During several years of reporting in eastern and southern Africa, Epstein interviewed a lot of people who were involved, with varying degrees of effectiveness and idealism, in the struggle to overcome the AIDS epidemic. Her vivid descriptions of personalities, anecdotes, and organizations is the strength of her account. Her conclusion, based mostly on Uganda's early successful efforts to reduce the rate of infection, is deceptively simple: the most successful programs are grass-roots, bottom-up efforts that lead to widespread community mobilization against the disease. Ugandans changed their sexual behavior as a result of the frank and widespread discussion encouraged by the government, which also frankly advocated sexual fidelity and abstinence. Epstein is much more skeptical, on the other hand, that the ongoing international aid effort will be nearly as successful; most of Uganda's success was achieved before it received international support for its AIDS programs. Her careful reporting and passionate stance makes this book well worth reading, but it should be obvious by now that international aid cannot substitute for savvy local governments and committed, united communities. Of course, if anyone knew exactly how to create such governments and communities, aid would no longer be necessary.
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