David France’s gut-wrenching new documentary “How to Survive a Plague” plunges viewers into the struggle of a group of mostly gay Americans to force the government and the medical profession to get serious about the AIDS crisis ravaging their community.
The story of AIDS is a global one — its sprawling canvas of suffering extends from the Castro District in San Francisco to Sub-Saharan Africa — but France’s film transports the audience back to a specific time and place: Greenwich Village in the 1980s and '90s at the height of the epidemic.
There, drawing on some 700 hours of archival footage, he focuses on a grass-roots activist group called ACT UP (AIDS Coalition to Unleash Power), whose members transformed themselves into science experts and clinicians to pressure a largely indifferent pharmaceutical industry to devote more resources to finding a cure.
“It was important to tell a true story about how individuals found the wherewithal to surmount the insurmountable,” France (pictured) told TheWrap. “It was really just a wonderful opportunity to look back at that period in history and see what lesson we could learn from it.”
And telling his story came with some unforeseen obstacles.
France said he found that persuading the families of AIDS victims and even survivors of the disease to reopen old wounds was a challenge.
“Fifteen or 16 years out from when these films were shot, many of the survivors who had witnessed these events had simply stopped sharing our stories,” said France, who lost his lover to AIDS in 1992. “It parallels what we know about survivors of the Holocaust who also have disdain for reviewing that chapter in their lives and who don’t want to revisit it.”
Ultimately, France said that nearly everyone he approached to share footage and memories from that time eventually relented, recognizing the importance of sharing their stories of survival and loss.
The decision of the activists to devote themselves to finding a wonder drug instead of just accepting what was, at the time, a death sentence forms the spine of this powerful documentary, which premieres in select cities on Friday and on video-on-demand the following week.
France benefited from a rich archive of footage both in private hands and at the New York Public Library. Fortuitously, France said he remembered people showing up to many of ACT UP’s meetings with cameras, which helped spur him to keep digging.
Eventually, he was able to find not just videos of raucous debates among the members and scenes of street protests but also intimate moments of AIDS patients having quiet birthday dinners, talking about the ever-present specter of their mortality and all too often succumbing to the disease itself.
Their youth — so many of the men were in their 20s when they were prematurely stricken, becoming hallowed out shadows of their once vibrant selves — is relentlessly chronicled and a shocking reminder of the disease's devastating toll.
“It was the first of the social justice movements that made its way onto video,” he said. “I was called to make this documentary by the footage itself.”
France felt that it was important to reassess ACT UP’s history, because the organization was better known for its work organizing colorful social demonstrations, such as putting a giant condom on homophobic Sen. Jesse Helms’ house than for its efforts to shake up the way the medical industry was approving and searching for new drug treatments.
“These are activists who invented the idea of citizen scientists,” France said. “Even though they had no science background, they became really effective partners with pharmaceutical researchers.
"That’s a little known story about what ACT UP was about, because at the time the headlines were dismissive and they were seen in the media as angry young people bereft from loss, but who were not constructive, which is not the truth.”
Through its research and collaboration with the government and pharmaceutical companies, France claims that ACT UP was successful in shaking up the organization of the National Institutes of Health so it could more nimbly respond to future epidemics, as well as dramatically reducing the time it takes for new drugs to go to market from 12 years to two.
Though death permeates France’s film, it ends on a note of triumph, with the years of advocacy giving way to a true medical breakthrough in the form of protease inhibitors. A testament to the efficacy of these drugs comes during a series of interviews at the end of the film with a number of the once youthful advocates, almost all of whom confess they did not believe they could outlive AIDS, now comfortably middle-aged.
The battle is not over, France notes. With 55,000 new cases of HIV infection reportedly annually in the United States, he believes that a younger generation has become dangerously complacent about the dangers of AIDS and is desperately in need of a history lesson.
“This story of how a community of people rose up and ultimately vanquished a virus hasn’t really been told to people under the age of 40,” France said. “When they hear about it hopefully they get a sense of responsibility to be vigilant and take precautions and not forget what these people did for us.”