Recognising Social Rights at the Cost of Social Citizenship? A Critical Analysis of the Discourses about Equality, Social Rights and Democratic Citizenship that were used to Secure the Right to HAART in South Africa

My thesis builds on T.H. Marshall's work on social rights. In contrast to Marshall, I argue that recognising citizens' social rights does not necessarily lead to the "abatement" of social class. Nor does it ensure that citizenship status replaces the market as the main mechanism of social stratification in capitalist democracies. Instead, social rights can be advanced through interventions that entrench market rationalities and leave existing patterns of social stratification intact, while nonetheless improving citizens' absolute welfare. I substantiate my claims through an analysis of the struggle for the right to antiretroviral (ARV) treatment in South Africa. Using three case studies, I demonstrate that social rights claims can be advanced by incorporating marginalised actors (poor consumers, developing states) into markets for essential goods (like ARVs). I examine how, between 1998-2004, this was done by: (1) Creating scientific data affirming the efficacy of ARVs in resource poor settings; (2) Adopting differential pricing regimes for ARVs; and (3) Encouraging greater competition in the market for new ARVs. These reforms advanced poor citizens' social rights because they affirmed the efficacy of ARVs in resource-poor settings, reduced ARV prices, and bolstered the capacity of governments to purchase ARVs and build public sector treatment programmes. The case studies thus show that social rights can be advanced in a manner consistent with market logics. However, I argue that market-based approaches to advancing social rights may lead to the entrenchment of practices (e.g. profiteering, pursuing growth rather than equity, protecting private property ownership) that ultimately preserve existing patterns of social stratification. Using market logics to promote social rights thus opens up the risk that the scope and content of these rights to social inclusion will ultimately be circumscribed by the economic utility of recognising social rights, rather than the democratic imperative to guarantee formal and substantive equality amongst citizens. Such an approach to promoting social rights prioritises the market - not equal citizenship - as the primary referent for determining the overall pattern of resource allocation in democratic communities.