How to Survive a Plague: The Story of How Activists and Scientists Tamed AIDS by David France - review by Richard Canning

Richard Canning

Anatomy of a Disease

How to Survive a Plague: The Story of How Activists and Scientists Tamed AIDS


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Until not long ago, the track record of journalists reporting the HIV/AIDS crisis was impoverished. One of very few bestsellers on the subject, Randy Shilts’s sensationalist And the Band Played On (1987), has, over the years, been largely and rightly debunked by a succession of biomedical studies. Notoriously Shilts, who worked for the San Francisco Chronicle and was himself gay, succumbed to the allure of simplified master narratives. One such involved Gaëtan Dugas, a French-Canadian flight attendant and early victim of AIDS who helpfully volunteered for several important medical trials before dying in 1984. Shilts’s characterisation of Dugas as – intentionally or otherwise – responsible, by jetting from one North American city to another, for hundreds of the earliest cases of HIV was entirely erroneous. Classified as ‘Patient O’ in one trial to signify that he was from ‘outside’ California, he appeared in Shilts’s account as the more sinister, gothicised ‘Patient Zero’. The book’s publicity campaign seized on this and helped spread the image of him as a homicidal villain and un-American disseminator of a national epidemic.

The case of Dugas is symptomatic of how paranoia and phobia, rather than reason and pragmatism, informed early debate about AIDS, not only in the USA but across the world as well. Tragically, this atmosphere did nothing to help raise awareness of what Shilts himself identified as the

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