LEST WE FORGET: THE 1980s AIDS CRISIS AND RANDY SHILTS’S AND THE BAND PLAYED ON

‘Lest We Forget’ is a phrase from Rudyard Kipling’s poem “Recessional” (1897) habitually quoted in war remembrance events. May 8 2020 was the 75th anniversary of the Nazi rendition but World War II is not the war I have in mind today. Contradicting my own injunctions to only read positive, ideally utopian books, I have spent many hours this past two weeks reading one of the most impressive American non-fiction works: Randy Shilts’s And the Band Played On (1987). This is a terrific account of the early phase of the AIDS plague, covering from the first cases until the public announcement in 1985 that star actor Rock Hudson was a victim of the disease. Shilts, an investigative journalist employed by the San Francisco Chronicle and a variety of Californian TV networks, wrote the book with passion and anger. A gay man himself, he waited to take the HIV test until the massive volume was published, and died of AIDS-related complications in 1994.

Shilts was the author of The Mayor of Castro Street (1982), the biography of Harvey Milk which was one of the sources for Oscar-award winner documentary The Times of Harvey Milk (1984), directed by Rob Epstein. Gus Van Sant’s film Milk (2008) was based on Epstein’s documentary. A while ago I wrote a book chapter comparing documentary and film, and explaining the connections between homophobia and patriarchal masculinity (the Spanish version is available online here https://ddd.uab.cat/record/147464). The point I made was that Dan White, Milk’s fellow supervisor in the San Francisco Board of Supervisors (or town council), did not murder him and Mayor George Moscone simply because he was a homophobe but because he felt disempowered by Milk’s election. Harvey Milk was the first openly gay officer ever elected in the USA and when White, a classic patriarchal man, lost his position as supervisor because of his own ineptitude, he blamed both Milk and Moscone for his disempowerment. Moscone’s death was basically read as collateral damage, though, by an angry gay community that has since then honoured Milk as a martyr. His death in 1978 was the catalyst for the beginning of a time of enormously increased visibility for the San Francisco gay community, which knew how to channel their anger into positive activism.

Shilts’s And the Band Played On reads as a second act in the tragedy that Milk’s death was. As he narrates, the new happier period in the life of gay men lasted for just very few years until AIDS emerged. Shilts’s volume, based on hundreds of interviews that he himself carried out, has an immense cast of (real-life) characters, among which several are members of the Harvey Milk Club, a referent for gay activism in the Castro neighbourhood. What Shilts narrates is the story of how the gay community resisted in a suicidal way any measure that might curb down their newly found sexual freedom. Homophobia was much more intense in the 1980s than it is now and many gays feared being ostracized as lepers by the health safety measures dictated by mostly homophobic public officers. The disease, in short, spread far more than it should have if only many gay men had listened to doctors’ advice and refrained from engaging in dangerous sexual practices. Of course, as Shilts notes with bitterness, the advice came too late, when the virus had been probably circulating for years undetected (he dates the first case back to 1976).

I knew, more or less, of the efforts made by the gay communities of San Francisco and New York, mainly, to organize themselves and work on promoting not only safe sex but also the use of innovative treatment. The book is very critical of how irresponsible personal behaviour contributed to spreading HIV (though Shilts is very unfair to Gaetan Dugas, the Québécois Canadian flight attendant that was never really Patient One). This is an important lesson to apply to our Covid-19 crisis: disobeying health measures is lethal, and personal freedom should always be second to safety. Of course, the main difference between AIDS and Covid-19 is that the former was initially associated to gay men, which caused homophobia to increase even further, whereas Covid-19 is not associated to any specific human group. The lesson, anyway, is still valid. It must be noted that Shilts mentions several times how AIDS was never seen as a gay disease in France, where researchers at the Pasteur Institute first isolated HIV. They saw the disease as a sexually transmitted infection which affected both gays and heterosexuals, and which could also be transmitted through other contacts involving blood (transfusions, sharing needles for IV drug use, drawing nourishment through a placenta from an infected mother in the case of foetuses).

As a researcher, though in the Humanities, I worry very much about how scientists do research in critical situations like the onset of AIDS or of Covid-19. Shilts has two main arguments to develop about this. On the one hand, he demonstrates how President Reagan’s administration (1980-1988) did all it could to hinder research for its own homophobic reasons and because Reagan did not want to lose his most conservative voters in the 1984 re-election. Funding only started to materialise when it became evident that AIDS was never a gay-exclusive disease. On the other hand, Shilts exposes how academic squabbling wasted precious years. Academic authorities withdrew funding and shunned researchers working on AIDS for purely homophobic reasons. Yet what seems to me most intolerable is how the peer reviewing system slowed down progress and how certain scientific stars placed their personal careers before the care of AIDS sufferers. Shilts always defends the idea that Dr. Luc Montagnier of the Pasteur Institute and Françoise Barré-Sinoussi were the discoverers of HIV, siding with those who accused Dr. Robert Gallo of the National Institutes of Health of somehow having used the LAV French samples sent to him as the basis for his discovery of the HLVT-III virus (both LAV and HLVT-III were actually the same virus, later called HIV). Gallo was left out of the 2008 Nobel Prize award, which went to the French virologists.

