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  • Tamara Giles-Vernick (a1), Ch. Didier Gondola (a2), Guillaume Lachenal (a3) and William H. Schneider (a2)

This essay considers how historians of Africa can draw from and critically contribute to biomedical debates. Recent virological research has established that the HIV/AIDS pandemic began with the passage of simian immunodeficiency viruses into human populations in the first half of the twentieth century. Current debates on the emergence of HIV are an opportunity for historians to engage with biomedical research to rethink social, political, and environmental histories of Africa. While biomedical writings focus on HIV ‘origins’, we propose a broader look at the historical changes associated with the beginnings of the HIV/AIDS pandemic.

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The authors would like to thank Jim Webb for helpful comments on and conversations around this article.

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1 The African continent has constituted a notable source of ‘emerging diseases’, although social scientists have criticized both the ‘emerging diseases worldview’ and Africa as ‘source’. Morse, S. S., ‘Factors in the emergence of infectious diseases’, Emerging Infectious Diseases, 1:1 (1995), 715; King, N. B., ‘Security, disease, commerce: ideologies of postcolonial global health’, Social Studies of Science, 32:5–6 (2002), 763–89.

2 Bill Schneider, who has conducted historical research on blood transfusions in Africa, began working with two prominent HIV/AIDS researchers, Preston Marx and Ernest Drucker, in 2004. He subsequently teamed up with another historian, Guillaume Lachenal, whose research has focused on health campaigns against trypanosomiasis and medical research in Cameroon. In collaboration with HIV researchers Marx, Drucker, and virologist François Simon, they organized a 2010 international symposium, ‘Simian Viruses and Emerging Diseases in Humans’. After giving a talk on human mobility and hunting at that symposium, Tamara Giles-Vernick joined the collaboration and, shortly thereafter, Didier Gondola began to contribute his expertise on equatorial African urbanization, migration, and gender. Schneider, W. H. and Drucker, E., ‘Blood transfusions in the early years of AIDS in sub-Saharan Africa’, American Journal of Public Health, 96:6 (2006), 984–94; Lachenal, G., Marx, P., Schneider, W., Drucker, E., et al. , ‘Simian viruses and emerging diseases in human beings’, Lancet, 376:9756 (2010), 1901–2.

3 Faria, N. R., Hodges-Mameletzis, I., Silva, J. C., Rodés, B., et al. , ‘Phylogeographical footprint of colonial history in the global dispersal of human immunodeficiency virus type 2 group A’, Journal of General Virology, 93:4 (2012), 889–99; Pépin, J., ‘The expansion of HIV-1 in colonial Léopoldville, 1950s: driven by STDs or STD control?’, Sexually Transmitted Infections, 88:4 (2012), 307–12; Pépin, J., The Origins of AIDS (Cambridge, 2011); Tebit, D. M. and Arts, E. J., ‘Tracking a century of global expansion and evolution of HIV to drive understanding and to combat disease’, The Lancet Infectious Diseases, 11:1 (2011), 4556; Timberg, C. and Halperin, D., Tinderbox: How the West Sparked the AIDS Epidemic and How the World Can Finally Overcome It (New York, 2012); Sharp, P. M. and Hahn, B., ‘Origins of HIV and the AIDS pandemic’, Cold Spring Harbor Perspectives in Medicine (2011), doi: 10.1101/cshperspect.a006841.

4 Notable works include Grmek, M. D., History of AIDS: Emergence and Origin of a Modern Pandemic (Princeton, NJ, 1990); Schoepf, B. Grundfest, ‘“Mobutu's disease”: a social history of AIDS in Kinshasa’, Review of African Political Economy, 29:93–4 (2002), 561–73; Iliffe, J., The African AIDS Epidemic: A History (Athens, OH, 2006).

5 Chitnis, A., Rawls, D., and Moore, J., ‘Origin of HIV type 1 in colonial French Equatorial Africa?’, AIDS Research and Human Retroviruses, 16:1 (2000), 58.

