Impact case study database
Seeing HIV/AIDS – Using Co-Produced Film
1. Summary of the impact
Award-winning and externally funded research by Professor Harman is changing how we understand the everyday politics of women living with HIV/AIDS. Underpinned by a practice-based research film project, developed and shot in Tanzania, this research is:
supporting the campaigns of high-level United Nations programmes and non-governmental organisations on HIV/AIDS and Sustainable Development Goals
creating tools for domestic practitioners and international donors to engage communities at risk of HIV/AIDS and change public perception of the disease
enhancing understandings of the intersection of HIV/AIDS, gender and poverty
2. Underpinning research
HIV/AIDS disproportionately affects women in terms of global prevalence (52% of the 36,900,000 people living with HIV/AIDS are women) and responsibility for informal care provision, peer education and the prevention of mother-to-child transmission. Although recognised in some global and domestic policy campaigns, gendered patterns of HIV infection and care burdens persist. Persistently, images of HIV/AIDS either focus on the early epidemic of the 1980s-1990s or present women living with HIV/AIDS as the benevolent poor or the resourceful solution to the AIDS pandemic. This research challenged this aesthetic and highlighted the complex politics of being a woman living with HIV/AIDS in sub-Saharan Africa [3.1, 3.2, 3.3]. The research sought to explore:
What are the everyday risks that people living with HIV/AIDS encounter?
How can such risks be communicated to broad and diverse audiences through co-produced research?
How can film make the lives of women visible in global health?
The project used the development and production of a narrative feature film as a method of co-produced practice-led research. From its inception, the project sought to embed impact within its objectives by engaging its subjects in the research methodology as co-researchers in order to generate new perceptions and practices in respect of the lives of Tanzanian women living with HIV/AIDS, and inform social and political understandings of their situation. The co-production took place between the academic researcher (Harman, PI), a UK and Tanzanian film crew, and a group of women living with HIV/AIDS from the Pwani region of Tanzania [3.1-3.4].
Harman and film director Leanne Welham met with over 80 women from Pwani to hear their life stories. Participants were guided by open-ended questions about their everyday lives, managing their HIV status, and hopes and ambitions in life. Core themes emerging from these stories were triangulated with Harman’s existing research [3.5, 3.6, 3.7] to form the over-arching story of the film. The story was tested with groups from Pwani for accuracy, authenticity, and believability. Welham wrote the screenplay and Ansity Noel Mahyenga translated it, although most aspects of the film were improvised on account of literacy issues.
Preparatory research was conducted over three weeks in November-December 2015 by Harman, Welham, and Mahyenga. The main production was a five week shoot in February-March 2016: Harman led as producer of the film with a crew of four UK film specialists and four Tanzanian assistants. Post-production was conducted by a UK-based editor, colourist, and sound team [3.2, 3.3, 3.4]. The film was cast from the communities around Miono and Bagamoyo: 65% of the cast are (self-disclosed) HIV positive. All locations are real: Harman’s relationship to regional Doctors facilitated use of functioning HIV/AIDS care and treatment clinics [3.1, 3.2, 3.3]. The film, Pili, premiered at international film festivals throughout the world in 2017, was released in UK cinemas in 2018 by Studio Soho Films and received the following awards: Hitchcock Audience Award (Dinard Film Festival, 2017); Special Mention for Screenplay (Dinard Film Festival); one BAFTA nomination; and one British Independent Film Award nomination 2018 (Welham, Best Director) and a long-list nomination (Harman, Breakthrough Producer). Pili has been screened on invitation from Politics and IR and global health departments in universities in the UK (Sheffield, Bristol, LSE, LSHTM, UCL, Manchester) and around the world (Oslo, Griffith, University of Queensland), and at international conferences (European International Studies Association, 2017). The film was praised for its path-breaking contribution to Politics and IR in a review article in leading journal, International Affairs (Duncombe, 2018). In addition, Harman has run masterclasses on film as method, based on Pili, on invitation from the Global Health Film Festival, London Interdisciplinary Social Sciences Doctoral Training Partnership, and Griffith University, Australia.
The research generated five main findings:
It found that self-stigma and shame persist in playing a key role in the everyday risks of living with HIV/AIDS [3.1].
It underlined the importance of time for women balancing informal employment, single motherhood, and structural obstacles (infrastructure, gender, distance to clinic) to accessing treatment [3.1, 3.2].
