The Battle Inside Authors’ Critique Leaves Us No Wiser Or Fit- Ter
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BOOKS & ARTS COMMENT every success but blames all problems on political meddling. Given that state inter- vention has produced notable successes, such as social programmes to reduce hunger, this is simplistic. The effect is that the authors have lit- COFFRINI/AFP/GETTY F. tle constructive to say about the role of politics in a world in which it inevitably mixes with markets. They fail to ask key questions. For instance, how much has public investment in transport infra- structure and agricultural research and development shaped the marketplace? And what if, rather than being ignorant of the thinking that an ever more spe- cialized division of labour will yield ever greater health, wealth and happiness, locavores are actually challenging it? For example, Desrochers and Shimizu celebrate the specialization in the food industry that has given us artificial sweet- Peter Piot co-discovered the Ebola virus and helped to coordinate the global response to HIV and AIDS. eners to fight type 2 diabetes. But that specialization has also given us abun- VIROLOGY dant empty calories and poverty-wage work, which contribute to the incidence of diet-related diseases. Local food won’t solve public-health problems, true, but the The battle inside authors’ critique leaves us no wiser or fit- ter. If, as they say, “the essence of progress José Esparza enjoys the memoir of a long-term veteran is to create less significant problems than of the virus wars. those that existed before”, should we just be thankful that we’re fat rather than hungry? The authors’ confidence that the sys- n 1933, Nobel-prizewinning physician previously undiscov- tem works sits oddly against evidence Charles Nicolle said that infectious dis- ered pathogen that that above a certain point, growth in gross eases “carry the traits of life that seeks came to be known as domestic product is not correlated with Ito perpetuate itself, evolving and trying to the Ebola virus. As improved well-being. At the core of pro- achieve equilibrium”. But this evolution has Piot works towards gressive locavore thinking are efforts to a high price for humans. The war between an understanding address this by questioning the association human and microbe is epic and ongoing. of Ebola haemor- between material consumption and pros- In No Time to Lose, Peter Piot, director of rhagic fever, the story perity, pushing use of renewable resources the London School of Hygiene and Tropical becomes the stuff of and reducing economic inequalities. Medicine, offers chronicles of two battles No Time to Lose: high drama: the writ- A Life in Pursuit of By hanging their argument on the from that war: his front-line fights against the Deadly Viruses ing is so vivid that I advantages that we enjoy over our ances- Ebola virus, which can trigger a highly lethal PETER PIOT felt as if I were beside tors, Desrochers and Shimizu give us lit- haemorrhagic fever, and HIV. The book does Norton: 2012. 304 pp. Piot in the Congolese tle more than an entertaining defence of not pretend to be a history of those viruses, $28.95, £17.99 jungle. business as usual. The UK government’s or a technical manual on infectious diseases The epidemic Piot unlocavorish Foresight unit, which generally. It is a memoir — although inter- witnessed was fast and furious, killing 431 advises on how to future-proof policy twined with epidemiology, science and poli- people in Zaire and Sudan in the last four decisions, found last year that “nothing tics — and, as such, it is Piot’s prerogative to months of 1976. As it raged, Piot began to less is required than a redesign of the remember and to recognize what he chooses. absorb the realities of research: the tensions whole food system to bring sustainabil- We witness Piot’s evolution over 35 years, between competition and collaboration and ity to the fore”. Desrochers and Shimizu’s from idealistic young medical scientist in the need for priority recognition of scientific prescription not to mess with the mar- Belgium to skilful United Nations politi- discoveries. He also started to learn how to ket seems a missed opportunity to say cian and diplomat in Geneva, Switzerland, communicate with affected populations, something altogether more imaginative as director of the Joint United Nations Pro- including Belgian nuns in the small village and more useful. Locavores don’t have gramme on HIV/AIDS (UNAIDS). Piot is of Yambuku, Zaire, four of whom succumbed a blueprint, but we should welcome the not always diplomatic: he paints a warts- to Ebola. Rather than just studying it as a ingenuity and challenge that they bring and-all portrait of how science is done and pathological phenomenon, Piot probed the to this urgent redesign. ■ public health protected. And, like many good epidemic’s human dimension — an essential storytellers, he identifies the good guys and component of modern epidemiology. Tom MacMillan is director of the villains in the threads of his narrative. During the epidemic, Piot collaborated innovation at the Soil Association in Piot’s first African adventure was in Zaire, and competed with several US scientists. Bristol, a UK charity that campaigns for now the Democratic Republic of Congo, in These encounters led him to study sexually planet-friendly food and farming. 