Vaccines are among the greatest public health achievements of the past century. Since 1900, vaccines have controlled smallpox, poliomyelitis, measles, rubella, tetanus, diphtheria and many other infectious diseases. In contrast, for the past 20 years we have been faced with HIV/AIDS, a deadly new infectious disease that continues to elude effective vaccines. HIV is now the primary cause of death in Africa and the fourth worldwide. More than 15,000 new HIV infections occur every day, most in developing countries, and over 34 million people now live with HIV or AIDS--including over 13 million children orphaned by fatally infected parents.

One might think that more than a decade's search for an AIDS vaccine would end with success. In Shots in the Dark, however, journalist Jon Cohen brilliantly describes the inextricable weave of science, politics, legalities, ethics and business that, like a dysfunctional family, seems to have repelled the very cooperation that a successful vaccine effort needs most. The biology of the HIV virus--numerous strains, rapid rates of mutation and replication, and its habit of attacking and exploiting the very cells that are designed to fend off infection--hinders the development of an effective vaccine. As the story unwinds, though, Cohen makes it clear that science presents fewer obstacles than other forces.

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