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The Origins of AIDS [Hardcover]

Jacques Pepin
4.8 out of 5 stars  See all reviews (4 customer reviews)
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Book Description

Oct. 17 2011 1107006635 978-1107006638 1
It is now thirty years since the discovery of AIDS but its origins continue to puzzle doctors and scientists. Inspired by his own experiences working as an infectious diseases physician in Africa, Jacques Pepin looks back to the early twentieth-century events in Africa that triggered the emergence of HIV/AIDS and traces its subsequent development into the most dramatic and destructive epidemic of modern times. He shows how the disease was first transmitted from chimpanzees to man and then how urbanization, prostitution, and large-scale colonial medical campaigns intended to eradicate tropical diseases combined to disastrous effect to fuel the spread of the virus from its origins in Léopoldville to the rest of Africa, the Caribbean and ultimately worldwide. This is an essential new perspective on HIV/AIDS and on the lessons that must be learnt if we are to avoid provoking another pandemic in the future.

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"Despite the scientific advances made since the discovery of HIV, questions of the pandemic's origin still trouble us. Why us? Why now? How could this happen? Pepin's remarkable book provides, at last, a comprehensive answer. Three decades of scientific and historical research are distilled into an engaging, highly readable, and sometimes disturbing account of HIV's journey that will interest students and researchers of the virus and its fallible host." Oliver G Pybus, Department of Zoology, University of Oxford

"In this scholarly and immensely readable account of the origin of AIDS, Dr Pepin draws on his personal experience of working in central Africa and his extensive knowledge of African history, as well as his training in infectious diseases, virology and epidemiology. Unlike others who have tackled the subject, he comes to it with an open mind, and this account is likely to be definitive." David Mabey, Professor of Communicable Diseases, London School of Hygiene and Tropical Medicine

"This first major re-assessment of the origin of AIDS since Hooper's The River, delves into the extensive archives on the AIDS epidemic. Weaving together the findings of many researchers currently working on the topic, it will undoubtedly stimulate discussion on a subject of great concern and interest: the historical record of the emergence of new viruses." -William H. Schneider, Professor of History, Indiana University

"The origin and early epidemiology of the Human Immunodeficiency Viruses (HIV) has been perplexing and controversial. Jacques Pepin provides a unique insight as an investigator who has spent years in several African countries and has contributed substantially to our knowledge of routes of transmission. We must learn from this history if we wish to avoid future pandemics." -Allan Ronald, Professor Emeritus, University of Manitoba

"A great book on the evolutionary origin of HIV and the possible role of cultural and medical practices in Central Africa in the dissemination of the virus" -Max Essex, Lasker Professor at Harvard University and author of "Saturdays are for Funerals"

"Extensively referenced, the well-written book reads like a detective story, while at the same time providing a didactic introduction to epidemiology and evolutionary genetics. As far as the origins of AIDS are concerned, unless some completely new evidence emerges, it will be difficult to come up with a better explanation than Pepin's." -Science

"This is a beautifully written book, which explains epidemiological and scientific concepts such as phylogenetic analysis in clear and simple language. Pepin has assembled a vast amount of information from a wide variety of sources, and paints a clear, coherent and convincing account of the origins of AIDS. This book is required reading for anyone with a serious interest in infectious diseases." -David Mabey, Sexually Transmitted Infections

"Superb ... Pépin rightly argues that, apart from social factors promoting HIV spread, inherent properties of the virus must determine its fitness to become pandemic. He also provides the best analysis I have read of the declining HIV-2 epidemic in West Africa." -Nature

"An impressive feat of scientific scholarship ... absorbing throughout, interweaving quantitative data with historical narrative and lively biographies." -The Lancet

"This book is an excellent, fair-minded attempt to elucidate a much-contested story.' -Literary Review

"Pepin's achievement is formidable. He has mastered a vast technical literature in French and English, exploited the archives and material remains of colonial and postcolonial Africa, and knows his African history to boot. He writes with grace and feeling, and makes accessible the scientific and clinical issues. Above all, he comes across as a humane and caring doctor. This is a major contribution to our understanding of the scourge that has defined our times." -TLS

