Sex without Birth or Death: A Story of Two International Humanitarian Movements

John G. Cleland, London School of Hygiene and Tropical Medicine

In this paper we compare two international movements aimed at changing two demographic processes, birth and death, in developing countries. The aim of the first is to reduce fertility by interrupting the connection between sex and birth. The aim of the second movement is to reverse the AIDS pandemic by interrupting the connection between sex and death. We show that despite the differences in aims and in time-periods, both movements are strikingly similar. In both, the problem and its solution were defined internationally, and exported to developing countries through donor support and technical assistance. A standard choreography was developed in the population movement: this choreography was transferred to the AIDS control movement with little alteration, despite fundamental differences between birth and death. We show the similarities and differences between the two movements, and their contexts, in detail, and speculate about the causes of these similarities and differences.