David France's acclaimed How to Survive a Plague has been streaming since mid-January on Netflix and other venues, giving those of us who haven't been in the neighborhood of a live screening a chance finally to see the film --- nominated this year for a "best documentary" Oscar.
The experience is illuminating --- and a little eerie. I keep catching the eye in crowds in near-seamless archival footage of Keith Haring (1958-1990), artist and social activist --- although not a major player in the film --- whose work I admire.
The great value of the film is its documentation of the supremely important place ACT UP (AIDS Coalition to Unleash Power) and its Treatment Action Group (TAG) had in the drive to contain --- so far prevention and cure have proved elusive --- HIV/AIDS.
First detected in 1981 --- a mere 30 years ago --- and perceived at first as a disease affecting expendable gay men, perhaps deserving the judgement of Christianity's petty little god of that time, neither the medical nor research community seemed in any hurry to deal with it.
ACT UP --- organized in New York City in 1987 --- changed all of that through a combination of activism, street theater, anarchy --- and hard science.
Faced with public hostility, apparent government indifference reflected in funding levels and the stately, but exceedingly slow, processes then in place at the Food and Drug Administration and Centers for Disease Control, ACT UP volunteers absorbed all there was to know about HIV/AIDS. They produced the first coherent treatment and research protocols for HIV/AIDS --- for the most part adopted later by both researchers and physicians --- and almost single-handedly forced a shift in research emphasis from the abstract to living (and dying) people.
All of this while focusing public attention on the disease and its victims in ways both polite and perceived by some as rude.
Finally, in 1996, with the introduction of protease inhibitors into antiretroviral combination therapies, it became possible to offer those afflicted with HIV/AIDS the potential of near-normal life spans and relatively good health, although drug therapies can have debilitating side effects and are not effective or have a limited span of effectiveness in some cases.
Larry Kramer --- an ACT UP organizer still alive, kicking and as irascible as ever --- maintains with a good deal of authority that today's therapeutic drugs and effective treatment and research protocols can be attributed directly to the organization he helped to found. He calls its work a shining example of how a community, once and in some cases still marginalized and despised, rose up and figured out for itself how to survive a plague.
This is not necessarily an easy film to watch, but it captures the essence of a decade of movement from death to hope better than anything else I've seen. It's even possible to laugh now and then --- at footage, for example, of activists wrapping Sen. Jesse Helms' Arlington, Virginia, home in a giant canvas condom as the old devil himself looks on, cradling his poodle. But humor is generally rare --- and dark.
The film also serves as a reminder of the perhaps 650,000 Americans who have died of AIDS and its complications, of the millions who have died in less-fortunate places, of the fact an estimated 1.1 million Americans currently are living with HIV/AIDS (roughly a fifth unaware because they haven't been tested) and many times that number in Africa, Asia and elsewhere, and that in the United States, an estimated 50,000 new cases of HIV infection occur annually.