1. The origins of AIDS: Jacques Pepin

    For decades AIDS has been used to stigmatise all manner of communities, from gays to Haitians and Africans. That could change with the recent publication of Jacques Pepin’s The Origin of AIDS. Pepin offers a readable, detailed account of how the virus jumped from chimpanzees to humans at the exact time that medical interventions and human migration were paving a path for wide-scale transmission. What Pepin describes is a perfect storm of biological developments and human activity that defies any attempt to assign culpability to a specific community.

    Pepin, a practicing infectious diseases physician and epidemiologist, spent four years in a bush hospital in then-Zaire in the early 1980s – a stint that coincided with the initial discovery of AIDS in the US and the slow realisation that it was already a global epidemic. The question he looks to answer in The Origin of AIDS, though, is what happened before he arrived on the scene? How could the transmission of a virus from one chimpanzee to one man sometime around 1921 explode into a global pandemic?

    Pepin concedes, “during my time in Zaire patients under my care were probably infected with HIV-1 during health care”, when glass syringes and reusable needles were not properly sterilised. And his subsequent research into the impact of this laxity is critical. It explains how, instead of one infected man with a small likelihood of transmitting the virus beyond, maybe, his wife, there was a community of people who had shared a needle with him and had been exposed to the virus. Perhaps hundreds became infected. And the likelihood increased that one of those people might join the growing migration to urban centers like Kinshasa or Brazzaville and become part of a sexual network with concurrent sexual partners.

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