The normalization of AIDS in Western European countries

The occurrence of AIDS led in every Western European country to exceptional innovations in prevention, patient care, health policy and questions of ci vil rights. This exception can be explained above all by the fact that not only was a health catastrophe feared but also civilizational harm in the fi eld of civil rights. Despite national differences, this brought about simil ar exceptionalist alliances consisting of health professionals, social move ments and those affected. With the failure of a catastrophe to arise, signs of fatigue in the exceptionalist alliance and increasing possibilities of medical treatment, exceptionalism in Europe is drawing to a close. Four pha ses are distinguished between in this process, given nationally different p atterns of development: Approx. 1981-1985: emergence of exceptionalism. The reasons underlying exceptionalism are investigated. Approx. 1986-1991. con solidation and performance of exceptionalism. The investigation centers on the exceptionalist policy model. Approx. 1991-1996. exceptionalism crumblin g, steps toward normalization. The forces driving the process of normalizat ion are investigated, Since 1996: normalization, normality. The forms and p erspectives of the changes made in the management of HIV and AIDS are eluci dated using examples from the fields of health care, primary prevention and drug policies. AIDS health-policy innovations, their risks and opportuniti es in the course of normalization are investigated. Three possible paths of development are identified: stabilization, generalization and retreat. The chances of utilizing innovations developed in connection with AIDS for the modernization of health policy in other fields of prevention and patient c are vary from country to country with the degree to which AIDS exceptionali sm has been institutionalized and the distance of these innovations from me dical, therapeutic events. (C) 2000 Elsevier Science Ltd. All rights reserv ed.