SHOTS IN THE DARK

A spirited and wide-ranging inquiry into the scientific community’s failure, after nearly 20 years, to put an end to AIDS.

Across the world, 16,000 people become infected with HIV every day; in sub-Saharan Africa alone, nearly 30 million suffer from the ravaging disease. Such numbers, Science journalist Cohen writes, are obviously horrific. Yet, he believes, most Americans have lost whatever interest they may have once had in the problem of AIDS: “With the advent of powerful cocktails of anti-HIV drugs in the late 1990s, journalists began trumpeting the idea that AIDS was history, which the American public readily accepted.” Those cocktails have led to falling death rates in populations lucky enough to have them, but the author suggests that the world at large might likely be free of AIDS had a vaccine been developed through the concerted efforts of government, industry, and academia. That vaccine hasn’t been created for many reasons, among them an appalling level of ignorance (the Reagan administration’s top health officer was apparently shocked to discover that homosexuals engage in anal intercourse), interagency rivalries, a lack of bold leadership or coordinated efforts, and the unwillingness of the pharmaceutical industry to turn its attention to a marginal profit center. By contrast, the author observes that Jonas Salk did not wait for the discovery of the ideal polio vaccine to begin treating patients, and he enjoyed the support of a vast organization (led by the March of Dimes) as well. Cohen invites us to consider what might have happened had similar research mandates and support been applied to AIDS—an unlikelihood, he admits, given the fact that the US has created “a scientific culture that looks askance at targeted research programs.”

A worthy addition to the body of popular literature on AIDS research.