Synopses & Reviews
In 1993, Helen Epstein, a scientist working with a biotechnology company searching for an AIDS vaccine, moved to Uganda, where she witnessed firsthand the suffering caused by the epidemic. Now, in her unsparing and illuminating account of this global disease, she describes how international health experts, governments, and ordinary Africans have struggled to understand the rapid and devastating spread of the disease in Africa, and traces the changes wrought by new medical developments and emerging political realities. It is an account of scientific discovery and intrigue with implications far beyond the fight against one tragic disease. The AIDS epidemic is partly a consequence of the rapid transition of African societies from an agrarian past to an impoverished present. Millions of African people have yet to find a place in an increasingly globalized world, and their poverty and social dislocation have generated an earthquake in gender relations that deeply affects the spread of HIV. But Epstein argues that there are solutions to this crisis, and some of the most effective ones may be simpler than many people assume. Written with conviction, knowledge, and insight,
Why Dont They Listen? will change how we think about the worst health crisis of the past century, and our strategies for improving global public health.
Helen Epstein writes frequently on public health for various publications, including
The New York Review of Books and
The New York Times Magazine. She is currently a visiting research scholar at the Center for Health and Wellbeing at Princeton University.
A New York Times Notable Book of the Year In 1993, Helen Epstein, a scientist working with a biotechnology company searching for an AIDS vaccine, moved to Uganda, where she witnessed firsthand the suffering caused by the epidemic. Now, in her unsparing and illuminating account of this global disease, she describes how international health experts, governments, and ordinary Africans have struggled to understand the rapid and devastating spread of the disease in Africa, and traces the changes wrought by new medical developments and emerging political realities. It is an account of scientific discovery and intrigue with implications far beyond the fight against one tragic disease. The AIDS epidemic is partly a consequence of the rapid transition of African societies from an agrarian past to an impoverished present. Millions of African people have yet to find a place in an increasingly globalized world, and their poverty and social dislocation have generated an earthquake in gender relations that deeply affects the spread of HIV. But Epstein argues that there are solutions to this crisis, and some of the most effective ones may be simpler than many people assume. Written with conviction, knowledge, and insight,
The Invisible Cure will change how we think about the worst health crisis of the past century, and our strategies for improving global public health.
Amid the partisan babble, Helen Epstein has for years generated some of the most sensible commentary around, posting dispatches from AIDS-afflicted countries in Africa to The New York Review of Books and other publications. As a scientist morphed into a journalist, Dr. Epstein combines an understanding of the biology of AIDS with a coolly impartial view of the political and social landscape of Africa. She has now assembled more than a decades worth of reporting into an enlightening and troubling book . . . Dr. Epstein makes a good case for the efficacy of a pervasive grass-roots effort, with ordinary people talking openly about AIDS and caring for the sick and orphaned in hundreds of small community initiatives in a spirit of collective action and mutual aid . . . Throughout the book, Dr. Epstein paints an unforgettably nuanced portrait of Western efforts in Africa: well-meaning, vitally necessary and yet often so misguided.”Abigail Zugar, M.D., The New York Times
Reading The Invisible Cure is like traveling into remote and hard-to-comprehend territory with an unblinking and sure-footed guide. After five years in Washington covering the politics of AIDS and three years in Africa writing about the lives of those infected and affected, in truth, I have little patience for books on AIDS in Africa. With few exceptions, they tend to be too self-important, too polemical, too grim or too at odds with my experiences in the field. Epstein, in contrast, teaches me things I didnt know. Her rigorous reporting unearths new findings among old, worn-out issues. And the evidence she puts forward could provide a roadmap for comprehensive prevention programs that incorporate teaching abstinence, using condoms and, most critically, emphasizing fidelity.”John Donnelly, The New York Times Book Review
Her book is intelligent and judicious . . . What she found is informative.”D.T. Max, Los Angeles Times
It takes a great deal of confidence to name a book about this disease The Invisible Cure. Luckily, Helen Epstein has a compelling thesis, and she explains it in lucid, sometimes extraordinary, prose.”Andrew Rice, The Nation
Helen Epstein is a biologist who volunteered to study a potential HIV vaccine in Uganda in 1993. The Invisible Cure is her autobiographical account of 15 years observing both the epidemic and the reactions to it of Western scientists, humanitarian agencies, and the communities most affected by AIDS death. Lucid, scientifically accurate, and well referenced, The Invisible Cure is in many ways more informative than any multimillion-dollar international AIDS conference or collection of regression analyses in a peer-reviewed journal. It compels the reader to ask why so many mistakes were madeand continue to be madein HIV prevention. Again and again, emotion has trumped evidence, and groups of professionals have failed to use the growing corpus of knowledge about prevention in a speedy, appropriate way.”Malcolm Potts, University of California, Berkeley, Population and Development Review
