Problematizations and Path Dependency: HIV/AIDS Policies in Denmark and Sweden

Problematization, or defining a phenomenon as a political problem, is a crucial step in any political process. It frames an issue as relevant and accessible to political action; it involves defining the nature of the problem, pointing to reasons for dealing with it, and identifying its causes as well as its possible solutions. In the words of Michel Foucault, ‘‘this transformation of a group of obstacles and difficulties into problems to which diverse solutions will attempt to produce a response, this is what constitutes the point of problematization’’. Foucault makes no mention of what is, in fact, a central component of problematization: namely, politicians or others perceiving the phenomenon as a ‘‘difficulty’’ worth dealing with. Problematization may encompass defining people with certain common features as a risk or target group, thereby placing them within reach of government. In political science the concepts of agenda setting and framing are used to describe central elements of the problematization process. In the political process of problematization, paths from previous political processes may be followed, not least when seeking solutions to the problem. Problematizations and path dependencies are interrelated in two ways: political paths influence what issues are perceived as problems and how they are perceived, and problematizations bring certain paths closer to hand. One might say that the choice of path, or path dependency, is an element of the problematization. In most respects, Danish and Swedish policies toward HIV/AIDS have been similar, relying on information and education as the primary means for governing citizens’ behaviour. There is, however, one crucial difference between the policies of the two countries, which has influenced researchers in their view of the countries’ respective policies: namely, that the option of using coercive means against people who expose others to contagion has been introduced in Sweden, while this practice has not been enforced in Denmark. Why would countries that in other respects have fairly similar policies in the area of disease prevention and health advocacy, take different paths regarding the use of coercion in this issue? The answer is sought by addressing two questions: did the ways