A chronicle of one of America’s bold health initiatives.
With 25 years of experience as an AIDS activist, journalist Bass makes a vivid book debut with a detailed recounting of a prevention program that effectively stemmed AIDS in Africa. Drawing on medical reports, scientific papers, and interviews with activists, AIDS sufferers and their families, and health care providers and administrators (Deborah Birx, among them), the author examines the impact of a plan put forth by George W. Bush in 2003: the President’s Emergency Plan for AIDS Relief. Astonishingly to Bass, the scientifically sound, rigorously researched plan—informed by experts including physicians Anthony Fauci and Mark Dybul—was met with skepticism both within Washington and among AIDS activists, who treated it “as a false promise and a political ploy.” As Bass watched the fate of the plan play out, she saw that “the structure of the program designed to wage war on the virus had engendered a war for resources” among a plethora of agencies whose acronyms sometimes overwhelm the narrative. The rivalries, she notes, continued “as long as the program did, defining and undermining this singular, purpose-built effort to control a modern plague.” Although in the U.S., “it was a workaround for the enduring ambivalence about foreign aid that made efforts by turns competitive, ineffective, and fragmented,” in Uganda—where Bass had been a Fulbright scholar in 2004-2005 and returned for many extended visits—PEPFAR became “a solution to the problem of keeping people with HIV alive when their own government did not care to try.” The plan had effectively “married research with implementation, relied on local partners, moved fast,” and responded to Ugandans’ urgent needs. PEPFAR, Bass asserts, proved to be “an unprecedented achievement in promoting public health instead of public death” and an important lesson “in how the US government can organize and implement a long-term plague war.”
A timely history of successful government intervention.Pub Date: July 6, 2021
ISBN: 978-1-5417-6243-5
Page Count: 496
Publisher: PublicAffairs
Review Posted Online: April 22, 2021
Kirkus Reviews Issue: May 15, 2021
Categories: SCIENCE & TECHNOLOGY | WORLD | HEALTH & FITNESS | UNITED STATES | U.S. GOVERNMENT
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The Covid-19 pandemic is not a one-off catastrophe. An epidemiologist presents a cogent argument for a fundamental refocusing of resources on “the foundational forces that shape health.”
In this passionate and instructive book, Galea, dean of the Boston University School of Public Health, writes that Covid emerged because we have long neglected basic preventative measures. “We invest vast amounts of money in healthcare,” he writes, “but comparatively little in health.” Readers looking to learn how governments (mainly the U.S.) mishandled the pandemic have a flood of books to choose from, but Galea has bigger issues to raise. Better medical care will not stop the next epidemic, he warns. We must structure a world “that is resilient to contagions.” He begins by describing the current state of world health, where progress has been spectacular. Global life expectancy has more than doubled since 1900. Malnutrition, poverty, and child mortality have dropped. However, as the author stresses repeatedly, medical progress contributed far less to the current situation than better food, clean water, hygiene, education, and prosperity. That’s the good news. More problematic is that money is a powerful determinant of health; those who have it live longer. Galea begins the bad news by pointing out the misleading statistic that Covid-19 kills less than 1% of those infected; that applies to young people in good health. For those over 60, it kills 6%, for diabetics, over 7%, and those with heart disease, over 10%. It also kills more Blacks than Whites, more poor than middle-class people, and more people without health insurance. The author is clearly not just interested in Covid. He attacks racism, sexism, and poverty in equal measure, making a plea for compassion toward stigmatized conditions such as obesity and addiction. He consistently urges the U.S. government, which has spared no expense and effort to defeat the pandemic, to do the same for social injustice.
An oft-ignored but fully convincing argument that “we cannot prevent the next pandemic without creating a healthy world.”Pub Date: Nov. 1, 2021
ISBN: 978-0-19-757642-7
Page Count: 280
Publisher: Oxford Univ.
Review Posted Online: Aug. 28, 2021
Kirkus Reviews Issue: Sept. 15, 2021
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BOOK REVIEW
A lucid (in the sky with diamonds) look at the hows, whys, and occasional demerits of altering one’s mind.
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Building on his lysergically drenched book How to Change Your Mind (2018), Pollan looks at three plant-based drugs and the mental effects they can produce.
The disastrous war on drugs began under Nixon to control two classes of perceived enemies: anti-war protestors and Black citizens. That cynical effort, writes the author, drives home the point that “societies condone the mind-changing drugs that help uphold society’s rule and ban the ones that are seen to undermine it.” One such drug is opium, for which Pollan daringly offers a recipe for home gardeners to make a tea laced with the stuff, producing “a radical and by no means unpleasant sense of passivity.” You can’t overthrow a government when so chilled out, and the real crisis is the manufacture of synthetic opioids, which the author roundly condemns. Pollan delivers a compelling backstory: This section dates to 1997, but he had to leave portions out of the original publication to keep the Drug Enforcement Administration from his door. Caffeine is legal, but it has stronger effects than opium, as the author learned when he tried to quit: “I came to see how integral caffeine is to the daily work of knitting ourselves back together after the fraying of consciousness during sleep.” Still, back in the day, the introduction of caffeine to the marketplace tempered the massive amounts of alcohol people were drinking even though a cup of coffee at noon will keep banging on your brain at midnight. As for the cactus species that “is busy transforming sunlight into mescaline right in my front yard”? Anyone can grow it, it seems, but not everyone will enjoy effects that, in one Pollan experiment, “felt like a kind of madness.” To his credit, the author also wrestles with issues of cultural appropriation, since in some places it’s now easier for a suburbanite to grow San Pedro cacti than for a Native American to use it ceremonially.
A lucid (in the sky with diamonds) look at the hows, whys, and occasional demerits of altering one’s mind.Pub Date: July 6, 2021
ISBN: 978-0-593-29690-5
Page Count: 288
Publisher: Penguin Press
Review Posted Online: April 14, 2021
Kirkus Reviews Issue: May 1, 2021
Categories: BODY, MIND & SPIRIT | SCIENCE & TECHNOLOGY | PSYCHOLOGY | NATURE | BODY, MIND & SPIRIT | HEALTH & FITNESS
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