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Vinh-Kim Nguyen. The Republic of Therapy: Triage and Sovereignty in West Africa's Time of AIDS. Durham, N.C.: Duke University Press, 2010. xi + 237 pp. Ill. $22.95 (978-0-8223-4874-0).
Vinh-Kim Nguyen's engaging new study of HIV/AIDS in Côte d'Ivoire and Burkina Faso sheds light on a previously unexplored aspect of contemporary history: the period between 1994 and 2000, once effective antiretroviral treatment for AIDS was discovered but before these treatments became more widely accessible in sub- Saharan Africa. Trained in both medicine and anthropology, Nguyen documents the human suffering of this period with sensitivity, drawing on his experiences as a doctor in Abidjan as well as field interviews. The book's real focus is, however, the political implications of HIV/AIDS treatment programs in conditions of extreme poverty and political instability. Ironically, HIV/AIDS treatment programs offer what he argues is the only meaningful type of citizenship in these two Francophone West African countries, battered by economic crisis, coups, and, in the case of Côte d'Ivoire, a recent civil war.
Two concepts are central to Nguyen's study: "therapeutic citizenship" and triage. Therapeutic citizenship refers to the benefits and responsibilities that AIDS treatment programs offer and impose on those enrolled in treatment programs, akin to...