6 Host shifts between animals and people are a significant feature of human history in Africa. They can take the form of zoonosis, in which a pathogen afflicting an animal ‘jumps’ to human beings, causing significant illness, sustained human-to-human transmission, or epidemics. Rabies, ebola virus, and influenza are examples of zoonoses. Other host shifts require some form of adaptation in order to be transmitted between people. Most virologists now concur that HIV was a ‘zoonotic transmission’, followed by a host adaptation occurring within a new social context that rendered the virus pathogenic and transmissible between human beings. ‘Zoonotic transmission’ differs from ‘zoonosis in that it results in mild or relatively easily suppressed infection’. F. Simon, personal communication, Sept. 2012. See also Hahn, B. H., Shaw, G. M., De Cock, K. M., and Sharp, P. M., ‘AIDS as a zoonosis: scientific and public health implications’, Science, 287 (2000), 607–14; Marx, P. A., Apetrei, C., and Drucker, E., ‘AIDS as a zoonosis? confusion over the origin of the virus and the origin of the epidemics’, Journal of Medical Primatology, 33:5–6 (2004), 220–26. For an ethnohistorical perspective on host shifts, see Giles-Vernick, T. and Rupp, S., ‘People, great apes, disease, and global health in the northern forests of equatorial Africa’, in Giles-Vernick, T. and Webb, J. L. A. Jr. (eds.), Global Health in Africa: Historical Perspectives on Disease Control (Athens, OH, forthcoming 2013).

7 Keele, B. F., Heuverswyn, F. Van, Li, Y., Bailes, E., et al. , ‘Chimpanzee reservoirs of pandemic and nonpandemic HIV-1’, Science, 313:5786 (2006), 523–6; Sharp and Hahn, ‘Origins’, 4–7; Wertheim, J. and Worobey, M., ‘Dating the age of the SIV lineages that gave rise to HIV-1 and HIV-2’, PLoS Computational Biology, 5:5 (2009), doi: 10.1371/journal.pcbi.1000377.

8 The earliest tissue sample found that tested positive for HIV dates to 1959. Korber, B., Muldoon, M., Theiler, J., Gao, F., et al. , ‘Timing the ancestor of the HIV-1 pandemic strains’, Science, 288:5472 (2000), 1789–96; Worobey, M., Gemmel, M., Teuwen, D. E., Haselkorn, T., et al. , ‘Direct evidence of extensive diversity of HIV-1 in Kinshasa by 1960’, Nature, 455 (2008), 661–4.

9 Lemey, P., Pybus, O. G., Wang, B., Saksena, N. K., et al. , ‘Tracing the origin and history of the HIV-2 epidemic’, Proceedings of the National Academy of Sciences of the United States of America, 100:11 (2003), 6588–92.

10 Hooper, E., The River: A Journey to the Source of HIV and AIDS (Boston, 1999); Worobey, M., Santiago, M. L., Keele, B. F., Ndjango, J.-B. N., et al. , ‘Origin of AIDS: Contaminated polio vaccine theory refuted’, Nature, 428 (2004), 820.

11 Marx, P. A., Alcabes, P. G., and Drucker, E., ‘Serial human passage of simian immunodeficiency virus by unsterile injections and the emergence of epidemic human immunodeficiency virus in Africa’, Philosophical Transactions of the Royal Society of London, Series B, Biological Sciences, 356 (2001), 911–20; Drucker, E., Alcabes, P. G., and Marx, P. A., ‘The injection century: massive unsterile injections and the emergence of human pathogens’, Lancet, 358:9297 (2001), 1989–92.

12 He and his collaborators later modified this explanation to include ‘a change in human ecology’. Worobey et al., ‘Direct evidence’, 663; Wertheim et al., ‘Dating’.

13 Chitnis, Rawls, and Moore, ‘Origin of HIV’, 5–8; Moore, J., ‘The puzzling origins of AIDS’, American Scientist, 92:6 (2004), 540–7.