"The superb organization organization of the book is noteworthy; the reader is never left hanging, and the path to the next topic is always clear. Highly recommended." -Choice

"Pepin has written an absorbing analysis of the roots of the epidemic." -Nicolas van de Walle, Foreign Affairs

"The language of Pepin's book is academic, yet easily accessible to a lay, educated readership. Graphics, charts and maps emphasize the text content. The Origins of AIDS offers, for the first time, an in-depth look into the pandemic prior to 1981 and, with that, the missing pieces that complete the story of AIDS." -Alina Oswald, A&U, America's AIDS magazine

Book Description

A compelling new account of the origins and development of HIV/AIDS before the disease was first identified in 1981. Jacques Pepin looks back to the early twentieth-century events that triggered the most dramatic epidemic of modern times and presents a synthesis of its historical, political, medical and molecular dimensions.

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2 of 2 people found the following review helpful
4.0 out of 5 stars See scientist speak English Jan. 5 2012
Many scientists do not seem to have a grasp of any language, but the much-traveled and multilingual Pepin does a fabulous job of putting together the complex science behind the origins of AIDS, yet presenting it in a charming and comprehensible fashion that is free of most scientific jargon.
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1 of 1 people found the following review helpful
5.0 out of 5 stars Wonderfully readable book on history of AIDS Feb. 26 2012
By bdeshar
I have been looking for a long time for a book outlining the history of AIDS, and this book is the scientific part of it.

It is written by Jacques Pepin, professor at Sherbrooke University in Quebec, Canada. One might expect an unreadable and boring extended scientific paper, but to my great pleasure, that is not the case. This book is easy to read, extremely interesting and yet scientifically rigorous.

However, this book is not talking about social debates associated with the emergence of AIDS after 1984 in North America, hence for a more sociological account, one might go and look for Engel's "The Epidemic".

Overall an excellent book, which I recommend to non-scientifics as well.
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5.0 out of 5 stars Why Teachers Should Read ''The Origins of AIDS'' March 10 2014
Format:Kindle Edition|Verified Purchase
I know AIDS has taken the lives of a lot of good people, millions in fact. I have contributed to charities raising funds for AIDS research, but I have never felt personally concerned about this disease more than about any other (an ancillary benefit of having been a one-woman man for the last 31 years, I suppose). I’ve never been particularly interested in medicine or biology for that matter. So what compelled me to read an extensive, detailed study of the history of the virus known as HIV?

I had read a lot of good reports about this book, how it was the truth about AIDS that nobody wanted to talk about. How many times had I heard that before? Although I’d never read a complete book on the subject, I had a hunch that this might be a book worth reading. Not because I was interested in AIDS per se, but because its spread had become such a cultural and educational phenomenon.

How many times have you heard it said that what we need is “AIDS education”? So after 30 years of AIDS education and an intense media blitz, how is it that someone like me, who can read and pay attention, is still so ignorant about this disease? AIDS, because it has been described as an epidemic beginning in 1981, is an example of how the population we are all part of is educated on a mass level. My conclusion is: very poorly.

Over the years, every time I encountered a discussion of AIDS it was invariably someone announcing that someone else was wrong about it’s etiology. The news media was only interested in an AIDS story if it involved a celebrity, a scandal or a surprising and dramatic turn of events. It was only news if someone was claiming an unexpected breakthrough or a cover-up.
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5.0 out of 5 stars The Origins of AIDS July 9 2013
Format:Paperback|Verified Purchase
This book is a scientific account of the origin of AIDS. The author has not only provided convincing evidence of the origin of AIDS but has described the social and political contexts of how the disease came to spread from an isolated area of central Africa to a world-wide situation. The key findings of the book resides in my view with the scientific approach used by the authors to validate his hypothesis. A great and interesting book to have in one's collection. Excellent research work.
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Most Helpful Customer Reviews on (beta) 4.5 out of 5 stars  24 reviews
40 of 42 people found the following review helpful
5.0 out of 5 stars The Prehistory of AIDS Oct. 19 2011
By R. Albin - Published on
This well written and fascinating book is a cogent attempt to reconstruct the process that generated the great HIV pandemic. The author is a Canadian infectious disease specialist and epidemiologist with considerable experience in HIV-related research, including a good deal of work in Africa. Based on a careful synthesis of research and his own archival investigations, Pepin presents a synthesis of molecular epidemiology, traditional epidemiology, and social history to explain the emergence of HIV.

