The response of the South African government to the HIV/AIDS epidemic has bewildered and frustrated both academics and HIV/AIDS practitioners, in its apparent contravention of dominant orthodoxy, promoted and adopted by international institutions, civil society organisations and states across the world. Nuanced understandings of why this is the case and explanations as to the existence of such an approach are not in evidence within wider academic literature. AIDS, South Africa, and the Politics of Knowledge explores the origins and explanations as to why the government of South Africa's response to the epidemic is characterised by this paradox between received wisdom and practice, through understandings of epistemic communities and the notion of multiple counter-epistemic communities.

Youde uses South Africa's history of apartheid and fractious relations with the international community as the basis for explaining why the government under Thabo Mbeki's leadership represents a counter-epistemic community to accepted wisdom and practice surrounding the HIV/AIDS epidemic. The counter-episteme represented within the government's response to HIV/AIDS is associated with historically bound distrust of science arising from the use of health as a means of oppression, and the need of the government to establish a post-apartheid identity. The corollary of this is that the South African government recognises the negative impact the epidemic has upon its identity within the international community, yet expresses its counter-approach to HIV/AIDS as a means of asserting its post-apartheid identity and thus status.

Youde's book is a welcome contribution to any real understanding of why the government of South Africa has adopted such a position on HIV/AIDS. Youde's analytical rigour and a historical assessment of this position unravel some of the bafflement and disbelief apportioned to Mbeki and his colleagues in this regard. Not only does Youde give a considered argument as to why South Africa has taken such an approach, he begins to illuminate the relationship between the power of seemingly improbable ideas and how they manifest into policy. There is, however, a tendency to err to reduce historical and cultural explanations to apartheid only, and an overemphasis upon the role of Mbeki and Manto Tshabalala-Msimang, with little attention to the counter-counter-epistemic communities that exist within the ANC. This presents two key problems with Youde's analytical approach. First, there is much explanation as to why the government of South Africa has adopted its position on HIV/AIDS, but little detail of how this counter approach has manifested itself within the government. Second, the use of multiple counter-epistemic communities begins to blur what is or is not accepted opinion within the varying levels of HIV/AIDS government and governance. Nevertheless, in providing a detailed analysis of why the opinion and practice of the government of South Africa in response to the HIV/AIDS epidemic runs contrary to prevailing international opinion, an understanding of how denial can be broken is cultivated. On the eve of leadership change in South Africa and the shifting of international donor priorities to a more health-based approach to HIV/AIDS, this book is both timely and revealing.