The Origins of AIDS
It is now thirty years since the discovery of AIDS but its origins continue to puzzle doctors and scientists. Inspired by his own experiences working as an infectious diseases physician in Africa, Jacques Pepin looks back to the early twentieth-century events in Africa that triggered the emergence of HIV/AIDS (human immunodeficiency virus/acquired immune deficiency syndrome) and traces its subsequent development into the most dramatic and destructive epidemic of modern times. He shows how the disease was first transmitted from chimpanzees to man and then how urbanisation, prostitution and large-scale colonial medical campaigns intended to eradicate tropical diseases combined to disastrous effect to fuel the spread of the virus from its origins in Léopoldville to the rest of Africa, the Caribbean and ultimately worldwide. This is an essential new perspective on HIV/AIDS and on the lessons that must be learned if we are to avoid provoking another pandemic in the future.
JACQUES PEPIN
is a Professor in the Department of Microbiology and Infectious Diseases at the Université de Sherbrooke, Canada, where he is also Director of the Center for International Health. He has conducted research on infectious diseases in sixteen African countries and, during the 1980s, worked for four years as a medical officer in a Zaire bush hospital.
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Library of Congress Cataloguing in Publication data
Pepin, Jacques, 1958–
The origins of AIDS / Jacques Pepin.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-1-107-00663-8 (hardback) – ISBN 978-0-521-18637-7 (pbk.)
1. HIV infections – Africa. 2. HIV infections – Etiology. 3. AIDS (Disease) –
Africa. 4. Emerging infectious diseases – Africa. I. Title.
[DNLM: 1. HIV Infections – etiology – Africa. 2. HIV Infections – history –
Africa. 3. Acquired Immunodeficiency Syndrome – history – Africa.
4. Communicable Diseases, Emerging – history – Africa. 5. Disease Vectors –
Africa. 6. HIV-1 – pathogenicity – Africa. 7. History, 20th Century – Africa.
WC 503.3]
RA643.86.A35P465 2011
362.196′97920096–dc22
2011007350
ISBN
978-1-107-00663-8
Hardback
ISBN
978-0-521-18637-7
Paperback
Cambridge University Press has no responsibility for the persistence or accuracy of URLs for external or third-party internet websites referred to in this publication, and does not guarantee that any content on such websites is, or will remain, accurate or appropriate.
I am grateful to several persons who helped me through the various steps of writing up this book. I will list them in chronological order.
At a very proximal stage, my career in the tropics (and thus my interest and competence in writing this book) would not have been possible without the support and patience of the late Christian Fisch and Jean-Louis Lamboray. I am also indebted to my former mentors and colleagues at the Université de Sherbrooke (especially Raymond Duperval), the University of Manitoba, where I learned respectively to practise medicine and infectious diseases, the Medical Research Council Laboratories in The Gambia, where I understood how to do research, and the London School of Hygiene and Tropical Medicine, where I studied epidemiology. For more than fifteen years, the Canadian International Development Agency (CIDA) sponsored public health interventions in Africa during which I discovered a lot about sex workers. CIDA had also funded the primary healthcare project in Zaire where I became fascinated by African trypanosomiasis and other tropical diseases.
Over the seven years that I ultimately spent collecting the historical documents listed in the references section, I was assisted in an ever friendly way by the librarians of the following institutions (also in chronological order): Widener Library of Harvard University; Canada Institute for Scientific and Technical Information in Ottawa; British Library and School of Oriental and African Studies in London; Institute of Tropical Medicine in Lisboa (when I was mostly interested in HIV-2); Institut de Médecine Tropicale du Service de Santé des Armées in Marseilles (where I discovered that what was true for HIV-2 also applied to HIV-1 and suddenly realised that there was enough material for a book, rather than a few standard 3,000-word scientific papers, which had been my initial goal); Archives Nationales d’Outre-Mer in Aix-en-Provence; Belgian Ministry of Foreign Affairs, the Royal Library and Université Libre de Bruxelles, in Brussels; Louvain University and Université Catholique de Louvain; Institute of Tropical
Medicine in Antwerp; United Nations Library and the World Health Organization in Geneva; Bibliothèque Nationale de France in Paris; University of Ottawa, Université Laval in Quebec City, Université de Montréal and Université du Québec à Montréal and my own institution, the Université de Sherbrooke.
During the lengthy process of writing up the manuscript, I became especially indebted to Bernadette Wilson, who expertly edited the many chapters that I had written in English, and translated a few more written in French, and to Christian Audet, who professionally designed the illustrations.
When I finally reached the stage of seeking a publisher, Michael Watson of Cambridge University Press was kind enough to look at my manuscript and to find it worthy of publication. He then guided me through the difficult but necessary process of further editing the work. Like most academic authors, I initially saw this last step as a multi-organ amputation, but it turned out to be just a long-overdue haircut. Chloe Howell assisted with the finishing touches.
This having been said, the most important person who helped me through this whole adventure will be acknowledged in the Introduction.