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Book review: Doctor fights deadliest infectious diseases

By Cody Corliss

"No Time to Lose: A Life in Pursuit of Deadly Viruses." By Peter Piot. W.W. Norton & Co. $28.95. 387 pages.

CHARLESTON, W.Va. -- Peter Piot's decision to specialize in infectious disease in the early 1970s came with a warning from one of his Belgian professors. According to one professor, that choice was career suicide. "There's no future in infectious diseases," the professor explained. "They've all been solved."

Unfortunately for the state of human health, that professor was absolutely wrong. If there can be a silver lining to an ill-considered prediction about the end of infectious disease, it's that fighting them became Piot's life work. And that work became the basis for a lively, absorbing memoir.

Dr. Piot's first encounter with a significant disease came in 1976 when he worked in an Antwerp laboratory. A mysterious disease had developed in the Congo, a former Belgian colony. The samples were sent to Antwerp, and the scenario to this day makes Piot "wince to think of it."

The blood samples were sent via passenger airplane and arrived in "a cheap plastic thermos flask, shiny and blue." The protective ice had melted, and one test tube broke in transport, mixing with the ice. Piot and his fellow lab workers wore only latex gloves, "no suits or masks of any kind." In another mishap, a professor leading the research dropped a test tube, splattering the contents onto a fellow worker's shoes.

So what was this newly discovered disease? It was Ebola, the highly contagious disease that inspired the 1995 hit movie "Outbreak."

"We didn't even imagine the risk we were taking," Piot recalls. "Indeed, shipping those blood samples in a simple thermos, without any kind of precautions, was an incredibly perilous act. Maybe the world was a simpler, more innocent place in those days, or maybe it was just a lot more reckless."

After discovering the disease in the lab, Piot raced to the Congo to work with the local population battling the disease -- and to keep Ebola from spreading to population centers.

With that crisis averted, life returned to normal for Piot. Then, a mysterious disease started appearing in San Francisco and New York in the early 1980s. By 1982, the disease had sprouted around the globe and carried an official name: AIDS.

Again Piot and his team sprang into action in Africa, establishing a safe blood supply, leading research initiatives and caring for the sick. Along the way, Piot survived a hijacking in Morocco and a prick with an AIDS-infected needle.

The work took a twist though. Piot traveled from the front lines into the international health bureaucracy, becoming the first director of UNAIDS, a United Nations agency devoted to fighting the AIDS epidemic.

Piot devoted much of his UNAIDS work to the developing world. Unquestionably the scale of AIDS there is mind-boggling. For example, a 2004 study found that 42 percent of pregnant women in Swaziland were infected with HIV.

It's not a cure, but for many, survival came through antiretroviral drugs that slowed the disease. Survival came at a steep price. At times, treatment in the United States cost $15,000 a year, a figure out of reach for the developing world where much of the population lived on $1 a day.

For his crowning achievement, Piot worked with world leaders and drug company executives to lower the cost of these medicines. It's probably Piot's greatest contribution to public health, but the bureaucratic morass isn't always interesting reading.

Still, Piot refreshingly tells the names of the good and bad actors, and that list can be surprising. The good include U.N. Secretary-General Kofi Annan and President George W. Bush, who worked hard to bring cheap AIDS drugs to Africa. On the other side were former South African President Thabo Mbeki and Russian leaders, all of whom denied AIDS problems. Mbeki was particularly culpable: At a time when AIDS was a public health crisis, he denied any link between AIDS and HIV and banned the use of antiretrovirals in public hospitals. British newspaper The Guardian reported that these AIDS policies led to 300,000 unnecessary deaths.

At its heart, Piot has written a valuable book about the challenges of fighting infectious disease. Even better, this story is anything but sterile: "No Time to Lose" has a swashbuckling hero fighting deadly viruses with many lives hanging in the balance.

Cody Corliss, a Wetzel County writer and lawyer, regularly reviews books for the Sunday Gazette-Mail.


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