Paper short abstract:

In Uruguay, public health interventions concerning HIV/AIDS do not promote the self-government of patients but rather dependency on omnipotent physicians. Biopolitics starts with the management of potential orphans that become the object of state intervention.

Paper long abstract:

The notion of biopolitics, in its original sense, as the investment into life through and through, creating human matter and thereby subjectivities that correspond to new modes of self-government, does not apply to every public health setting. Although HIV/AIDS prevention, based on transnational institutions and development organizations, can be understood as a global biopolitics, national variants do not necessarily comply. Public health in Uruguay, which is almost entirely populated by European immigrants, does not follow this enlightenment project. Autonomy and individual behavior change among families living with HIV/AIDS is not promoted by an "empowerment" approach that either boosts individual responsibility or claims social and economic rights. In the face of medical institutions all people living with HIV/AIDS turn into children tutored by an omnipotent physician-father. New subjectivities based on self-government are not induced by a state organized biopolitics but rather through resistance against medical paternalism. Taken the severity of the disease, this resistance is maladaptive and frequently results in the death of the protagonists. Biopolitics starts with the management of potential orphans that become the object of state intervention. Looking at the international Convention on the Rights of the Child a fundamental contradiction of the enlightenment project becomes salient: How to mediate autonomy and dependency? Who is responsible for children's rights in the face of death?