Disease & Democracy The Industrialized World Faces AIDS

“A historical masterpiece! Just when we thought we knew everything about the politics and policies of the HIV/AIDS pandemic, Peter Baldwin surprises us with innovative insights about the sharp differences in policy among countries as well as complex tradeoffs between civil liberties and public goods. This is a refreshing and readable book in which AIDS is used as a lens to understand the public health enterprise ranging from leprosy and syphilis to tuberculosis and SARS. Baldwin offers a deeply historical and comparative understanding of HIV in the industrialized world.”—Lawrence O. Gostin, author of Public Health Law: Power, Duty, Restraint

"Although a vast literature has emerged to chronicle and reflect on the history of the AIDS epidemic since it was first reported almost a quarter of a century ago, there is nothing like Peter Baldwin's probing and synthetic analysis of AIDS in the industrialized world. Building on his masterful Contagion and the State in Europe 1830-1930, Baldwin has provided a complex historical tapestry of how an epidemic threat has challenged and exposed democracies that thought infectious threats a thing of the past."—Ronald Bayer author of Private Acts, Social Cosequences:Aids and the Politics Of Public Health and coauthor with Gerald Oppenheimer of AIDS Doctors:Voices from the Epidemic

Disease and Democracy is the first comparative analysis of how Western democratic nations have coped with AIDS. Peter Baldwin's exploration of divergent approaches to the epidemic in the United States and several European nations is a springboard for a wide-ranging and sophisticated historical analysis of public health practices and policies. In addition to his comprehensive presentation of information on approaches to AIDS, Baldwin's authoritative book provides a new perspective on our most enduring political dilemma: how to reconcile individual liberty with the safety of the community.

Baldwin finds that Western democratic nations have adopted much more varied approaches to AIDS than is commonly recognized. He situates the range of responses to AIDS within the span of past attempts to control contagious disease and discovers the crucial role that history has played in developing these various approaches. Baldwin finds that the various tactics adopted to fight AIDS have sprung largely from those adopted against the classic epidemic diseases of the nineteenth century—especially cholera—and that they reflect the long institutional memories embodied in public health institutions.

Peter Baldwin is Professor of History at the University of California, Los Angeles. Among his books are Contagion and the State in Europe, 1830-1930 (1999) and The Politics of Social Solidarity: Class Bases of the European Welfare State, 1875-1975 (1990).

Foreword by Daniel M. Fox and Samuel L. Milbank

Acknowledgments

Abbreviations

Introduction: Slaves to the Past

1. Bodily Fluids and Citizenship

2. What Came First

3. Fighting the Previous War: Traditional Public Health Strategies and AIDS

4. Patients into Prisoners: Responsibility, Crime, and Health

5. Discrimination and Its Discontents: Protecting the Victims

6. Every Man His Own Quarantine Officer: The Voluntary Approach

7. The Polymorphous Politics of Prevention

8. To Die Laughing: Gays and Other Interest Groups

9. Vox Populi Suprema Lex Est: Expertise, Authority, and Democracy

10. Clio Intervenes: The Effect of the Past on Public Health

11. Liberty, Authority, and the State in the AIDS Era

Notes

Index