Book review: How AIDS ends: an anthology from San Francisco AIDS Foundation

Book review: How AIDS ends: an anthology from San Francisco AIDS Foundation

HIV Australia | Vol. 11 No. 1 | March 2013

How AIDS ends: an anthology from San Francisco AIDS Foundation. Edited by Reilly O’Neal.

ABIGAIL GROVES critiques a collection of essays looking towards an ‘AIDS free generation’.

At the most recent World AIDS Conference, US Secretary of State Hillary Clinton raised the prospect of an ‘AIDS-free generation.’

‘The goal of an AIDS-free generation may be ambitious,’ she said, ‘but it is possible with the knowledge and interventions we have right now … imagine what the world will look like when we succeed.’

Her pronouncement may be premature, but with huge increases in the number of people on treatment and the effectiveness of treatment as prevention now proven, a world after AIDS is now, just, imaginable.

It is in this atmosphere of hope that the San Francisco AIDS Foundation has produced How AIDS Ends, an anthology of writings in which each author is asked: ‘when the history of HIV/AIDS is written, what will the final chapter look like?’

This is an appealing question, and the anthology has attracted some impressive contributors, with a foreword by Bill Clinton and pieces from luminaries of the HIV world such as Robert Gallo (credited with identifying HIV), Cleve Jones (founder of the Quilt Project) and the ‘Berlin patient’, Timothy Ray Brown, the first person to be cured of HIV.

Indeed, Brown’s chapter is one of the most interesting, recounting the (no doubt harrowing) treatments he received for leukaemia, which failed.

The innovative stem cell treatment he received was a last resort, and Brown was given only a 5% chance of survival. But what is most inspiring about Brown’s story is not just that the treatment cured both his leukaemia and HIV, but his response.

Brown started his own Foundation dedicated to finding a cure for HIV. ‘I want other people to benefit from this,’ he writes. ‘I don’t want to be the only person in the world cured of HIV’.

Looking to history

Many of the pieces look back into the history of the epidemic, rather than forward to the future. For a reader without a strong background in HIV, these accounts are certainly interesting in themselves. For example, Scott Wiener, a city Councillor in San Francisco, writes about leadership.

‘In 1997, he says, there were few gay male elected officials in San Francisco. I asked someone I knew at the time why that was, and he responded, “Most of the people who would’ve held those positions are dead”’.

Wiener’s account is an arresting reminder of the effects of the epidemic on the gay community.

Unfortunately, the anthology degenerates into a pep talk about the need for more education, more compassion, more work, and more funding. No doubt this is the purpose of the book, as AIDS will not end without all of these things, but it makes for rather dreary reading.

As medical anthropologist Paul Farmer and his colleagues point out, ‘Lofty dreams of the end of AIDS must be interrogated, asking where, when, and for whom’.

The book is disappointingly short on this sort of interrogation. And for all the illustrious names, the contributors are ultimately repetitive.

Despite all the talk of the millions of people affected by HIV around the world, all of the contributors come from the US, and most are white.

While Mark Dybul, Executive Director of the Global Fund to Fight AIDS, TB and Malaria, speaks of industrious Africans helping their communities, it would be great to hear from some of the Africans themselves, and their own dreams about the end of AIDS. Perhaps these voices are less appealing to potential funders.