As we follow the evolution of the HIV/AIDS epidemic in the third decade of its emergence and devastation, our conceptual capacities are being challenged as more emerge that go beyond our collective limited focus on the biomedical and behaviour factors. Tony Barnett and Alan Whiteside confront the social and economic impact of the disease in this book AIDS in the Twenty-First Century: Disease and Globalization by looking at the epidemic historically and by studying the impacts of the disease in the terms of various societal perspectives from individuals to the households, communities and various sectors of human endeavour. They examine the impact of HIV/AIDS on subsistence agriculture, industries and the very concept of development and globalization. The central focus of the book is on sub Saharan Africa where the authors admit that the existence of 'inequality, exploitation, and poverty allow the epidemic to grow and thrive'. Illustrations are also drawn from Asia, especially Thailand, and from other parts of the world. The central argument of the book is that 'HIV/AIDS is a symptom of the way we organize our social and economic relations'. Throughout the book, the authors consistently and persuasively argue that 'the epidemic is par excellence a collective event; that an epidemic is not mere chance but it is tied to the economic and social character of a society, its intergroup relations, balance of power, lines of fracture and stress. Then it follows that the social and economic impacts of an epidemic are not chance events either'. The book is divided into three parts. The first provides, in the first two chapters, respectively, an introduction to the disease and its epidemiology. The second part is on 'susceptibility' (covering three chapters) and the last part is on 'vulnerability and impact' (in nine chapters). An historical review of national and international responses is also included in this third and last part.
The book starts by observing that the morbidity and mortality due to AIDS have increased tremendously with time and that the burden of disease and toll of death is daunting. It lampoons the initial collective silence and lethargic response of governments especially of the 'South' to the disease and notes, equally, the development of denial, stigmatization and discrimination. The initial response was attributed to the different phases of HIV infection and AIDS itself, the long incubation period and the gradual process of attrition-'it is hard to perceive and measure very slow events'. There is also a review of the current situation of the disease. In a very incisive way, the authors examine the competing theories of the origin of the virus, basic