No Time to Lose: A Life in Pursuit of Deadly Viruses by Peter Piot

Reviewer: Jennifer Albertini, Senior HIV/AIDS Technical Advisor, Africa Bureau

Synopsis:

For many, childhood is a time of wonder and ambitious dreams to travel to foreign lands and work on issues of social justice.

Often times, such dreams remain unfulfilled – but, not for Peter Piot. As he details in “No Time to Lose: A Life in Pursuit of Deadly Viruses,” more than half of Piot’s life has been spent chasing viruses and politicians around the globe in his effort to understand and mitigate the impact and devastation of infectious diseases.

What started as a mysterious virus delivered to his laboratory in Belgium in 1976 led to his first trip to Africa to pursue what later became known as Ebola. Before he knew it, Piot was partnering with scientists in Africa to investigate other infectious diseases, including sexually transmitted infections, positioning him well for when AIDS began chipping away at the continent in the early 1980’s. He was at the forefront of efforts to unravel what quickly became the newest and fastest growing pandemic. Translating his scientific prowess into bureaucratic-ease, a decade later, Piot helped bring together 10 United Nations agencies to form UNAIDS, the Joint United Nations Programme on HIV/AIDS. UNAIDS was the first UN agency dedicated solely to working on fighting one disease. He led the agency for 14 years (1994-2008).

 “No Time to Lose…” isn’t just about the laboratories and boardrooms that Piot was able to grace during his career. As he describes, his relationship with truck drivers and heads of state, physicians and patients, and commercial sex workers and advocates is what pushed him to keep fighting, learning, fundraising, and advocating for those affected with infectious diseases for more than thirty years. These relationships still drive him, and this book is as much a reflection of his career in global health as it is an expression of his respect for the people who have been most affected around the world.

Review:

Piot’s book is not just a clinical review of infectious diseases – in fact, in the context of his narrative, Ebola or HIV & AIDS could have gone by any other name. What matters – and where Piot devotes much of his prose – is the impact that these diseases have had on the fabric of societies, and how the themes of poverty, family and governance radiate throughout all of their (and our) lives. He was able to connect the science uncovered in the laboratories with the faces of the patients he saw in clinics from Brussels to Kinshasa – and throughout the world. Perhaps most importantly, his book brings these stories to the world leaders he lobbied for so many years to do more to advance efforts to fight HIV & AIDS in their countries. He was not always successful at moving them towards action, but he always tried. And, his persistence is palpable through the pages.

I first saw Peter Piot in a nightclub in Rio during the International AIDS Society conference of 2005. As a self-proclaimed ‘public health nerd’, it was practically a celebrity sighting to see such an esteemed man dancing with the rest of us mere mortals. The results of a successful male circumcision trial in South Africa had been released that day and there was buzz in the air about this highly efficacious prevention intervention. It felt good to take a deep breath and celebrate a win for once.

One of my favorite quotes from Piot as he describes AIDS is, “This time, I knew, we were looking at the worst epidemic I could imagine, the greatest assailant I would ever face, something that would absorb all the energy that I could throw at it, and far more. In my mother tongue, Dutch, I wrote in my notebook:  Incredible. A catastrophe for Africa. This is what I want to work on. It will change everything.”

A lot of progress has been made since that catastrophe first started 30 years ago. We are now - hopefully - on a path towards creating an AIDS-free generation. As we commemorate World AIDS Day this year, a review of Piot’s book seems most timely. It allows us to reflect on where we have been and how far we have come, but it also serves as an impetus to keep moving towards our goal with a sense that there is ‘no time to lose.’

Discussion Questions

1. Although Piot lobbied South African President Mbeki repeatedly to change his way of addressing HIV/AIDS in his country, years went by before real change happened as the epidemic grew worse. Was there anything Piot could have done differently to have moved Mbeki into action earlier?
2. Certain African leaders (like Festus Mogae of Botswana) have been outspoken champions on HIV/AIDS. What are the characteristics or drivers which have made them positive leaders and what would it take for more of their peers to also take on these efforts?
3. Did the creation of UNAIDS serve (one of) its intended purpose of focusing UN efforts around a single disease to achieve maximum impact, or would they have made more of an impact utilizing their existing platforms?
4. Several recent articles have focused on balancing career and family, like Anne-Marie Slaughter’s piece ‘Why Women Still Can’t Have It all’. Piot mentions his family rarely in this book, although the birth of his children coincided with the beginning of the initial Ebola and AIDS outbreaks and he speaks volumes about his incessant travelling, late nights at work, etc. What are the differences that would have been experienced by a woman taking on Piot’s role at the time he worked on these issues?  What, if anything, would be different now?

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