How To Survive A Plague

There are some things one never expects to be able to look back on as history. There are times when doing so reveals causes and consequences one could never have guessed at the time. On the surface a straightforward documentary account, How To Survive A Plague digs deep under the skin of its subject to develop a narrative that is bold, insightful and still emotionally raw.

Back in the early 1980s, gay men and intravenous drug users starting dropping dead in the prime of life, their immune systems mysteriously failing them. Soon it became apparent that other sections of the population were affected too, though this awareness took a while to grow, allowing plenty of time for the development of prejudice that still lingers today. Vitriol and violence were targeted at the weak. Yet at the time, in the gay community, these seemed minor compared to the sheer horror of losing so many people in an apparently random way. "It was like living in a war zone," one survivor recalls. "Friends were dying all around me."

From The Omega Man to Perfect Sense, cinema has built many stories around plagues, around human reactions to the threat of extermination. As is often the case, how people respond in real life exceeded expectations. This is the story of Act Up, the New York City pressure group that transformed society's approach to the disease. It follows artists who through sheer hard work transfomed themselves into epidemiologists and clinicians, running underground drug trials until they were able to win the attention and respect of big pharmaceutical companies. It follows bereaved partners and family members who took their fight first to the city streets, then to Congress, then to the White House itself. It is a heroic tale, but more effective because it also shows naivety, failures, splits, despondency, the heartbreak and the petty quarrels along the way. Overcoming these human difficulties, which will be familiar to anyone who has done activist work, proved as vital as the rest.

In keeping with the inspirational nature of its subject, this film takes an approach to science and politics that invites the viewer in, making complex stories accessible without ever becoming boring. It's a must watch for those in the medical professions but easy enough to follow even for complete beginners. Through this, a bigger picture develops. Act Up not only changed the way AIDS was understood and treated, but the way doctors and pharmaceutical companies interact with patients generally, opening up a once secretive culture. Furthermore, their actions had an enormous impact on the burgeoning LGBT rights movement. Formerly cowed minority groups became aware that they could have a political impact. Looking at this today, one cannot help but note what pollsters have said about the LGBT vote being a key factor in the re-election of President Obama, a turning point in history where the locus of power shifted from a dominant majority group to a collective of smaller ones. Although these issues are not addressed directly by the film, the changing landscape is made visible by judicious use of archive interview and press conference material, vox pops and clps of home video.

Of course, AIDS is still out there, and if the film ends on a note of triumph, looking at those original Act Up members who survived, this is undercut by an intertitle reminding us that where treatment is unaffordable, one person dies from AIDS-related causes every four minutes. It's a sobering note that helps to keep things in perspective. This is not just a piece of history, it's a how-to guide with lasting relevance. What it really has to celebrate is not what has been achieved but what can be achieved, what is possible if people work together. Its message extends to issues far beyond AIDS, and yet it is, in part, the story of how one virus has transformed the world as we know it.