David France: The AIDS Crisis Demanded We Become Human First

David France was holding a copy of the New York Times on July 4, 1981, when he read the headline that would define the next fifteen years of his life: a strange cancer detected in forty-one homosexual men. The journalist and filmmaker, who would later direct an Oscar-nominated documentary on the same subject, had just witnessed the opening sentence of a catastrophe that would reshape medicine, politics, and what it meant to be human in the face of indifference.

Between that first case and the arrival of effective antiretroviral drugs in 1996, roughly 600,000 Americans died of AIDS. The global toll reached forty million—double the deaths from the bubonic plague in fourteenth-century Europe. But those numbers, staggering as they are, obscure a darker truth: in the early years, families refused to visit their dying relatives in hospitals. Homosexual patients were turned away at the door. Death certificates listed other causes to spare families the stigma of what was called, even in Spain, the gay cancer. The real count was always worse than what anyone reported.

France's new memoir, "How to Survive a Plague," published this month in Spain by Capitán Swing, is a firsthand account of those years and the unlikely activists who forced the world to pay attention. He was there. He watched a small group of people from every profession imaginable form ACT UP, a movement that somehow convinced science and politics to mobilize against a virus that seemed unstoppable. When France began writing the book, nearly fifteen years after the first effective treatments arrived, the survivors had largely stopped talking about what happened. The trauma had been so complete that once there was hope, people simply turned away. They needed to breathe. They needed to forget, or try to.

But France felt obligated to collect these stories before they vanished entirely. The younger generations, he argues, know almost nothing of the scale of the suffering. They were born after the crisis peaked, after the worst was over. And that forgetting, he believes, is partly the fault of those who survived. "We didn't know how to pass our history to younger people," he said in an interview. "Everyone stopped talking about it when we got effective treatment in 1996. It was that simple. It was a consequence of our trauma." If the lessons are not embraced, he warns, the conditions for such a catastrophe to return remain in place.

What strikes France most, looking back, is that the first battle was not medical at all. It was moral. "The first challenge in fighting HIV was making homosexual people human," he said. "It sounds ridiculous to say now, but nobody cared that we were dying. And what was even more painful, our own families didn't care. They had completely embraced the prejudices against us and wouldn't even visit their relatives in the hospital." The gay community had been living in a parallel society—their own doctors, their own lawyers, their own neighborhoods, completely isolated from the rest of the world. The virus made that isolation unsustainable. It forced a reckoning. It demanded that people see them as people.

Out of that plague came unexpected progress. The fight for survival became a fight for recognition, which became a fight for marriage equality, for visibility in culture and politics and sport. Would these advances have come anyway? Perhaps. But they came through blood and collective action. The scientific breakthroughs—the drugs that transformed AIDS from a death sentence to a manageable condition—emerged from the pressure that activists applied while simultaneously learning virology themselves, forcing their way into laboratories and boardrooms, refusing to accept that nothing could be done.

Today, France watches with something between despair and defiance as the United States dismantles the very institutions that built this progress. Robert Kennedy Jr., now the secretary of health, has halted AIDS research funding at major universities and ended thirty years of policies that delivered HIV medications to the world, saving roughly fifty million lives in sub-Saharan Africa alone. The infrastructure for responding to infectious disease is crumbling. The anti-science sentiment that France sees spreading globally feels, to him, unprecedented in its depth and reach. Yet he finds himself returning to the same question that animates his book: if three or four thousand people, most of them without power or resources, could change the course of American policy through intelligence and persistence and collective will, why not now? The answer, he admits, he does not yet know. But the example remains. It is there to be learned from, if anyone is willing to look.