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Peter Piot, founding executive director of the Joint United Nations Programme on HIV/AIDS (UNAIDS), recounts his experience as a clinician, scientist, and activist fighting the disease from its earliest manifestation to today. The AIDS pandemic was not only catastrophic to the health of millions worldwide but also fractured international relations, global access to new technologies, and public health policies in nations across the globe. As he struggled to get ahead of the disease, Piot found science does little good when it operates independently of politics and economics, and politics is worthless if it rejects scientific evidence and respect for human rights. Piot describes how the epidemic altered global attitudes toward sexuality, the character of the doctor-patient relationship, the influence of civil society in international relations, and traditional partisan divides. AIDS thrust health into national and international politics where, he argues, it rightly belongs. The global reaction to AIDS over the past decade is the positive result of this partnership, showing what can be achieved when science, politics, and policy converge on the ground. Yet it remains a fragile achievement, and Piot warns against complacency and the consequences of reduced investments. He refuses to accept a world in which high levels of HIV infection are the norm. Instead, he explains how to continue to reduce the incidence of the disease to minute levels through both prevention and treatment, until a vaccine is discovered.
Epstein shows the extent to which AIDS research has been a social and political phenomenon and how the AIDS movement has transformed biomedical research practices through its capacity to garner credibility by novel strategies.
Last year, more African Americans were reported with AIDS than any other racial or ethnic group. And while African Americans make up only 13 percent of the U.S. population, they account for more than 55 percent of all newly diagnosed HIV infections. These alarming developments have caused reactions ranging from profound grief to extreme anger in African-American communities, yet the organized political reaction has remained remarkably restrained. The Boundaries of Blackness is the first full-scale exploration of the social, political, and cultural impact of AIDS on the African-American community. Informed by interviews with activists, ministers, public officials, and people with AIDS, Cathy Cohen unflinchingly brings to light how the epidemic fractured, rather than united, the black community. She traces how the disease separated blacks along different fault lines and analyzes the ensuing struggles and debates. More broadly, Cohen analyzes how other cross-cutting issues—of class, gender, and sexuality—challenge accepted ideas of who belongs in the community. Such issues, she predicts, will increasingly occupy the political agendas of black organizations and institutions and can lead to either greater inclusiveness or further divisiveness. The Boundaries of Blackness, by examining the response of a changing community to an issue laced with stigma, has much to teach us about oppression, resistance, and marginalization. It also offers valuable insight into how the politics of the African-American community—and other marginal groups—will evolve in the twenty-first century.
A Nobel Prize–winning cancer biologist, leader of major scientific institutions, and scientific adviser to President Obama reflects on his remarkable career. A PhD candidate in English literature at Harvard University, Harold Varmus discovered he was drawn instead to medicine and eventually found himself at the forefront of cancer research at the University of California, San Francisco. In this “timely memoir of a remarkable career” (American Scientist), Varmus considers a life’s work that thus far includes not only the groundbreaking research that won him a Nobel Prize but also six years as the director of the National Institutes of Health; his current position as the president of the Memorial Sloan-Kettering Cancer Center; and his important, continuing work as scientific adviser to President Obama. From this truly unique perspective, Varmus shares his experiences from the trenches of politicized battlegrounds ranging from budget fights to stem cell research, global health to science publishing.
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In the late 1980s, after a decade spent engaged in more routine interest-group politics, thousands of lesbians and gay men responded to the AIDS crisis by defiantly and dramatically taking to the streets. But by the early 1990s, the organization they founded, ACT UP, was no more—even as the AIDS epidemic raged on. Weaving together interviews with activists, extensive research, and reflections on the author’s time as a member of the organization, Moving Politics is the first book to chronicle the rise and fall of ACT UP, highlighting a key factor in its trajectory: emotion. Surprisingly overlooked by many scholars of social movements, emotion, Gould argues, plays a fundamental role in political activism. From anger to hope, pride to shame, and solidarity to despair, feelings played a significant part in ACT UP’s provocative style of protest, which included raucous demonstrations, die-ins, and other kinds of street theater. Detailing the movement’s public triumphs and private setbacks, Moving Politics is the definitive account of ACT UP’s origin, development, and decline as well as a searching look at the role of emotion in contentious politics.
Brazil’s public policy response to the AIDS epidemic preceded those of many developing countries. During my tenure as President, in 1996, Brazil adopted a law guaranteeing free and universal access to AIDS treatment for all people living with HIV/AIDS. Brazil became the first developing country to provide publicly-financed AIDS treatment for all people living with HIV/AIDS. We now have one of the world’s most successful AIDS programs that is considered a model for other dev- oping countries. Today, 185,000 people receive life-saving AIDS cocktails in Brazil, and thousands of lives have been saved. But this was not an easy battle. There were many challenges along the way. Twenty years ago, Brazil’s achie- ments today might have seemed impossible. During the 1980s, in Brazil, as elsewhere, there was overwhelming stigma associated with AIDS; people living with HIV often lost their jobs and died quickly before the advent of life-saving antiretroviral drugs. Brazil’s AIDS movement was extraordinarily important in promoting progressive AIDS policies; associations of people living with HIV were the first to denounce pervasive AIDS-related discri- nation and called public attention to the importance of AIDS. Activists protested in the streets for over a decade, engaged the media, and framed AIDS as a human rights issue.
Will to Live tells how Brazil, against all odds, became the first developing country to universalize access to life-saving AIDS therapies--a breakthrough made possible by an unexpected alliance of activists, government reformers, development agencies, and the pharmaceutical industry. But anthropologist João Biehl also tells why this policy, hailed as a model worldwide, has been so difficult to implement among poor Brazilians with HIV/AIDS, who are often stigmatized as noncompliant or untreatable, becoming invisible to the public. More broadly, Biehl examines the political economy of pharmaceuticals that lies behind large-scale treatment rollouts, revealing the possibilities and inequalities that come with a magic bullet approach to health care. By moving back and forth between the institutions shaping the Brazilian response to AIDS and the people affected by the disease, Biehl has created a book of unusual vividness, scope, and detail. At the core of Will to Live is a group of AIDS patients--unemployed, homeless, involved with prostitution and drugs--that established a makeshift health service. Biehl chronicled the personal lives of these people for over ten years and Torben Eskerod represents them here in more than one hundred stark photographs. Ethnography, social medicine, and art merge in this unique book, illuminating the care and agency needed to extend life amid perennial violence. Full of lessons for the future, Will to Live promises to have a lasting influence in the social sciences and in the theory and practice of global public health.
An investigative account of the medical, sexual, and scientific questions surrounding the spread of AIDS across the country.