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The early 1980s were a scary time for gay men in the United States. I lived in Berkeley across the San Francisco Bay from one of the nation’s biggest gay communities. The news media was beginning to run more and more stories about a “new gay cancer.” Friends of mine who were both gay and male told me about a growing fear of some kind of disease that seemed to be spreading in the gay men’s community. The first obvious signs seemed to be a series of lesions that appeared on the afflicted individual’s body. This was accompanied by other illnesses that just would not go away no matter what medicines were tried. When I would be hanging out with these friends smoking weed, they would warn me not to smoke from the same bong or pipe. I didn’t know how serious to take their warnings. By 1985, four of my friends had died from the disease and at least six more were ill from it. By then, the disease was known as Auto Immunity Deficiency Syndrome (AIDS), which was a better name for it than its original name Gay Related Immune Deficiency, but there were still very few answers regarding its origins or treatment. Also, by 1985, the disease was appearing in other segments of the population, especially intravenous drug users.
Opportunistic right wing politicians and hateful preachers were calling the epidemic the work of a wrathful god, while most liberal politicians were just ignoring it. The Reagan White House—a den of both opportunistic rightwingers and hate—refused to acknowledge the epidemic at all. Given this neglect, most medical providers were neither capable of treating those with the disease or slowing its transmission. The only humans willing to go into this abyss of neglect were some medical practitioners who were treating hundreds of people with AIDS, some People with AIDS and some of their lovers and friends. Homophobia was still a very dominant social reality in 1980s United States and gays and lesbians were legally and openly discriminated against in every walk of life.
This is the world author David France describes in his new book How to Survive a Plague: The Inside Story of How Citizens and Science Tamed AIDS. This more than 500 page work is a tour de force of reporting. A gay man who wrote about the AIDS epidemic for the New York alternative journal The New York Native from the days of the public’s first knowledge of the disease, France provides a history of the grassroots struggle to find a treatment that would allow People With AIDS (PWA) a means to live. The narrative he creates describes an uphill battle against the aforementioned political and religious establishment, a medical establishment with its own issues of homophobia and a pharmaceutical industry whose concern for maximum profit overrode most humane motivations. He weaves a personal history into his broader detailed text describing the arc of both the epidemic and the efforts to find a treatment.
This means that personal tales of his friends with AIDS bring an emotional emphasis to his descriptions of medical discoveries, patient advocacy, and battles with corporate chiefs and doctors more or less in their pocket. There are also accounts of the weekly meetings of various AIDS activist organizations, most prominently those of New York City’s chapter of ACT UP. The internal politics of these meetings are part of the narrative, too. There are heroes and there are villains. However, in France’s telling, both come across as three dimensional humans who cannot help but be affected by the constant death around them. That in itself means the supposed villains commit heroic acts while the supposed heroes occasionally expose their venal side, too. The detailed reportage of some of the ACT UP protest actions are simultaneously humorous, instructive and heart-wrenching. The impatience, fear, humor and determination of the ACT UP activists is at once tragic, courageous and audacious. As a protest organizer myself, the protests and actions described in How to Survive a Plague reminded me of how much ACT UP added to the nature and possibilities of political protest.
The 1980s were fearful times. The right wing was resurgent and neoliberal capitalism was beginning it profit-driven march to rule the world at the expense of working people, the environment and common sense. This fact is also part of France’s narrative. He describes the fight to get pharmaceutical companies—specifically Wellcome Burroughs—to lower its prices on AZT, the primary AIDS drug at the time and the drug company’s resistance to doing so. If one was a gay man, the fear present in the 1980s was increased at least ten fold. As the decade wore on, that increase of fear would be felt in numerous other subcultural communities in the United States and on the African continent, where AIDS was ravaging the population. Still, the pharmaceutical industry was looking for profit maximization.
How to Survive a Plague ends on a somewhat positive note culminating in the development of an understanding of how the virus worked and the manufacture of drugs to fight it. Nowadays, HIV and AIDS remain commonplace but are no longer the death sentence they once were. This medical fact is largely due to the persistence, intelligence and organization of the individuals and groups whose story is chronicled in David France’s text.
This work is an excellent history. The author skillfully weaves intimately personal tales of men suffering with AIDS and their efforts to find a cure with a broader history of the crisis. In the telling, the reader discovers the homophobia and venality of much of the government, the medical profession, and most of the religious establishment. At once both a medical thriller and political history, How to Survive a Plague is an achievement without any parallel to date; it is important, essential and very well told.