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Book Review: Racism in medicine: an agenda for change

WHO work on comparative life expectancy and the new DALE index. I would have expected this to be addressed in a book that claims as its subject ‘the public health issues that are important for the new century’. Public health is equated with social justice, in Dan Beauchamp’s chapter, on a local rather than a global level. Nowhere in the book is this distinction more clear than in the chapters discussing HIV, AIDS and other communicable diseases. Reading these gives no sense that AIDS has become the biggest public health issue in sub-Saharan Africa. A presentation of the ethical difference between closing down the San Francisco bath houses as a moral measure and closing them down as a public health measure, has little significance in the context of the numbers of African children who become ‘AIDS orphans’ every day. Even the discussion of the ‘novel variant of cholera’ (0139 Bengal) in the chapter by Paul R Epstein, seems to be more concerned with the one case imported into the USA than with the thousands of cases in India, Thailand and Pakistan. The book ends with a section on ‘New technology and the public’s health’, including discussion of reproductive issues and genetic testing, screening and therapy.