14 de Sousa, J. D., Müller, V., Lemey, P., and Vandamme, A.-M., ‘High GUD incidence in the early 20th century created a particularly permissive time window for the origin and initial spread of epidemic HIV strains’, PloS One, 5:4 (2010), doi: 10.1371/journal.pone.0009936, e9936; Pépin, Origins, esp. 221–37. Margaret Lock and Vinh-Kim Nguyen see these debates as reflecting a ‘consensus about the complex interplay between the biological and social factors’ that brought about HIV emergence. This recognition has not, however, shaped explanations for contemporary differences in HIV prevalence; here biology remains distinct from the social, cultural, and historical, ‘thus making it difficult to apprehend how biology and social relations are co-produced as local biologies and generate epidemics’. Lock, M. and Nguyen, V.-K., An Anthropology of Biomedicine (Malden, MA, 2010), 107.

15 Iliffe, African AIDS. The first book-length analysis, Grmek's History of AIDS, insightfully recognized iatrogenesis as an important means of transmission.

16 While colonial authorities did conduct smallpox vaccination campaigns, there was never a vaccination campaign against sleeping sickness. Arm-to-arm inoculation was a technique predating colonial campaigns. Iliffe, African AIDS, 7.

17 Iliffe, African AIDS, 16.

18 Timberg and Halperin, Tinderbox.

19 Ibid. 50–1, 57.

20 De Sousa et al., ‘High GUD’, e9936.

21 The railway was constructed between 1921 and 1934. Pépin uncovers intriguing medical reports from the Congo-Océan Railway construction that document a mysterious, fatal illness among railroad construction workers (‘Cachéxie de Mayombe’). Its symptoms were ‘suggestive of AIDS’. Pépin, Origins, 36–9.

22 Marx, Alcabes, and Drucker, ‘Serial human passage’; Drucker, Alcabes, and Marx, ‘Injection century’; Gisselquist, D., ‘Emergence of the HIV type 1 epidemic in the twentieth century: comparing hypotheses to evidence’, AIDS Research and Human Retroviruses, 19:12 (2003), 1071–8. See also Pépin, J., Plamondon, M., Alves, A. C., Beaudet, M., et al. , ‘Parenteral transmission during excision and treatment of tuberculosis and trypanosomiasis may be responsible for the HIV-2 epidemic in Guinea-Bissau’, AIDS, 20:9 (2006), 1303–11; Pépin, J. and Labbé, A.-C., ‘Noble goals, unforeseen consequences: control of tropical diseases in colonial Central Africa and the iatrogenic transmission of blood-borne viruses’, Tropical Medicine & International Health, 13:6 (2008), 744–53; Pépin, J., Deslandes, S., Frost, E., Labbé, A.-C., et al. , ‘Iatrogenic transmission of human T cell lymphotropic virus type 1 and hepatitis C virus through parenteral treatment and chemoprophylaxis of sleeping sickness in colonial Equatorial Africa’, Clinical Infectious Diseases, 51:7 (2010), 777–84.

23 See for instance de Sousa et al., ‘High GUD’, e9936; Pépin, Origins, 45–6, 91, and 93.

24 Stoler, A. L., ‘Colonial archives and the arts of governance’, Archival Science, 2:1–2 (2002), 87.

25 Ibid. 90–1.

26 These large-scale transformations appear in one form or another in Pépin, Origins, esp. chs. 6, 8, and 9; Timberg and Halperin, Tinderbox, chs. 5, 6, and 7; de Sousa et al., ‘High GUD,’ e9936; Worobey et al., ‘Direct evidence’, 662–3; Wertheim et al., ‘Dating’, 6; Hahn et al., ‘AIDS as a zoonosis’, 611; Pépin et al., ‘Iatrogenic transmission’. But see Drucker et al., ‘Injection century’.

27 Porter, R., ‘Tissue wars’, London Review of Books, 22:5 (2000), 34–5.

28 Foucault, M., ‘Nietzsche, genealogy, history’, in Rabinow, P. and Rose, N. (eds.), The Essential Foucault: Selections from Essential Works of Foucault, 1954–1984 (New York, 2003), 353, 355.

