Tinderbox

This absorbing interdisciplinary study of HIV/AIDS explores how the West inadvertently unleashed the AIDS epidemic and then failed to combat it effectively, especially in the most vulnerable regions in Africa. Drawing on the latest genetic research, Washington Post reporter Timberg and Harvard epidemiologist and medical anthropologist Halperin trace the disease’s origins in the Cameroonian jungle, where HIV’s transmission from chimps to humans coincided with the rapacious period of colonial expansion as the quest for rubber sap and ivory created new transportation networks (porter paths, steamship lines, airstrips, and highways), along which the disease traveled, and a large, hectic colonial city (Leopoldville; now Kinshasa in the Democratic Republic of the Congo). Africa’s susceptibility, the authors suggest, was partly due to changing social customs. For example, Christian missionaries discouraged rituals such as male circumcision, now known to significantly reduce the spread of HIV. As the Western powers (namely the U.N. AIDS program and President George W. Bush’s initiative) poured money into combating the spread of AIDS, they favored biomedical approaches (shots, pills, HIV testing, condom promotion) and ignored potentially life-saving African initiatives, such as modifying sexual behavior and male circumcision. Highlighting the politics of AIDS, where there were powerful incentives to work within the conventional wisdom to win lucrative government contracts, this timely exposé advocates practical solutions to a seemingly intractable problem.

Publishers Weekly

Timberg, the former Johannesburg bureau chief for the Washington Post and current deputy national security editor, and Halperin, an epidemiologist and AIDS expert at Harvard, trace the history, growth and spread of HIV and present what will in the minds of many be a controversial approach to addressing the disease.

Although the subtitle sounds vaguely conspiratorial, the authors crisply chronicle the origins of AIDS from chimpanzees in West Africa and follow the perhaps shockingly slow spread of HIV across the African continent and to the rest of the world. The key factor in the spread of the disease was the expansion of European colonialism in Africa, which took a virus that otherwise may well have died off and instead created the conditions by which, decades later, it would become a scourge in many parts of the world. But European colonial-era malfeasance is not the only issue at work in this book. In addition to a useful history of the disease, Timberg and Halperin examine how to confront it and develop more effective ways to fight it. If Western imperialism is to blame for the initial proliferation of HIV/AIDS, Western arrogance and the unintended consequences of good intentions may well have prevented adequate treatment. While Western health advocates have supported abstinence campaigns and condom use, the authors argue that homegrown initiatives hold more promise than many Westerners have been willing to acknowledge, and that new research on the importance of sexual behavior and male circumcision is central to developing a coherent approach going forward.

Timberg and Halperin may ruffle feathers with some of their unorthodox views, but they present a forceful case with which future students of HIV and AIDS will have to reckon.