Movie review: How to Survive a Plague

Published 02, Nov, 2012
Author // John McCullagh - Publisher emeritus

John McCullagh reviews the documentary movie that tells the story of how AIDS was turned from a death sentence into a chronic, manageable condition.

Movie review: How to Survive a Plague

As founder Brian Finch recently pointed out,  it’s difficult for anyone who didn’t live through the first decade of AIDS to truly grasp the horror of those dark times, when the gay community, so quickly following on the heady days of “gay liberation”, was decimated by HIV.  

But by remarkable good fortune, those early “plague years” also saw the emergence of the video camcorder. So it was that the mobilization of the gay community in the face of death was recorded for posterity by media-savvy activists. This footage has been distilled into a remarkable series of documentary movies that have appeared this year, most of which we’ve reviewed in these pages (see the Related Articles links at the foot of this page). 

One doc that we haven’t reviewed until now is How to Survive a Plague, which is opening in Toronto today at the Bell Lightbox, in Vancouver on November 7 and throughout the fall in other Canadian cities. It was released in the US on September 21. I was fortunate to catch a screening last spring at the Toronto Inside Out LGBT Film Festival.  

This documentary can be seen as a sequel to Larry Kramer’s play The Normal Heart, currently being reprised in Toronto, which dramatized the story of the first AIDS activists who struggled to understand what was happening to them and their community and who founded New York’s Gay Men’s Health Crisis, the world’s first AIDS service organization. 

How to Survive a Plague picks up the story in 1987, six years into the epidemic when half the gay men in New York’s Greenwich Village were HIV-positive. With no drugs to treat the disease, AIDS is nearly 100% fatal. These men decided that they were no longer going to be satisfied with asking politely for treatment options and patient rights and so founded the AIDS Coalition to Unleash Power (ACT UP). In this doc, we have an inside seat as we watch how these men and a few women responded to the cataclysmic crisis of AIDS before effective treatment became available. 

The story is told through the experiences of a few key participants, notable among them Peter Staley, a closeted Wall Street bond trader when he was infected with HIV in 1987 at the age of 26. Given two years to live, he joined ACT UP, became a full-time AIDS activist and campaigned for increased research spending. 

Staley is one of the lucky ones because, remarkably, he didn’t die (now 51, he was present at the Toronto LGBT film festival screening I attended). Sadly though, most of those featured in the doc didn’t survive. Notable among them was Bob Rafsky, a married man and father who came out later in life at the start of the epidemic. Like so many in that era, he fought to combat indifference from government and big pharma and active hostility from politicians and church leaders such as President Ronald Reagan, Senator Jesse Helms, Pat Buchanan and Cardinal O’Connor, the archbishop of New York. Even though he knew he was going to die, he fought to the bitter end so that others (including all of us who live with HIV today) could survive.  

There is some remarkable footage in the documentary. Not only do we have an inside peek at strategy discussions at ACT UP meetings and the usual rallies and demonstrations but we also witness activists dumping the ashes of their loved ones on the White House lawn, the disruption of a mass at St Patrick’s Cathedral, and, in a moment of good humour, the covering of the home of Jesse Helms with a giant condom. Perhaps most poignant of all, though, we see activists carrying the bodies of their loved ones to the reelection campaign headquarters of President George H.W. Bush and holding a funeral on the doorstep. 

Eventually the tension between those who advocated direct political action and those who wanted to sit down with big pharma to search for effective treatment produced a split among the activists. It resulted in Peter Staley leaving ACT UP and founding, in 1992, the Treatment Action Group (TAG). He was among the activists who self-educated themselves about virology, immunology, cellular biology and pharmacology. This knowledge eventually got them a seat at the research table. It was they who ensured that the mistakes of the early efforts at treatment, such as the enormously costly drug AZT, were not repeated. 

These efforts led directly to the discovery of protease inhibitors which, starting in 1996, changed the face of HIV from a death sentence into a chronic, manageable disease. And it was TAG that wrote the trial protocol that brought these effective drugs to the market. 

Back here in Canada, and specifically in Toronto, our own home grown activist group, AIDS Action Now! (AAN), followed in the footsteps of ACT UP. As veteran activist Tim McCaskell has written:

“While AAN! never developed civil disobedience to the high art ACT UP did in New York, we did disrupt question period in the provincial parliament. We chained ourselves to the furniture in the offices of the minister of health. We held massive die-ins at the Pride parade. We disrupted the NDP convention when Bob Rae was about to speak. And as a result, we won the Trillium Drug Program so that nobody in Ontario should have to get sick or die because they can’t afford medicine. Without ACT UP’s example, I doubt that any of that would have happened.”

How to Survive a Plague is the story of heroism and perseverance. All of us who are living with HIV today are the beneficiaries of the activists portrayed in this remarkable documentary. As Staley says: “...a brave group of people stood up and fought, and in some cases died, so that others might live and be free”. 

This is why activism is important and why this documentary movie is essential viewing for every gay man. 

How to Survive a Plague (U.S., 2012). Directed by David France. Released in Canada by Mongrel Media. 120 minutes.


About the Author

John McCullagh - Publisher emeritus

John McCullagh - Publisher emeritus

John McCullagh is the publisher of He's an HIV-positive gay man who’s been active in Toronto's LGBTQ community since immigrating to Canada from his native Britain in 1975. A social worker by profession, he's worked in government and the not-for-profit sector in both front-line and management positions. His experience includes research, policy analysis, strategic planning, program development, project management, and communications.  

In the early years of the AIDS epidemic, John was a counsellor at the Toronto Counselling Centre for Lesbians and Gays (now known as David Kelley Services), an organization he co-founded and which was one of the first agencies in Toronto to offer professional counselling to those infected with and affected by HIV. 

Now retired, John volunteers with the AIDS Committee of Toronto (ACT) and is a board member of CATIE, Canada’s national HIV and Hepatitis C knowledge broker.  

John regularly contributes articles to about his personal experiences of living with HIV and about issues relevant to Canada's HIV and LGBTQ communities.