29 Our expanding group is in the early stages of developing this research.

30 Keele et al., ‘Chimpanzee reservoirs’, 523–6. On the ‘cut hunter’ see Pépin, Origins, ch. 4.

31 Chitnis, Rawls, and Moore, ‘Origin of HIV’, 5–8; Worobey et al., ‘Direct evidence’; Hahn et al., ‘AIDS as a zoonosis’; Takehisa, J., Kraus, M. H., Ayouba, A., Bailes, E., et al. , ‘Origin and biology of simian immunodeficiency virus in wild-living western gorillas’, Journal of Virology, 83:4 (2009), 1635–48.

32 Du Chaillu, P. B., Explorations and Adventures in Equatorial Africa (New York, 1969 [orig. pub. 1861]), 86–8; Giles-Vernick, T. and Rupp, S., ‘Visions of apes, reflections on change: telling tales of great apes in equatorial Africa’, African Studies Review, 49:1 (2006), 54–9; Newman, J., ‘Discovering gorillas: the journey from mythic to real’, Terrae Incognitae, 38:1 (2006), 3654; Reade, W. Winwood, Savage Africa: Being the Narrative of a Tour in Equatorial, South-Western, and North-Western Africa (New York, 1864), 164–7.

33 Klieman, K. A., ‘The Pygmies Were Our Compass’: Bantu and Batwa in the History of West Central Africa, Early Times to c. 1900 C. E. (Portsmouth, NH, 2003), 183–91 and 224–5. On the Atlantic trade in Central Africa, see; Miller, J. C., Way of Death: Merchant Capitalism and the Angolan Slave Trade, 1730–1830 (Madison, WI, 1988); and Vansina, J., Paths in the Rainforests: Toward a History of Political Tradition in Equatorial Africa (Madison, WI, 1990), ch. 7.

34 Rupp, S., Forests of Belonging: Identities, Ethnicities, and Stereotypes in the Congo River Basin (Seattle, 2011), 68–72, 78–82, and 85–6.

35 Copet-Rougier, E., ‘Political-economic history of the Upper Sangha’, in Eves, H. E., Hardin, R., and Rupp, S. (eds.), Resource Use in the Trinational Sangha River Region of Equatorial Africa: Histories, Knowledge Forms, and Institutions, bulletin series, Yale School of Forestry and Environmental Studies, no. 102 (New Haven, CT, 1998), 4184; Giles-Vernick, T., Cutting the Vines of the Past: Environmental Histories of the Central African Rain Forest (Charlottesville, VA, 2002), 22 and 70; Harms, R. W., River of Wealth, River of Sorrow: The Central Zaire Basin in an Era of the Slave and Ivory Trade, 1500–1891 (New Haven, CT, 1981), 43–5; Klieman, ‘Pygmies’, 184.

36 Coquery-Vidrovitch, C., Le Congo au temps des grandes compagnies concessionnaires, 1898–1930 (Paris, 1972), 367–8.

37 Giles-Vernick and Rupp, ‘Visions’, 59–60 and 63.

38 Coquery-Vidrovitch, Congo, 73–8 and 83–4.

39 The first hunting laws in French Equatorial Africa (1916) created several hunting permits for purchase, giving sport and commercial hunters more latitude than African hunters in the numbers and types of game they could kill. These laws also limited the number of gorillas that could be killed; chimpanzee hunting was not outlawed until 1929–30.

40 Feierman, S. and Janzen, J. M., ‘Introduction’, in Feierman, S. and Janzen, J. M. (eds.), The Social Basis of Health and Healing in Africa (Berkeley, CA, 1992), 16.

