Quotes from The Invisible Cure, by Helen Epstein

- ‘In 2005, roughly 40 percent of all those infected with HIV lived in just eleven countries in this region – home to less than 3 percent of the world’s population. In Botswana, Lesotho, and Swaziland, roughly a quarter of adults were infected, a rate ten times higher than anywhere else in the world outside Africa.’ (xii)

- ‘For more than twenty years, scientists have been trying to make [an AIDS] vaccine, and most experts predict it will take at least another decade.’ (xii)

- In 1996, a combination of three antiretroviral drugs, taken for life, was found to dramatically relieve the symptoms and extend the lives of HIV-positive people. At the time, these drugs were patented and extremely expensive, and for years they were out of reach of the millions of poor African patients who needed them. Before long, a worldwide network of AIDS activists began to pressure pharmaceutical companies to cut the prices of these drugs and urged international donors to raise billions of dollars to fund AIDS treatment programs in developing countries. As a result millions of Africans with HIV are now receiving treatment.’ (xii-xiii)

- ‘Because Africa’s health-care infrastructure is in such a dire state, treatment programs are expensive and difficult to administer, even when the drugs themselves are practically free. Those who do receive treatment can expect to gain, on average, only 6.6 years of life because the virus eventually develops resistance, necessitating second- and third-line treatment, presently all but unavailable in Africa.’ (xiii)

- ‘To date, the closest thing to a vaccine to prevent HIV is male circumcision, which was shown in 2006 to reduce the risk of HIV transmission by roughly 70 percent. The widespread practice of male circumcision in predominantly Muslim countries of West Africa may largely explain why the virus is so much less common there than it is along the eastern and southern rim of the continent. It is urgent that as many men as are willing to undergo the procedure have access to cheap, safe circumcision services.’ (xiii)

- ‘Like many newcomers to Africa, I learned early on that the most successful AIDS projects tended to be conceived and run by Africans themselves or by missionaries and aid workers with long experience in Africa – in other words, by people who really knew the culture.’ (xiv)

- ‘Women are not physically more vulnerable to infection than uncircumcised men.’ (xxii)

- ‘Antenatal surveys are based on tests of blood samples drawn from pregnant women in antenatal (or prenatal) clinics.’ (xxii)

- ‘The prevalence of HIV infection in pregnant teenagers aged fifteen to nineteen is sometimes used as a rough measure of the incidence of new infections in population. This is because so few children below age fifteen are HIV positive, so most cases of infection in pregnant teens are assumed to have occurred recently.’ (xxii-xxiii)

- ‘In East and southern Africa, HIV rates are higher among women than among men, while the opposite is the case in the rest of the world. Sub-Saharan Africa is also home to 90 percent HIV-positive children. Without antiretroviral drug treatment roughly 25 percent of babies born to HIV-positive women inherit the virus.’ (xxiii)

- ‘There were so few nurses at Mulago that patient care – feeding, washing, and alerting the doctors in emergencies – was virtually all done by family members.’ (13)

- ‘You have to accept that what happens in Africa doesn’t matter that much back home.’ (35)

- ‘Hooper also maintains that the AIDS epidemic must have been set off by something more than a hunter’s wound. Africans have been killing and eating monkeys for at least fifty thousand years, and yet African and colonial doctors never saw anything like AIDS until the 1960s.’ (43)
- ‘The HIV rate in Uganda peaked at 18 percent in the early 1990s, but it never exceeded 1 percent in the United States. A key difference between Uganda and the United States, Morris found, is that although heterosexual Americans tend to have several long-term relationships over a lifetime, they usually have them sequentially, not concurrently. If an American contracts HIV from a boyfriend, she probably won’t pass it on to anyone else until the couple breaks up and she finds a new partner. She might well infect that new partner, but then the virus will be trapped in this new relationship for months or years, as long as the couple stays together.’ (57)

- ‘Domestic violence affects one in three women worldwide. Abusive partners are responsible for half of all female homicides, and their victims are also more prone to HIV, STDs, miscarriage, depression, and other mental-health problems.’ (79)

- ‘What may have helped spare the West a heterosexual AIDS epidemic on the scale of Africa’s is the romantic belief that there is a ‘perfect partner,’ a ‘soul mate,’ to be cherished ‘for richer or poorer’ – if not for life, then for a long time. This convention, inculcated in us from earliest childhood by fairy tales, novels, and movies, forms the cultural underpinning of monogamy, or at least its aspiration. It is also responsible for many Western ills, including divorce and the neurotic pursuit, through painful serial relationships, or an ideal conjugal love that may not exist.’ (85)

- ‘If someone who is exposed to HIV through a needle stick takes a high dose of anti-retroviral drugs immediately afterward, his changes of becoming infected are greatly reduced. These drugs, in kit form, are supposed to be available in all hospitals for health-care workers at risk of needle-stick injuries.’ (110-111)

- ‘In 2000, the gap between rich and poor was greater in South Africa than in any other country except Brazil.’ (111)

- ‘There is a direct correlation between young people’s sexual behavior and their sense of confidence in the future.’ David Harrison (130)

- ‘Until 2006, no public health campaign in southern Africa had informed people of the dangers of long-term concurrency.’ (144)

- ‘In her 1987 book Illness as Metaphor, Susan Sontag described how, when people don’t understand the causes of a disease – why some people get it and others don’t – they tend to imbue these afflictions with moral or metaphysical significance.’ (148)

- ‘It seemed to me that what mattered most was something for which public health experts had no name or program. It was something like ‘collective efficacy’ – the ability of people to join together and help one another.’ (160)

- ‘Most of the $15 billion in the AIDS plan was to be spent on medical treatment for people with AIDS, but $1 billion was earmarked for HIV prevention problems that encouraged sexual abstinence.’ (187)

- ‘To date, every abstinence-only program that has ever been evaluated has failed to reduce rates of teen pregnancy or sexually transmitted disease.’ (187)

- ‘President Bush announced the fifteen-billion-dollar [sic] PEPFAR program on national television one week before the start of the war against Iraq, and it was meant to send a clear signal that his foreign policy was compassionate as well as tough.’ (220)

- ‘When the Americans come, we sing, we dance, they take our picture, and they go back and show everyone how they are helping the poor black people. But then all they do is hijack our projects and count our children.’ Ugandan community organizer (227)

- ‘Half a million children – most of them African – die every year from measles, which is preventable with a five-cent vaccine. More than a million pregnant women in Africa have syphilis that is never treated and puts their newborns at risk of deformity or death. The tests and rugs to eliminate this risk cost only twenty-five cents. Hundreds of thousands of children go blind every year, and more than a million die, because they are deficient in Vitamin A. Vitamin A supplements, which need to be taken only twice a year, are virtually free. Treating AIDS patients is far more complicated than testing for syphilis or administering Vitamin A drops or measles vaccines. AIDS patients need counseling, laboratory tests, and ongoing clinical care to treat opportunistic infections and monitor drug resistance and side effects.’ (265)

- ‘Some people probably have good reasons to flee from an HIV testing nurse – especially women. In a series of studies analyzed under the auspices of the World Health Organization, some 20 percent of African women who tested positive for HIV experienced some sort of negative outcomes if their husbands or boyfriends found out. Some women were blamed for brining the infection into the relationship; others were beaten or thrown out of their houses.’ (267)