Feature

New virus, new stories

AIDS AND THE PUBLIC DEBATE.
C Hannaway, VA Harden, J Parascandola (eds.) IOS Press, 1995

It seems barely credible, given its profound impact, that a mere 16 years ago AIDS ostensibly did not exist. Few epidemics of infectious disease seem to have had so many political, moral and social connotations. This book, which is divided into three parts, provides a fascinating insight into the history of AIDS.

Part I, AIDS and the United States Public Health Service, includes papers by the former US surgeon general, C Everett Koop, and the director of the National Institute of Allergy and Infectious Diseases, A S Fauci. It chronicles AIDS from suspicions about the existence of a new disease in 1981, to the present day, and outlines the tortuous process of elucidating the causative organism, developing an antibody test, researching treatments and co-ordinating public health strategies. The reluctance of the Reagan administration to take a lead role receives a fair amount of flak, highlighting the uneasy but critical relationship between politics and health.

Having seized the opportunity in part I to acquire a thorough working knowledge of the many acronyms used by the American public health service, you can embark on the next section with confidence. Part II, AIDS and American Society, presents a broader picture of the impact of AIDS. It ranges from the devastating loss of talent in the artistic world to the explosion of racial and sexual prejudice, largely fuelled by ignorance, with its attendant civil rights implications. Another interesting paper describes the endeavours of the pharmaceutical industry to develop treatments and vaccines in a climate of panic, vocal pressure groups and intolerance for the ponderous methods of the Food & Drug Administration.

Readers could be forgiven at this point for having the impression that AIDS is a uniquely American 20th century disaster story, and I have to say that part III, ambitiously titled The International Consequences of AIDS, offers a rather cursory acknowledgement of the rest of the world. In fairness, the editors do not claim to present the global problems of AIDS, but relegating the problems in Africa to a single paper on the plight of Ugandan women seems outrageously dismissive. The chapter describing the shenanigans in the French blood transfusion service would be farcical had the consequences not been so tragic. Food for thought for both Europhobes and Europhiles.

Despite the lack of breadth in the final section, this book is interesting, informative and highly readable.