Who Cares?: AIDS in Africa (review)

This book is a frank discussion of the serious threat which HIV/AIDS poses for the future of humanity and of our attempts to wage war on similar epidemics in the past. It is a work which skilfully combines history, anthropology and medical science with contemporary statistics. It focuses on a topic which cannot be ignored since the killer disease has taken a global toll of more than 30 million lives and there are estimates that 18 million Africans will die from AIDS by 2010.

The author’s employment as a university lecturer in Uganda from 1989 to 1995 and her work with various organizations provides a personal insight into a continent in the throes of sickness, death and devastation. One of the unique aspects of the publication is its blend of a narrative style with the presentation of historical and scientific facts. The author’s use of characters such as Molly, Pauline and Robina reflects the voice of working-class females and illustrates their struggle to provide assistance and address the plight of infected persons. While Africa is ravaged by the AIDS virus, it is further burdened by a lack of proper medical resources to curb the disease’s rapid spread. This is illustrated by statements from South African hospitals to the effect that ‘You’ve got AIDS. We can’t help you. Go home and die’ (p. 38). It is such cold and callous responses that exacerbate a helpless situation, further complicated by the prevailing ignorance surrounding the disease and the stigmatization of infected persons.

Hunter discusses the frightening possibility of AIDS mutating and points out that HIV drugs must be continuously updated to overcome the virus’s survival strategies. The author must be commended for seeking to explain the history, composition and spread of the HIV virus in a manner easy for the layperson to grasp. This includes explanations of why persons with certain genetic traits are able to resist HIV infection, and why some microbes are harmless.

One of the shortcomings of the book is the occasional seemingly irrelevant comparison with the United States. For instance, the author provides data on the average age for sexual activity among young Americans and the percentages of those persons who committed bestiality (p. 42, p. 44). Comparisons with the Caribbean or Brazil would have provided a more enlightening perspective on the magnitude of the problem in the developing world.

Chapter 7 on ‘Disease and Evolution’ would have been more appropriately placed at the start. It focuses on the climatic and environmental changes coupled with migration, which occurred thousands of years ago, and the repercussions on human survival. More importantly, Hunter discusses the evolution of other sexually transmitted diseases such as syphilis, gonorrhea and herpes simplex.

Chapter 5 mostly refers to life in medieval Europe, ancient Greece and the colonial era. It could have been summarized and drawn into the introductory section.

Despite the minor flaws, the majority of the chapters should be compulsory reading for international organizations and countries which are assiduously working to alleviate the suffering of millions and to combat a pandemic which has crippled a continent. It seems that Africa is no longer the ‘white man’s burden’ but, with HIV/AIDS, has become the ‘world’s burden’.