How to Survive a Plague

There are three groups of players that orbit around one another in David France's documentary about the early years of the AIDS epidemic, How to Survive a Plague (the film mostly takes place between about 1987 and 1996).  There are the politicians, responsible for setting the policy for how the government is going to respond to the crisis.  There are the scientists, men and women both in the private sector, as well as at NIH and the FDA, doing the work to identify and bring to market some sort of cure.  And there are the activists of ACT UP (AIDS Coalition to Unleash Power), some of whom are HIV-positive (many, or even most, of the people France focuses on within ACT UP seem to be positive, although not all), agitators for changes both in policy and in how the scientists do their business.

The memorable characters in the film are, with one exception, entirely from the ACT UP side of the proceedings.  There is playwright Larry Kramer, who gives the film its title with an impassioned plea for unity from his fellow activists when everything seems to be spinning out of control within ACT UP.  There is Mark Harrington, the brains of the treatment activist group, who teaches himself (and his fellow activists) to speak to the scientists with an astonishing level of sophistication.  There is Garance Franke-Ruta, the young true believer with the dodgy taste in hats.  There is Peter Staley, the natural spokesperson, who faces down Pat Buchanan on Crossfire and gives a rousing speech to a packed house at the 1990 International AIDS Conference in San Francisco.  And there is Bob Rafsky, author of this famous campaign moment, whose fatalism about the short time he assumes he has left on Earth is matched in intensity by his drive to find a cure one way or another.

The one character who cuts a memorable figure within the film and is not a part of ACT UP is Senator Jesse Helms, shown in file footage, representing the fear and the bigotry of an entire group of Americans who had no interest in pushing for a cure to a disease that disproportionately affects gay men.  Most of the drama in How to Survive a Plague happens in scientific conferences and board meetings, as scientists and activists work, sometimes in tandem, sometimes at odds over logistics, but always towards a common goal.  But the specter of Helms always lingers over the film, the foot-dragging that he represents linked, explicitly and implicitly, to a body count that could have been lower but for people like him in positions of power (including the Archbishop of New York, John O'Connor, responsible for some truly backwards writing on contraception and AIDS prevention) having no real interest in AIDS prevention.

The problem here is that Helms himself is a minor figure in the broader AIDS drama.  His inflammatory speeches from the floor of the Senate provide good sound bites, but there is a pretty clear implication from the film that there was an institutional rot within both the American government and the scientific community when it came to confronting the AIDS epidemic (which is, presumably, why ACT UP came into existence in the first place), and it is never made terribly clear who the players really were, and how anti-gay bigotry helped foster an apathy towards finding a cure.  Ronald Reagan's name is invoked a couple of times, and George H.W. Bush is on the business end of at least one (quite unfair) potshot about him playing golf while people die, but the dots are just never connected between federal foot-dragging on the "gay plague" and what is going on at the FDA or the NIH, where treatments are either being tested too slowly, or else being neglected entirely.  When the scientists finally settle on the combination therapy (including the breakthrough of finding protease inhibitors that specifically inhibit HIV replication) that works to truly extend the lives of those who are HIV-positive in 1996, it is clearly a triumph for everyone involved, but because of the lack of clear dot-connecting between the work of the ACT UP activists and improvements in how the treatment and approval processes were carried out, it never coalesces on screen just what, exactly, ACT UP was responsible for, and what was just normal scientific progress.  France also makes the choice to hold the revelation of which of the film's characters have survived to the present day thanks to combination therapy, and which ones succumbed to the infection, until the end of the film.  It's a bittersweet moment to see the faces of the people from the archival footage, 20 years older, knowing that so many of the people in the film didn't survive to see their work come to fruition.  They are emotional revelations, no doubt, seeing people who were already HIV-positive in the late-80's still alive and in good health in 2013, but it has the unfortunate effect of robbing the film of the contemporary perspective of so many of the players in the drama.

There is an important and powerful story within the raw material from which How to Survive a Plague is constructed.  Oftentimes it comes through, and the collective force of the personalities involved forces you to take notice one way or another throughout much of the film.  But the narrative is too often muddled and unclear, and the story suffers for it.  B-