Jacques Pepin (2)

Jacques Pépin, an infectious disease researcher at the University of Sherbrooke, has written a comprehensive history on the early beginnings of HIV and AIDS in this book, "The Origins of AIDS." The book covers a tremendous amount of historical ground and includes many interesting anecdotes in the history of infectious disease.

Large chunks of the book focus on the impact of colonialism in central Africa, from urbanization to new trading networks to the overall disruption of life. Pépin has brought extensive sources from his research in France to the book in order to show how Europeans - particularly the French and Belgian colonial regimes - upset the region in ways that triggered HIV's first infections in humans.

With his own research and the research of many others, Pépin claims that a version of HIV crossed from chimpanzees to humans in the early 20th century. HIV exploded when it arrived in the huge metropolitan areas like Leopoldville (presently Kinshasa) that were set up by Europeans in order to exploit the continent. The explosion was aided by many colonial factors, but perhaps most importantly by unhygienic and slipshod medical practices, including not sterilizing syringes during vaccination campaigns despite knowing the potential effect, and policies that encouraged prostitution.

During the political upheaval of the Democratic Republic of Congo's independence, HIV was transferred to Haitian advisors stationed there and then spread throughout North America by companies that exploited the international trade in blood. In the meantime, HIV continued its vicious course throughout Africa and was, at various times, transmitted to different parts of the world.

Parts of the book were a bit technical for me as a layperson with little medical knowledge. The author acknowledges this and apologizes for it, but continues with the history. "The Origins of AIDS" is quite complicated, but Pépin does a nice job of compartmentalizing information into chapters and sections, making it easy for readers to skim through some of the heavier parts. Chapter 14, titled "A Long Journey," is an excellent summary of the entire history.

The book includes endnotes and a very comprehensive index.… (plus d'informations)

Understanding the origins of AIDS is important for at least three reasons. First, HIV/AIDS is an important biomedical global disease that is still not conquered. Second, much cultural rhetoric due to stigma exists in society about this disease, and blame for the AIDS pandemic have been wrongfully placed at the feet of many oppressed groups. Third, contemporary events with coronavirus have shown that humans aren’t as safe from disease and pandemic as we might imagine, and understanding pandemics more generally is an advantageous endeavor.

In the second edition of this work, Pépin makes a compelling case that HIV/AIDS arose in central Africa, probably in Cameroon, from a hunter preparing and eating infected ape-meat. This likely happened in the early twentieth century, not mid-century as traditional tales tell. It was soon transmitted to the metropolis of Léopoldville in the Belgian Congo (now Kinshasa in the Democratic Republic of the Congo). The contagion was spread by the medical establishment (that is, iatrogenically) through intravenous injections with insufficient cleaning. Tribal social conditions in prior generations in Africa might have kept this disease at bay, but rapid urbanization contributed to the disease’s spread through a high male:female ratio, which encouraged sexually polyamorous relationships.

The disease was spread to North America through Haiti. Haitian teachers had come to the Congo to serve as civil servants (due to the collapse of colonialism), contracted the disease through normal sexual relations, and brought it back with them to their homeland. Pépin suggests, again, that iatrogenic means were instrumental in its spread. Contrary to popular legend that claims that licentious homosexuality deserves most of the blame, he makes a detailed case that plasmapheresis centers to collect human plasma amplified the disease among Haitians in and around the capital Port-au-Prince. Eventually, sexual contact and travel brought it to New York and San Francisco, where it spread rapidly among illicit drug users and a homosexual community that was just coming out of social oppression. It continued to spread in sub-Saharan Africa, and the American medical-industrial complex continued to study and define the disease as it spread. Particularly in sub-Saharan Africa, simple public health measures (like education about condoms in at-risk populations) could have slowed its reach dramatically.

Pépin tells this complicated tale with detailed reasoning gained through a medical degree, an epidemiology PhD, and a lifetime of medical work in Africa. He seamlessly combines social and political history with medical research to trace this disease’s spread. Of course, he acknowledges that he cannot define every step with certainty, but instead reasons through the probabilities of the possibilities with academic rigor. The first edition of this work has been well-received by the scientific and literary communities, so it likely will continue to gain an audience among interested parties worldwide.

This work addresses many potential audiences – including those interested in global and public health, international politics, AIDS and infectious disease research and treatment, the spread of disease and pandemics, contemporary affairs in North American or Europe, colonial and post-colonial African history, and the social theory of oppressed groups. Frankly, it is a compelling work of genius, and kudos go to Cambridge University Press for publishing it in a second edition. My interest was gripped from the opening to the closing, and I sincerely hope that others will hold it in similar esteem.… (plus d'informations)