Precarious future: Community volunteers and HIV/AIDS in a Tanzanian roadside town.

Abstract

This study focuses on a widely promoted belief that community-driven and community-based interventions for development are not only cost-effective, but also just and democratic. In particular, this study examines community-based initiatives with regard to HIV/AIDS in one Tanzanian roadside town. The interventions I discuss suggest that increased community participation does not automatically lead to more equitable access to services, to the empowerment of the poor, or even to the planned service delivery at all. Dependence on local volunteers with multiple motives and interests can hamper the relationship between provider and beneficiary. A concern for minimal state involvement and maximum decentralisation can easily lead to institutional abandonment, and trust in an undefined `community¿ can prevent rather than encourage coordination at community-level. As I discuss below, such factors can result not only in a service not being delivered, but can also readily lead to increased local conflict over scarce resources, increasing unfulfilled expectations, affirmation of inequalities, and government neglect. In the absence of a strong institutional framework such as the state, community structures and social relationships ¿ unquantifiable and often particular to specific locations ¿ seem central to the functioning of community-based development interventions, including those of AIDS related prevention and care.