Subject: "The Global Impact of AIDS" Date: Published in 1989 (132 lines) &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& B O O K R E V I E W &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& "The Global Impact of AIDS," proceedings of the First Interna- tional Conference on the Global Impact of AIDS, edited by Alan F. Fleming, Manuel Carballo, David W. FitzSimons, Michael R. Bailey and Jonathan Mann. New York: Alan R. Liss, Inc. 427 pages hardcover. AIDS Around the World -- 1988 Reviewed by Ben Gardiner The full story of AIDS was not known when the material for this book was collected. It constitutes a beginning, and comes from an historic conference that followed soon after the World Summit of Health Ministers on AIDS, both in early 1988. Only a little more than a year later, it often appears that we still do not know the full story of AIDS. This scholarly book gives a perspective on AIDS that is at once helpful and disturbing. Helpful in that it brings us up out of our immediate surroundings, and disturbing in that it shows what tremendous differences there are between the health care delivery systems around the world. It doesn't tell us today anything new about AIDS, it offers no news of cures, no safe place to go away from AIDS. What it does do is begin the process of finding how AIDS is likely to affect the entire population of the planet. There is in this task an unspoken assumption, with which some would disagree. The assumption is that AIDS is everywhere a similar malady. At present, two years after much of the material in this book was prepared, there are indications that AIDS is not the same in all places and at all times. The significance of the book may then well be in its descriptions and indications of the state and character of the health care delivery systems (or the absence of them) in places far from the cities in the U.S.A. where AIDS has been making news for the past few years. For the perspective, it includes an important article on the sociological impact of AIDS in places where the losses of popula- tion are large. Like wars, AIDS is generally killing people who are in the prime of life, the most productive years, and conse- quently the loss of those people will have the greatest impact on the societies where it is occurring. It is not easy reading unless you are accustomed to govern- ment documents and papers by medical scholars, none of which get praised for being well written. No, were the subject not so serious, this would be a book to put you to sleep. It has facts, it has graphs, it has tables of numbers. Sometimes it seems that these displays can mislead one into thinking there is truth where the reality may be that a fool with a lot of statistics is just a fool with a lot of statistics. One may assume that these authors are not fools. It's just that most of us have no way of knowing what happened in a country eight or ten thousand miles and a whole culture gap away, two years ago. A lot of us may not even know what's happening in such a country today. Or care. With AIDS we are led to care for people and situations that may not have seemed important before. In Africa, for instance, we find they have lots of AIDS. How many people remember that only a few years ago several million people in Africa were starv- ing? That was no virus. Two million people died of starvation. The book is well introduced by Jonathan Mann, Director of the Global Programme on AIDS, World Health Organization, who points out its value as a record of the beginning of an unpre- cedented medical action. It is well summed up by The Hon. Jus- tice Michael Kirby. Your reviewer found that, in addition to the illumination of some little-known corners of the travesty we know as AIDS, this book is a good candidate for the prize as one of the dullest ways to deal with a poignant and tragic event that may prove to become a milestone in disaster along the road of human destiny. Sitting in the country whose former President couldn't manage to say the word AIDS aloud for six years, it is shocking or enervating to learn that other countries have taken the threat of AIDS very seriously. Most of us have heard of what was being done in Europe, but here in this book is record of work in Africa, in Brazil, in international trade and population movements, and clues to its possible impact on the future of civilization. Until very recently it is unlikely that most Americans would have even thought of these things. If this book could have come out before some of the melodramatic writing that has so much affected people's emotions, it might well reach the kind of place that books on the greenhouse effect do. I found nothing flip in the entire volume. Boring maybe but not exploitative of the reader's base emotions. Representing a wide spectrum of contributors, it includes some that have distinct prejudice against the people who, in the U.S.A., have been first hit the hardest -- the male gay communi- ty. It also reveals that in many countries in Europe, AIDS is not considered to be as important a problem as cancer. While Americans have been fed stories of either horror or hope, one of the scholars goes to great lengths to show that it is the grandmothers who will bear much of the burden that follows in the path of AIDS. Again the similarity to wars, in that the survivors are likely to be either very old or very young. More than one article indicates that those between 25 and 40 will be scarce in some countries, and sorely missed in others. The summary speech from the end of that historic first conference reminds us that alongside the tragic facts and devas- tating projections about AIDS are the facts of other conditions with which society has been assaulted for some time, especially cancer, and the results of the abuse of alcohol and other drugs. It should also be noted that the overwhelming majority of those participating in the conference were from countries other than the U.S.A. The English-speaking world is heavily represented, but there are also a number of participants from Africa, India and Japan. &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& End of display