It highlighted that the agency of women living with such limitations, and the everyday difficult decisions they make, create greater long-term risks even though they are made to maximise their health or that of their families [3.1; 3.2; 3.3].
It affirmed the pervasiveness of gatekeeping politics at every level of decision-making and the direct consequences of this for people’s lives [3.1; 3.2, 3.4].
It advanced an alternative way of conducting research in politics and international relations, and in film production [3.2].
3. References to the research
[3.1] Welham, L. (Director). (2017). Pili [feature film]. Kuonekana Films, distributed by Studio Soho Films.
[3.2] Harman, S. (2019). Seeing politics: film, visual method, and international relations. McGill-Queen's Press-MQUP.
[3.3] Harman, S. (2018). Making the invisible visible in International Relations: Film, co-produced research and transnational feminism. European Journal of International Relations, 24(4), 791-813.
[3.4] Harman, S. (2016). Film as research method in African politics and international relations: reading and writing HIV/AIDs in Tanzania. African Affairs, 115(461), 733-750. doi.org/10.1093/afraf/adw057
[3.5] Harman, S. (2011). The dual feminisation of HIV/AIDS. Globalizations, 8(2), 213-228. doi.org/10.1080/14747731.2010.493023
[3.6] Harman, S. (2011). Governing health risk by buying behaviour. Political Studies, 59(4), 867-883. doi.org/10.1111/j.1467-9248.2011.00920.x
Evidence of quality of the research
[EQR.3.2] Praise for Seeing Politics: 'This is one of the best books I have read in a long time: it is well-written, informative, sophisticated, and genuinely original.' (Roland Bleiker, University of Queensland)
[EQR.3.2] A special Symposium on the book was published by the popular academic blog The Disorder of Things to coincide with its publication https://thedisorderofthings.com/tag/seeing-politics/
4. Details of the impact
Pili is the first feature film to be co-written and produced as a practice-based research output in Politics and International Studies. Its use by practitioner communities has been the key mechanism by which the impacts have been achieved.
Harman’s co-produced film, combined with her existing research and networks in global health, is supporting, informing and influencing key impact beneficiaries [5.2-5.9, 5.12]. These include:
the United Nations (UNAIDS, Ciné-ONU, UN Women)
UK and US government agencies (Foreign, Commonwealth and Development Office, US Embassy, Tanzania)
NGOs (STOP AIDS, the National Council of People Living with HIV/AIDS (NACOPHA)
international media
Supporting global health campaigns
Pili has been used by three UN agencies - UNAIDS [5.2], UN Women [5.6, 5.14], and UNFPA [5.13] - to support their global campaigns around Zero Discrimination, Goals 3 (Good Health and Well-Being) and 5 (Gender Equality) of the Sustainable Development Goals and Accelerating the Promise on sexual and reproductive health, and NGO campaigns such as STOP AIDS’ #itaintover [5.4].
The UN Information Service in Geneva expressed interest in this research as a unique method of women telling their own stories, communicating new and old themes, and aligning with concerns over the general complacency around HIV/AIDS. In 2017, the UN made a screening of Pili + Q&A a centrepiece of its World AIDS Day activities in Geneva. Harman shared her knowledge and research expertise with UNTV [5.1], for UNAIDS press work around World AIDS Day [5.2], and in a Q&A with people living with HIV/AIDS [5.3]. The UN Information Service stated that the screening and subsequent discussion allowed attendees ‘to draw further insight into the problem […] [M]any told us the film had done a good job of portraying the vulnerability of women affected by HIV but also the strength they must display to fight for their dignity and their children’s’ [5.3].
Following the success of the Geneva screening, UN Women first screened Pili in New York as part of the high level 2019 meeting on the SDGs. The screening was introduced by the Deputy Executive Director of UN Women, concluded by UNAIDS’s Director in New York, and included another Q&A with Harman. This was followed by a second screening at the UN Women Global Meeting of HIV programme staff from over 20 countries.
The success of the screenings led to Harman developing a toolkit [5.14] on how in-country partners can use Pili in their work alongside UN Women and a UNFPA screening of the film at the high level ICPD+25 Summit in Nairobi.
Providing tools to change perceptions on AIDS and global health
UN Women invited Harman to develop guidance for how their in-country partners could use Pili in their work. This led to the development of a toolkit [5.14], which will be used by national governments, civil society, and various UN and development partners in their advocacy work on gender equality and HIV. The target audience for the toolkit are decision-makers with influence on policy-making, practitioners and technical programme staff in government agencies across a range of related sectors. The toolkit was published on the UN Women website and shared with in-country partners in October 2020.
