAC) that mobilized civil society and like-minded health practitioners and researchers within the innovation system. Dependency Theory coupled with a Quadruple Helix model of the innovation system offer possible explanations of this complex human tragedy and the way that government was compelled to embark on a massive program of providing anti-retroviral therapy that has now significantly improved life expectancy. The paper provides socio-economic context, appraisal of the innovation system, and a sketch of how the Quadruple Helix took form. Of special importance is the independence of South Africa’s ‘Republic of Science.’ Independent courts were critical in allowing TAC to obtain remedy against government, Big Pharma, and AIDS dissident scientists. It is argued that its Republic of Science met its obligation of objectivity by shifting emphasis to the cause of AIDS research in the face of official denialism. In effect, the system of innovation and social entrepreneurs are shown to have acted in concert in constituting a Quadruple Helix.

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Notes

  1. Though apartheid regulations have been removed from the statute books, the racial typology of the apartheid years endures. Official policy considers the population to be comprised of the same four groups of the apartheid years: Africans, Coloureds, Indians and Whites.

  2. http://www.southafrica.info/business/economy/middle-class-300413.htm#.VA8VpWSSy3g.

  3. http://www.brookings.edu/blogs/africa-in-focus/posts/2014/01/27-south-africa-welfare-poverty-bhorat.

  4. Recent evidence points to 1920s Kinshasa, DRC as the epicenter of HIV. See Faria et al. (2014).

  5. http://www.hivsa.com/static/hiv-aids-in-south-africa#edays.

  6. www.cptech.org/ip/health/sa/pharma-v-sa.html.

  7. http://www.politicsweb.co.za/politicsweb/view/politicsweb/en/page71619?oid=83213&sn=Detail.

  8. http://www.news24.com/SouthAfrica/News/MRC-head-slated-on-Aids-stats-20050210.

  9. The Grootboom judgment dealt with the rights of evictees, and had far-reaching consequences through the system of legal precedence that is characteristic of South African jurisprudence. See e.g. http://www.saflii.org/za/journals/LDD/2002/6.pdf.

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Acknowledgments

This paper arose from a discussion with Prof. Gita Surie of Adelphi University, New York. The paper is the work of an independent unaligned analyst and was self-funded. The final paper has benefited from the comments of two anonymous reviewers to whom thanks are due.

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  1. DST/NRF Centre of Excellence in Scientometrics and Science Policy, Centre for Research on Evaluation, Science and Technology, Stellenbosch University, Stellenbosch, Western Cape, South Africa

    Michael Kahn

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Kahn, M. Mitigating South Africa’s HIV Epidemic: The Interplay of Social Entrepreneurship and the Innovation System. Minerva 54, 129–150 (2016). https://doi.org/10.1007/s11024-016-9293-x

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