More of a document about AIDS activists than AIDS itself, How to Survive a Plague jumps feet-first into 1987, when AIDS had been around for six years and was spreading in alarming rates, especially in the gay community. New York City was hit hard in the early days, making it a Ground Zero for the plague. Dismay and rage was boiling from the gay community who felt that nothing was being done. People were angry and justifiably freaked out by this disease that had pretty much a 100% fatality rate. Hospitals were overflowing, bodies were put into black trash bags, and funeral homes were refusing the remains of victims. All the while, the government remained tight-lipped about the growing disaster. The community decided to make some noise and demands—and from this anger, the AIDS Coalition to Unleash Power (ACT UP) was born.
Told almost entirely through archival footage of heated crowded community meetings, gatherings in people's homes, and first-person views of protests, How to Survive a Plague feels intimate and urgent. It's impressive that there is so much original footage. Because most of the voice-over is taken from period interviews, you are left biting your lip, anxiously watching the health of some of the prime players in the movement. Bob Rafsky, who gained notoriety for yelling at Presidential candidate Bill Clinton on his campaign tour, is a healthy 40-something man at the beginning of the film. But as the years progress, and ACT UP hits roadblock after roadblock (from drug companies to government policy to infighting), you can see the stress wear on the members; and worse, the disease decimates the ranks of the group, including Rafsky. It is devastating.
Since 1996, when a mix or "cocktail" of drugs was found to actually work to inhibit the disease, AIDS no longer feels like a death sentence (at least in the Western world where people have access to such drugs). It is a shocking and jarring reminder to see the images in this film of those suffering and dying—mostly young, mostly men reduced to skeletal shells of their former selves, with lesions and no longer able to see. Ray Navarro, a cheeky performance artist who shows up dressed as Jesus in early protests, appears later in a wheelchair, smiling weakly at the camera, unable to see that they had started filming. Another heartbreaking scene shows protestors breaking through police barricades to toss the ashes of their dead loved ones through the iron fence onto the White House lawn.
It would all be almost unbearable to watch if you didn't know that there was a light at the end of the tunnel—if not for those in the movie, but for those who came after. For many, the drug breakthrough simply arrived too late.
The final minutes of the film offer a heartening and sobering, "What ever happened to...?" update. "Like any war, you wonder why you came home..." says one survivor. These activists fought loud and hard, bringing much needed attention and urgency to a disease that politicians were choosing to ignore. You could only wonder how many could have been saved if "the powers that be" had paid attention earlier.