Therapeutic Borderlands: Austerity, Maternal HIV Treatment, and the Elusive End of AIDS in Mozambique


“End of AIDS” requires ambitious testing, treatment, and adherence benchmarks, like UNAIDS’ “90‐90‐90 by 2020.” Mozambique’s efforts to improve essential maternal/infant antiretroviral treatment (ART) exposes how austerity‐related health system short‐falls impede public HIV/AIDS service‐delivery and hinder effective maternal ART and adherence. In therapeutic borderlands—where household impoverishment intersects with health‐system impoverishment—HIV+ women and over‐worked care‐providers circumnavigate scarcity and stigma. Worrisome patterns of precarious use emerge—perinatal ART under‐utilization, delayed initiation, intermittent adherence, and low retention. Ending HIV/AIDS requires ending austerity and reinvesting in a public sector health workforce to ensure universal health coverage as household and community safety nets.