Review of Hooper, E. 1999. The River: a Journey to the Source of HIV and AIDS

Professor of Anthropology and Biological Sciences, Rutgers University and Adjunct Professor of Pediatrics, UMDNJ

Times Higher Educational Supplement, 18 February 2000

Many Africans and African-Americans believe that HIV and AIDS were either the direct invention of the white man–cooked up, for example, in the biological warfare labs in Beltsville, MD–or somehow preferentially directed at them by wicked, white scientists. A new book by Edward Hooper suggests that something like this may actually have happened, that the AIDS epidemic may have started when HIV was accidentally introduced into hundreds and perhaps thousands of Africans during vaccinations of over one million people, mostly children, against polio in 1958 and 1959 in Rwanda-Burundi and selected places in the Congo.

In a masterful account of the early history of HIV infection and AIDS Hooper shows that HIV first jumped to substantial heights in human populations in exactly those sections of the above countries in which large-scale polio vaccinations took place twenty years before. This naturally makes one wonder whether the two events were related. The most plausible connection–and the one pursued by Hooper–is that the live polio vaccine, orally administered, was contaminated with the HIV virus (or, technically, the chimpanzee’s HIV, called SIV) so that a small fraction of those taking the vaccine may also–through oral lesions, for example–have taken up an HIV infection. Since more than one million Africans were vaccinated, the fraction would not have to be high (say, 1 in 1000) to produce a substantial seed population (1000 infected individuals) with which to begin a worldwide epidemic.

The alternative theory is that we contracted HIV from the chimpanzee SIV either by eating undercooked infected chimpanzees or by accidental transfer during killing, skinning or keeping them as pets. This theory has the advantage that repeated such events must have been occurring over a long period of time. The disadvantage is that the infection starts at a very low frequency–one or a few individuals–and is likely on statistical grounds alone to go extinct in each case before an adaptively evolving parasite can successfully be launched into hundreds and then thousands of humans. As for early appearance of the epidemic, this theory suggests no particular time but does suggest areas of Africa where chimp hunting and eating were common, which are not the precise sections of Africa in which HIV actually came to numerical prominence.

The oral vaccine theory for the introduction of HIV into humans suffers from the lack of any direct evidence that chimpanzee tissue was used to culture the polio vaccines. To be sure, the chief vaccinator, Hilary Koprowski, kept a huge chimpanzee colony in the Congo, far larger than needed to test the attenuated virus (for possible crippling effects) and he was known to have sent chimpanzee kidneys back to Philadelphia for other kinds of work.

Koprowski–and the few remaining survivors (among the scientists)–of this vaccination deny that chimpanzee tissue was ever used to culture the polio virus but Koprowski has several problems with his own denial. Koprowski vaccinated more than a million human beings without ever publishing the s definitive account of the early spread of HIV provides many fascinating insights and/or speculations. For example, why Haitians? They were among the original “4 h’s”, the other three of which we understand because once introduced HIV will gain easy access into others: homosexuals (via anal intercourse), hemophiliacs (via blood transfusions) and heroin-users (via shared needles). But why Haitians? Hooper points out that some middle-class Haitians worked in French-speaking sections of Africa, such as the Congo, in the 1950’s when a need arose for middle-class dark-skinned workers in these countries. The men would have had ready access to many women in Africa and, in turn, many women when they returned home. Hooper’s research also suggests that Idi Amin’s final good-bye present to East Africa may have been the hastening of the HIV epidemic into both Uganda and Tanzania. When he unwisely seized a small section of Tanzania in 1979, President Nyerere decided he had had enough of Amin and drove the Ugandan army out of the seized territory and then marched into Kampala to liberate Uganda. But the problem is that the Tanzanian army camped for nearly a year in and near the seized land and had ready access to a town that was a smuggling center across Lake Victoria and which harbored many prostitutes and other young women, which the Tanzanian soldiers may be assumed to have taken to enthusiastically. This area was an early area of high HIV infection and Hooper speculates that the Tanzanian army brought HIV in large numbers into Kampala and then brought it home with them when they returned to Dar es Salaam.

Hooper’s book makes the OPV-HIV theory for the origin of AIDS the theory to beat. In the process of solving this puzzle we will undoubtedly get a much deeper understanding of the myriad ways in which white people, inadvertently or otherwise, may have helped launch plagues on the great African continent.