In This Review

The Origins of AIDS
The Origins of AIDS
By Jacques Pepin
Cambridge University Press, 2011, 310 pp
Tinderbox: How the West Sparked the AIDS Epidemic and How the World Can Finally Overcome It
Tinderbox: How the West Sparked the AIDS Epidemic and How the World Can Finally Overcome It
By Craig Timberg,Daniel Halperin
The Penguin Press HC, 2012, 432 pp

These two books deserve to be read by anyone interested in Africa's HIV/AIDS crisis. Pepin has written an absorbing analysis of the roots of the epidemic. It reads a bit like a crime novel, as he gathers evidence from various colonial-era archives to trace the spread of the virus, beginning with its initial transmission from chimpanzees to humans in central Africa sometime during the first half of the twentieth century. Pepin argues convincingly that modernization, urbanization, and the growth of prostitution all combined with catastrophic flaws in colonial health systems to aid the spread of the virus. He presents a readable explanation of the complex biological details of the virus and its different strains while also providing an intriguing social history of central Africa.

Pepin's story ends in the early 1980s, when the epidemic exploded. That is about when Timberg and Halperin's account begins, focusing on the international effort to overcome the disease. Like Pepin, they contend that colonialism "sparked" an epidemic by spurring rapid modernization in central Africa. But long after the end of the colonial era, HIV/AIDS, now a global pandemic, continues to hobble the continent, in part because of HIV's origins in the region and in part because of Africa's poverty and woeful health systems. Today, roughly two-thirds of all HIV infections occur in sub-Saharan Africa, and mortality rates for the disease are considerably higher there than elsewhere. (In the past three decades, fewer than one million Americans have died of AIDS-related illnesses; in 2009 alone, 1.3 million Africans died because of the disease.) The book's account of the global campaign to combat HIV/AIDS focuses almost entirely on individual researchers and international agencies; African governments are strikingly absent from the narrative. The authors are highly critical of aid programs that promote sexual abstinence, which they view as ineffective. They are also particularly disappointed that the discovery that male circumcision makes infection considerably less likely has not resulted in major new programs to promote large-scale circumcision campaigns.