There is a passage in And the Band Played On which, as a researcher, I found very scary. The French team isolated the virus in 1983, one year before Gallo. They did try to publish their research in the USA but, Shilts writes, “they were inexperienced at writing papers for American scientific journals. They did not present their data as well as American scientists. The Pasteur’s primary spokesman, Dr. Luc Montagnier, lacked the charisma and forcefulness of Gallo”. Peer reviewing, Shilts notes, was also used to prevent the French team from publishing, with prestige journals using reviewers connected with Gallo’s employer institution or others with a known animosity against Montagnier. That this kind of corruption could happen made me even more indignant than the shenanigans of the Reagan Government, for these were no surprise. Call me naïve but I should have thought that national or personal arrogance should play no role in science at times of crisis. Reading Shilts is not at all reassuring in that sense. I would expect personal irresponsibility and political interests to be the cause of many deaths, as we are seeing in the case of Covid-19, but the details of how some scientists misbehaved in the early 1980s in relation to AIDS are simply revolting.

Just this morning I received the Catalan bulletin for research, this time a monographic issue on Covid-19. As you may imagine, and I assume this is the same all over the world, the bulletin is pretty bombastic about the magnificent work of local researchers. I am sure that they are doing their best but what irks me is the nationalist angle at a time when this is the last thing we need. There are, at least, two news items about international matters publicizing the existence of the Covid-19 Clinical Research Coalition and the Coronavirus Research and Innovation Portal of the EU. More importantly, the bulletin includes a short piece defending the need for international open research, which highlights the Global Research on Coronavirus Disease (COVID-19) portal run by WHO, and other initiatives mainly referring to open access repositories, among them Elsevier’s Novel Coronavirus Information Center. I cannot say, though, whether publications available there, like The Lancet or Cell Press, have made their peer reviewing processes more agile. Shilts describes the overwhelming frustration of early AIDS researchers forced by indispensable journals such as the New England Journal of Medicine to wait a minimum of three months before publication (remember these were pre-internet times) and not to leak any information to the media under penalty of article withdrawal. The media, I must complain, should be giving us information about all this: how science is being run right now, and not just the endless lists of figures which in the end mean very little.

And the Band Plays On narrates in the last segment the process by which the first antibody tests were put on the market. This will ring familiar: the tests were not made available to all who needed them, they were not 100% reliable, and did not necessarily result in the isolation of infected patients. Like Covid-19, HIV can be carried asymptomatically (the virus, it was determined, may take years to attack the immune system) which is why testing is so important. In case anyone thinks that HIV is under control, think twice: 700000 persons died last year of this disease all over the world. The number of new infections has gone down in most countries (South Africa remains a hot spot) and the rate of survival is much higher, with HIV carriers keeping the disease in check for decades. It must be noted, though, that only two persons have been cured thanks to stem cell transplants “from donors with a genetic mutation present in less than one percent of Europeans that prevents HIV from taking hold” (https://www.sciencealert.com/hiv-cured-london-man-still-has-no-trace-of-infection-nearly-3-years-after-treatment). The second patient was pronounced healthy just last March. Note that here is no vaccine yet, after 35 years of quite dynamic research. 35 million people have died of AIDS since 1981. This week a series of clinical trials have started in different labs of different nations, which sounds promising; there is talk of a functional anti-Covid-19 vaccine for 2021. Apart from questions of funding (remember covidiot President Trump withdrew US funding from WHO?), researchers are now facing ethical dilemmas such as whether it is legitimate to infect healthy persons for the experiments (logically, you could not do that with HIV), because there is always a risk of death. One hundred vaccines are currently being developed (see https://www.bioworld.com/COVID19products#vac). Now, try not to think of the still missing vaccines for AIDS.

Shilts explains that US citizens were shocked into the realization that AIDS was there to stay when they saw images of Rock Hudson’s ravaged physique in his last public appearance (on a TV show with former co-star in many films, Doris Day). Hudson still denied he was suffering from AIDS but his death in October 1985 was used to instil into the nation a widespread fear of the new plague, for good and for bad reasons. We have not gone yet through a Rock Hudson moment, that is to say, we still lack an image so potent that we finally understand what Covid-19 is about. We are being fed images of happy survivors and of hard-working doctors and nurses, but I don’t think we really understand that this coronavirus is potentially lethal for all, hence the daily acts of disobedience.

The US media, Shilts complains, were guilty of misinforming his fellow citizens about the urgency and gravity of the AIDS crisis but he is himself an outstanding example of the best investigative journalism. Read his book, pay him homage, and hope that current journalists are also doing their best.

I publish a post once a week (follow @SaraMartinUAB). Comments are very welcome! Download the yearly volumes from: http://ddd.uab.cat/record/116328. My web: http://gent.uab.cat/saramartinalegre/

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