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Where and Who and WHEN?

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I was infected with HIV around 3 a.m. on 21 August 2005. In the village quaintly known as Iowa City. And by a guy named "Matt" (more about him in a bit). I know these three things beyond a degree of reasonable doubt. Am I lucky, am I glad, to be in possession of this knowledge--the when, the who, the where--or unlucky, unhappy, to have it?

 

Neither, I think: I don't feel lucky or unlucky, sad or glad. It's a complicated and touchy subject. It's not a theoretical matter of epistemological apathy. Nor is it some casual triple-shrug of practical indifference. But many friends and acquaintances simply will not not not believe me when I say that, on balance, I could live pretty easily without this knowledge. What can I say to counter their doubt? Make some kind of all-vanquishing aphoristic retort? So... "Ignorance may not always be Bliss, but Knowledge is not always Power either." More loud cries of disbelief--and derision! I don't think I'm going to win this one.

 

Even so...I've never quite understood the obsession some HIV-positive gay men have with identifying, with some precision, When they were infected. I mean, it's a natural desire to have, of course I get that, the desire to know how long you've had this bug inside you--but is it worth agonizing over? And over and over? And then, after a while, all over again? Pop psychology: well, it's a defense mechanism, it helps block the awful feelings of the present, especially if you've just been diagnosed. The hope is that, once other ways of coping have been found, the severity of this yearning will pass if not the actual desire itself.

 

Impossible not to look backward; but let's try to look forward as much as possible, yeah? You have your test results--and no, you cannot do a simple extrapolation from the current CD4 count and viral load to determine length of infection--and let those be the guides from now on. And no, don't go hunting around for "detuned assays," whatever you may have read on the Internet. Even if you find a commercial lab that can and will perform one (very unlikely), it's not going to tell you much, trust me. All that, in brief--lots of italicized words, trying to mingle an emphatic tone with empathy--is what I've found myself telling many men over many years.

 

And, to make the obvious point, this obsession--let it be a brief one!--underscores, in one strong way, the need to be tested annually. For HIV and other STIs if you're a sexually active man or woman. Take A. and B. and C. Three intelligent and highly-educated and successful and good-looking men, from three different countries I should mention--none of them had had an HIV test for at least three years before testing positive. A. simply didn't think he was at risk, the sex he had was so "tame and negotiated." B. acknowledged high-risk behaviors but was terrified of a laboratory Day of  Reckoning. And C. was bafflingly clueless, for whatever reason, about the importance of annual testing--his longtime GP had after all never said any thing.

 

Crudely: complacency, fear, and lack of knowledge. A. and B. and C. took quite a while to reach even the first "pillar" of the treatment cascade: diagnosis. B. half-expected his test results, but A. and C. were stunned. B. is again the exception: he was curious, more than curious, about the method of transmission rather than the exact time of infection and seroconversion, though he urgently wanted to know if infection-length dictated the nature and speediness of treatment. A. became briefly obsessed with the When question. With C. I feared that the relentless pursuit of an answer had risen to clinical OCD levels (and after much gentle-strong nudging, he did go into cognitive-behavioral therapy for a few months).

 

More about these, and related, matters in my next.


JV 

An ART Start. Some Numbers. Choices.

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Today I took my first antiretroviral pill. Yep, just one pill--Stribild. With lunch: a cheese and mayo and tomato sandwich washed down with grape juice (no, not wine). Yum. A bit nervous, yes; but every time I look at the people in the ads for Stribild--in their blue overcoats, complete with epaulettes and bright yellow collars and cuffs and plackets--I have to laugh.

 

For those with a biblical bent, look up these verses: Jeremiah 8:22 and Hosea 6:8.

 

It seemed like the right time to begin. I chose to swallow. I could have, ahem, chosen to spit--by which I mean, bad wordplay notwithstanding, I could have made a decision to delay treatment.

