Review of The River: A Journey Back to the Source of HIV and AIDS
Edward Hooper. Harmondsworth: Allen Lane The Penguin Press. Boston: Little, Brown. 1999. Pp 1070. £25, US$35. ISBN 0-713-99335-9.
Lancet, September 25, 1999; Volume 354, Number 9184
Edward Hooper’s river–at 1000 pages, more Amazon or Congo than Thames–is the AIDS epidemic in full flood, but what interests him is the trickle with which it all began. What also interests both him and the Oxford evolutionary biologist W D Hamilton, who writes the enthusiastic foreword to this provocative book, is what lessons might be drawn if the origin of HIV/AIDS is indeed an instance of medicine gone wrong. The hypothesis, which in part at least is testable, is that one type of oral poliovaccine developed in the 1950s involved culture in kidney cells of chimpanzees. The chimpanzee simian immunodeficiency virus is the non-human one most closely related to HIV-1 and, the argument runs, it was via the vaccination campaigns in Africa in the late 1950s (and possibly elsewhere) that SIV reached man. After that came mutation to HIV and spread to eventual epidemicity via several routes, one possibility being Haitian technicians returning home after assisting the newly independent Congo republic. An iatrogenic disaster in other words, “bidding to prove itself more expensive in lives than all the human attritions put in motion by Hitler, Stalin, and Pol Pot” (Hamilton).
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