This book theorizes the AIDS epidemic and history of antiretroviral treatment in South Africa primarily through the lens of a few individuals living in informal settlements outside Johannesburg. Decoteau’s main informants are a translator and two sangomas (traditional healers) who were friends with the translator. She argues that the information gleaned through her interviews is “corroborated with academic scholarship” (62) and allows her to “position” her broader political-economic analysis (which blames the economic ills of postapartheid South Africa on neoliberalism) “within the squatter camp,” thereby allowing her to consider “HIV/AIDS politics from the perspective of those in whose name these battles are fought but who have been rendered voiceless in the telling” (8).

Unfortunately, there is no discussion of the extent to which these respondents are representative of the urban poor in whose name the book purports to speak, or of the limitations of the empirical data for the author’s broader political-economic analysis. Furthermore, the research she claims “corroborates” her argument is selective and fails to engage substantively with the South African scholarship relevant to her central claims.

For example, one of Decoteau’s core arguments is that there is a “myth of incommensurability,” by which she means “the ideology that indigenous [read ‘traditional’] and biomedical [read ‘modern’] forms of healing are irreconcilably incompatible” (8). But in making her case, she sidesteps the literature on the toxicological dangers of mixing antiretroviral drugs with some herbal medicines (i.e., showing that the myth of incommensurability is not always a myth) and she does not acknowledge the South African research making similar arguments to her own. Not engaging with the work of Jo Thobeka Wreford (especially two articles published in Social Dynamics [2005], her book Working with Spirit: Experiencing Izangoma Healing in Contemporary South Africa [Berghahn Books, 2008], and several working papers available online on collaborations between sangomas and medical professionals) is particularly puzzling. So too is her failure to cite or engage with the work of Nathan Geffen, a Treatment Action Campaign activist who has written several articles and the book Debunking Delusions: The Inside Story of the Treatment Action Campaign (Jacana Books, 2010) on the struggle for AIDS treatment and the problems posed by nonscientific approaches.

Another key theme in Decoteau’s book is that the Mbeki government was engaging in “thanatopolitics” (delivering death to some citizens) in an attempt to resolve the “post-colonial paradox” of national transformation in the context of neoliberal policies. This analysis, which essentially hypothesizes that there was a financial calculus delaying the provision of antiretrovirals in the public sector, irritated me for two reasons. First, it does not acknowledge that I made it ten years ago, without recourse to Foucaultian terminology, in The Moral Economy of AIDS in South Africa (Cambridge University Press, 2003). Second, it ignores the corrective I published in later work, notably in Mortal Combat: AIDS Denialism and the Struggle for Antiretroviral Treatment in South Africa (KwaZulu-Natal Press, 2007), in which I acknowledged that the Minister of Finance had allocated sufficient budget for an antiretroviral treatment rollout from 2003 but that the Minister of Health had chosen not to spend the money. And, even when antiretroviral treatment prices fell so far that it was cheaper for the state to put people on antiretrovirals than allow them to get AIDS-sick¸ Mbeki’s health minister continued to oppose antiretrovirals. In other words, the argument that Mbeki’s stance on AIDS had to do with saving money is incorrect. And, contra to Decoteau’s assumptions that neoliberal policies are to blame, postapartheid South Africa has always been more social democratic than neoliberal, with strong labor-market protection and a higher proportion of the government budget spent on health and welfare than anywhere else in the global South.

Several South African scholars and Mbeki’s biographer (Mark Gevisser) have argued that Mbeki’s position on AIDS should rather be understood in terms of his intellectual fascination with AIDS denialism. But Decateau does not engage with this argument or even reference Gevisser’s monumental Thabo Mbeki: The Dream Deferred (Jonathan Ball, 2007), choosing instead to argue that Mbeki was articulating an “African” response. But in so doing she ignores the uncomfortable fact that Mbeki was an embarrassment to his own party over AIDS, that almost all sections of civil society were calling for an antiretroviral treatment rollout, and that there was serious conflict within the state itself (e.g., between the Treasury and the Ministry of Health, and between provincial governments and the national government) over AIDS policy. Instead she talks about Mbeki’s views and that of “the state” and “the South African government” as if they were interchangeable.

Decateau’s approach, for all its pretentions to providing a postcolonial account, is deeply colonial in practice in that it raids South African material for facts while ignoring key arguments by South African scholars and intellectuals, whether similar to or in direct opposition to her own.