 

The rest of this post is pretty nerdy in parts--it has lots of Numbers and Acronyms. Future posts, I hope, will not have more than a just concentration of jargon. But Numbers and Acronyms and watered-down Medicalese are part of my HIV life and cannot wholly be avoided.

 

The decision to start ART, antiretroviral therapy, wasn't taken lightly and I suppose it never should be. Some general points, probably known to most readers. If CD4 numbers are low-ish or low (below 500 cells/mm3 or 350, depending on where you live--and even who you ask, even in 2015), a certain measure of choice is taken away from you: you will be strongly urged to start ART. Even "bullied" (!) to do so by your healthcare provider, if he or she is a JustDoItDammit type of person. There is a now a worldwide near-consensus that if CD4 counts fall below 500, treatment is strongly indicated. In "resource-rich" countries any way.

 

What's more, the current United States DHHS guidelines recommend that everyone who is HIV+ should be receiving ART. (There are complex scientific and epidemiological and public-health matters behind this blanket recommendation, none of which needs to be addressed right now.)

 

And I live in the U. S. of A.

 

Some biographical, and numerical, facts.

 

(1) I was infected on 21 August 2005, around 3 a.m., in Iowa City.

 

(2) Over the last ten years my "numbers" have been remarkably good. My mean and median absolute CD4 counts are still, as of March 2015, around 750.

 

(3) My CD4%--a number that is generally more stable over a period of time, given that absolute CD4 counts can fluctuate quite a bit, even within the course of a single day--has been rock solid for most of the previous decade, 37%. So: in early 2007, my CD4 count was 550 or so (the lowest it's been); in mid-2011, it was 1,050 (the highest it's been). But despite these fluctuations, within the normal range, the CD4% was identical: yes, 37%.

 

(4) My viral load, until recently, has remained well under 1,000 copies per m/L for eight years. For most of those years it has been close to undetectable.

 

(5) Though the definitions of "LTNP" ("Long-Term Nonprogressor") and "Viremic Controller" differ somewhat among scientific studies, I have satisfied the conditions for both appellations. I was enrolled in one of Dr. Bruce Walker's studies at the Ragon Institute, in Cambridge, MA, for a long time. I was almost enrolled in an NIAID study at the NIH--but the bureaucratic hassles proved to be exasperatingly insuperable.

 

(6) All my other "numbers"--CBC, Chem Panel, eGFR, BMI and so on--are fine, although even a skinny guy like me has to watch his cholesterol (too much Cookies-and-Cream ice-cream?). No STIs, no Hepatitis C. Boringly normal. Even inflammatory markers (more about these, and the ongoing research about the role and consequences of inflammation in general, in a subsequent post) are normal. Measured twice, with a five-year interval between the tests. Specifically: CRP, D-Dimer, IL-6.

 

(7) A "virtual phenotype" was conducted in 2009. I had no resistance whatsoever to any of the ARVs then available--"maximal responses" that is. (Janssen Diagnostics, by the way, no longer offers this test.)

 

(I know, I know: when will he get to the juicy parts, about fucking and breakups and all the narrative stuff? Soon, soon!)

 

(8) I have been blessed with excellent nurse-practitioners and doctors in Iowa City, Boston, and now New York. Each respected (and respects) my intelligence and knowledge and none was (or is) of the JustDoItDammit type. Shudder. I would not be able to accept medical advice--or dicta--from such a person.

 

(9) I take antidepressant medications. (My first depressive episode was at the age of 10.) The "cocktail" of these meds--and we speak also of HIV or AIDS "cocktails"--has been adjusted, tweaked, gradually or radically, over the last 20 years.

 

(10) I met a man in 2008 with whom I was involved (as they say) for almost a year. He was and is HIV negative. In 2010 I met a man who I married in 2011; we got divorced in 2014. He, too, was and is HIV negative. Five years, let's say, of monogamous serodiscordant relationships in the past decade. I am 42-years-old.

 

But I have now slightly exceeded my 800-word blog post limit.

