Foucault (1990), (2007) and Biehl (2008)

Michel Foucault. (1990). The History of Sexuality. Part V. Right to Die and Power over Life.
The right of the sovereign was centered in taking the life, the right to let die or let live, but the west has seen a profound change in this right and now the right lies on the social body and its capacity to maintain and develop its life. There is a dual power over death and over life. Is not the sovereign who needs to be protected but the whole population needs to be defended. The work of the state, according to Foucault has an underlying principle “the tactics of battle –that one has to be capable of killing in order to go on living- has become the principle that defines the strategy of the states” (137). Power is exercised at the level of the biological existence of the population: a biopolitics of the population. And it has two aims: subjugation of bodies and control of populations. Foucault defines bio-power as “what brought life and its mechanisms into the realm of the explicit calculations and made knowledge-power an agent of transformation of human life” (143). There is a relation between the law, which operates through the norm, which are incorporated within power apparatuses with the aim to regulate population and, ultimately, to normalize society.

Michel Foucault. (2007). Security, Territory, Population. Some quick ideas taken from Chapters 1, 2, 5 and 9.
The main question that circulates through all Foucault’s work is how specific forms of power had been produced, contested, reproduced, applied and resisted in the history of the western world. Politics of stuggles and truth are at stake, especially mechanisms of power (disciplinary mechanisms, mechanisms of security, and juridico-legal mechanisms). Foucualt wants to show the correlation between juridico-legal, disciplinary and security mechanisms of power. More over, he focuses on the slow development of techniques of security and its relation with the control of populations conceive as multiplicities. There is a central relationship according to Foucault among security, territory and population. The sovereign power in the last 200 years changed in quality and it was needed to produce a different form of power not tied to controlling populations fixed in a state but in terms of probabilities and risks, in terms of the uncertainties of the event, in relation of the circulation of good and people. Security mechanisms came precisely to reduce the insecurity of the event (and of controlling the populations). And here Foucault clearly differentiates the distinction between disciplinary mechanisms with their centripetal forces that concentrate and enclose, and the security mechanisms with their centrifugal forces that “lets things happen” (freedom of circulation it’s a technology of power in itself). Finally, the discussion Foucault starts in relation to governmentality is so pioneering that after more than 30 years it is a “hot topic” nowadays. He is trying to think on the “art of government” and how it emerged in the western world and consolidated in the totalizaing institution of the state. The modern state has to control multiplicites that are constantly moving, this pastoral power is what charactaerize the modern forms of governmentality.

Joao Biehl. (2008) Will to Live. AIDS Thereapies and the Political of Survival. Princenton/Oxford: Princenton University Press.
AIDS in Brazil is a particular case of state formation, civil activism, political rights and access to health. In many cases NGO activism came together with state policy making, and with the emphasis on treatment access instead of prevention “political rights have moved toward biologically based rights” (2008). Many activists groups in order to change the political economy of AIDS became visible through lobbying and pushing for lawmaking. Brazilian State central role in reaching a wider population of people experiencing AIDS (33% of its total population have free public treatment provided by the state) was performed thanks to what Biehl calls as the “pharmaceuticalization of public health”. Which means the creation of state responses that some times contradicts the global political economy of pharmaceutics and their drug monopoly, a pharmaceutizalization of governance and citizentship. Brazil broke the patent of an AIDS drug and started to import a generic one from India. Still marginalized underclass people, even in Brazil, are not taken care and they have to make big efforts to receive treatment.

The book is centered in both macro (state and pharmaceuticals) and micro-levels (an NGO in Salvador) of analysis and a two-phase fieldwork on 1997 and 2001 which helped Biehl to re-consider the trajectories and struggles people experiencing AIDS had, especially people that left the NGO and were not considered for treatment because they were seen as homeless that could not assure their willingness to follow the treatment. But as Biehl shows, these people also had the will to live and their personal stories show that. The interconnections among AIDS, pharmaceuticals, global health initiatives, the state, social inequalities, social experience, and subjectivity were central to understand what’s going on in the crossroads between medicine, political activism, public health, state policy, science, charity and homelessness. But this is an open-ending story, big pharma companies are constantly lobbying in order to not lose their monopolist rights, and the Brazilian state under Lula’s government has move in a slightly different direction jeopardizing some of the state sovereignty in terms of biological and pharmaceuticals governance. Although in 2007 the state made the movement to stat buying to India generic forms of AIDS drugs. But still the state has a different standard for black or non-black population not only in regards to AIDS but also in relation to public allocation of resources.

What I take from these quick readings (I have to come back and read them more carefully)?
From Foucault: the historization of power mechanisms and the State, and, at the same time, the de-naturalization of power and the State and de-centralization of the State. Also the political intervention over populations as an object of study and political manipulation. The different types of illnesses that Foucault considers, and the forms of political intervention (lepra/isolation, quarantaine/encloser, free circulation/security), are all important to think the sorts of illnesses that are useful to develop the system in terms of security and biopolitics (infectious diseases and environmentals) but don't know how this would play if I use this analysis in the children's hospital I will work in relation to cancer and hereditary diseases... I should ask why these children are sick? In terms of population and probabilities, these children are a small population of rare types of diseases in comparison with the average because the hospital treat children from all over the country and even bordering countries such as Paraguay. I would probably find different interpretation of why these children are sick by the children, their families on the one hand, and the more scientific view from the different class of professionals on the other hand. The case of children with AIDS would also be interesting to analyze using a Foucaultian frame in relation to discplines and management of populations. Indeed, within the hospital the two mechanisms of power, disciplinar mechanisms and security mechanisms should be very present (in the way children and families can or cannot do certain things, but in the way families trangess certain order but professionals and nurses let them do it i.e. letting eat more than the children when the family lack resources).

From Biehl what I take is his approach: he goes from micro to macro leveles of analysis, from the experience of localized and situated real people, with their unique faces and trajectories, to the political economy of pharmaceutical multinationals with their lobbying powers of seduction and corruption, from the politics of public health in Brazil, especially in Salvador do Bahia, to the global debates in relation to AIDS and poverty, from the wide access to AIDS drugs from a free and public state to the activists and NGOs that pushed and lobbied to produce that form of state, and ultimately from the marginalized people outside any type of assistance or access to anything but who still have the will to live to the extreme social inequalities of Brazil today. And Biehl adds, when all this approach lacks of words, he puts images, so there are pictures taken by a friend and fotographer (Eskerod) in black and white that gives you a different close view to the lives of these people (which, in Foucault's terms, the people are the ones that are against the security mechanisms of the population because they refuse to be treated as population).

I think what is important from these readings in both Foucault and Biehl is the need to re-think the state. For instance, we talked with Jon about the different approach to the state in Negri (antagonism), Holloway, Zizek (in relation with the statist such as Lenin) in which the state is the exercise of the collective will. For Jon this is a sign of a post-hegemonical state where the state is immanent, for him neither power nor the state is at stake... I guess what is at stake is the affective "power" of the multitude, a power that is completely unexpected in its effects and consequences...

Another thing worth checking is the multiplicities of power that traverse and experiment the hospital, and how they contribute to the tensions within the abstract and general logic of biopower. My focus, in the same line with Biehl, would be the tensions between populations, statistics and the real people... putting always people first.