I. Surveillance: Coloniality and Complicity
The History of the African AIDS Epidemic
Routine monitoring and sample collection by Western-based corporations identified novel viral signatures in blood but concealed these findings from workers and public health authorities. The lack of surveillance technology to identify it didn’t mean HIV wasn’t spreading,; it meant systems of power failed to look further, fund research, or listen to affected communities. Their silence was an act of violence and serves as evidence of the power that health surveillance technologies have in forecasting and deciding the future.
Evidence from Kinshasa, once a Belgian colonial outpost, reveals HIV in archived blood specimens dating back to the 1950s and 60s. The virus moved slowly along colonial trade routes here, incubating in silence, before reaching urban centers where it eventually drew institutional attention. Yet even then, the signs were ignored. For nearly two decades, as the virus circulated and death escalated, it was dismissed as malnutrition, as tropical pathology, or as the moral failing of the marginalized (Bushmen and migrant frame labor.).
The early devastation among sex workers and men who have sex with men was politicized and pathologized, instead of contextualized. Despite clear etiological patterns, Western health authorities disregarded African data and frontline warnings, (ignoring he reported patterns of causation and consequences of systemic similarities in morbidity and mortality across the Sahel.) They were seen as inferior to Western accounts; and African elites and state actors collaborated as frontmen for their denial of the crisis.
Historiographic reports indicated the ubiquity of fear that counter arguments to Western power would lead to economic disruption. It was a poor choice to side with the servants of Capital, over the liberation of the people; especially considering the enormity of death from AIDS would have far reaching and long lasting effects on the political economy of African societies for generations. There would no other place on Earth that suffered more loss than Africa, and I don’t think it was coincidence.
The architecture of underdevelopment, rooted in colonial extraction and neoliberal dependency, primed Africa for epidemic vulnerability ( World Bank, UN, US, Western Loans). But it was the monopolization of biomedical foresight that allowed the virus to spread unchallenged. Privileged knowledge, collected by privileged people, and privatized for private ends. This was not ignorance. It was an intentional safeguarding of profit and geopolitical control.
To disclose the truth would have been to democratize knowledge, and to anrm workers and communities with epistemic power. That is, a way of accessing the source of information which could then be culturally, contextualize, and valuable and prevention and care work. But instead, silence was weaponized. Global institutions—NGOs, the WHO, UN agencies, the World Bank, and Western governments—chose strategic omission, preserving access to African labor while externalizing the cost of mass death onto those rendered surplus by the global economy.
Those who foresaw the epidemic were protected by systems designed to consolidate predictive technology and profit; and at the intersection of bio security, bio defense and surveillance, (e.g. Booze Allen Hamilton), were choices made, and power was cultivated as strategical plans. This was not a tragic failure of governance. It was the capitalist world-system operating exactly as designed: foresight, like the means of production, remains in the hands of the transnational ruling class. There would no path for African development without the West maintaining control.
Hopefully, it is clear that the African AIDS Epidemic was not merely a biomedical event. It was colonial violence reticulated through scientific rationality—a continuation of empire by epidemiological means.
Colonial Pathways and Viral Emergence
In his book [Link], the author presents a powerful historical narrative of continental Africa’s experience during the early days of the Age of AIDS. The text explores the region around Lake Victoria—where the HIV virus was first identified—and traces the epidemic’s trajectory along the infrastructure of colonial expansion. Roads, trade routes, and systems of labor exploitation became the very conduits of viral transmission. This framework positions colonialism not as historical background, but as a material foundation for how the pandemic unfolded.
The most explicit example of this is how epidemiological records of frozen blood samples retrospectively tested (e.g., a 1959 Kinshasa specimen), identify HIV decades before it was globally names and addressed.
How did colonial medical practices and social change facilitate the unnoticed spread of the virus before it was formally recognized, is an excellent question here?
Why didn’t the epidemiologists or principal investigators let people know what information was being collected and what other information was found?
They ignored their ethical obligations and abandoned the commitment to public health. It’s an extension of coloniality, whereby authority values only that which is extracted. Sixty years later, minoritized communities are still dealing with similar ethical problems with Molecular HIV Surveillance. The reuse of a genetic material collected from routine labs is done without consent and has the surveillance potential to prove directional HIV transmission networks ( what the state calls clusters), that can be used in criminal prosecution efforts. This issue is addressed in the post, Surveillance: MHS and CDR.
Private Surveillance and Biomedical Extraction
Drawing on historical evidence, the book describes a multinational, Western-based corporation that conducted surveillance on its African employees, collecting and monitoring biomedical data to assess their “fitness for work.” Through this private biotechnical archive—blood samples collected for internal security purposes—patterns began to emerge. A viral anomaly appeared with increased frequency. But the corporation withheld this discovery. The dates of this data collection predate the widespread appearance of symptomatic AIDS. Yet no alerts were made to public health agencies, governments, or international institutions.
Why was this critical epidemiological information not shared? One answer lies in the lack of consensus in the early 1980s around what was causing the immune collapse appearing across diverse global populations. But a deeper truth lies in the logic of capital: to share the data would be to implicate the company, to invite regulation, accountability, and loss of control.
Financial Forecasting as Imperial Domination
There was a choice made, and it was easy. Surveillance was never a public resource for thr health benefits of the working collective; it was a technology of corporate governance.
I reached out to the author to reticulate the evidence supporting the claim that Western-based multinational corporations operating on the African continent, using African labor, possessed the biomedical surveillance technologies necessary to identify the etiology of AIDS, and other health issues that had the potential to threaten workforce readiness and labor value.