 

PS: Pretty much all that I have recounted here is Good Stuff. Looking over my lab reports, a friend once asked me--it was a bemused accusation--whether I was this obsessed with being in the 99th percentile. The natural question then: why did I choose to start ART now?

 

PPS: Think of this post, perhaps, as the "setting" of a multi-part porn series: the meaty matter (such as it is) comes after the first installment.

 

PPPS: In the comments, assuming there are any comments, I'll be happy to respond to some of the technical matters mentioned here or ask someone to do so on my behalf.

 

JV

The Lunaris Caeruleus Caseus Journal: 3

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This is the third of seven sections.

 

I realize that I could have condensed and disposed, as it were, all of this blue-cheese-moon stuff with a simple 300-word, half-hour-effort, blog post: Truth wins out! Jefferys is vindicated! Farber the Loser loses! Beefy quotes from court transcripts and interviews, links to sources -- and be done with it. But the case, though obscure in one way, is also an important one, and raises some fundamental indeed foundational concerns. Keeping that in mind, I wanted to make what I think are a couple of pertinent connections, and also to put some narrative flesh on the bare bony facts of the case and its two (welcome) verdicts.  

 

First things first: there's the matter of scope and detail. I'm not a lawyer but I can muddle my way through some legalese if need be. That having been said, I'm hardly well-versed in New York State's legal structure, or the composition and hierarchy of its courts, or the specific procedures to be followed in a libel case such as this one, or the appointment and terms (not to mention the individual temperaments and reputations) of judges and justices. But over the last few days I've learned, even if only at a superficial level, something about all those matters -- because they matter to the case at hand, and mattered (and might still matter), anxiously and painfully one would imagine, for Richard Jefferys.

 

If I've inflicted pain upon myself (I haven't) and also on those of you still reading (I hope I haven't) by doing some high-speed research and writing; if I have, adventitiously perhaps, invoked Snyder v. Phelps and battles over the teaching of evolution; and if I've summarized the legal process at greater length than strictly necessary ... Well, let's do some vicarious and metaphorical shoe-swapping: imagine what Jefferys must have endured for nearly four years: these words, and the time, are a trickle merely and a blink of an eye in comparison. (One could argue then, yes I know: why not write 10,000 or 100,000 words etc -- but let's not go there, to that place of particularly tedious tediousness.) Imagine the shock and pain, the steep learning curve, the quotidian hassles, the nagging doubt (however small) that it ain't over till it's over. His long-awaited victory, and its implications, deserve better than simply the "summary judgment" of relief. They deserve, rather, the light of being thrown into stark relief, and more commemoration -- some day by someone better than the present writer.

 

Second, the question of censorship. It's important to remember that no one was censoring, and no is planning to censor, Celia Farber. Plaintiffs, when they sue because of their loony, and mortally -- sub-lunarily -- dangerous beliefs, can spin the narrative, as politicians do -- "I'm suing only because they're bullies and they're trying to shut me up! I'm David and they, the mean and spiteful boys who want to control everything, are Goliath!" The retort, as Bart Simpson might put it: "Au contraire, mon frère!" Nothing of the sort. Farber's suit, in fact, was an intimidatory tactic: don't you, or anybody else, call me out or I'll sue your underpaid ass. There's a grimly delightful acronym for this sort of legal shenanigan: SLAPP: Strategic Lawsuits Against Public Participation. It is SLAPP-filers who intend to silence critics, and it is SLAPP-happy people and corporations (also people now, legally speaking, of course) who are the ones that, directly and indirectly, promote a kind of censorship. In recognition of the harm that these lawsuits do to civil society and public discourse, 28 states, including New York, have some form of "statutory protection" against being SLAPPed around (though the wording of the statutes, and the scope of protection offered, varies widely).