41 Worobey et al., ‘Direct evidence’.

42 Gondola, Ch. D., Villes miroirs: migrations et identités urbaines à Brazzaville et Kinshasa, 1930–1970 (Paris, 1997).

43 Sautter, G., De l'Atlantique au fleuve Congo: une géographie du sous-peuplement, Volume 1 (Paris, 1966).

44 Ascherson, N., The King Incorporated: Leopold the Second and the Congo (New York, 2001); Coquery-Vidrovitch, Congo; Giles-Vernick, Cutting the Vines; Harms, River of Wealth; Hochschild, A., King Leopold's Ghost: A Story of Greed, Terror, and Heroism in Colonial Africa (New York, 1999); Marchal, J., Lord Leverhulme's Ghosts: Colonial Exploitation in the Congo (London, 2008); Nelson, S. H., Colonialism in the Congo Basin: 1880–1940 (Athens, OH, 1994); Rinchon, D., La traité et l'esclavage des Congolais par les Européens: histoire de la déportation de 13 millions 250.000 noirs en Amérique (Bruxelles, 1929); Vangroenweghe, D., Du sang sur les lianes: Léopold II et son Congo (Bruxelles, 1986); Vansina, Paths.

45 Dianzinga, S., ‘Santé et maladie en situation coloniale: l'exemple du moyen Congo (1908–1958)’, Annales de l'Université Marien Ngouabi, 10:1 (2009), 95; Lyons, M., The Colonial Disease: A Social History of Sleeping Sickness in Northern Zaire, 1900–1940 (Cambridge, 1992).

46 Gondola, Villes miroirs, 88.

47 Pépin, ‘Expansion of HIV-1.’

48 De Sousa et al., ‘High GUD’, e9936.

49 De Sousa et al., ‘High GUD’, e9936.

50 Colonial sources indicate the absence of ‘sex work’ and serial prostitution in Central Africa prior to French and Belgian colonization. For example, in his Enquête coloniale dans l'Afrique française occidentale et équatoriale (published in 1930), French ethnographer Maurice Delafosse links prostitution to urbanization and ‘European civilization’; see Gondola, Villes miroirs, 111.

51 In the late 1920s, alarmed by what they perceived as endemic ‘prostitution’, colonial authorities ruled it a moral, health, and criminal matter. They suspected that sex traffickers had set up maisons de passe (unregulated brothels) in African settlements but lacked the means to ascertain the brothels’ existence or to conduct widespread police operations. Instead, they registered single women (filles publiques) and rounded them up for regular medical exams. Lauro, A., Coloniaux, ménagères et prostituées au Congo Belge, 1885–1930 (Loverval, Belgique, 2005), 166 and 177.

52 De Sousa et al., ‘High GUD’, e9936; Pépin, Origins. See also Headrick, R., Colonialism, Health and Illness in French Equatorial Africa, 1885–1935, with Headrick, D. (ed.) (Atlanta, GA, 1994), 3641; Hunt, N. R., ‘STDs, suffering, and their derivatives in Congo/Zaire: notes toward an historical ethnography of disease’, in Becker, C., Dozon, J.-P., Obbo, C., and Touré, M. (eds.), Vivre et penser le sida en Afrique/Experiencing and Understanding AIDS in Africa (Paris, 1999), 111–31; Dianzinga, ‘Santé’.

54 Gondola, Villes miroirs, 111. The need for Victorian men to have a ménagère (African maid) camouflaged their view of the colony as a place replete with ‘sexual opportunities’ since the ménagère provided a rampart against the ‘venereal peril’. Lauro, Coloniaux, 33, 68, and 92.

55 Hunt, N. R., ‘An acoustic register, tenacious images, and Congolese scenes of rape and ruination’, Cultural Anthropology, 23:2 (2008), 220–53; Hochschild, King Leopold's Ghost, 162.

56 Gondola, Ch. D., ‘Oh, rio-Ma!: musique et guerre des sexes à Kinshasa, 1930–1990’, Revue française d'histoire d'outre-mer, 84:314 (1997), 5181; Gondola, Ch. D., ‘“Bisengo ya la joie”: fête, sociabilité et politique dans les capitales congolaises’, in Goerg, O. (ed.), Fêtes urbaines en Afrique: espaces, identités et pouvoirs (Paris, 1999), 87111; Comhaire-Sylvain, S., Femmes de Kinshasa hier et aujourd'hui (Paris, 1968), 163.