Pepin begins with the generally accepted idea that HIV crossed from its chimpanzee ancestor in central Africa sometime in the early 20th century, very likely because of hunting of chimps for meat. This concept is supported by molecular phylogenetic reconstructions and the fact that the bush meat trade probably increased markedly in the relevant area of central Africa with greater demand for meat and greater availability of firearms. Pepin estimates the number of individuals affected in this way to be very small, perhaps as small as 1 - 2. These infections would have been a dead end without some amplifying mechanism, which Pepin suggests was the widespread use of parenteral treatments for several tropical diseases. In the first half of the 20th century, French and Belgian colonial governments pursued impressive public health campaigns to suppress Sleeping Sickness and other illnesses. Many of these campaigns involved indiscriminate use of parenteral treatments with reusable and inadequately sterilized needles and syringes, a fertile breeding ground of this type of viral infection. The result was an expanded pool of infected individuals in rural French and Belgian central Africa. Some of these individuals migrated to cities to serve as laborers or, in the case of many women, to participate in various forms of prostitution. In these environments, HIV began to circulate via sexual transmission, particularly in the linked cities of Brazzaville and Leopoldville-Kinshasa. The explosive growth of prostitution after Congolese independence in the latter particularly favored expansion of the infected pool. From these sources, HIV would disseminate throughout the world. Pepin provides an interesting analysis of the probable route for transmission from Congo to the western hemisphere via Haitians who worked in the Congo after independence.

Pepin supports this model with careful arguments and analysis of the existing data. His integration of the colonial medical experience and the complex social history of central Africa with the epidemiology of HIV is impressive. The emergence of the HIV pandemic is presented as the result of the interaction between interesting biological phenomena, a serial cross-species jump of viruses, and the enormous social changes resulting from European colonialism. A good part of his model is based on inference but all is plausible and the whole hangs together particularly well. Well written and illustrated, this is actually gripping reading.
18 of 19 people found the following review helpful
5.0 out of 5 stars Fascinating and highly readable Nov. 5 2011
By Sarah - Published on
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HIV began as an obscure, poorly transmissible chimpanzee virus that may have infected only one person in an isolated part of rural Africa in 1920. How did it turn into a global plague? Pepin's book is a thoroughly fascinating, highly readable, and exhaustively researched account of how colonial public health efforts in central Africa during the 1920's-1950's amplified the virus. Tens of thousands of people were injected (often repeatedly) with unsterilized syringes in an effort to wipe out tropical diseases such as sleeping sickness and yaws. Meanwhile, urbanization and widespread prostitution in central African cities caused the virus to explode into the population. Ironically, STD clinics treating prostitutes and their clients in Leopoldville, in the Belgian Congo, may have played a crucial role in spreading the virus in the early years of the epidemic. This book serves as a good sequel of sorts to Randy Shilts' "And The Band Played On", which was written when much about the origin of AIDS was still a mystery. It would also be interesting to read along with "King Leopold's Ghost", which tells the tragic story of colonialism in the Belgian Congo. AIDS, it appears, is one of those restless ghosts.
14 of 15 people found the following review helpful
5.0 out of 5 stars brilliant, complex and tragic Oct. 30 2011
By simpcity - Published on
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from an injured bush hunter (or cook) in about 1921, SIVcpz (chimpanzee SIV) makes the leap to humans to become HIV. it was a leap that likely happened on more than one occasion. however, this time the european colonial drive on equatorial Africa had created conditions for a "perfect storm." how this one case led to tens of millions is quite a story.

the colonials wanted to make tropical Africa safe for their civilizing mission. well, at least safe for europeans! this meant eradicating endemic diseases and resulted in inoculation after inoculation with syringes that were not sterilized. (who knew, huh?) additionally, the civil war in the [former Belgian] Congo after independence created such poverty and disruption in the capital Leopoldville as to create the perfect environment for sexual acceleration of the virus through a new [for Africa] kind of high-volume cash-based prostitution.