With elegant prose, a scientific background and a journalists searching anecdotal eye, Epstein combines personal research and corroborative evidence from others to posit the view that where Africas AIDS rates are highest, the key difference is not the numbers of sexual partners, but the timing . . . She argues persuasively that the UN has long known that reduction in the number of sexual partners has been a factors wherever rates have fallen, from Uganda to San Francisco, and yet it refuses to act on it.”Stephen Lewis and Paula Donovan, Nature
"Her tone is level and undogmatic, but the news that Helen Epstein brings from the African front lines about AIDS is searing. So many lives have been lost, so much time and money wasted in badly-designed public and private campaigns against the disease. What actually works is both simple and subtle. There may be no magic bulletthere may never be a vaccinebut there are success stories, even in very poor countries. This is a landmark study. "William Finnegan, author of Cold New World: Growing Up in a Harder Country and A Complicated War: The Harrowing of Mozambique Epstein, a molecular biologist who has worked as a researcher, writer, and consultant on AIDS in Africa, explores the nature and underlying causes of the epidemic there. She analyzes why AIDS is so prevalent in Africa, focusing on the political and economic changes that ignited the epidemic as well as the social and sexual customs that fuel it. To Epstein's mind, there is plenty of blame to go around, e.g., concurrent sexual relationships, lack of women's rights, and failed political leadership. She also turns a critical eye to various attempts to slow the epidemic, contrasting the success of early public education campaigns in Uganda with other, less successful attempts. She concludes that the most promising efforts are locally developed projects that address risky behaviors openly and pragmatically, in ways that reflect local cultures and foster a spirit of mutual support and communication. Highly recommended.”Janet A. Crum, Library Journal
During several years of reporting in eastern and southern Africa, Epstein interviewed a lot of people who were involved, with varying degrees of effectiveness and idealism, in the struggle to overcome the AIDS epidemic. Her conclusion, based mostly on Ugandas early successful efforts to reduce the rate of infection, is deceptively simple: the most successful programs are grass-roots, bottom-up efforts that lead to widespread community mobilization against the disease . . . Her careful reporting and passionate stance makes this book well worth reading.”Nicolas van de Walle, Foreign Affairs
"Public-health specialist Epstein takes a stark yet hopeful look at the AIDS epidemic in Africa. Forty percent of the world's population infected with HIV live in African countries that are home to only three percent of the world's population, she states, illustrating the severity of the problem. Trained as a molecular biologist, the author opens with an account of her naive and frustrated attempts to study HIV in Uganda in 1993. Since then, Epstein has traveled widely in Africa, studying gender relations and developing a theory about the spread of AIDS. She argues that the epidemic has been triggered by upheavals caused by the rapid shift for millions of Africans from an agrarian, tribal society to a semi-urbanized way of life in a bureaucratic state, as well as the consequent disruptive shift in the balance of power between the sexes. She credits Uganda's homegrown Zero Grazing campaign of the 1980s with reducing the HIV rate more than either abstinence or condoms. The program recognized that polygamy, formal or informal, was the norm, but encouraged men to stick to one partner or, if they must have multiple partners, to avoid casual encounters with prostitutes. According to Epstein, such a program could not operate in the current political and religious climate. AIDS, she maintains, is now a multibillion-dollar enterprise with highly paid outside consultants offering a menu of options that fail to consider the cultures of those they seek to reach. What is needed is not just medical treatment for those already infected, but support for community-based, locally conceived and locally controlled preventive initiatives. Critical analysis of a dire situation and a compelling argument for the power of social mobilization."Kirkus Reviews
"Epstein, a public health specialist and molecular biologist who has worked on AIDS vaccine research, overturns many of our received notions about why AIDS is rampant in Africa and what to do about it. She charges that Western governments and philanthropists, though well-meaning, have been wholly misguided, and that Africans themselves, who understand their own cultures, often know best how to address HIV in their communities. Most significant is Epstein's discussion of concurrent sexual relations in Africa. Africans often engage in two or three long-term concurrent relationshipswhich proves more conducive to the spread of AIDS than Western-style promiscuity. Persuade Africans to forgo concurrency for monogamy, and the infection rate plummets, as it did in Uganda in the mid-1990s. On the other hand, ad campaigns focused on condom use helped imply falsely that only prostitutes and truck drivers get AIDS. In addition, Epstein examines what she calls the 'African earthquake': social and economic upheaval that have also eased the spread of HIV. Epstein is a lucid writer, translating abstruse scientific concepts into language nonspecialists can easily grasp. Provocative, passionate and incisive, this may be the most important book on AIDS published this yearindeed, it may even save lives."Publishers Weekly
