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To End a Plague: America's Fight to Defeat AIDS in Africa
Shortlisted for the Lionel Gelber Prize
“Randy Shilts and Laurie Garrett told the story of the HIV/AIDS epidemic through the late 1980s and the early 1990s, respectively. Now journalist-historian-activist Emily Bass tells the story of US engagement in HIV/AIDS control in sub-Saharan Africa. There is far to go on the path, but Bass tells us how far we’ve come.” —Sten H. Vermund, professor and dean, Yale School of Public Health
With his 2003 announcement of a program known as PEPFAR, George W. Bush launched an astonishingly successful American war against a global pandemic. PEPFAR played a key role in slashing HIV cases and AIDS deaths in sub-Saharan Africa, leading to the brink of epidemic control. Resilient in the face of flatlined funding and political headwinds, PEPFAR is America’s singular example of how to fight long-term plague—and win.
To End a Plague is not merely the definitive history of this extraordinary program; it traces the lives of the activists who first impelled President Bush to take action, and later sought to prevent AIDS deaths at the whims of American politics. Moving from raucous street protests to the marbled halls of Washington and the clinics and homes where Ugandan people living with HIV fight to survive, it reveals an America that was once capable of real and meaningful change—and illuminates imperatives for future pandemic wars. Exhaustively researched and vividly written, this is the true story of an American moonshot.
“Randy Shilts and Laurie Garrett told the story of the HIV/AIDS epidemic through the late 1980s and the early 1990s, respectively. Now journalist-historian-activist Emily Bass tells the story of US engagement in HIV/AIDS control in sub-Saharan Africa. There is far to go on the path, but Bass tells us how far we’ve come.” —Sten H. Vermund, professor and dean, Yale School of Public Health
With his 2003 announcement of a program known as PEPFAR, George W. Bush launched an astonishingly successful American war against a global pandemic. PEPFAR played a key role in slashing HIV cases and AIDS deaths in sub-Saharan Africa, leading to the brink of epidemic control. Resilient in the face of flatlined funding and political headwinds, PEPFAR is America’s singular example of how to fight long-term plague—and win.
To End a Plague is not merely the definitive history of this extraordinary program; it traces the lives of the activists who first impelled President Bush to take action, and later sought to prevent AIDS deaths at the whims of American politics. Moving from raucous street protests to the marbled halls of Washington and the clinics and homes where Ugandan people living with HIV fight to survive, it reveals an America that was once capable of real and meaningful change—and illuminates imperatives for future pandemic wars. Exhaustively researched and vividly written, this is the true story of an American moonshot.
496 pages, Hardcover
First published July 6, 2021
21 people are currently reading
247 people want to read
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Displaying 1 - 11 of 11 reviews
December 28, 2023
A comprehensive global history of the AIDS epidemic and the creation of the President's Emergency Plan For AIDS Relief (PEPFAR). People in the HIV world will recognize many of the characters appearing throughout this book, though their contributions, political influence, and personal sacrifice often surprised me. I wish I'd been around to witness the early days of the epidemic, horrible as they sound, to have a better appreciation for the massive progress achieved in options for treatment and prevention; the scale and scope of testing among high risk communities; and the socio-behavioral understanding of how social networks, cultural stigma, and political will can greatly affect the likelihood and risk of someone being exposed to and/or transmitting HIV.
Emily Bass does a good job of weaving objective journalistic reporting with her own personal experience from the front lines of the epidemic. I appreciated her reflections on the myriad ethical challenges of the response over the years, how it's changed and yet remained the same in may ways. If you work in the HIV sphere, this is a must read (along with 'And The Band Played On'). I would also recommend adding 'The Wisdom of Whores' to your list.
Emily Bass does a good job of weaving objective journalistic reporting with her own personal experience from the front lines of the epidemic. I appreciated her reflections on the myriad ethical challenges of the response over the years, how it's changed and yet remained the same in may ways. If you work in the HIV sphere, this is a must read (along with 'And The Band Played On'). I would also recommend adding 'The Wisdom of Whores' to your list.
July 31, 2022
I enjoyed this book but more so because I’ve worked on pepfar. It explains a lot of the why behind the very tense agency relationships and how it came to be. It’s more of a memoir but worth reading if you’re interested in the US aids response.
November 19, 2021
In the 1990s, scientists made significant advances to limit the impact of HIV upon human lives… in the West. However, HIV continued to flourish in sub-Saharan Africa, and it remained for the new millennium to limit its reach there. Bass’s book tells the story of the American effort in this quest that spanned multiple presidencies across both political parties. She concludes with its impact on the COVID pandemic.
The effort to defeat HIV/AIDS is so large that any one author cannot hope to contain the entire story. Bass’s account is primarily political, sociological, and anthropological, not biological. She tells the stories of individuals on the ground in Africa along with leaders of the effort in the United States. Her story is not one of lab science but of the organized coordination of massive human effort. Her story centers on the American government (PEPFAR) and not the international Global Fund. She covers everything from activist efforts to bring the pandemic to the fore to the politics of passing a funding bill to its data-driven transformation under the leadership of Dr. Deborah Birx.
Due to a lack of investigative journalism, many books about HIV/AIDS neglect the story on the ground in Africa in favor of one around governmental and scientific efforts in America. Fortunately, Bass does not neglect these oft-ignored African voices but amplifies them with objective journalism and warm, human friendship. She seems to have de-identified the primary characters on the ground due to privacy concerns. The wide reach from politics to people is particularly welcoming because readers get to see the practical results of actions thousands of miles away.
