Transnational networks and community-based organizations: The dynamics of AIDS activism in Tijuana and Mexico City (Mexico).

摘要

World-wide gains in public health would result from international cooperation between organizations in industrial and developing nations, yet to date such cooperation has not successfully reduced global health disparities. This project investigates why international collaboration to address health disparities---specifically in relation to HIV/AIDS---has been unsuccessful. The study focuses on how qualitative aspects of transnational networks shape structural and ideological components of local organizations in the US-Mexico border region and central Mexico, and shows how transnational networks affect local organizations in positive and negative ways. This project distinctively moves beyond national or individual-level health outcomes to examine: (1) the generation of health inequalities at the "meso-level" of organizations and organizational fields; and (2) the transnational processes by which health policy and organizational responses are created within a nation and in the transnational border area between two nations.; The methodological design is a qualitative, historical-comparative approach to studying community health organizations and transnational networks, utilizing in-depth interviews, participant observation and archival research. The focus is on HIV/AIDS organizations in Tijuana, Mexico, involved in binational relations with their San Diego counterparts. I also conducted similar research in Mexico City to highlight the importance of geo-political context and provide a comparison between "binational" and "international" collaboration.; This dissertation shows that transnational networks possess two faces---they empower certain local actors at the expense of others. Taking into consideration the dual nature of transnational networks allows for a theory that explains how (1) the simultaneous reduction and (re)production of inequities between local organizational actors occurs; (2) transnational ties can be "good" for individual organizations and "bad" for the local inter-organizational relationships; and (3) local actors' perceptions of transnational networks, local politics, and organizational culture become more salient than economic constraints in predicting organizational outcomes.; The dissertation contributes to medical sociology, transnational social movements, and organizational studies by increasing understanding of how transnational networks effect community-based organizations and organizational fields at local and transnational levels. The study also clarifies what resources, policies and collaborative institutional processes are required for effective state-community partnerships and sustainable local organizations to negotiate complex transnational health issues.