Review
"Her tone is level and undogmatic, but the news that Helen Epstein brings from the African front lines about AIDS is searing. So many lives have been lost, so much time and money wasted in badly-designed public and private campaigns against the disease. What actually works is both simple and subtle. There may be no magic bullet--there may never be a vaccine--but there are success stories, even in very poor countries. This is a landmark study. "
--William Finnegan, author of Cold New World: Growing Up in a Harder Country and A Complicated War: The Harrowing of Mozambique
Review
"An enlightening and troubling book."--The New York Times
"Helen Epstein is one of a rare species: the scientist turned storyteller. . . . [A] blunt, informed critique."--Salon.com
"The UN and President Bush should not just read Epstein's book, they should distribute it around Africa."--The Sunday Times (London)
"Elegant prose, a scientific background, and a journalist's searching anecdotal eye."--Nature
"Sometimes a bolt of clarity shoots out of the blue . . . as it will for readers of this book who yearn for insights on how a deadly virus now infects an estimated 25 million Africans and has killed untold millions more."--The New York Times Book Review
"Epstein has a compelling thesis, and she explains it in lucid, sometimes extraordinary prose."--The Nation
Synopsis
In 1993, Helen Epstein, a scientist working with a biotechnology company searching for an AIDS vaccine, moved to Uganda, where she witnessed firsthand the suffering caused by the epidemic. Now, in her unsparing and illuminating account of this global disease, she describes how international health experts, governments, and ordinary Africans have struggled to understand the rapid and devastating spread of the disease in Africa, and traces the changes wrought by new medical developments and emerging political realities. It is an account of scientific discovery and intrigue with implications far beyond the fight against one tragic disease. The AIDS epidemic is partly a consequence of the rapid transition of African societies from an agrarian past to an impoverished present. Millions of African people have yet to find a place in an increasingly globalized world, and their poverty and social dislocation have generated an earthquake in gender relations that deeply affects the spread of HIV. But Epstein argues that there are solutions to this crisis, and some of the most effective ones may be simpler than many people assume. Written with conviction, knowledge, and insight, Why Don't They Listen? will change how we think about the worst health crisis of the past century, and our strategies for improving global public health.
Synopsis
In 1993, Helen Epstein, a scientist working with a biotechnology company searching for an AIDS vaccine, moved to Uganda, where she witnessed firsthand the suffering caused by the epidemic. Now, in her unsparing and illuminating account of this global disease, she describes how international health experts, governments, and ordinary Africans have struggled to understand the rapid and devastating spread of the disease in Africa, and traces the changes wrought by new medical developments and emerging political realities. It is an account of scientific discovery and intrigue with implications far beyond the fight against one tragic disease. The AIDS epidemic is partly a consequence of the rapid transition of African societies from an agrarian past to an impoverished present. Millions of African people have yet to find a place in an increasingly globalized world, and their poverty and social dislocation have generated an earthquake in gender relations that deeply affects the spread of HIV. But Epstein argues that there are solutions to this crisis, and some of the most effective ones may be simpler than many people assume. Written with conviction, knowledge, and insight,
Why Dont They Listen? will change how we think about the worst health crisis of the past century, and our strategies for improving global public health.
Helen Epstein writes frequently on public health for various publications, including
The New York Review of Books and
The New York Times Magazine. She is currently a visiting research scholar at the Center for Health and Wellbeing at Princeton University.
A New York Times Notable Book of the Year In 1993, Helen Epstein, a scientist working with a biotechnology company searching for an AIDS vaccine, moved to Uganda, where she witnessed firsthand the suffering caused by the epidemic. Now, in her unsparing and illuminating account of this global disease, she describes how international health experts, governments, and ordinary Africans have struggled to understand the rapid and devastating spread of the disease in Africa, and traces the changes wrought by new medical developments and emerging political realities. It is an account of scientific discovery and intrigue with implications far beyond the fight against one tragic disease. The AIDS epidemic is partly a consequence of the rapid transition of African societies from an agrarian past to an impoverished present. Millions of African people have yet to find a place in an increasingly globalized world, and their poverty and social dislocation have generated an earthquake in gender relations that deeply affects the spread of HIV. But Epstein argues that there are solutions to this crisis, and some of the most effective ones may be simpler than many people assume. Written with conviction, knowledge, and insight,
The Invisible Cure will change how we think about the worst health crisis of the past century, and our strategies for improving global public health.
