In an era where HIV/AIDS seems like a “manageable” disease in the Global North, the not-so-distant-past looks not only foreign, but downright scary. How To Survive a Plague is an important reminder of just how deadly HIV/AIDS has been, particularly to gay communities. Some things are left out of the film—such as US President Ronald Reagan’s refusal to even use the word “AIDS” until 1987, after 20,000 Americans had died—but other even more crucial embarrassments are included, such as homophobe Senator Jesse Helms’s outspoken condemnation of gays and indifference to their suffering. In the interest of scoring ideological points against “the homosexual agenda”, Helms and many others, including New York City mayor Ed Koch dismissed demands for governmental intervention into the AIDS crisis (Koch goes so far as to allege that AIDS activists are involved in fascism). Curiously, Koch’s own ambiguous sexual identity is not called into question.
Not only did the AIDS-inflicted gay community suffer the ultimate losses with the death of loved ones, friends, neighbors, and others, but also the post-death indignities of hospitals not acknowledging patients’ partners or funeral parlors refusing to take the bodies of those who died of AIDS-related causes. In the face of these seemingly unsurmountable odds, activists form a broad movement to address not only the homophobic indifference of politicians and inaction of policy, but also the practical health needs of the inflicted. Underground pharmaceutical networks are created, underground drug trials are run, resource and skill-sharing communities facilitate the care of AIDS patients, and other crucial activities occur that were necessary in the absence of the action from the American medical establishment.
Most importantly, gay rights and AIDS activists form the AIDS Coalition To Unleash Power (ACT-UP), which engages in direct action tactics to confront politicians, corporate executives, scientists, and other public officials over their inaction or slow response to the AIDS crisis. They protest at conferences, speaking engagements, and the headquarters of corporations and the Federal Drug Administration. Members educate themselves about AIDS, disease science, and how to conduct trial research. They create a glossary of AIDS-treatment terms that they distribute to people so the inflicted can be more informed about their disease. Non-gay supporters, including physicians like Dr. Barbara Starrett, join ACT-UP, some making it their life’s work to advocate for this cause. Chemists help ACT-UP get the skills to apply for grants and conduct research. At a large AIDS conference, ACT-UP introduces an sophisticated plan to design better AIDS studies to find drug cures.
How To Survive a Plague is also a wonderful case study in organizational politics. ACT-UP apparently had lots of video footage taken at its internal meetings, thus viewers can observe how “they arouse to anger” people to go out and challenge the powerful who have sidelined themselves during the AIDS crisis. Dramatic speeches are given, but also incredible, painful conflict is shown, as people not only struggle with the rapid loss of their own lives and fellow activists, but also struggle over power and the direction of the organization. Some come to believe a lack of progress was holding the organization back, others think that an internal elite had emerged, and still others differed in their opinions on which tactics to pursue. All the political strain and physical death wears down the organization—which eventually sees an organization (the Treatment Action Group, or TAG) splinter-off. Successive deaths occur each year, and while many of the activists interviewed during the 1980s and 1990s are still alive and interviewed in the current period, others die. The film provides a touching and tragic view of some of these men, while also retaining a macro-level focus, with each successive year of the crisis passes, a running clock of global AIDS deaths records the spreading devastation.
Some drugs are assumed to work early on and activists demand access to them. Other drags make people very sick (and are very expensive). Dozens of drugs fall into the “what the hell” category, where they are hoped to have some possible effect on the disease; desperate AIDS patients take these drugs, while activists push for more testing on them. Finally, years later, a three-drug cocktail is stumbled upon as a solution. People are, of course, very happy by this discovery, but it is still very expensive and people continue to die—even today. One of the few downsides of the How To Survive a Plague is clear here: the global AIDS death body count is the only nod towards the international nature of the crisis—today it is at epidemic levels in Africa where it is not confined to gay communities. The expensiveness of the current drug regime precludes the ability of poor Africans to treat their disease. Thus, the middle-class background and First World privilege of American gay men helped ACT-UP, but is not able to translate into victories for poorer folks elsewhere. All the same, the nature of the social treatment of the AIDS is very different than it likely would have been had it not have been for ACT-UP’s disruption of business-as-usual. There very likely would have been a far higher death-toll and much slower action from political and medical elites had it not have been for AIDS activism. That is itself something worth celebrating.
Topics: medical, sexuality, social movements