 

From Wikipedia (though there are dozens of other sites on the subject needless to say, some highly technical, some with a great many examples, some with advice on how to proceed if you've been SLAPPed), a good opening and explanation: "A strategic lawsuit against public participation (SLAPP) is a lawsuit that is intended to censor, intimidate, and silence critics by burdening them with the cost of a legal defense until they abandon their criticism or opposition." And, with emphasis added for the next sentence: "The typical SLAPP plaintiff does not normally expect to win the lawsuit. The plaintiff's goals are accomplished if the defendant succumbs to fear, intimidation, mounting legal costs or simple exhaustion and abandons the criticism. A SLAPP may also intimidate others from participating in the debate...The difficulty is that plaintiffs do not present themselves to the Court admitting that their intent is to censor, intimidate or silence their critics."

 

Next on: Celia Farber can go on spewing her lies for all eternity; she has that right. But does she, or should she?

The Lunaris Caeruleus Caseus Journal: 2

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This is the second of seven sections.

 

The irony of it: someone tells the truth about someone who lies, and then the liar accuses the truth-teller, the actual whistleblower in a sense, of being a liar. This is an oversimplification of course. Defamation, libel, lying, slander -- there are subtle but important linguistic, and legal, distinctions to be made with these words. There are also the matters of bias, intent, irresponsibility, malice, and negligence Additionally, Celia Farber sued not only Richard Jefferys but also two somewhat controversial figures once associated with Emory University: Kevin D. Kuritzky (sometimes misspelled "Kuritsky"), an expelled medical student, and James J. Murtaugh, M.D. The legal matters that I've mentioned pertain to Richard Jefferys alone. Welcome to the wonderfully wacky world of nuisance suits -- certainly not Hedi Slimane for Dior Homme, sorry but I needed to be at least momentarily frivolous -- and the tortuously complicated torts of slander et cetera. 

 

Farber didn't actually file suit until May 2009 -- what's a year between soon-to-be legal disputants? -- but after that the judicial machinery started operating, slowly and tediously at times, but seriously too. (Jefferys was ably represented, pro bono, by the attorney Joseph Evall.) Motion to dismiss, opposition to the motion to dismiss, conversion of motion to summary judgment... Well. Finally, on 2 November 2011, Justice Louis B. York of the New York State Supreme Court (New York County) pronounced:  "Now, after careful consideration, the Court grants the motion and dismisses the action as it applies to Jefferys." In other words, Celia Farber didn't have grounds to file a defamation suit in the first place, and certainly couldn't claim that she was owed legal remedy.

 

The end? Not so, because Farber appealed. And it was only last week, on 19 February 2013 -- nearly five years after the (truthful) "liars and frauds" remark, nearly four years after Farber sued, and more than 15 months after the first decision -- that a five-member (appellate) panel of the State Supreme Court unanimously agreed with Justice York. They dismissed the complaint (made by Farber) and affirmed "with costs." ("Costs" here means filing and copying and other fees associated with the bureaucratic aspect of a lawsuit, not "damages" awarded, and also not Joe Evall's fees -- which anyway were zero since he was representing Jefferys pro bono. In other words, Farber, the loser, has to pay, and nothing comes out of Jefferys's pocket.)

 

The end? One would certainly hope so. Technically, however, Celia Farber could drag this on -- and on -- further, if she and her legal team want to. The name notwithstanding, the Supreme Court, in New York, is not the highest court in the state: it's a "trial-level" court. The Appellate Division of the Supreme Court is, in practice, an intermediate appeals court; and its First Department (there are four in total), with 19 justices, has jurisdiction over Manhattan and the Bronx. The highest court in New York State is the Court of Appeals: one chief judge, seven associate judges. (Yes, the nomenclatural stuff is confusing, as is almost everything about the vagaries of legal terminology.)

 

Farber has the theoretical possibility of appealing again: that's the bad news. She could ask that all 19 justices of the Appellate Division's First Department consider her complaint (in legalese: en banc). Or, she could take her case to the Court of Appeals; or both. However: the good news is that en banc hearings are granted pretty rarely (I don't have New York's precise statistics at hand) and also that the Court of Appeals agrees to listen to less than 5% of the cases that are presented for petition. As that Court's website has it: "New York's highest appellate court was established to articulate statewide principles of law in the context of deciding particular lawsuits. The Court thus generally focuses on broad issues of law as distinguished from individual factual disputes."

