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70 Million and Counting 

The clash of politics and morality in The Age of AIDS

Wednesday, May 24 2006
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The two-part Frontline documentary The Age of AIDS, a sobering TV history of one of the world’s most brutal pandemics, plays like a disturbing series of short tragedies linked by compassion, befuddlement and despair. And, of course, absurdities.

It’s an overwhelming saga, and a lot is covered in series producer Renata Simone’s four hours, including the growth of awareness as AIDS went from being a casually dismissed four-H concern — homosexuals, hemophiliacs, Haitians and heroin users — to a plague that affects everybody, as well as the prejudices that stirred gays to new heights of empowerment and activism, while fostering a crippling social stigma in an increasingly decimated black population.

With clear-eyed patience and seriousness, The Age of AIDS shows that while HIV needed no help in replicating itself inside humans, its most helpful friends were traits already well-lodged in humans: ignorance, apathy, fear and prejudice. Watching with 2006 hindsight, those initial emotionally fraught skirmishes in the early ’80s between well-meaning health experts in San Francisco and liberated gay men who wanted their bathhouses kept open seem historically quaint compared to today’s more dispiriting conflicts between moralizing forces and commonsense warriors. Take the anti-condom, pro-abstinence movement that has characterized President Bush’s grand-gesture money disbursement and often-sidelined prevention programs that were working in parts of the world that have seen the most dramatic rising numbers of new HIV cases. As former amFAR (Foundation for AIDS Research) president Merv Silverman says in the film, “Without question, politics has been one of the driving forces behind the spread of this disease.”

click to enlarge Sign of the times: AIDS ribbon at the opening of the World AIDS Conference in Durban, South Africa (Frontline/WGBH)
  • Sign of the times: AIDS ribbon at the opening of the World AIDS Conference in Durban, South Africa (Frontline/WGBH)

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The herky-jerky, valiant, then flawed efforts to counter AIDS and stop it from spreading since the first cases emerged 25 years ago are less a case of one step forward and two steps back, but rather a few steps forward and then — to note the number of new cases every year — five million steps back. A discouraging snarl of politics and morality, capitalism and Third World geography has stymied the global fight.

On the medical front, the documentary revisits the way scientists struggled to pinpoint the disease’s source, which ultimately led to the Congo and the determination that the 70 million that have been infected so far can be traced to one transmission between chimpanzee and man. Then there’s the race for a cure, which brought early hope that AZT and the eventual drug combos — the triple cocktail — would extend the lives of those with HIV. Says on-camera interviewee William Dodge, an early patient in the cocktail trials with an almost touching sense of his place in history, “There was the world of HIV prior to me, and the world of HIV from my time forward.” Part of that new world, though, was a whole new fight with pharmaceutical companies over the affordability of such vital treatment.

One of the strongest arguments the film makes is how much good can be done when all elements of a country’s infrastructure align to better people’s lives, when social desire and political desire see eye to eye and a financial commitment emerges, and likewise, what damage indifference and neglect can do. While close-mindedness was hampering an effective response from U.S. leaders, for example, Uganda took a bold, direct approach; its president, Yoweri Museveni, preached tolerance, easing fears about transmission, and distributed condoms. In Brazil, the government passed a law guaranteeing retroviral treatment for AIDS to all its citizens. It took Ronald Reagan seven years, meanwhile, just to mention AIDS for the first time in public. And, as the film explains, his first speech on the topic — at an amFAR event in 1987 — segued weirdly and discouragingly from a plea for understanding to a push for intolerance when he cited the disease as a reason to keep foreigners out of the country.

And if one needed any proof that before the WMD fiasco other administrations believed experts got in the way of policy, there’s a damning interview with speechwriter Landon Parvin, who says that when he started working with Reagan on his amFAR remarks, he realized that Reagan and Surgeon General C. Everett Koop had never had a single conversation about AIDS. Plus, Parvin was asked by an Oval Office staffer to remove a mention that one couldn’t get the disease from mosquitoes. Says Parvin, “It didn’t make much sense to have White House staff second-guessing a medical doctor, but it happened.”

Bill Clinton naturally comes off better — more knowledgeable and compassionate in his interview for the documentary — but the filmmakers don’t let him off the hook either, citing his refusal to back needle-exchange programs, a proven quasher of new HIV cases. “The country wasn’t ready for it,” Clinton says.

Arguably the saddest story of miseducation, though, is South Africa’s, where President Thabo Mbeke, under the sway of denialist scientists like UC Berkeley’s Peter Duesberg, questioned publicly whether HIV causes AIDS, leading to irreparable damage to the country’s efforts to get drug treatment to citizens. He banned AZT and triple cocktails, calling them “too toxic.” Perhaps the most wretched irony of all is that Mbeke was handpicked by Nelson Mandela, and Mandela’s son would eventually die of AIDS.

Obviously this isn’t the most upbeat of topics, even though the on-camera talking heads present a wide spectrum of thoughtful, intelligent and inspiring leaders, from progressive scientists like David Ho to grass-roots activists like Noerine Kaleeba, who founded Africa’s first AIDS support organization, to UNAIDS executive director Peter Piot, and even a glamour humanitarian like Bono. But Simone and her writer/director colleagues William Cran and Greg Barker know better than to equate celebrity charm with cheap positivism. And in the end, even after four hours of viewing, I found myself unable to forget a description in the first minutes of Part I from UCSF professor of clinical medicine Molly Cooke, who said of those early casualties at San Francisco General Hospital: “Patients would die of their own dementia the way 80-year-olds do — curl up in bed and die. And these were young men.”

FRONTLINE: THE AGE OF AIDS | PBS | Tuesday, 9 p.m.

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