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The Origins of AIDS, by Jacques Pepin
Free PDF The Origins of AIDS, by Jacques Pepin
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It is now thirty years since the discovery of AIDS but its origins continue to puzzle doctors and scientists. Inspired by his own experiences working as an infectious diseases physician in Africa, Jacques Pepin looks back to the early twentieth-century events in Africa that triggered the emergence of HIV/AIDS and traces its subsequent development into the most dramatic and destructive epidemic of modern times. He shows how the disease was first transmitted from chimpanzees to man and then how urbanization, prostitution, and large-scale colonial medical campaigns intended to eradicate tropical diseases combined to disastrous effect to fuel the spread of the virus from its origins in Léopoldville to the rest of Africa, the Caribbean and ultimately worldwide. This is an essential new perspective on HIV/AIDS and on the lessons that must be learnt if we are to avoid provoking another pandemic in the future.
- Published on: 2012-06-05
- Binding: Printed Access Code
Review
"Despite the scientific advances made since the discovery of HIV, questions of the pandemic's origin still trouble us. Why us? Why now? How could this happen? Pepin's remarkable book provides, at last, a comprehensive answer. Three decades of scientific and historical research are distilled into an engaging, highly readable, and sometimes disturbing account of HIV's journey that will interest students and researchers of the virus and its fallible host." Oliver G Pybus, Department of Zoology, University of Oxford
"In this scholarly and immensely readable account of the origin of AIDS, Dr Pepin draws on his personal experience of working in central Africa and his extensive knowledge of African history, as well as his training in infectious diseases, virology and epidemiology. Unlike others who have tackled the subject, he comes to it with an open mind, and this account is likely to be definitive." David Mabey, Professor of Communicable Diseases, London School of Hygiene and Tropical Medicine
"This first major re-assessment of the origin of AIDS since Hooper's The River, delves into the extensive archives on the AIDS epidemic. Weaving together the findings of many researchers currently working on the topic, it will undoubtedly stimulate discussion on a subject of great concern and interest: the historical record of the emergence of new viruses." -William H. Schneider, Professor of History, Indiana University
"The origin and early epidemiology of the Human Immunodeficiency Viruses (HIV) has been perplexing and controversial. Jacques Pepin provides a unique insight as an investigator who has spent years in several African countries and has contributed substantially to our knowledge of routes of transmission. We must learn from this history if we wish to avoid future pandemics." -Allan Ronald, Professor Emeritus, University of Manitoba
"A great book on the evolutionary origin of HIV and the possible role of cultural and medical practices in Central Africa in the dissemination of the virus" -Max Essex, Lasker Professor at Harvard University and author of "Saturdays are for Funerals"
"Extensively referenced, the well-written book reads like a detective story, while at the same time providing a didactic introduction to epidemiology and evolutionary genetics. As far as the origins of AIDS are concerned, unless some completely new evidence emerges, it will be difficult to come up with a better explanation than Pepin's." -Science
"This is a beautifully written book, which explains epidemiological and scientific concepts such as phylogenetic analysis in clear and simple language. Pepin has assembled a vast amount of information from a wide variety of sources, and paints a clear, coherent and convincing account of the origins of AIDS. This book is required reading for anyone with a serious interest in infectious diseases." -David Mabey, Sexually Transmitted Infections
"Superb ... Pépin rightly argues that, apart from social factors promoting HIV spread, inherent properties of the virus must determine its fitness to become pandemic. He also provides the best analysis I have read of the declining HIV-2 epidemic in West Africa." -Nature
"An impressive feat of scientific scholarship ... absorbing throughout, interweaving quantitative data with historical narrative and lively biographies." -The Lancet
"This book is an excellent, fair-minded attempt to elucidate a much-contested story.' -Literary Review
"Pepin's achievement is formidable. He has mastered a vast technical literature in French and English, exploited the archives and material remains of colonial and postcolonial Africa, and knows his African history to boot. He writes with grace and feeling, and makes accessible the scientific and clinical issues. Above all, he comes across as a humane and caring doctor. This is a major contribution to our understanding of the scourge that has defined our times." -TLS
"The superb organization organization of the book is noteworthy; the reader is never left hanging, and the path to the next topic is always clear. Highly recommended." -Choice
"Pepin has written an absorbing analysis of the roots of the epidemic." -Nicolas van de Walle, Foreign Affairs
"The language of Pepin's book is academic, yet easily accessible to a lay, educated readership. Graphics, charts and maps emphasize the text content. The Origins of AIDS offers, for the first time, an in-depth look into the pandemic prior to 1981 and, with that, the missing pieces that complete the story of AIDS." -Alina Oswald, A&U, America's AIDS magazine
About the Author
Jacques Pepin is Professor and Head of the Infectious Diseases Division, Department of Microbiology and Infectious Diseases at the University of Sherbrooke, Canada, where he is also Director of the Centre for International Health. He has conducted research on infectious diseases in sixteen African countries.
