Recent genetic studies have traced the birth of HIV to the forbidding equatorial forests of Cameroon, where chimpanzees carried the virus for millennia without causing a major outbreak in humans. During the Scramble for Africa, colonial companies blazed new routes through the jungle in search of rubber and other riches, sending African porters into remote regions rarely traveled before. It was here that humans first contracted the strain of HIV that would eventually cause 99 percent of AIDS deaths around the world.
Western powers were key actors in turning a localized outbreak into a sprawling epidemic as bustling new trade routes, modern colonial cities, and the rise of prostitution sped the virus across Africa. Christian missionaries campaigned to suppress polygamy, but left in its place fractured sexual cultures that proved uncommonly vulnerable to HIV. Equally devastating was the gradual loss of the African ritual of male circumcision, which recent studies have shown offers significant protection against infection.
Timberg and Halperin argue that the same Western hubris that marked the colonial era has hamstrung the effort to fight HIV. From the United Nations AIDS program to the Bush administration's historic relief campaign, global health officials have favored well-meaning Western approaches--abstinence campaigns, condom promotion, HIV testing--that have proven ineffective in slowing the epidemic in Africa. Meanwhile they have overlooked homegrown African initiatives aimed squarely at the behaviors spreading the virus.
In a riveting narrative that stretches from colonial Leopoldville to 1980s San Francisco to South Africa today, Tinderbox reveals how human hands unleashed this epidemic and can now overcome it, if only we learn the lessons of the past.
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About the Author
Daniel Halperin, PhD, is an epidemiologist and medical anthropologist at the University of North Carolina, Chapel Hill and has taught at Harvard and the University of California, Berkeley. He was a top technical adviser in the US government's PEPFAR program to combat AIDS.
Table of Contents
Book I Silent Spread
1 Francistown 13
2 Searching for the Beginning 23
3 One Tiny Speck of Truth 30
4 A Tale of Two Viruses 37
5 The Lion and Dr. Livingstone 42
6 Femmes Vivant Théoriquement Seules 53
7 The Gift 61
8 The Big Bang 67
Book II An Epidemic of Politics
9 Americanizing AIDS 77
10 It Can't Be Here Already! 85
11 Attention na SIDA 92
12 You Won't Believe 100
13 Fear Worked 109
14 Born in Africa 119
15 The Condom Code 126
16 The Beat-up 136
17 Things Just Fell Apart 152
Book III The Humbling
18 X Factor 169
19 The Interests of the ANC 181
20 Poverty Trap 192
21 A, B, and C 198
22 On the Jericho Road 206
23 Gordon and Thandi 213
24 A Marshall Plan for Botswana 224
25 What Shall We Do? 234
26 Raymond the Great 243
27 Makhwapheni Uyabulala 256
28 The Flood 263
29 Mother and Son 272
30 What Shall We Do? Part II 280
Appendix: How the AIDS Epidemic Can Be Overcome 305
References to the Appendix 388
Additional Suggested Readings 403
What People are Saying About This
"A remarkable volume. With rare clarity, Tinderbox lays bare the origins of the AIDS virus, and then reveals the often hapless and delinquent responses of the international community. It's a fascinating read: relentlessly honest, sometimes scathing, alway principled."
—Stephen Lewis, Founder/Director of AIDS-Free World, Former UN Special Envoy on AIDS in Africa
"Remarkable...reads like a detective novel."—The New Yorker
“Gripping … buy the book.”—The Nation
"A strong warning to those who would disregard the cultural specificities of those one is trying to serve."—The New York Times (EDITORS CHOICE)
"Tinderbox will help readers understand...why the period ahead is so critical in fighting the epidemic. Millions of lives depend on the effort."—The Washington Post
“In addition to a useful history of the disease, Timberg and Halperin examine how to confront it and develop more effective ways to fight it…[Timberg and Halpern] present a forceful case with which future students of HIV and AIDS will have to reckon.”—Kirkus (STARRED REVIEW)
“Essential for understanding a relentlessly urgent issue.”—Library Journal
“An essential and engrossing read, Timberg and Halperin’s sweeping work covers AIDS from its origins…to its impact on the world today…Extensively researched, eminently readable and accessible, Timberg and Halperin’s work is a notable and invaluable addition to the AIDS canon.”—Booklist (STARRED REVIEW)
"Tinderbox is an unusually compelling and informative account of how the AIDS epidemic has affected the world, particularly the peoples of Africa. In a compassionate and engaging manner, Timberg and Halperin bring to life the story from its beginnings to the most recent evidence on how to effectively prevent further tragedy."
—Jay Levy, M.D., director, Laboratory for Tumor and AIDS Virus Research, University of California, San Francisco
"Craig Timberg and Daniel Halperin have written a searing book about the AIDS epidemic. Tinderbox is an indictment of Western ineptitude and meddling and lost opportunities to prevent millions of infections and deaths. But it also contains valuable prescriptions for making changemdash;and it's an important read for anyone who cares about Africa."
—Stephanie Nolen, author of 28: Stories of AIDS in Africa
"Timberg and Halperin have been challenging conventional wisdom (and behavior change skeptics like me) for years. Their book is entertaining, thought-provoking, human, and in the end, hopeful for a continent that craves some answers after two decades of HIV prevention failures."
—Francois Venter, M.D., president, Southern African HIV Clinicians Society
"Randy Shilts's And the Band Played On was the first—and for decades the best—book on AIDS. Craig Timberg and Daniel Halperin's Tinderbox is every bit as good, revealing the same denial, the same story of politics trumping science, and the same tragedy. This time, it is about the whole world, not just San Francisco. Read it!"
—Malcolm Potts, M.D., author of The AIDS Reader and Ever Since Adam and Eve
"The sometimes glorious, often tragic constellation of science, politics, and personalities in the fight against AIDS comes to life in the masterful storytelling of an energetic journalist and a passionate scientist."
—Arthur Allen, author of Vaccine: The Controversial Story of Medicine's Greatest Lifesaver
"An excellent read. Tinderbox brilliantly outlines the successes, failures, and missed opportunities in the battle of HIV prevention over the last thirty years."
—Elly Katabira, M.D., president, International AIDS Society