The AIDS Pandemic: Impact on Science and Society
http://www.100md.com
《新英格兰医药杂志》
Know syphilis, and you will know all of medicine, advised Sir William Osler at the turn of the 20th century. In that era, the pervasive consequences of syphilis deeply involved specialties from neurology to cardiology to orthopedics, as well as a large proportion of the population. Beyond clinical medicine, responding to syphilis became the central organizing focus of public health, and the fundamental systems of disease control and prevention that have operated for most health conditions until today have been conditioned around the response to this one overriding epidemic.
The global pandemic of HIV and AIDS is now having similar transformational effects, suggest Kenneth H. Mayer, H.F. Pizer, and colleagues in The AIDS Pandemic. The authors' premise is that as diverse scientific disciplines, social structures, and even global economic processes respond to the challenge of AIDS, each of the disciplines is itself being transformed. Nineteen chapters allow the premise to be explored in an intriguing variety of domains: in basic virology, immunology, and clinical-trials methodology; in effects on the control of sexually transmitted diseases, vaccine development, microbicides, and behavioral approaches to disease prevention and health promotion; in economics, world trade (in pharmaceuticals), and diverse patterns of effects across vast geographic areas (including Africa and Asia); in specific sociologic contexts of risk (e.g., in correctional settings, among intravenous drug users, and within gay society in general); and in law and ethics.
The result is a compelling montage, full of interesting and unexpected twists in the storyline, even to a reader who has spent most of the past two decades deeply engaged with AIDS. Although all the chapters in this book are excellent summaries of the state of AIDS within the respective disciplines or sociologic domains, the chapters on immunology and on the public health response to AIDS stand out, not only in explicating the transformation of the field with depth and detail but also in pointing out the effect of how the transformed discipline deals differently with other health and disease issues than it did before AIDS. Side-by-side chapters on the development of comprehensive care for patients with HIV and AIDS in the United States and the approach to AIDS in developing countries are devastating in their unintended effect. Given the eerie relatedness, but also lack of relatedness, between the intensity and effectiveness of responses in industrialized and developing countries, it seems as if we must be talking about different planets, centuries, or even species. In fact, the montage effect of this book is the most interesting aspect of all, as in certain plays in which we hear the diverse but linked perspectives of various narrators recounting the same chronology.
Of course, the AIDS epidemic is young, is still rapidly evolving, and has still to reveal its full effect on science and society. This fine collection of essays records the early transformations of many disciplines in and beyond medicine. It is an excellent, up-to-date, readable start to an examination of how AIDS has challenged and changed us all, in medicine, public health, and beyond.
Michael St. Louis, M.D.
Centers for Disease Control and Prevention
Atlanta, GA 30333
mes2@cdc.gov(Edited by Kenneth H. Maye)
The global pandemic of HIV and AIDS is now having similar transformational effects, suggest Kenneth H. Mayer, H.F. Pizer, and colleagues in The AIDS Pandemic. The authors' premise is that as diverse scientific disciplines, social structures, and even global economic processes respond to the challenge of AIDS, each of the disciplines is itself being transformed. Nineteen chapters allow the premise to be explored in an intriguing variety of domains: in basic virology, immunology, and clinical-trials methodology; in effects on the control of sexually transmitted diseases, vaccine development, microbicides, and behavioral approaches to disease prevention and health promotion; in economics, world trade (in pharmaceuticals), and diverse patterns of effects across vast geographic areas (including Africa and Asia); in specific sociologic contexts of risk (e.g., in correctional settings, among intravenous drug users, and within gay society in general); and in law and ethics.
The result is a compelling montage, full of interesting and unexpected twists in the storyline, even to a reader who has spent most of the past two decades deeply engaged with AIDS. Although all the chapters in this book are excellent summaries of the state of AIDS within the respective disciplines or sociologic domains, the chapters on immunology and on the public health response to AIDS stand out, not only in explicating the transformation of the field with depth and detail but also in pointing out the effect of how the transformed discipline deals differently with other health and disease issues than it did before AIDS. Side-by-side chapters on the development of comprehensive care for patients with HIV and AIDS in the United States and the approach to AIDS in developing countries are devastating in their unintended effect. Given the eerie relatedness, but also lack of relatedness, between the intensity and effectiveness of responses in industrialized and developing countries, it seems as if we must be talking about different planets, centuries, or even species. In fact, the montage effect of this book is the most interesting aspect of all, as in certain plays in which we hear the diverse but linked perspectives of various narrators recounting the same chronology.
Of course, the AIDS epidemic is young, is still rapidly evolving, and has still to reveal its full effect on science and society. This fine collection of essays records the early transformations of many disciplines in and beyond medicine. It is an excellent, up-to-date, readable start to an examination of how AIDS has challenged and changed us all, in medicine, public health, and beyond.
Michael St. Louis, M.D.
Centers for Disease Control and Prevention
Atlanta, GA 30333
mes2@cdc.gov(Edited by Kenneth H. Maye)