The work of early AIDS organizing efforts remain visible in contemporary health infrastructures. The impact of AIDS activists and community health workers can be traced across cities: from needle exchanges and syringe laws, through still operational health centers, the design of experimental drug trials, and the work of the AIDS activists that continue to fight the still present crisis. At the same time, many structural conditions which produced HIV/AIDS as a deadly epidemic remain the same – exploitative global commodity chains, mass incarceration, commercialized medicine, and neoliberal medical systems (Cooper, 2017 and Shabazz, 2012). In this paper, I discuss the real and imagined health infrastructures created through the Philadelphia-based AIDS information project Critical Path, the parts of the project that have been worked into today’s AIDS service networks in Philadelphia, and the more radical imaginaries of medical design that were lost or abandoned over time. I argue that these absent infrastructures both continue to haunt the present and offer important ways for reimaging collective health and liberation in unevenly deadly neoliberal cities.
Critical Path was founded as a Philadelphia-based newsletter, using the utopian design visions of Buckminster Fuller’s theory of critical path planning. (Fuller, 1981). Contributors created extensive lists of local health and social service services, drug distributors, research updates, and political manifestos. The project was eventually extended online, and also served as a major dial-up internet provider and web host for HIV+ Philadelphians. In 2000, limited parts of the project were incorporated into a digital education program by a local LGBT health nonprofit. I work from the starting place that modes of media production play an important role in shaping perception (Parikka, 2013). This infrastructure “making” is something created in the work of information media production, which connects resources, drugs, scientific information, technologies, political ideas, and people in new relationships, articulating new connections and ways of knowing that are profoundly political (Haraway, 1997). These reworked configurations also provide important ways for people to navigate across patchy and sometimes violent health and social service infrastructures, creating a new kind of “shadow care infrastructure” (Power et al, 2022) and concretizing it through the infrastructure-building work of serving as a major internet provider and web host.
Attending to infrastructural presences and absences in the present, I explore the infrastructures taken up by major nonprofits and “ghost infrastructures” that were never implemented or discarded, seen in the never implemented founding demands and in archives of now-defunct hosted sites and their campaigns. Ultimately, the project offers a case study for considering the role of grassroots AIDS information work, and how the lost or discarded visions embedded within them haunt contemporary AIDS infrastructures mediate the extant crisis. It offers a way of understanding information media-making as infrastructure building and looks grassroots information media archives to both understand the infrastructural contours of contemporary urban health systems and as vitally important speculative design with the potential to produce more liberatory imaginaries of health infrastructure that can promote collective survival in the contemporary AIDS crisis and beyond.
