Infectious diseases physician and epidemiologist Jacques Pepin, in his The Origins of AIDS (Cambridge University Press, 2011), tells an illuminating and sobering story of the spread of HIV. This is a scholarly, detailed work written for a general audience..
Dr. Pepin, who has done research in sixteen African countries, knows the continent and its history, and the AIDS pandemic, as he reveals that history, is very much a legacy of colonialism. The colonizers liked to proclaim that they were bringing civilization and Christ to Africa, but, in truth, theirs was a racist mission of military conquest and economic exploitation.
His own story in Africa, the continent where SIV jumped from one subspecies of chimpanzee to become the human pathogen HIV-1, began in the 1980s when he was a medical officer in a bush clinic in Zaire. In years following his service there, he came to realize that patients that had visited the clinic seeking help for various conditions probably left infected with HIV. Because of frequent power outages (sometimes lasting two months), which made the autoclave inoperable, proper sterilization of re-usable syringes and needles had not been guaranteed at the clinic.
In earlier decades, starting in 1920, the approximate year of the origin of HIV-1, use of improperly sterilized syringes and needles would have occurred even more often than in the 1980s. The French and Belgian colonial powers (their territories are where the virus first appeared), in an effort to protect the Europeans who had arrived in Africa, set up aggressive inoculation programs for tropical diseases and STDs. These campaigns went on for years. Medical negligence and public health policy ensured that an extremely pathogenic virus spread exponentially, a virus that otherwise might have died out after infecting a few people.
Other factors also amplified the spread of HIV-1. It was colonial policy to gather men of working age into urban areas that were essentially work camps or to conscript them into work gangs to build a railway. The policy was to separate the men from their families, and that policy encouraged prostitution.
The story continues, with Dr. Pepin offering piece after piece of the puzzle of how and why disease spread across the globe.
Knowledgeable and passionate, Jacques Pepin wrote this book, in good part, out of moral obligation to those who have suffered. And, as he says in his epilogue, he wanted to remind the world that the most dangerous threat to the human species is the human race itself. He goes on: . . . the one new message that the HIV epidemic, as chronicled in this book, should bring home is that well-intentioned human interventions can have unpredictable and disastrous microbiologic consequences.
Book Review: The Origins of AIDS by Jacques Pepin
Blog entry posted by Merry, Jan 26, 2012.