 

The facts are not in dispute here as, first, Justice York, and then (in order of seniority) Justices Tom, Moskovitz, Richter, Manzanet-Daniels, and Clark, found, citing copious case law; a broad issue of law -- who can fairly be called a liar? in what context? what is defamation-in-general? what are the binding precedents? -- is not, it would seem, at stake. So: Jefferys is home safe (let's hope and trust) and Farber has lost and is free to lick her wounds as publicly as she wishes -- apparently, she is a good friend of the New York Post's former Page Six editor, Richard Johnson.

 

The Lunaris Caeruleus Caseus Journal: 1

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This is the first of seven sections.

 

If I believe that the moon is literally made out of blue cheese -- it's rather a pleasant thought, actually -- then not only am I free to believe that, but also to talk about it and write about it. And wear a t-shirt that says "THE MOON IS MADE OUT OF BLUE CHEESE." As long as I am not a public nuisance or a danger to myself or others, I have the right, guaranteed by the First Amendment, to express freely my, erm, eccentric views. And that freedom extends to my publishing articles about my beliefs in learned periodicals such as The Lunaris Caeruleus Caseus Journal.

 

But you knew that already. Matters become iffier when personal beliefs impinge, or have a significant impact, upon the lives of others; and that's when lawyers and legislatures enter the picture. Creationists can build and have built a museum in which Adam and Eve are shown cavorting with dinosaurs. (In Petersburg, Kentucky; general admission tickets for adults priced at $29.95.) The Westboro Baptist Church can and does picket military funerals with signs saying "GOD HATES FAGS." (The Supreme Court reaffirmed this right in Synder v. Phelps, 2 March 2011, by a vote of 8-1.) And AIDS-denialists -- people who deny the existence of HIV and ergo AIDS altogether, or those who deny any causal connection between HIV and AIDS -- can and do promote their views in print, in visual media, and on the Internet.

 

But then I'm free, am I not, to fight for evolution to be taught as scientific truth in schools, and not as just one among many equally valid points of view? I am free, also, to agree with the Southern Poverty Law Center when it calls the Westboro Baptist Church a hate group, correct? Yes and yes. And, with the weight of overwhelming scientific evidence on my side which says that X is wrong, along with the exposure that X manipulated data, misquoted and misrepresented the words of others, and aired outright fabrications as the truth -- I have the right, surely, to call X, who is a liar, a "liar," yes? Apparently not -- X can then sue me for libel.

 

Celia Farber is a prominent AIDS-denialist. (There are several other "prominent" ones who could be named -- but why list them here? Or their websites? The recitation of their names and web-caverns would only serve to conjure up a stench of fecal fermentation. Cheap scatological insult? Yes.) The ethics of whether or not a highly-regarded magazine or peer-reviewed journal should publish the work of dangerous quacks is admittedly a difficult one. The journalistic duty not to censor unpopular views is at least an argument worthy of consideration; the ritual genuflection about providing "balance" is mere sophistry -- let the blue-cheese-moon believers have an Op-Ed platform in The New York Times then. At any rate: I was amazed to learn, while looking a few things up for this post, that the enormously prestigious journal, Science, had published a letter in 1995, signed by a dozen "We object" skeptics, including Farber, who represented the "Group for the Scientific Reappraisal of the HIV/AIDS Hypothesis." I knew about the long article Farber wrote for Harper's in 2006 -- a piece so full of holes, so replete with factual errors and logical fallacies, that it could, and was, torn apart by a single tug.  

