AEGiS-BKREV: AIDS in the World

AIDS in the World

Harvard University Press, 79 Garden St., Cambridge, MA 02138-9983. 1,037p., illus., bibliog., index. ISBN 0-674-01265-8, 0-674-01266-6pbk. $34.95, $15.95pbk
Edited by Jonathan M. Mann, Daniel J.M. Tarantola, Thomas W. Netter. 1992.

This is the first global report on AIDS published by the Global AIDS Policy Coalition, an independent coalition, with funding coming from the Association Francois-Xavier Bagnoud. It "covers the period from the recognition of AIDS in the early 1980s through mid-1992, and thus contains both a retrospective and a current analysis of the pandemic's dimensions, shape, and impact, as well as the range of societal responses." The Coalition discovered very quickly the unavailability of information throughout the world. Some of the information is incomplete because various governments are not willing to share the data on AIDS with anyone. The basic features of this pandemic are frightening--"No community or country in the world already affected by AIDS, can claim that HIV spread has stopped." "HIV is spreading-- sometimes quite rapidly--to new communities and countries around the world." "The epidemic becomes ever more complex as it matures: the global epidemic is composed of thousands of smaller, complicated epidemics." The statistics alone are chilling: "By early 1992, 12.9 million people around the world (including 4.7 million women, 7.1 million men, and 1.1 million children) had been infected with HIV. About one-fifth (2.7 million; 21 percent) have thus far developed AIDS; of these, over 90 percent (nearly 2.5 million) have died." These are grave facts that are unfortunately falling on deaf ears of the world's leaders. It is estimated that with no vaccine or cure there will be a minimum of 38 million adults with HIV infection by the year 2000. Complacency seems to be the norm. Of the 37 countries surveyed by the Coalition, the head of state has said nothing publicly about AIDS in 13 with an additional 13 only having made their first statements since 1989! This is a pessimistic but realistic book that is intended to "guide and inspire individual, community, and global work for health into the next millennium."

Part 1--"The Impact of the Pandemic"--covers the status and trends of the HIV pandemic, the pandemic itself, interactions of HIV and other diseases, HIV and other sexually transmitted diseases, and the demographic, economic, and social impact of AIDS. These are serious chapters setting the stage for the rest of the book. Statistics, graphs, charts, and other visual data are used throughout making the impact even greater. Much of this information is data gathered by the Coalition and never before published. Part 2--"The Global Response"--covers four phases: mid-1970s until 1981 where HIV spread, silently and unnoticed to all inhabited continents; 1981-1985, a period of discovery and initial response marked by tremendous scientific creativity and progress; 1985-early 1990 when the world's first truly global strategy against a disease was developed; and finally the current phase where commitment and resources have reached a plateu with the pandemic intensifying and the gap between the pace and the response growing and widening dangerously. Part 3--"Global Vulnerability"--is a very informative section consisting of one chapter that discusses individual vulnerability in becoming infected with the HIV virus. From these facts it then discusses collective vulnerability with a warning to those countries that have thus far escaped the brunt of the HIV/AIDS pandemic, including Indonesia, Egypt, Pakistan, Nigeria, Bangladesh, Afghanistan, and Somalia--"you must act now--for the warning signs are clear."

The last part--"Critical Issues"--looks at a variety of issues. Trends in the United States and Europe are discussed, as are such topics as breast feeding, perinatal HIV transmission, does male circumcision prevent HIV infection?, gay men and AIDS, children and AIDS, and dementia. This is the part to read if one is interested in how the world should be attacking this problem. Policy and program issues are critical. Without strong policies and programs, AIDS will continue to expand and the world will continue to suffer from this devastating disease. The final chapter of this excellent book covers "The Next Epidemic." There are currently some 60 newly recognized viral agents whose origins are unknown. Any one of these agents could be the next epidemic. It is extremely important that global surveillance be top priority in funding by all nations of the world. Numerous tables of AIDS statistics are included in the appendices. This is a highly recommended book for all libraries. It is heavy reading, full of facts and figures, and alarming. (H. Robert Malinowsky)

Keywords: Epidemiology; World Health

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Copyright © 1993 - The University of Illinois at Chicago. All materials in the journal are subject to copyright by the Board of Trustees of the University of Illinois and may be reprinted or redistributed for the noncommercial purpose of scientific or educational advancement granted by Sections 107 and 108 of the Copyright Revision Act of 1976. For other reprinting, redistribution, or translation, address requests to H. Robert Malinowsky, University of Illinois at Chicago Library, PO Box 8198, Chicago, IL 60680 or electronically to hrm@uic.edu.

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