To End a Plague: America's Fight to Defeat AIDS in Africa

by Emily Bass

Overview

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.

Product Details

ISBN-13:	9781541762435
Publisher:	PublicAffairs
Publication date:	07/06/2021
Pages:	496
Sales rank:	1,130,388
Product dimensions:	6.10(w) x 9.10(h) x 1.90(d)

About the Author

Emily Bass has spent more than twenty years writing about and working on HIV/AIDS in America and East and Southern Africa. Her writing has appeared in numerous books and publications including Foreign Policy, TheWashington Post, The Lancet, Esquire, and n+1, and she has received a notable mention in Best American Essays. A lifelong social justice activist, Bass has served as an external expert for the World Health Organization and a member of the What Would an HIV Doula Do collective. She is the recipient of a Fulbright journalism fellowship and a Martin Duberman Visiting Research Fellowship from the New York Public Library. She lives in Brooklyn with her family.

Editorial Reviews

05/03/2021

Bass, a journalist and AIDS activist, debuts with a granular yet wide-ranging history of the President’s Emergency Plan for AIDS Relief (PEPFAR), “the largest disease-specific foreign aid effort in the history of and the world.” She notes that President George W. Bush announced the program in the same 2003 State of the Union speech in which he outlined justifications for the invasion of Iraq; details the activism that forced drug companies to significantly reduce the price of HIV/AIDS medication, making large-scale treatment programs in low-income countries possible; and explains the origins of a “conscience clause” exempting faith-based groups that receive PEPFAR funds from providing “any services or commodities,” including condoms, that run counter to their beliefs. Drawing on multiple visits she made to Uganda between 2005 and 2019, Bass profiles patients, nurses, and doctors, and documents the logistical and cultural challenges to halting the AIDS epidemic in Africa. She also documents Deborah Birx’s efforts to revitalize PEPFAR with a data-driven approach after funding for the program hit an “all-time low” in 2013. Bass’s personal reflections occasionally distract from the larger story, and the level of detail may be overwhelming for generalists. Still, readers with a background in the subject will consider this essential. (July)

Publishers Weekly

Readers with a background in the subject will consider this essential.”—Publishers Weekly

In "To End a Plague", Emily Bass chronicles in detail how this [American AIDS] plan came to be…[A] new very, very helpful history. —Rachel Maddow

“With 25 years of experience as an AIDS activist, journalist Bass makes a vivid book debut with a detailed recounting of a prevention program that effectively stemmed AIDS in Africa…A timely history of successful government intervention.”—Kirkus Reviews

"Massive in scope and detail, Bass's crucial if at times dense tome could not be more timely.”—Booklist

“Bass has written a memory map of activism; a love song to a generation that insisted that African lives mattered. Told with compassion and grit, this is a searing story of a generation of women warriors."—Sisonke Msimang, author of Always Another Country

“Emily Bass reveals a vast and intricate web of cause and effect that spans the globe. A must-read for citizens of countries at the receiving end of donor aid.”—Doreen Baingana, author of Tropical Fish

With the sustained rhetorical power of a seasoned journalist and the nuance of a social theorist, Emily Bass drops us into America’s decades-long war on ‘AIDS in Africa.’ Essential reading for everyone who hopes that the scattershot production of vaccine will meaningfully end the current plague.”—Cindy Patton, author of Sex and Germs

“Emily Bass brings passion, originality, honesty, grit, and fierce independence to her assessment of the wildly ambitious—and inarguably successful—PEPFAR. Bass threw herself, whole heart, at this project, recounting PEPFAR’s story in greater detail than ever before..”—Jon Cohen, senior correspondent at Science

“Emily Bass’s granular account tracks what happened after the American media klieg light shifted away from AIDS, without sacrificing poetry to mountains of data.”—Avram Finkelstein, founding member of the Silence=Death collective

“To End A Plague is a triumph, the sort of masterful, commanding work that comes around only once in a great while. Wonderful and wildly important—a landmark work that will endure.”—Martin Duberman, distinguished professor emeritus of history, CUNY

“The book must be on every US President’s table at the Oval Office to remind them of their commitment to continue foreign aid for good, be it for AIDS, COVID-19, or tuberculosis.”—Lancet

“Fascinating…nicely balances accounts of the debate over [PEPFAR] and the difficulties in running it with the reflections of the Africans [Bass] met on the frontlines of the battle against [AIDS].”—Foreign Affairs

“The resonance of that advice speaks to the astonishing scope of Bass's reporting and the honesty of her writing, but particularly her scrupulousness in rooting her conclusions in the experiences of HIV/AIDS activists and the people who built and benefited from PEFPAR.”—Andrew Green, Lancet

From the Publisher

2021-04-22
A chronicle of one of America’s bold health initiatives.

With 25 years of experience as an AIDS activist, journalist Bass makes a vivid book debut with a detailed recounting of a prevention program that effectively stemmed AIDS in Africa. Drawing on medical reports, scientific papers, and interviews with activists, AIDS sufferers and their families, and health care providers and administrators (Deborah Birx, among them), the author examines the impact of a plan put forth by George W. Bush in 2003: the President’s Emergency Plan for AIDS Relief. Astonishingly to Bass, the scientifically sound, rigorously researched plan—informed by experts including physicians Anthony Fauci and Mark Dybul—was met with skepticism both within Washington and among AIDS activists, who treated it “as a false promise and a political ploy.” As Bass watched the fate of the plan play out, she saw that “the structure of the program designed to wage war on the virus had engendered a war for resources” among a plethora of agencies whose acronyms sometimes overwhelm the narrative. The rivalries, she notes, continued “as long as the program did, defining and undermining this singular, purpose-built effort to control a modern plague.” Although in the U.S., “it was a workaround for the enduring ambivalence about foreign aid that made efforts by turns competitive, ineffective, and fragmented,” in Uganda—where Bass had been a Fulbright scholar in 2004-2005 and returned for many extended visits—PEPFAR became “a solution to the problem of keeping people with HIV alive when their own government did not care to try.” The plan had effectively “married research with implementation, relied on local partners, moved fast,” and responded to Ugandans’ urgent needs. PEPFAR, Bass asserts, proved to be “an unprecedented achievement in promoting public health instead of public death” and an important lesson “in how the US government can organize and implement a long-term plague war.”

A timely history of successful government intervention.

Kirkus Reviews