A well-researched, academic account of the AIDS epidemic

In their introductory comments at the start of the book, Tony Barnett and Alan Whiteside claim that “together and separately we have researched the social and economic impact of the HIV/AIDS epidemic since 1986.” By the authors’ own account, AIDS in the twenty-first century is the culmination of all these years of painstaking research, and thus the book contains a wealth of academic information (a full 365 pages) on the subject of the HIV/AIDS epidemic. AIDS in the twenty-first century is certainly a much-improved effort compared to Alan Whiteside’s previous collaborative endeavour (AIDS: The challenge for South Africa, with Clem Sunter, 2000), a quirky little book that seems to have been hastily strung together in the face of a demanding deadline. The result of Barnett and Whiteside’s collaboration, however, or rather the collective effects of their 16 years of research, is a book that sets new standards in the demanding world of research in the academic battlefield of HIV/AIDS.

After initialising their narrative with a statement of ‘Abantu Abaafa!’ (People are dying! – allegedly spoken by an elderly woman from a rural village in Uganda on the effects of AIDS on her community), Barnett and Whiteside proceed to divulge the current status of the epidemic worldwide. Continent by continent, the authors probe the HIV/AIDS epidemics that characterize each area. In between, the authors also expound on certain aspects of the global epidemic, i.e. AIDS and gender and AIDS and time. Barnett and Whiteside then venture into the epidemiological side of the epidemic, producing an extensive chapter that fills the reader in on the required information of HIV/AIDS: the microbiological details of HIV, the origins of the disease, modes of transmission, and treatment. The information is presented throughout the book in a clear, academic style, accessible to the occasional reader and useful to the expert.

Interestingly (and perhaps quite uniquely) Barnett and Whiteside also pay considerable attention the history of the HIV/AIDS epidemic, with special attention to Africa. In two chapters entitled ‘Epidemic roots’ and ‘Why Africa?’, the authors venture into considerable detail as to the history of the epidemic and the historical roots of Africa’s plight regarding the epidemic. The authors take a detached view of Africa’s historical disposition, and in taking a broad sweep of African history so as to better clarify the current epidemic, the authors state that their “argument is that epidemics in Africa are the product of histories that have made many of that continent’s societies ‘unhealthy.’” Tables and graphs are also used often in these chapters (as they are basically throughout the whole book) to denote detailed information. In a chapter entitled ‘Cases’, Barnett and Whiteside set out their theoretical framework to explain why certain countries and communities are more at risk than others, using a nexus of wealth and social cohesion to explain HIV prevalence in any specified area.

In subsequent chapters the authors explore the impact of the AIDS epidemic on various sectors of society, including individuals, households, communities, orphans and the elderly. Barnett and Whiteside then proceed to investigate the effects of the epidemic on rural societies, especially subsistence farmers. The economy, business enterprise and government are also discussed in succeeding chapters. In the penultimate chapter of the book, entitled ‘Responses,’ Barnett and Whiteside examine the responses to the HIV/AIDS epidemic, “where priorities have been and where they should have been.” At the hand of six stated concepts, the authors try to determine what has worked against the AIDS epidemic, what has not worked, and why. “We argue,” the authors state, “that there should be a continuum of policy and practice spanning prevention and impact mitigation.” The meticulous research and in-depth analysis of the authors are perhaps most evident in this chapter, and no doubt it would be most useful for those working within the AIDS field to peruse.

In the concluding chapter of the book, the authors underscore the stated theme of the book, Disease and Globalization. In ‘Globalization, Inequality, HIV/AIDS, and the Intimacies of Self,’ Barnett and Whiteside seek to place the AIDS epidemic squarely in the twenty-first century. In linking the AIDS epidemic with globalization and big business, and exploring the changing global perceptions of medicine and disease, the authors create a uniquely modern outlook on the AIDS epidemic, and for this reason AIDS in the twenty-first century cannot be disregarded in the current discourse on HIV/AIDS. The authors conclude the book by taking the opening theme of the book, Abantu Abaafa!, a step further: “to recognize the importance of ‘ubuntu’, an African idea, that we are only people because of other people. We are all human and the HIV/AIDS epidemic affects us all in the end.”