December 29, 2012 -- When I first heard about this documentary covering the early years of the AIDS epidemic, it sounded like it was covering the same ground as last year's fine documentary, “We Were There,” but this new documentary has a different focus. While “We Were There” was about the AIDS response primarily in San Francisco, “How to Survive a Plague” is about the response from Greenwich Village in New York and the remarkable efforts of the activist organization ACT UP.
This film begins in the sixth year of the AIDS epidemic in New York City. With no treatment options, hospitals refusing to admit the dying, indifference from the Kotch and Reagan administrations, the AIDS Coalition to Unleash Power (ACT UP) begins a campaign of civil disobedience to publicize the plight of the stricken in 1987.
At this point, there is no treatment for AIDS and the disease is near 100 percent fatal. Worldwide deaths from AIDS have reached 500,000. For those with the infection, they have nothing to lose and nothing to fear from the police, courts, or politicians. Their very lives are at stake. But others have taken up the cause as well, appalled by the lack of action, concern and compassion for those dead and dying from the disease.
Activist Peter Staley summed up the feeling of many at the time when he said he didn't think AIDS would be conquered for many years in the future and that he and most of the people he knew were going to die because of it. “It's like living in a war. All around me, friends are dropping dead. You are scared for your own life at the same time ... Everything I read said I had two years to live, at most.”
Bob Rafsky, media coordinator, is one of the many ACT UP activists in the film who would die of AIDS before effective treatments for the disease was found. There is footage of Rafsky at AIDS rallies from 1987 until his death at the age of 47 in 1993. There is a lot of footage of Rafsky with his former wife, Barbara Krolik, and his child. “I know this sounds ironic, considering it ended in divorce,” he said of his marriage, “but I think it's fair to say it's the only really successful love affair of my life.” His wife and daughter are seen at his funeral.
A surprising number of those early ACT UP activists, including Peter Staley did outlive the AIDS plague through their own efforts to improve AIDS research, get drug trials and approvals started earlier, and to improve treatment options. Perhaps the most impressive achievement of ACT UP and the related organization, TAG (Treatment Action Group) was to design better drug trials and to get those new trial protocols adopted. The film argues that activists designed clinical trials which are responsible, ethical and effective. This got AIDS drugs on the market in months, rather than years. It did not go smoothly, however, there were setbacks and in-fighting among the activists themselves, who did not agree on treatment and clinical trial options.
The big breakthrough came with the triple drug combination treatment in 1996, including protease inhibitors. Like a miracle, patients at death's door were brought back to life and health, in short order. It was a tremendous victory by activists and medical researchers. There is a grim reminder, however, that AIDS is still on the loose. According to the film, 2 million people die from AIDS every year because they cannot afford the drugs to fight it, four people every minute. Between 1987 and 1995 some 8 million people died from AIDS before an effective treatment was found.
The impressive thing about the ACT UP activists is that most of them did not have a medical background when they started out. Many of them were artists and others from non-technical fields, but they became medical experts because they had to. The film is a tribute to political activism and the power of people to change the world. This film rates an A.
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