 

Richard Jefferys works at the Treatment Action Group (TAG) as Coordinator for the "Basic Science, Vaccines, and Prevention Project." He's been involved in the HIV/AIDS research and activism field or fields since at least 1993. On 25 April 2008, Jefferys read an article in the New York Post about a certain Semmelweis Society -- a group which assists those in the healthcare professions who have had their licenses revoked or been otherwise censured or impugned because they have, putatively, been "falsely accused of misconduct... based upon false allegations." It claims to provide justice for those who are punished simply because they dissent from mainstream scientific opinion/propaganda. This Society planned to give Farber, and fellow denialist Peter Duesberg, their "Clean Hands Awards" at a series of events in D.C. called "Whistleblower Week in Washington." The Semmelweis Society was one of the three sponsors of this conference.

 

It's one thing for an obscure group to hand out sham certificates and tinfoil medals to liars, fools, blue-cheese-moon believers; it's entirely another for that group (and its honorees) to receive extensive press coverage, and to claim (falsely) that Farber and Duesberg were going to "address Congress." This, in his own words, is what ensued (so to speak) after Jefferys read the Post article: "I sent emails to a few people and the US-based listserv for discussing Federal AIDS Policy, highlighting this concern about Farber and Duesberg's involvement. I also sent a short comment via a feedback form on the Whistleblower Conference website, and it was this message -- which stated my belief that Farber and Duesberg are liars and frauds and also noted that they alter and misrepresent quotes from the scientific literature -- that Farber obtained and filed suit over."

At the Sundance Film Festival last year, one documentary garnered particular praise and attention: the Oscar-nominated How to Survive a Plague. And let's hope that on the 24th of February, it's David France and Howard Gertler - along with a host of others: the cast who "play" themselves - who get on the stage at the Dolby Theatre to accept those universally-recognized golden statuettes.

 

I don't study the splendid shenanigans of Sundance any more; no longer an earnest young cinephile. So it was a surprise to come across news and reviews of another "break-out" (why use a different adjective, journalists,  when the Dictionary of Clichés is always handy?) documentary about HIV/AIDS at this year's festival: Dylan Mohan Gray's directorial debut, Fire in the Blood.

 

From the film's Facebook (and IMDb) page:

 

"An intricate tale of 'medicine, monopoly and malice,' Fire in the Blood tells the story of how Western pharmaceutical companies and governments blocked access to low-cost AIDS drugs for the countries of the global south in the years after 1996 -- causing ten million or more unnecessary deaths -- and the improbable group of people who decided to fight back.

 

"Shot on four continents and including contributions from global figures such as Bill Clinton, Desmond Tutu and Joseph Stiglitz, Fire in the Blood is the never-before-told true story of the remarkable coalition which came together to stop 'the crime of the century' and save millions of lives in the process."

 

Genocidal indifference: vastnesses of suffering, a fragile half-century of progress shattered in whole countries, a trail of death that requires seven zeroes after the number 1 to be even approximately mapped, enumerated - that's "the crime of the century" being chronicled here. Fiery stuff indeed.

 

I haven't seen the film, so I can't comment on its cinematic power, its technical prowess, its structure, and so on. Those who have seen the documentary, however, give it very high marks. (A sampling of reviews and quotes, below.) And many have commented that Fire in the Blood is a "global sequel" to How to Survive a Plague.

 

*        *        *

 

Check out the movie's Facebook page (www.facebook.com/fireintheblood) for news of screenings, more assessments, comments and conversations, and videos (interviews, the trailer). But here are a few other sites you might want to visit; I've extracted a few passages from them, to provide a sample of what it is that this documentary documents.

 

(1) www.pbs.org/pov/blog/docsoup/2013/01/fire-in-the-blood-a-must-see-film-at-sundance/#.URVr1vJ7xmg

 

"And the one film that I'd put to the top of your must-see list is Fire in the Blood. This World category entry, directed by Dylan Mohan Gray, who's based in Mumbai, is about how Western pharmaceutical companies block access to cheaper medicines in developing nations, in turn denying people access to AIDS-combatting drugs. Gray speaks to survivors, doctors, and activists. He lays it all out...

