Dragon Within the Gates: The Once and Future AIDS Epidemic Dr. Stephen C. Joseph has written the best kind of social history: informative, engaging, and vitally important. Dragon Within the Gates mixes an overview of the AIDS crisis with a fascinating explanation of how and why epidemics occur. The book also sounds an alarm, a warning that may well go disastrously unheeded. As Commissioner of Health of New York City from 1986 to 1990, Dr. Joseph was in the very eye of the storm that raged over attempts to use proven public health measures to control the epidemic. He proposed testing and contact tracing of those engaging in high risk sex and the needle exchange program for intravenous drug users, measures that encountered furious political resistance. This clash between two competing values - civil rights and public health policies - remains unresolved and highly controversial today. In retelling this story that played out in such a volatile atmosphere, Dr Joseph charts a balance between the current pain, loss, and rage with the lessons available (if they will only be learned) for the future. In identifying the origin of the HIVirus in Africa and tracing its terrible journey to the United States, Dr. Joseph provides answers to some intriguing questions about the very nature of pandemics. In an utterly absorbing section he describes the virus's strategy for survival and explains why it is considered a "smart" disease. The book candidly addresses a number of issues about which there is either confusion or contested evidence and that are of great concern to the public-at-large: Are heterosexuals at equal risk? Were major opportunities to protect against the spread of the infection missed? What is the relationship between AIDS and drug abuse? Howdid it originate in Africa, and why is the principal means of transmission there different than in the West? Dr. Joseph is realistic about the tough political and economic choices that have to be made if we are to protect the uninfected and treat the sick. He reasons that the worst of the mortality among homosexuals is still to come. This crisis will occur in the mid to late 1990s. The American health system, especially in cities like New York, is woefully unprepared. He also describes why the transmittal of the disease has peaked among white gay males and has shifted its pathway toward inner-city minority heterosexuals. Intelligent, compassionate, and crisply written, Dragon Within the Gates is essential reading for everyone concerned about the ravages of AIDS, for everyone who wishes to clearly understand what has happened and why, and what the choices are for the future. |
Other editions - View all
Dragon Within the Gates: The Once and Future AIDS Epidemic Stephen C. Joseph No preview available - 1993 |