1976. He was chasing an unusual epidemic transmitted infections with epidemiologist e-mail: [email protected] caused, he and his colleagues learned, by a King Holmes in Seattle, Washington. 7 JUNE 2012 | VOL 486 | NATURE | 31 © 2012 Macmillan Publishers Limited. All rights reserved COMMENT BOOKS & ARTS He was at the University of Wash- PSYCHOLOGY ington for a little more than a year, but this period was a turning point for Piot, preparing him for his next challenge: the emerging AIDS epidemic. It was to Markets in mind absorb the next 30 years of his life. Now pursuing HIV, Piot returned to Investment bankers are addicts on a steroid roller Kinshasa. In 1984, he and his collabora- coaster, finds Richard Lea. tors established Project SIDA, which pro- duced most of the early information on AIDS in Africa. The project was led at first ené Descartes may have sparked the The Hour Between in cortisol during by the epidemiologist Jonathan Mann; in Enlightenment when he proposed that Dog and Wolf: volatile markets. He 1986, Mann became the first director of thought is the basis for existence, but Risk-taking, Gut saw this chemistry in the Global Programme on AIDS of the RCartesian mind–body dualism has fallen out Feelings and the action on Wall Street: Biology of Boom World Health Organization (WHO). of favour in philosophy. According to neuro- and Bust traders on a roll, in Piot details the personal differences and scientist John Coates, however, there is one JOHN COATES clubs and prowling for changing focus that led to the dissolution domain in which the idea of a mind driven by Fourth Estate/Penguin: sex, and the men’s toi- of the Global Programme and the launch pure rationality persists: economics. 2012. 288/352 pp. lets exuding a slaugh- of UNAIDS. Piot served as its first direc- In The Hour Between Dog and Wolf, Coates £20/$27.95 terhouse stench as the tor from 1996 until 2008 — a period that tests this to breaking point, with an area of market tumbled. makes up the bulk of the book. A more economics where rationality does not rule. When testosterone levels rise during a bull definitive overview of these years appears Using physiology and neuroscience, and market, with successes following each other in AIDS at 30 (Potomac, 2012) by Victo- grounded by 12 years working in New York’s so rapidly that there is no time for hormone ria Harden, a historian at the US National financial district, Coates paints a vivid picture levels to return to normal, stockbrokers can Institutes of Health. of stockbrokers as thrill junkies, surfing waves fall prey to the “irrational exuberance” that Piot resolved that on the research front, of boom and bust on steroid hormones. powers a bubble. During a declining ‘bear’ UNAIDS would focus on epidemiology. Coates suggests ways to calm those waves, market, sustained levels of cortisol can fuel But it also ran many other activities, par- but his prescription doesn’t go far enough. He the panic before a crash and even, Coates sug- ticularly coordination of the country-level focuses on strategies for controlling the testos- gests, contribute to hypertension and type 2 response to AIDS. terone highs of the “Masters of the Universe” diabetes in individuals. A system that evolved Piot’s main focus was “Despite — as Tom Wolfe styled them in The Bonfire of to respond to physical threats over seconds advocacy, community the efforts the Vanities (Farrar, Straus and Giroux, 1987) or hours — the leopard in the forest, the rival mobilization, politi- of virus — instead of restructuring a financial system in the group — is unable to cope with threats cal sensitization and hunters, that currently “balances precariously on the that evolve over weeks or months. fund-raising, and he neither mental health of these risk takers”. The drawbacks of Coates’s familiarity found success. I am Ebola nor Coates begins with a vibrant portrait of a with the trading floor become plain when disappointed, how- Wall Street investment bank as the markets he proposes fixes. Perhaps traders will be less ever, that as a medical HIV is under prepare for an interest-rate announcement. stressed if they practise yoga or take up a wind scientist, he does not control.” He conjures up the excitement of the trading instrument as he suggests, but his broader use his book to dis- floor, a “parabolic reflector” gathering infor- solutions — such as restraint from middle cuss the enormous research effort behind mation and registering early signals.