"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"
Owner Reviews, Ratings, Comments and Criticism
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.