 

"This may be a must-see film but don't think of it as spinach. (Or, if it is, it's as if it were prepared by Alain Ducasse.) Gray crosses the planet and manages to set up a lot of breath-taking wide shots of faraway places that make this a beautiful film to watch. And he talks to people who give great interviews, including Bill Clinton and several mavericks who've led the fight against the pharmaceutical companies.

 

"Really, Fire in the Blood should be considered a companion film to David France's much-championed Oscar-nominated film, How to Survive a Plague, about the AIDS activist movement of the 1980s and 1990s. That was history. But the plague continues in the rest of the world." (Tom Roston)

 

(2) www.variety.com/review/VE1117949149/

 

"While How to Survive a Plague and We Were Here have commendably essayed the U.S. end of the AIDS crisis, the devastation the disease has wrought in the developing world is a topic that has long merited a documentary of equivalent substance. Enter Fire in the Blood, a basically constructed but rivetingly researched examination of the global fight for affordable antiretroviral therapy against Western pharmaceutical companies, whose restrictive patent laws amount to a death sentence for millions of Third World HIV/AIDS patients. Impassioned, persuasive film won't have trouble spreading its essential message across the fest circuit and beyond."

 

"[A]fter a mid-2000s breakthrough that led to a 1,000% increase in African patients receiving treatment by 2012, the door looks ominously likely to close again at the behest of the World Trade Organization." (Guy Lodge)

 

(3) www.hollywoodreporter.com/review/fire-blood-sundance-review-413424

 

"Picking up more or less where [HTSAP] left off, Fire in the Blood is in a sense a global sequel, showing how AIDS activist groups [a provocative claim about activists in the affluent "global north" - JV] and government bodies turned their backs on the plight of Africa, a continent that by 2000 had more than two-thirds of the world's cases of HIV infection.

 

"Given the prohibitive pricing of branded drugs and the trade restrictions that kept cheaper generic alternatives out of reach, Africa had minimal access to lifesaving medications for years after they became available. According to one statistic cited by George W. Bush in his 2003 State of the Union address, out of 30 million Africans with HIV, only 50,000 were receiving treatment.

 

"The explanation for how that genocide of indifference was allowed to continue for so long and now risks a recurrence after some years of reprieve is simple. It boils down to blatant manipulation by the pharmaceutical giants. The most profitable industry on the planet strictly interprets the word 'patent' to mean 'monopoly.'

 

"Just as France's film identified heroes within the movement, so too does Gray focus on a handful of individuals who made a difference. Among them are James P. Love, an American intellectual property activist; Dr. Peter Mugyenyi, head of the largest HIV treatment and research center in Uganda; Zackie Achmat, a South African AIDS activist; and Yusuf Hamied, the Indian scientist behind the socially conscious pharmaceutical manufacturer Cipla."

 

"Gray's central narrative outlines the plan spearheaded by Hamied to slash the cost of generic antiretrovirals for poor countries, and provide their governments with the know-how and technology to manufacture their own drugs. When that offer found no takers at the European Commission in Brussels, Hamied and his colleagues then returned with a second proposal that eliminated all overheads, charging only for the ingredients. That step made sense purely on a humanitarian level, not an economic one.

 

"The wall of willful ignorance put up against this strategy by the World Health Organization, UNAIDS and by U.S. and European governments in the stranglehold of the pharmaceutical lobby is expertly outlined. But mounting political and public pressure ultimately broke the blockade.

 

"The film is extremely moving as it illustrates the overwhelmingly positive impact of affordable ARVs in African countries. But that uplifting chapter ends abruptly. While Big Pharma conceded the battle, the industry won the war by enlisting the World Trade Organization as its global bully to protect future profits." (David Rooney)

 

*        *        *

 

And so the battles and the wars continue, on many fronts. And stories, an infinitude, continue to be told. And, sometimes, movies get made that chronicle the victories and defeats, movies that look into abysses and stare, as well, at the empyrean;  movies which become part of the chronicle itself. Let's hope many of us get to see this one.

 

JV

 



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