This book will gain an audience especially among those interested in government and public health. Those interested in the health history of the 2000-2020 will also find interest in this book. Finally, those interested in how the rise of the data information sciences has affected human life practically will benefit from Bass’s writing. In 2021, AIDS seems much more contained than it was in 2001. Many people deserve credit for this, from George W. Bush to Barack Obama, from activists in America to healthcare workers on the ground in Africa. And as detailed here, the AIDS effort laid a foundation for COVID efforts even though these are different diseases, especially in their spread. Bass’s account brings this story to an accessible summary whereby we can all gain from it.
The effort to defeat HIV/AIDS is so large that any one author cannot hope to contain the entire story. Bass’s account is primarily political, sociological, and anthropological, not biological. She tells the stories of individuals on the ground in Africa along with leaders of the effort in the United States. Her story is not one of lab science but of the organized coordination of massive human effort. Her story centers on the American government (PEPFAR) and not the international Global Fund. She covers everything from activist efforts to bring the pandemic to the fore to the politics of passing a funding bill to its data-driven transformation under the leadership of Dr. Deborah Birx.
Due to a lack of investigative journalism, many books about HIV/AIDS neglect the story on the ground in Africa in favor of one around governmental and scientific efforts in America. Fortunately, Bass does not neglect these oft-ignored African voices but amplifies them with objective journalism and warm, human friendship. She seems to have de-identified the primary characters on the ground due to privacy concerns. The wide reach from politics to people is particularly welcoming because readers get to see the practical results of actions thousands of miles away.
This book will gain an audience especially among those interested in government and public health. Those interested in the health history of the 2000-2020 will also find interest in this book. Finally, those interested in how the rise of the data information sciences has affected human life practically will benefit from Bass’s writing. In 2021, AIDS seems much more contained than it was in 2001. Many people deserve credit for this, from George W. Bush to Barack Obama, from activists in America to healthcare workers on the ground in Africa. And as detailed here, the AIDS effort laid a foundation for COVID efforts even though these are different diseases, especially in their spread. Bass’s account brings this story to an accessible summary whereby we can all gain from it.
July 14, 2021
To End A Plague is a monumental journalistic effort! Emily Bass remarkably weaves togerther her personal journey, her long term tracking of people and AIDS programs in Uganda, and she shares incisive reporting on the advocacy and policy dynamics in Washington DC and in Africa. This combination of information is truly fascinating, daunting, and inspiring! I relived my own journey as I absorbed this book. To End A Plague is a must read for anyone who cares about controlling pandemics today or in the future.
July 11, 2022
Written as a memoir, this book spends an incredibly small amount of time even talking about PEPFAR, UNAIDS, or any aspect of the US response to AIDS. Instead, the author spends times documenting activist work, as if there is an invisible line differentiating Activists from PEPFAR staffers, and their own personal stories.
The author switches between praise and criticism on a whim, usually citing only commonly known issues with global development work. The author spends little to no time on the development of policy, evaluation, country planning or otherwise.
There are numerous other books and sources that outline the history of the US AIDS response that I would recommend.
The author switches between praise and criticism on a whim, usually citing only commonly known issues with global development work. The author spends little to no time on the development of policy, evaluation, country planning or otherwise.
There are numerous other books and sources that outline the history of the US AIDS response that I would recommend.
October 21, 2021
A detailed and fascinating history of PEPFAR and all that it did (and didn't do) to help save countless lives across the world. The author's interactions with people in the story work well sometimes (e.g. her relationships with people living with HIV) and feel bizarre at other times (her failed romantic relationships). Could have used some more detail on the evangelical Americans and Africans whose concern for AIDS helped make PEPFAR a reality. A great read for people who are interested in global health, the HIV/AIDS epidemic, and the way in which tough public health decisions are made.
August 23, 2021
The US Campaign on Defeating AIDS in Africa
This is the second book I’ve read on a pandemic virus today and the second one to contain high high praise for Dr. Debbi Birx. This book covers US efforts to defeat AIDS in Africa over three presidencies. The crowning achievement is hiring Dr. Debbi Birx in both Democratic and Republican presidencies and running a successful AIDS program. One explanation is that foreign governments are easier to persuade than states.
This is the second book I’ve read on a pandemic virus today and the second one to contain high high praise for Dr. Debbi Birx. This book covers US efforts to defeat AIDS in Africa over three presidencies. The crowning achievement is hiring Dr. Debbi Birx in both Democratic and Republican presidencies and running a successful AIDS program. One explanation is that foreign governments are easier to persuade than states.
August 12, 2022
This book was solid, and think it did a decent job describing the success for PEPFAR. The issues in this book were that the memoir and the other history did not seem to mesh as well to me. Appreciated some of the personal stories, and how it worked with programs, but it feels like she started getting lost towards the end maybe due to her less involvement. I feel like I have a better background now, but overall themes and successes to take were not as well defined as I would of liked.
January 7, 2024
A fascinating looks at the PEPFAR from the beginning to looking ahead at its uncertain future, with a little sprinkled in about COVID. I loved the author's focus on all the levels of this program, from the activists that fought for it to the people leading the program to the people working on and experiencing it at the ground level. Truly a great example of how interviews can propel a nonfiction story to greater heights.
March 6, 2022
Maybe if I had read the book, instead of listening to it, it would not have taken me 8 months to finish it. It's well-written, but it is more of a memoir, hence, a definite bias was present that wore on me.
December 19, 2021
A fascinating combination of data and development, of policy and personality, told with insight and humanity.
Displaying 1 - 11 of 11 reviews