Review of Edward Hooper, The River: A Journey Back to the Source of HIV and AIDS

(Harmondsworth: Penguin; Boston: Little, Brown, 1999), xxxiii + 1070 pages, ISBN 0-713-99335-9 hardback, £25; ISBN 0-316-37261-7, US$35.

 Published in New Genetics and Society, Vol. 19, No. 1, 2000, pp. 106-107

Reviewed by Brian Martin

How did AIDS begin? There are lots of theories, from a monkey bite to biological warfare experiments gone wrong.

Who wants to know? Some AIDS researchers would, especially if the answer gives insights useful in the struggle against AIDS or for preventing a similar disaster.

Edward Hooper, more than nearly anyone else, wanted to figure out how AIDS began. He initiated a personal investigation that ended up being a nine-year saga. The River is the story of his incredible journey, which took him around the world searching for documents, undertaking interviews and exploring trails of evidence.

Hooper tracks the way AIDS spread in the early years, especially via wars in central Africa and through a few individuals in America and Europe. He is especially interested in the earliest cases of AIDS, scrutinising each suspected case. With this evidence, he is able to eliminate most origin theories.

The most commonly accepted theory is that simian immunodeficiency viruses (SIVs) entered humans to become HIVs via "natural transfer," for example a hunter butchering a monkey and getting monkey blood in a cut. But monkeys have been butchered for millennia. Why is AIDS so new, with the earliest HIV-positive blood sample dating from 1959?

In 1992, there was widespread publicity about the theory that AIDS arose from contaminated polio vaccines. The world’s first mass polio vaccination campaigns were conducted by Hilary Koprowski in central Africa from 1957-1960, with hundreds of thousands of people given live-virus vaccine orally. The timing and location fit beautifully with the epidemiology of AIDS. Polio vaccines are cultured on monkey kidneys; at the time, SIVs were unknown and there was no screening for them. It is known that another monkey virus, SV40, was given to millions of people via polio vaccines, so monkey virus transfer via vaccines is certainly possible. Albert Sabin found an unidentified, non-polio virus in the particular batch of vaccine used in Koprowski’s African campaigns.

The oral-polio-vaccine theory of AIDS was developed by several people, including Louis Pascal, Jennifer Alexander, Mike Lecatsas, Blaine Elswood and Tom Curtis. Building on their insights, Hooper has done the investigations to show its plausibility. He describes his fascinating interviews with AIDS researchers and polio pioneers, gradually getting closer to specifics that can pin down the origin.

The River is an epic scientific detective story that is eminently readable. It combines archival investigations, insightful interviewing and close reasoning in a productive combination seldom found in this era of scientific specialisation.

Along the way, Hooper came up with the answer to another question: "Who doesn’t want to know?" Many scientists are antagonistic to the oral-polio-vaccine theory. Seed samples of Koprowski’s vaccine apparently remain untested for SIV years after testing was proposed. Koprowski has sued publishers for defamation over stories about the theory. So publication of The River is a great social as well as scientific accomplishment. Whether a fair and open evaluation of the theory will occur remains to be seen.

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