Debates over strategies to combat HIV/AIDS in sub-Saharan Africa often focus on the technical, economic and political details. They address whether leaders have the political will to provide treatment, or whether a country's health care infrastructure can withstand the influx of patients seeking antiretroviral drugs. Too often lost in these debates, though, are questions over our ethical obligations. Van Niekerk and Kopelman's edited volume brings together scholars from the worlds of economics, demography, bioethics, law, public policy, philosophy and medicine to tackle these questions.

Admirably, the slender volume does not provide easy answers, nor does it present ethical questions in an either-or dichotomy. The authors examine what we know, what we do not know and how these questions affect how domestic and international actors should respond to these challenges. The first two chapters illustrate this approach nicely. Alan Whiteside lays out the extent of the AIDS epidemic in Africa, and what can be expected in the absence of treatment interventions. He also discusses the disease's potential economic and social effects. The following chapter, written by Whiteside in collaboration with Tony Barnett, Gavin George and Van Niekerk, then takes these data apart, investigating the problems associated with collecting reliable HIV/AIDS statistics in sub-Saharan Africa, and the assumptions currently built into data collection efforts. These ambiguities, combined with the long-time horizon over which the AIDS epidemic unfolds, they argue, have allowed political leaders to deny the extent of the problem. They not only appeal to the moral obligations of politicians to address this crisis, but also call on the data collectors to continually improve their methods. Subsequent chapters examine the international community's obligations to help provide a more equitable distribution of health care, justifying compulsory licensing of antiretroviral drugs on consequentialist grounds, and the role of traditional African values in fighting the epidemic, among other topics. Taken together, they offer the reader a wide-ranging examination of the myriad of ethical concerns that the HIV/AIDS epidemic in sub-Saharan Africa raises for both African and non-African political systems.

Most of the chapters included in the book have previously been published in journals, particularly the Journal of Medicine and Philosophy. At first glance, this may appear to detract from the volume's usefulness. However, by bringing these articles together in a single place, and presenting readers with one of the first volumes to explicitly consider the moral and ethical ramifications of the HIV/AIDS epidemic in sub-Saharan Africa, the editors drive home the importance of considering these questions and the need to continue to explore them. The academic diversity of the contributors also exposes the readers to a useful diversity of perspectives. This book raises important questions for all interested in AIDS and the international community, and is a welcome addition to the literature.