57 Quoted in Gondola, ‘“Bisengo”’, 101.

58 Pépin, Origins, 103; Pépin, J., Lavoie, M., Pybus, O. G., Pouillot, R., et al. , ‘Risk factors for hepatitis C virus transmission in colonial Cameroon’, Clinical Infectious Disease, 51:7 (2010), 768–76; Pépin et al., ‘Iatrogenic transmission’; Njouom, R., Nerrienet, E., Dubois, M., Lachenal, G., et al. , ‘The hepatitis C virus epidemic in Cameroon: genetic evidence for rapid transmission between 1920 and 1960’, Infection, Genetics and Evolution, 7:3 (2007), 361–7; Nerrienet, E., Pouillot, R., Lachenal, G., Njouom, R., et al. , ‘Hepatitis C virus infection in Cameroon: a cohort-effect’, Journal of Medical Virology, 76:2 (2005), 208–14; Pépin, et al. , ‘Noble goals’; G. Lachenal, ‘Quand la médecine coloniale laisse des traces. L’épidémie iatrogène de VHC en Afrique’, Les tribunes de la santé, 33 (2012), 5966.

59 Schneider and Drucker, ‘Blood transfusions’.

60 Pépin, in his search for ‘patient zero’, minimizes the role of transfusion. Providing little evidence to support his claim, he concludes that because so many children received blood transfusions, they represented ‘epidemiological dead ends’. Pépin, personal communication, June 2010; Pépin, Origins, 159–60.

61 Piot, P. and Bartos, M., ‘The epidemiology of HIV and AIDS’, in Essex, M., Mboup, S., Kanki, P. J., Marlink, R. G., et al. (eds.), AIDS in Africa (New York, 2002), 200–17; Baggaley, R. F., Boily, M. C., White, R. G., and Alary, M., ‘Risk of HIV-1 transmission for parenteral exposure and blood transfusion: a systematic review and meta-analysis’, AIDS, 20:6 (2006), 805–12.

62 This claim is based on documented growth in transfusions in Belgian Congo in the interwar and post-Second World War period. See also Hooper's story of a Canadian engineer, who received a transfusion in Kisangani after a plane crash but died in 1980 with unusual symptoms. His stored blood, tested after HIV was identified, was found to be HIV-positive. Schneider, W. H., ‘History of blood transfusion in sub-Saharan Africa’, Transfusion Medicine Reviews 27:1 (2013), 21–8; Hooper, The River, 97–8; Rogan, E. Jr., Jewell, L. D., Mielke, B. W., Kunimoto, D., et al. , ‘A case of acquired immune deficiency syndrome before 1980’, Canadian Medical Association Journal, 137:7 (1987), 637–8; Croix Rouge du Congo, Rapport annuel, (1954), 47–9 and 70; (1955), 30, 38–9, and 59–60; (1956) 23 and 54–5; (1957), 40–1 and 50–1.

63 The earliest identified transfusion in sub-Saharan Africa (excluding South Africa) took place in Tanganyika; it was conducted by a Belgian doctor on a European officer suffering from blackwater fever. Lejeune, E., ‘Transfusion sanguine après hémoglobinurie grave’, Annales de la société Belge de la médecine tropicale, 1 (1921), 299300.

64 Spedener, D., ‘Le traitement des pneumonies des noirs par transfusion de sang des convalescents’, Bulletin médical du Katanga, 1 (1924), 234–8; Lambillon, J. and Denisoff, N., ‘Etude de l'organisation d'un service de transfusions sanguines dans un centre hospitalier d'Afrique’, Annales de la societe Belge de medecine tropicale, 20 (1940), 279–85.

65 Ronsée, C. S., ‘Anémies malariennes des enfants et transfusions sanguines; avec observations sur les groupes sanguins des Bakongo’, Memoires Institut Royal Colonial Belge section des sciences naturelles et medicales, 20 (1950), 164.

