Adaption of a lecture series at the Collège de France by Piot (No Time to Lose: A Life in Pursuit of Deadly Viruses, 2012, etc.), the founding executive director of the Joint U.N. Programme on HIV/AIDS.
Though that series dates back five years, the author’s findings, updated to 2012, should give anyone pause who thinks that AIDS is a thing of the past. New antiretrovirals exist, but these are mostly available to consumers in developed nations. As Piot notes, in 2012, more than 1.6 million people died of AIDS, most “in sub-Saharan Africa, where AIDS is the first cause of death in about half the countries.” Those figures alone make AIDS the worst pandemic since the Spanish flu of 1918-1921, but international agencies have much to be proud of, since the epidemic did indeed bring about unprecedented global cooperation—and especially global funding, which amounted to $15 billion in 2012. Even so, serious challenges remain. The epidemiology, writes the author, is difficult, since the highest risk populations in much of sub-Saharan Africa are “men who have sex with men, injecting drug users, and mobile populations,” people who for various reasons are difficult to monitor, with the result that “efforts to control an epidemic will be inadequate.” Efforts at doing just that have had some success, however. The spread of AIDS in Southeast Asia mostly happened in the realm of commercial sex, but campaigns for universal condom use have yielded a near-complete end to that source of transmittal. Unexpectedly, Piot adds, in some parts of the world, the epidemic has helped give voice to the voiceless, including marginalized populations, sex workers among them.
Somewhat arid, as medical policy works tend to be, but of considerable use to readers with an interest in public health issues.