a single Haitian UN contract worker in the now independent Congo then brings the virus home. in itself, this simple act might not have lead to contagion in Haiti were it not for a shadowy international plasma trade that found perfect conditions to operate under the dark tyranny of 'Baby Doc' Duvalier. from a pool of impoverished and infected plasma donors the virus is again accelerated through the sex trade. the leap to North America is swift and efficient, with gay men and IV drug users the first bridgehead and blood products close behind.

an elegant hypothesis, nicely documented, thoughtfully stated. without finger-pointing or shame. just brilliant! a must read! thank you, Jacques Pepin.
8 of 10 people found the following review helpful
5.0 out of 5 stars Finally a plausible explanation for the real origin of the AIDS pandemic Oct. 20 2011
By Emc2 - Published on
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Despite its academic nature this book is a page-turner, you will enjoy it like a really brilliant CSI episode. Dr. Jacques Pépin was quite successful in writing a book that reaches both academics and the laymen. Until now all the serious discussions and theories about the origins of the AIDS pandemic had been limited to academic journals. The book point of departure is based on these research findings, which are presented in the first chapters, and provide a comprehensive and very good summary of the state-of-the-art for the laymen. The reader shouldn't be intimated by some technical language, as the book was written for all audiences and the author did the extra work of explaining medical jargon for the general public when required, and anyway, most of the times you do not need to remember all of it to fully grasp the main storyline (just keep in mind a few key concepts, particularly the definition of HIV-1 group M, and subgroups B and C). Also from the start, Dr. Pépin debunks the two most common theories that tried to explain the origin of the AIDS pandemic.

After a very impressive Sherlock Holmes-like detective work through historical records, Dr. Pépin develops a very plausible explanation, going back to the colonial era in the early 1900s all the way to the early 1980s, with very solid theory, based on both circumstantial and hard evidence, following the path of the virus from Africa, to Haiti, and to the U.S., Europe and the rest of the world. The author did not intended to go any further, as the history and evolution of AIDS has been already covered by several authors.

The evolution of this pandemic illustrates one more time the unintended and even disastrous consequences of good intentions, and also, how medicine works and evolves in the real world. I do not wish to comment on the details of Dr. Pépin findings to avoid spoiling the story, but if you really need to know beforehand, take a look at the New York Times recently published article about Dr. Pépin's contribution, which tells the whole story in a nutshell.
7 of 9 people found the following review helpful
4.0 out of 5 stars What a nice book! Dec 25 2011
By Occasional Amazonian - Published on
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First things first: You can read and understand this book.

When I read about this book in the New York Times I just had to get it for myself. I like non-fiction a lot (particularly modern history) and this is a topic that interests me (the origin of HIV/AIDS). I wanted to review this book already when I was halfway through.

Everyone brings certain strengths and weaknesses to a book. Here were my strengths.

1. I had read (the majority of) "And the Band Played On" by Randy Shilts as well as "The Coming Plague" by Laurie Garrett so I was familiar with what the author was trying to get across (tracing a disease across continents). More importantly I had known some of the facts before.
2. I've done a fair bit of science in school--so that helped me out a little bit.

My weaknesses:

1. I have a hard time following abbreviations.
2. I don't pick up on new terminology right away.
3. Statistics is a challenge for me.

That said, the author does a spectacular job writing for the lay reader. This is not dry academic writing at all. Do not think you will not understand.

He carefully lays out the pieces of the puzzle: all his assumptions and models and it's a thing of beauty. For example, he uses the spread of Hepatitis C and B as a way to figure out the spread of HIV across populations. He explains very carefully why we can trace HIV back to a similar virus (SIV) in chimpanzees--among many other examples. I was also very impressed with the way the author explained the date of first crossover of SIV to humans.

I was very pleased. Where he was not sure, he made it clear. He did not try to make things sensational--and it worked! I believe, now, (in my limited capacity for what it's worth) that this is as close to the truth about the origin and spread of HIV as I have ever read.
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