Frontline Does it Again

For the better part of the last two evenings, I was mostly out of commission, thoroughly absorbed by The Age of AIDS. The latest installment of PBS's Frontline series, this two-part, four-hour program was only the most recent reminder of Frontline's status as an unqualified national treasure. Its relentless, exhaustive reporting and the epic narrative arc of most of its programs only grows more distinctive and important as other media steadily gravitate away from ambitious, hard-edged storytelling.

Having lived through the entire life of this story and watching it unfold through incremental news reports, I found I'd missed so many crucial parts of it, or at least failed to understand their importance at the time, or how these various developments fit into the larger picture.

This show masterfully took you back over the whole broad sweep of the story, told by patients, leading medical investigators and world leaders. It wonderfully explained how the pandemic converged politics, public health, faith (and sometimes superstition) into the same narrow corridor, where they were left to fight it out to the death. It highlighted the clash between developed and developing world as few other issues could.

By the end of the last century, no fewer than 20 million people around the world had died of AIDS, and yet most national governments remained in deep denial about its ravages. Clinton cabinet secretary Donna Shalala recalled how the Chinese health minister told her his nation, with closed borders, could not possibly have this disease (about one million Chinese nevertheless did). While we naturally tend to remember Reagan's stubborn refusal to either speak up about the epidemic or provide funding to battle it, Frontline points out that he was hardly alone in avoiding the stigma of plague. Even the sainted Nelson Mandela refused to invest any personal attention in the subject (delegating it instead to aides) even though his South Africa had the world's highest incidence of the disease. A white South African nurse vividly recalled how doctors and other health professionals there were left to ignore AIDS patients to care for those with a greater chance for survival, creating yet another level of apartheid.

As always with Frontline, the producers don't pull their punches. They point fingers at mistakes along the way and name names of those who made them. One of the more illuminating disasters involved the World Health Organization--which in the early days of the epidemic was on a roll, spending $100 million on interventions and racking up some impressive victories. Eventually, the director tired of all the media attention being showered on one of his employees, a heroic doctor who tirelessly campaigned for resources to respond to the epidemic, and the doctor soon left. The WHO would never again take the lead in the global public health intervention (eventually, the United Nations Security Council met to discuss the problem, the first and only time that body has ever met to take up an issue other than that of war and peace).

Ultimately, after pressure from protestors as well as goverments around the world, the big pharmaceutical companies dropped the prices of the cocktail therapy for patients in poor nations, from $16,000 annually to $400. With that therapeutic success (there is no cure) and the leveling off of media attention in recent years, it's easy to jump to the conclusion that the problem of AIDS has been largely solved, but this program disabuses you of that notion. Forty million people around the world now have the virus, and that number is climbing by five million each year. Twenty percent of Brazil's health spending is devoted to the disease. "I think we won a few battles," says one middle-aged researcher, who predicts no cure in either his lifetime or that of his children. "But most of the time, HIV wins."