Para-States and Medical Science: Making African Global Health
The situations of government employees on antiretroviral therapy (ART) provide a unique perspective on the contemporary para-state. Dependent on external funding, and divested of many of its earlier functions, the state is still a highly valued employer, not least for soldiers, teachers, health workers, and officials surviving on art. Those whose health and future have been rendered uncertain are especially appreciative of a reliable salary. Although their pay does not match the best in the ngo and private sector, they have job security and pensions. Absenteeism and sick leave are rarely grounds for termination. Government employment positions them well for taking advantage of donor and ngo projects, especially the many possibilities that have appeared in response to the AIDS epidemic. Remarkably, the para-state of science provides twice over for many government health workers—offering extra opportunities for earning and supplying the treatment that allows them to keep on working.