In 1983, during the early days of the AIDS epidemic, I was heartbroken to watch a Providence police officer bring his daughter, who was dying of the disease, to the hospital. Fifteen years later I spent several days treating patients at a clinic in Chennai (Madras), India, to which a number of older parents brought their adult children who were sick with HIV-related diseases. These encounters were on my mind as I watched Rory Kennedy’s five-part documentary Pandemic: Facing AIDS, which premiers on HBO June 15. In all the talk about the number of people in the world infected with HIV (the latest estimate is 40 million), it is easy to forget that each case represents an individual family saga, and that those dramas are always playing out somewhere on the planet (every ten seconds someone dies of an HIV-related illness).
In this film, which is narrated by Elton John, Kennedy brilliantly depicts the impact of the epidemic on individual patients, their families, and communities in five countries—Thailand, Uganda, India, Russia, and Brazil—while documenting the reasons for the syndrome’s aggressive spread. The film, for example, follows the attempts of a former Thai sex worker, who is slowly dying, to reconcile with her parents; they fear the shame she will bring to their village. In southern India a young married couple, both HIV-infected, pay an enormous economic cost to bring their baby into the world uninfected. In Russia a woman cares for her three-year-old grandson, whose parents, both HIV-infected, are former intravenous drug users and victims of the chaos that followed the breakup of the Soviet Union. In one of the movie’s most poignant scenes, a choir of Ugandan AIDS orphans weeps while singing about the epidemic’s destruction of their community.
A story from Brazil, however, provides hope. There Kennedy follows an HIV-infected gay man who begins antiretroviral therapy provided free by the government. In fact, about a quarter of Brazil’s health budget is spent on antiretroviral therapy, and the country has made great strides in decreasing the number of new cases over the past few years. While refusing to gloss over the seriousness of the patient’s condition—including the many side effects of the multiple medications he must take daily—the film shows a developing-world society successfully addressing the challenges posed by this epidemic.
Pandemic is the cornerstone of a public-awareness campaign (pandemicfacingaids.org) Kennedy is codirecting. The multimedia project includes a book of essays by such public figures as Kofi Annan and Nadine Gordimer; a musical compilation of works by Philip Glass, Lou Reed, and Ravi Shankar; and a traveling exhibition of photographs by Robert Mapplethorpe, Cindy Sherman, and others (the show is at the Corcoran Gallery in Washington, D.C., through June 10; it will come to Brown in the spring of 2004).
The battle to stop the AIDS pandemic still faces many difficult obstacles beyond the scope of Pandemic: how to empower women in order to decrease the virus’s spread, for example, how to solve the global inequities that limit access to lifesaving medications, and how to overcome the prejudices that limit the development of effective education and prevention programs. More than 20 million people have died, and by the end of this decade more than 100 million will likely be living with HIV. The rate of death and destruction will continue to escalate.
The irony is that we have medications that can slow the spread of HIV and allow infected people to live productive, and often healthy, lives. With generic drugs, medication can cost as little as one dollar a day, but fights over international intellectual property have slowed the use of these medications in the countries that need them most. There is hope, though. Foundation support; the establishment of the Global Fund to Fight AIDS, Tuberculosis, and Malaria; and such programs as President Bush’s proposed $15 billion, five-year commitment to combat AIDS all should help to attenuate the pandemic’s spread.
The great value of Pandemic will be in raising public awareness by putting human faces on this global crisis. This passionate and creative tour de force takes viewers beyond the numbers and and carries them closer to understanding.
Kenneth Mayer is director of Brown’s AIDS program and a professor of medicine and community health. He is the author of The Emergence of AIDS: The Impact on Immunology, Microbiology, and Public Health.