DRAGON WITHIN THE GATES: The Once and Future AIDS Epidemic

A cool, scientific overview of the AIDS epidemic, combined with a passionate defense of his own battle to protect public health, from a former N.Y.C. Health Commissioner. Joseph (Dean of the School of Public Health/Univ. of Minnesota) discusses how epidemics arise and spread, why the AIDS epidemic could have been much worse, what the future is likely to hold, and what needs to be done from a public-health standpoint. AIDS, he says, is the first major public-health issue of our time for which social and political values rather than health requirements have set the agenda--and consequently, be contends, opportunities to control the epidemic have been missed, particularly the failure to use testing appropriately. Joseph argues that protecting the uninfected and treating the sick should be our primary objectives, not the protection of civil liberties. His own promotion, while health commissioner, of widespread testing, mandatory reporting of infection, and tracing and notification of sex partners of infected individuals aroused angry, sometimes violent, resistance in New York, especially from gay activist groups such as ACT UP. This same group, however, supported Joseph's introduction of a needle-exchange program aimed at curbing the spread of AIDS among drug addicts and their sex partners when the program ran into tough opposition from religions and political leaders. Joseph can personally attest to the bigotry, ignorance, and fear that have often marked responses to the AIDS epidemic, but he nevertheless remains hopeful that we still have the power to modify our behavior, increase our knowledge, and take the necessary actions. A clear explanation of AIDS as an epidemic, and a forceful presentation of controversial proposals for dealing with it.