“Amid the partisan babble, Helen Epstein has for years generated some of the most sensible commentary around, posting dispatches from AIDS-afflicted countries in Africa to The New York Review of Books and other publications. As a scientist morphed into a journalist, Dr. Epstein combines an understanding of the biology of AIDS with a coolly impartial view of the political and social landscape of Africa. She has now assembled more than a decades worth of reporting into an enlightening and troubling book . . . Dr. Epstein makes a good case for the efficacy of a pervasive grass-roots effort, with ordinary people talking openly about AIDS and caring for the sick and orphaned in hundreds of small community initiatives in a ‘spirit of collective action and mutual aid . . . Throughout the book, Dr. Epstein paints an unforgettably nuanced portrait of Western efforts in Africa: well-meaning, vitally necessary and yet often so misguided.”Abigail Zugar, M.D., The New York Times
“Reading The Invisible Cure is like traveling into remote and hard-to-comprehend territory with an unblinking and sure-footed guide. After five years in Washington covering the politics of AIDS and three years in Africa writing about the lives of those infected and affected, in truth, I have little patience for books on AIDS in Africa. With few exceptions, they tend to be too self-important, too polemical, too grim or too at odds with my experiences in the field. Epstein, in contrast, teaches me things I didnt know. Her rigorous reporting unearths new findings among old, worn-out issues. And the evidence she puts forward could provide a roadmap for comprehensive prevention programs that incorporate teaching abstinence, using condoms and, most critically, emphasizing fidelity.”John Donnelly, The New York Times Book Review
“Her book is intelligent and judicious . . . What she found is informative.”D.T. Max, Los Angeles Times
“It takes a great deal of confidence to name a book about this disease The Invisible Cure. Luckily, Helen Epstein has a compelling thesis, and she explains it in lucid, sometimes extraordinary, prose.”Andrew Rice, The Nation
“Helen Epstein is a biologist who volunteered to study a potential HIV vaccine in Uganda in 1993. The Invisible Cure is her autobiographical account of 15 years observing both the epidemic and the reactions to it of Western scientists, humanitarian agencies, and the communities most affected by AIDS death. Lucid, scientifically accurate, and well referenced, The Invisible Cure is in many ways more informative than any multimillion-dollar international AIDS conference or collection of regression analyses in a peer-reviewed journal. It compels the reader to ask why so many mistakes were madeand continue to be madein HIV prevention. Again and again, emotion has trumped evidence, and groups of professionals have failed to use the growing corpus of knowledge about prevention in a speedy, appropriate way.”Malcolm Potts, University of California, Berkeley, Population and Development Review
“With elegant prose, a scientific background and a journalists searching anecdotal eye, Epstein combines personal research and corroborative evidence from others to posit the view that where Africas AIDS rates are highest, the key difference is not the numbers of sexual partners, but the timing . . . She argues persuasively that the UN has long known that reduction in the number of sexual partners has been a factors wherever rates have fallen, from Uganda to San Francisco, and yet it refuses to act on it.”Stephen Lewis and Paula Donovan, Nature
"Her tone is level and undogmatic, but the news that Helen Epstein brings from the African front lines about AIDS is searing. So many lives have been lost, so much time and money wasted in badly-designed public and private campaigns against the disease. What actually works is both simple and subtle. There may be no magic bulletthere may never be a vaccinebut there are success stories, even in very poor countries. This is a landmark study. "William Finnegan, author of Cold New World: Growing Up in a Harder Country and A Complicated War: The Harrowing of Mozambique
Synopsis
A New York Times Notable Book of 2007
The Invisible Cure is an account of Africa's AIDS epidemic from the inside--a revelatory dispatch from the intersection of village life, government intervention, and international aid. Helen Epstein left her job in the US in 1993 to move to Uganda, where she began work on a test vaccine for HIV. Once there, she met patients, doctors, politicians, and aid workers, and began exploring the problem of AIDS in Africa through the lenses of medicine, politics, economics, and sociology. Amid the catastrophic failure to reverse the epidemic, she discovered a village-based solution that could prove more effective than any network of government intervention and international aid, an intuitive response that calls into question many of the fundamental assumptions about the AIDS in Africa.
Written with conviction, knowledge, and insight, The Invisible Cure will change how we think about the worst health crisis of the past century--and indeed about every issue of global public health.
About the Author
HELEN EPSTEIN writes frequently on public health for various publications including The New York Review of Books and The New York Times Magazine. She is currently a visiting research scholar at the Center for Health and Wellbeing at Princeton University.