He revealed how strategic development plans were implemented that included the widespread applications of epidemiological research designs, which required the systematic collection, analysis, and interpretation of biomedical data. These corporate overseers were responsible for creating private, (and, notably militant), surveillance and health monitoring systems that saw into the bodies snd futures of African societies. The use of this information to support corporate financial forecasting and predict market expansion were entirely dependent on workers to give specimens. Awareness of the virus was made visible from this routine surveillance data; and is evidence of the complicity and conspiracy of corporate responsibility.
From Kinshasa to South Africa, African bodies were positioned as sites of exploitation, experimentation, and control. Those laboring for global capital—in the employ of multinational corporations—were never regarded as equal stakeholders in the enterprise. Black African laborers were seen not as subjects worthy of medical investment, but as expendable resources whose replacement cost was more palatable to capital than any sustained intervention into their health. Recognition of HIV would have required acknowledgment not only of the virus but of its structural embeddedness in the colonial logics of extractive labor.
Global Data
Throughout the 1980s, public health surveillance systems such as the MMWR in the United States, and efforts in France and South Africa, began to document rising cases with common symptom profiles. These early epidemiological indicators were remarkably similar across continents, yet fragmented. No centralized response emerged. The failure to integrate this knowledge—especially data hoarded by private companies—delayed the global understanding of HIV’s spread and etiology.
Denial from Western Leaders and African Viceroy’s
This historical moment also points to a broader phenomenon: the denialism that defined the early period of the AIDS pandemic. Institutions and individuals across the Global North deployed the full weight of political and epistemological power to discredit the African origins of the virus—despite epidemiological traces linking it to the Lake Victoria basin and southern Africa. This coordinated obfuscation led to the misappropriation of medical resources, the formulation of incongruous health policies, and the normalization of scientifically inaccurate narratives surrounding transmission.
Denialism was not neutral; it was a racialized political economy of knowledge suppression. In its wake, a moralist propaganda emerged—one aimed not at care but at punishment. The disease became a canvas upon which imperial morality was painted, and the infected body became a signifier of deviance.
Denial begot stigma, which produced shame—and together they formed a tumultuous triangle of psychological, emotional, social, and existential violence. Those living with HIV found themselves ensnared in a structure that pathologized them, not only as diseased, but as deserving of disease. Within this matrix, the desire for social acceptance is placed in direct tension with the need for self-actualization. For many, the cost of navigating this contradiction proved too high. They succumbed—not to the virus alone—but to the crushing weight of the ideological apparatus that surrounded it…
Science, Power, and the Banality of Structural Violence
This failure to act is not an aberration—it is a reflection of how the banality of power operates within late capitalism. Power no longer requires dramatic declarations; it functions through systems, norms, and institutional habits that appear neutral. The logical structure of science—valued for objectivity, rigor, and progress—is often mobilized in the service of elite interests. When scientific knowledge is monopolized by the wealthy and influential, it becomes a tool not for liberation but for management: of populations, of narratives, and of risk.
Scientific discourse, when embedded in elite corporate and state apparatuses, can be used to suppress, delay, or redirect attention away from urgent truths. In this case, the silence of corporations about the emerging virus reflects not a lack of knowledge, but the strategic deployment of ignorance. This is structural violence disguised as protocol—banal in appearance, catastrophic in outcome.
From Epidemic Discovery to Grassroots Mobilization
It wasn’t until virologists and clinicians across the globe, especially in France, the U.S., and South Africa, confirmed that it was a virus that was destroying immune systems; that a coherent narrative began to form and the and nosology and nomenclature began to coalesce around case studies snd reports. The virus that is now defined as HIV, was known by many names. Etiological patterns in advanced HIV, like Kaposi’s sarcoma, lymphadenopathy, persistent diarrhea, oral thrush, and ultimately death caused by opportunistic infections, (such as pneumonia, all converged into a global medical picture.
This recognition catalyzed the transformation of AIDS from a mystery to a political and biomedical emergency. Communities most affected—especially LGBTQ people, sex workers, people who use drugs, and racial minorities—mobilized. They demanded access to treatment, inclusion in research, and an end to the systemic discrimination that devalued their lives.
Their demands were not only medical—they were philosophical: the right to experience illness and death with dignity. A global grassroots movement forced institutions like the CDC, NIH, and even presidential administrations to respond.
Climate Parallels: The Exxon Example
This structure of concealment is not unique to the HIV epidemic. In a similar case, ExxonMobil conducted climate research between 1968 and 1973, collecting extensive data on the environmental impacts of fossil fuels. Their scientists confirmed the dangers of carbon emissions decades before climate change entered the public conversation. Yet they buried the findings. It wasn’t until whistleblowers came forward that the truth emerged—too late to prevent the crisis now unfolding.
The pattern is clear: whether in public health or planetary survival, corporations conceal knowledge when revelation threatens power.
Toward an Ethics of Shared Knowledge
I’ve long been concerned with how the commodification of the Poz body in global markets—whether for drugs, labor, or information—reflects broader dynamics of biopolitical exploitation.
It’s clear that Iliffe understood the gravity of what he had uncovered, even if the full implications remain under-articulated. There is a powerful case to be made: the corporation’s silence constituted not just ethical failure, but structural violence and a violation of human rights. It denied people—especially the most vulnerable—the information that could have saved lives.
- What is privileged knowledge in health surveillance?
- How is emergency preparedness used to safeguard the state at the expense of the people?
- What makes the democratization, open access, and data justice so dangerous?
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