66 Schneider, ‘History of blood’.

67 Lemey et al., ‘Tracing the Origin’, 6588–92.

68 See Pépin and Labbé, ‘Noble Goals’, 744–53. For smallpox, see Schneider, W. H., ‘Smallpox in Africa during colonial rule’, Medical History, 53:2 (2009), 193227.

69 For example, see Hahn et al., ‘AIDS as a zoonosis’, 607–14.

70 Early critiques include; Dozon, J.-P. and Fassin, D., ‘Raison épidémiologique et raisons d’État. Les enjeux socio-politiques du SIDA en Afrique’, Sciences sociales et santé, 7:1 (1989), 2136; Fassin, D., Quand les corps se souviennent: expériences et politiques du sida en Afrique du Sud (Paris, 2006), 228–38; Lock and Nguyen, Anthropology, 103–7; Packard, R. M. and Epstein, P., ‘Epidemiologists, social scientists, and the structure of medical research on AIDS in Africa’, Social Science & Medicine, 33:7 (1991), 771–94.

71 Tousignant, N., ‘Trypanosomes, toxicity and resistance: the politics of mass therapy in French Colonial Africa’, Social History of Medicine, 25:3 (2012), 625–43; G. Lachenal, ‘Biomédecine et décolonisation au Cameroun, 1944–1994: technologies, figures et institutions médicales à l'épreuve’ (unpublished PhD thesis, Université Paris 7 Denis-Diderot), 2006.

72 Foucault, M., ‘Crise de la médecine ou crise de l'anti-médecine? (1976)’, Dits et écrits 1954–1988, Volume 1 (Paris, 2001), 813–28.

73 For discussion of accidents during French sleeping sickness campaigns, see Tousignant, ‘Trypanosomes’; and Bado, J.-P., Eugène Jamot, 1879–1937: le médecin de la maladie du sommeil ou trypanosomiase (Paris, 2011).

74 Although it never figured into campaigns, intravenous malaria treatment also transmitted hepatitis C in Cameroon. Pépin et al., ‘Risk factors’, 772 and 774.

75 Similarly, see Little, L. K., ‘Plague historians in lab coats’, Past and Present, 213:1 (2011), 289–90.

76 Our team would welcome additional participants with relevant expertise in West Africa.

77 Ginzburg, C., ‘Clues: roots of an evidential paradigm’, in Ginzburg, C., Clues, Myths, and the Historical Method (Baltimore, 1989), 96125.

78 Gilbert, M. T., Rambaut, A., Wlasiuk, G., Spira, T. J., et al. , ‘The emergence of HIV/AIDS in the Americas and beyond’, Proceedings of the National Academy of Sciences of the United States of America, 104:47 (2007), 18566–70.

79 HIV transmission from Haiti to the United States, for instance, was epidemiologically successful only once, despite continuous contact between Haitian and American populations. M. Worobey, ‘From natural hosts to other species. What can we learn?’, Paper presented to the conference, ‘Simian viruses and emerging diseases in humans’, Université Paris Diderot, 9 June 2010, Paris.

80 For a problematic example, see Wolfe, N., The Viral Storm: The Dawn of a New Pandemic Age (New York, 2011). For a critical perspective on this view, see Lachenal, G., ‘Lessons in medical nihilism. Virus hunters, neoliberalism and the AIDS crisis in Cameroon’, in Geissler, P. W. (ed.), Para-states of Science: Ethnographic and Historical Perspectives on Biomedicine, Government and Public in 21st-century Africa (Durham, NC, forthcoming 2013).

81 On the importance of investing in health care structures and training to prevent pandemic emergence, see also Bogich, T. L., Chunara, R., Scales, D., Chan, E., et al., ‘Preventing pandemics via international development: a systems approach’, PLoS Medicine, 9:12 (2012), doi: 10.1371/journal/pmed.1001354.

* The authors would like to thank Jim Webb for helpful comments on and conversations around this article.

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