London School of Hygiene & Tropical Medicine

A landmark new book, which compares different countries' responses to their HIV epidemic, twenty five years after the first reported AIDS cases in 1981, is published today.

The book, The HIV Pandemic: local and global implications, published by Oxford University Press, includes contributions from 165 authors, contains 28 country case studies, and 22 thematic chapters. It is being launched this evening at the London School of Hygiene & Tropical Medicine.

The book's publication coincides with the twenty fifth anniversary of the first reported AIDS cases by the Morbidity and Mortality Weekly Reports (MMWR - CDC) in June 1981. Since then, 60 million people worldwide are estimated to have been infected, 20 million of whom are thought to have died.

The authors build on information from World Health Organisation and UNAIDS, which generally examines the pandemic from a global perspective, by going a step further and locating the responses firmly within the context of each particular country and its health system. Secondly, and for the first time in book form, each chapter combines two perspectives - one from health policy experts, the other from HIV specialists - thereby providing an analysis, which integrates a 'top down' health system approach with a 'bottom' up HIV-specific perspective.

The authors ask vital questions about which health systems have performed well in tackling HIV and which less so, and hope that the answers will make it easier for countries to learn from one other and attempt to use, where appropriate, approaches which have been shown to be effective towards controlling the HIV epidemics in countries.

The twenty-eight countries were selected to provide a geographic spread across the regions of the world, including a range of high, middle and low-income countries and a variety of different types of health system. The countries studied are at different stages of the epidemic, have different levels of incidence and prevalence, and have responded to the epidemic in a variety of ways.

In the foreword to the book, Peter Piot, Executive Director of UNAIDS, comments: 'Almost from the time it was first described 25 years ago in the US, AIDS has outstripped our worst fears and predictions. This disease has become one of the make-or-break issues of our times, on a par with global climate change and the persistence of mass, extreme poverty'.

He adds: 'In the final analysis, countering the AIDS pandemic is a political matter. We have now reached a point in the global response where we can get ahead of the epidemic. To succeed in this critical stretch, we must intensify our efforts to make AIDS a key political concern in all countries, poor and rich alike'.

According to Professor Nicholas Mays, of the London School of Hygiene & Tropical Medicine, co-editor of the book: ' This book is a valuable historical record of an important endeavour in the history of public health - that of trying to tackle a disease which has claimed an estimated 60 million lives since it was first recognised, a quarter of a century ago. This book has been a huge endeavour, and has been several years in the making, but it has been well worth the effort.

Professor Eddy Beck, of McGill University, another co-editor of the book, adds: 'By bringing together health generalists and HIV specialists, and encouraging the two to think laterally, and collaboratively, as to what has and has not worked in terms of tackling the epidemic within their countries, we hope to ensure that the next stage of the process - which needs to include greater mutual learning, and the sharing of best practices- can be intensified'.