How do discourses appear and interact in the PDs?

Discourses can be identified by the frequency of references to the key words and concepts of the discourse in the text. There are paragraphs and sections within the text where one of the discourses is clearly dominant.

As declarations of action on an epidemic, the public health and biomedical discourse dominates all four PDs. Words characteristic of this framing are

numerous and appear with greater frequency than words of the other discourses, as demonstrated in the graphs in annex 2.2 Some of the public health and

biomedical words appear between 20 and 80 times in one PD (e.g. health, prevention, treatment, epidemic). In each of the PDs there are sections on HIV prevention, treatment, care and support, which contain significant detail on the public health measures needed to achieve the goals and targets. PD2016, 60 a-h provides a good example of a series of detailed biomedical paragraphs on scaling up HIV testing and treatment (see annex 8.4).

The second most dominant discourse is human rights and gender. Significant key words associated with this discourse generally appear between 5 and 20 times, with a jump in number of references to human rights (to 33) and women (to 64) in PD2016. In PD2016, there are also increases in references to sexual and reproductive health, populations at higher risk of HIV infection, and violence, including sexual violence, but no significant increase in references to men and boys or key populations. PD2016, 61a-o) is an example of a section of

commitments on women and girls. The human rights and gender discourse is dominant in these paragraphs, interspersed with a few paragraphs where the public health discourse is dominant e.g. PD2016, 61j.

Words characteristic of the traditional religio-cultural discourse and the national sovereignty discourses appear much less frequently (generally below 10). The text of PD2001 and PD2011 include the most references to words and concepts characteristic of the traditional religio-cultural discourse. Annex 2.2 shows that the word ‘family’ occurs frequently in both PD2001 and PD2011, 15 and 18 times respectively. As discussed in Chapter 5, the traditional family is a central

concept to the traditional religio-cultural discourse.

PD2011, 2, repeated in PD2016, 4, and is an example of a paragraph where the national sovereignty discourse is dominant (See table 8.1). Phrases from this paragraph are repeated in other paragraphs, sometimes together with phrases from the traditional religio-cultural discourse in order to limit content in the PDs.

PD2011, 43 contains similar language to PD2001 20, and 31 in which the traditional religio-cultural discourse is dominant:

Reaffirm the central role of the family, bearing in mind that in different cultural, social and political systems various forms of the family exist, in reducing vulnerability to HIV, inter alia in educating and guiding children, and take account of cultural, religious and ethical factors in reducing the vulnerability of children and young people… (General Assembly Resolution 2011, 43).

Words and phrases characteristic of the traditional religio-cultural discourse are inserted into paragraphs on HIV, prevention and human rights to limit,

compromise or qualify the proposed action. Examples of this are discussed in the next section. Examples of how tension between the discourses can be seen in colour coded paragraphs can be found in annex 2.1.

8.3.1 Interaction of the discourses in the PDs

Most paragraphs of the four political declarations have one dominant discourse throughout the paragraph, generally undisturbed by other discourses.

In each of the PDs, paragraphs are clustered according to themes. Substantial sections of the texts discuss HIV prevention and treatment. These paragraphs are predominantly framed using a public health discourse (e.g. PD2011, 33, 66 and 67; PD2016, 34 and 60 a-i).

The sections on human rights also include paragraphs on women, girls and gender equality. These paragraphs are framed through the biomedical and human rights and gender equality lenses (e.g. PD2016, 33 and 61a-e). It is clear that the public health, biomedical, and human rights, gender equality discourses work together and frequently appear together in paragraphs and sections (e.g.

PD2016 10, 14, 15, 21, 44 and 47).

Political commitment and national sovereignty discourses are prominent in all PDs. Some paragraphs express strong political commitment (e.g. PD2016, 1, table 8.1). Others express national leadership and ownership (e.g. PD2016, 57).²⁸ Some focus on national sovereignty (e.g. PD2011, 2, repeated in PD2016, 4,) which is more limiting in nature. A few paragraphs are framed solely in terms of a traditional religio-cultural discourse (e.g. PD2001, 63, see annex 8.1, repeated in PD2011, 43).

In some paragraphs several discourses are present; this clustering of discourses can easily be seen by colour coding the text of the PD. The public health, biomedical discourse appears with the human rights and gender discourse in PD2016, 44 and 47. The traditional religio-cultural discourse appears together with the national sovereignty, public health and human rights and gender discourses in PD2011, 20. Some paragraphs include a mixture of discourses with no apparent conflict or competition between them. In these paragraphs the mix of issues is complementary; it draws out the multifaceted nature of the AIDS

28 PD2016, 57: Commit to differentiate HIV responses, based on country ownership and

leadership, local priorities, drivers, vulnerabilities, aggravating factors, the populations that are affected and strategic information and evidence, and to set ambitious quantitative targets, where appropriate depending on epidemiological and social context, tailored to national circumstances in support of these goals

epidemic and the need for a multi-sectoral response (e.g. PD2001, 27) (see chapter 2 and annex 2.1).

In some paragraphs however, the discourses are in tension with one another. For the purposes of this study, these paragraphs are the most interesting. This phenomenon occurs in both framing and commitment paragraphs. The traditional religio-cultural discourse and national sovereignty discourse limit public health and rights-based approaches to HIV prevention in PD2011, 59 and 59h (see annex 8.3) and compromise human rights statements in PD2011, 38. A traditional religio-cultural discourse limits PD2016, 62c on public health and gender (see annex 8.4). Such tensions are less evident in sections about treatment, women and girls, and children.