We were all shocked to learn of Dr. Padmini Coopamah's sudden and tragic passing in the United States. I had the privilege of interacting with her both in Mauritius and later in the States. We spoke often about health and human security in Africa during my time working in Washington, D.C. As her family and friends piece together the fragments of her extraordinary life--from Quatre-Bornes to Florida--I would like to share some insights into her remarkable research on HIV/AIDS in Africa.
Long before "global health governance" became a policy buzzword, Padmini Devi Coopamah was asking a question most researchers hesitated to touch: Why do some African governments fight HIV/AIDS as if their future depends on it, while others avert their eyes?
The year was 2009. Billions of dollars were pouring into HIV programs. NGOs were multiplying. Development agencies were promoting "best practices." But Coopamah--then a sharp, quietly relentless PhD candidate at the University of Arizona--noticed something everyone else seemed to overlook: politics was the missing variable.
Her dissertation, a sweeping comparative study of 29 sub-Saharan African countries, reads like a political X-ray of the epidemic. She didn't limit herself to prevalence curves or treatment rollouts. She studied power-- who held it, how they wielded it, and whether they felt accountable for the lives at stake.
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The result is as bold as it is unsettling.
There is no single African narrative.
Coopamah shows that strong responses to HIV/AIDS emerge from multiple political pathways. A stable state with a robust bureaucracy can act decisively. So can a poorer country with an empowered civil society. Sometimes, the sheer brutality of the epidemic forces the government's hand. And in a few cases--most notably Botswana--democratic habits become a life-saving asset.
But she is equally blunt about the limits of the "demo- cracy saves lives" argument.
Democracy without civil liberties? Useless.
Civil liberties without competitive elections? Toothless. True accountability, she argues, exists only in that narrow intersection where citizens can speak, vote, mobilize--and leaders know they are being watched.
The Botswana chapter is the centerpiece of her work. While international observers applauded the country's epidemiological indicators, Coopamah traced the invisible scaffolding behind them: decades of predictable elections, a politically engaged public, a press unafraid to question authority, and a government accustomed to negotiating openly with its own people. In her hands, Botswana becomes less a miracle and more a textbook example of democracy under pressure.
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What sets Coopamah apart is not just her data--it's her instinct. She understood HIV/AIDS not only as a virus but as a stress test for political systems. Her work shows, quietly but powerfully, that epidemics reveal the true character of governments. Where institutions are brittle, the disease exploits every weakness. Where politics remains responsive, the state has room to fight back.
Fifteen years later, her insights feel hauntingly prophetic. COVID-19 would demonstrate the same lesson on a global scale. But Coopamah saw it early, through the lens of an African tragedy too often stripped of its political context.
Her dissertation stands as both a landmark piece of scholarship and a warning: public health is never just about health--it is a mirror of political power.