Most helpful customer reviews
46 of 49 people found the following review helpful.
The Prehistory of AIDS
By R. Albin
This well written and fascinating book is a cogent attempt to reconstruct the process that generated the great HIV pandemic. The author is a Canadian infectious disease specialist and epidemiologist with considerable experience in HIV-related research, including a good deal of work in Africa. Based on a careful synthesis of research and his own archival investigations, Pepin presents a synthesis of molecular epidemiology, traditional epidemiology, and social history to explain the emergence of HIV.
Pepin begins with the generally accepted idea that HIV crossed from its chimpanzee ancestor in central Africa sometime in the early 20th century, very likely because of hunting of chimps for meat. This concept is supported by molecular phylogenetic reconstructions and the fact that the bush meat trade probably increased markedly in the relevant area of central Africa with greater demand for meat and greater availability of firearms. Pepin estimates the number of individuals affected in this way to be very small, perhaps as small as 1 - 2. These infections would have been a dead end without some amplifying mechanism, which Pepin suggests was the widespread use of parenteral treatments for several tropical diseases. In the first half of the 20th century, French and Belgian colonial governments pursued impressive public health campaigns to suppress Sleeping Sickness and other illnesses. Many of these campaigns involved indiscriminate use of parenteral treatments with reusable and inadequately sterilized needles and syringes, a fertile breeding ground of this type of viral infection. The result was an expanded pool of infected individuals in rural French and Belgian central Africa. Some of these individuals migrated to cities to serve as laborers or, in the case of many women, to participate in various forms of prostitution. In these environments, HIV began to circulate via sexual transmission, particularly in the linked cities of Brazzaville and Leopoldville-Kinshasa. The explosive growth of prostitution after Congolese independence in the latter particularly favored expansion of the infected pool. From these sources, HIV would disseminate throughout the world. Pepin provides an interesting analysis of the probable route for transmission from Congo to the western hemisphere via Haitians who worked in the Congo after independence.
Pepin supports this model with careful arguments and analysis of the existing data. His integration of the colonial medical experience and the complex social history of central Africa with the epidemiology of HIV is impressive. The emergence of the HIV pandemic is presented as the result of the interaction between interesting biological phenomena, a serial cross-species jump of viruses, and the enormous social changes resulting from European colonialism. A good part of his model is based on inference but all is plausible and the whole hangs together particularly well. Well written and illustrated, this is actually gripping reading.
20 of 21 people found the following review helpful.
Fascinating and highly readable
By Sarah
HIV began as an obscure, poorly transmissible chimpanzee virus that may have infected only one person in an isolated part of rural Africa in 1920. How did it turn into a global plague? Pepin's book is a thoroughly fascinating, highly readable, and exhaustively researched account of how colonial public health efforts in central Africa during the 1920's-1950's amplified the virus. Tens of thousands of people were injected (often repeatedly) with unsterilized syringes in an effort to wipe out tropical diseases such as sleeping sickness and yaws. Meanwhile, urbanization and widespread prostitution in central African cities caused the virus to explode into the population. Ironically, STD clinics treating prostitutes and their clients in Leopoldville, in the Belgian Congo, may have played a crucial role in spreading the virus in the early years of the epidemic. This book serves as a good sequel of sorts to Randy Shilts' "And The Band Played On", which was written when much about the origin of AIDS was still a mystery. It would also be interesting to read along with "King Leopold's Ghost", which tells the tragic story of colonialism in the Belgian Congo. AIDS, it appears, is one of those restless ghosts.
16 of 17 people found the following review helpful.
brilliant, complex and tragic
By simpcity
from an injured bush hunter (or cook) in about 1921, SIVcpz (chimpanzee SIV) makes the leap to humans to become HIV. it was a leap that likely happened on more than one occasion. however, this time the european colonial drive on equatorial Africa had created conditions for a "perfect storm." how this one case led to tens of millions is quite a story.
the colonials wanted to make tropical Africa safe for their civilizing mission. well, at least safe for europeans! this meant eradicating endemic diseases and resulted in inoculation after inoculation with syringes that were not sterilized. (who knew, huh?) additionally, the civil war in the [former Belgian] Congo after independence created such poverty and disruption in the capital Leopoldville as to create the perfect environment for sexual acceleration of the virus through a new [for Africa] kind of high-volume cash-based prostitution.
a single Haitian UN contract worker in the now independent Congo then brings the virus home. in itself, this simple act might not have lead to contagion in Haiti were it not for a shadowy international plasma trade that found perfect conditions to operate under the dark tyranny of 'Baby Doc' Duvalier. from a pool of impoverished and infected plasma donors the virus is again accelerated through the sex trade. the leap to North America is swift and efficient, with gay men and IV drug users the first bridgehead and blood products close behind.
an elegant hypothesis, nicely documented, thoughtfully stated. without finger-pointing or shame. just brilliant! a must read! thank you, Jacques Pepin.
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