The format of the toolkit follows the successful trial of mobile film screenings in Tanzania led by the US government. The US government became interested in the project following Pili’s release in the UK and the associated press coverage [5.8]. In November 2018, the Center for Disease Control in Tanzania hosted the Tanzanian premiere of Pili in partnership with the US Embassy and the leading NGO, NACOPHA. Senior Tanzanian officials and the local press attended. The uniqueness of the film – its use of Swahili, method, and message - were recognised as having significant potential for communication and outreach. Subsequently, the US Embassy in Tanzania and NACOPHA screened Pili in five high-risk areas, each attracting approximately 500 people [5.7; 5.8]. The screenings sparked discussions on stigma, discrimination and adherence to HIV/AIDS treatment [5.7; 5.8]. The lead on the US government’s flagship HIV/AIDS programme (the President’s Emergency Plan for AIDS Relief) stated the following: ‘I believe the impact of the film could be huge in addressing the stigma that so many people living with HIV face on a daily basis’ [5.7].
Enhancing understanding of HIV/AIDS, gender and poverty
Pili has been called ‘a ground-breaking co-production project’ (Durose et al, 2018; Nature). The significance of the work is evident from external recognition by established film critics and awards (highly reviewed by film critics writing for Time Out (4*), Total Film (4*), Sight and Sound, The Guardian (3*; print readership: 3,600,00; circulation: 111,953;), The Times (3* circulation: 359,960), The Telegraph (circulation: 317,817), Attitude (4* circulation: 50,000), and The Observer (circulation: 139,831). Critics called the film ‘remarkable’ ( Metro), shot with ‘compassionate and remarkable boldness’ (Peter Bradshaw, The Guardian), that ‘transforms a simple tale into a substantial film. It’s a very moving story, if far from melodramatic – knotty moral quandaries such as these are the stuff of stimulating drama’ (Pamela Hutchinson, Sight and Sound). The culmination of this recognition was Harman’s personal nomination for the 2019 BAFTA for Outstanding Debut by a British Producer, Director or Writer.
This practice-based research has enabled sharing of knowledge and expertise with a wider audience beyond academia and the global health sector through question and answer sessions associated with screenings of Pili, and has developed networks with associations and bodies interested in using Pili to support their work [5.10, 5.12]. For example, since the film’s release, Harman worked closely with the Global Health Film Festival to educate and inform public understanding, and that of future film-makers and global health experts, about the potential of film to effect change [5.11]. In addition to the enhanced visibility lent to women with HIV/AIDS through screenings of the film, Harman’s research and Pili have informed and influenced a wider set of audiences through television, radio, film reviews, social media, press releases and other media, and continues to do so [5.2; 5.6; 5.9; 5.10]. For example, the film has enhanced understanding of how HIV/AIDS, gender and poverty intersect. Following a screening arranged in conjunction with STOPAIDS in 2018, respondents said of the film:
‘[Pili] made me understand how [HIV/AIDS] … effects someone on a personal level more, particularly someone who has the challenges of poverty’ [5.12; respondent 2]
‘[Pili] reinforced the importance of underlying vulnerabilities in exacerbating the negative effects of HIV/AIDS’ [5.12; respondent 12]
‘[will be] advocating for funding for better technology to fight HIV/AIDS’ [5.12; respondent 9].
5. Sources to corroborate the impact
[5.1] [Press] UNTV https://www.youtube.com/watch?v=5YGxmxQM3dU
[5.2] [Press] UNAIDS
[5.3] [Testimonial] UN Information Service [Corroborator 1]
[5.4] [Testimonial] STOP AIDS [Corroborator 2]
[5.5] [Events] UN Women https://www.unwomen.org/en/news/events/2019/07/event-film-screening-pili
[5.6] [Press] UN Women Press Release
[5.7] [Testimonial] UN Embassy Tanzania
[5.8] [Press] Guardian on Sunday Press Cutting
[5.9] [Press] The Conversation and The Huffington Post Op Eds
[5.10] [Reviews] Film ‘Pili’
[5.11] [Testimonial] Global Health Film Festival [Corroborator 3]
[5.12] [Testimonial] STOPAIDS audience feedback, 2018
[5.13] [Programme] UNFPA ICPD+25 Summit
[5.14] [Toolkit] QMUL/UN Women ‘Making the HIV/AIDS response work for women through film: A Toolkit for Action’ [Corroborator 4]