Examining and explaining the history of HIV/AIDS vaccine research, from its beginning rounds on up through 2000, just after which the book was published, Cohen's work explores the individuals, the politics, the bureaucracy, the funding, the scientific processes involved in vaccine research, and even past vaccine developments--all in an effort to untangle the spiderweb of developments, and more often non-developments, that accounted for work toward a vaccine over the first few decades of the world's awareness of HIV/AIDS.

Throughout the book, what is frightening clear is how many different personalities and forces did as much to hinder the process as to help. From average slow-moving politics to individuals and companies who could see only their way of doing things and refused to accept options, and on to parties who were unwilling to accept that the traditional paths of research wouldn't work in the case of HIV/AIDS, research was more spastic and half-hazard than clearly directed toward a unified purpose. Cohen at one point describes the various efforts in terms of a child's soccer game, where a team's many members are gathered in an organized fashion, all flailing and kicking in the direction of the ball so that it eventually, more by chance than direct effort of a team, shoots out into some unpredicted direction...and very rarely hits the goal. Similarly, the description above isn't to say that many smart and dedicated individuals weren't directing their efforts toward the search for an AIDS vaccine--it is to say that many of them were working at cross-purposes, or at best, working on niche goals that weren't conceived or clearly understood in relation to other efforts.

Cohen's work is meticulously researched, and includes material not just from publicly available documentation, but from personal interviews, observations, and access to personalities and documents generally kept private by the research and/or government offices involved in the research and politics at the heart of this subject. His writing is clear and detailed, giving a careful view to the race for an HIV/AIDS vaccine.

On the whole, the book is hard to read not because of Cohen's writing or because of the subject---he's done an admirable job of making the material accessible and allowing readers into the world depicted here, both in terms of science and in terms of politics--but because it is all too clear that the bureaucracy of it all, and the fear of making a mistake, has far more to do with failure than success. In fact, reading Cohen's work and putting together the different pieces makes it seem rather a miracle that our society has ever managed vaccines or scientific developments that depended on more than the power of one individual. Simply, cooperation isn't in the vocabulary of too many people who were directly involved in the work discussed here, and as a result, it is a frustrating read.

All told, Cohen's work is an admirable one, depicting a maze of research and personalities which is difficult to accept, but utterly too real. I'd recommend the work to anyone interested in the processes involved in scientific research related to inter-agency or government cooperation and/or funding, or interested in the beginning years' progression of research which is still working toward establishing some level of dependable vaccine for HIV/AIDS. ( )