How to Survive a Plague by David France

I am very pleased to be taking part in the official Wellcome Book Prize blog tour this week to champion ‘How to Survive a Plague’ by David France which is one of six titles shortlisted for this year’s prize awarded to a book on the subject of healthcare or medicine. It follows France’s 2012 Oscar-nominated documentary film of the same name and is a remarkable account of the activists and scientists who campaigned for awareness and funding towards fighting the AIDS epidemic in the United States.

The figures are stark. In July 1981, the New York Times published a short article with the headline “Rare Cancer Seen in 41 Homosexuals”. A little more than three decades later, over 35 million people worldwide had died from AIDS-related illnesses, including over 650,000 in the United States alone, and a further 36 million people worldwide are living with HIV/AIDS today.

‘How to Survive a Plague’ isn’t a global history of AIDS but instead focuses on the work of a group of gay activists in New York City. The fight to “tame” AIDS was not just about tackling the scientific and medical challenges in AIDS care, treatment and prevention but also about confronting stigma and changing social attitudes towards the LGBT community and the disease itself. The bureaucratic obstacles posed by the political and health care systems are particularly shocking. US President Ronald Reagan didn’t publicly acknowledge the existence of AIDS until 1985, by which point thousands of patients had already died. This was followed by several more years of chronic underfunding towards research as well as the AZT drug debacle and bitter disputes between American and French scientists over who should claim credit and royalties for discovering the HIV-1 virus.

France explains the medical developments of AIDS research in great depth but his account always remains highly accessible for general readers and he never loses sight of the human scale of the crisis. He watched close friends and his partner Doug Gould die of AIDS-related complications and the real power of his narrative lies in the personal stories of several activists and physicians including controversial playwright and author Larry Kramer, former Wall Street bond trader Peter Staley and researcher Joseph Sonnabend who established the first officially recognised buyer’s club allowing patients access to alternative therapies. Many others were involved in influential campaign groups such as ACT UP. From promoting safe sex to organising clinical drug trials, these individuals and organisations became self-taught experts in their field and the power of their grassroots activism paved the way towards the breakthrough of protease inhibitors becoming commercially available in 1996.

‘How to Survive a Plague’ is a dense, detailed and devastatingly powerful piece of social history. It is up against some very strong competition on the shortlist this year but I would be delighted to see this fascinating account win the Wellcome Book Prize next Monday.

Three other Wellcome Book Prize shortlisted authors Sarah Moss, Siddhartha Mukherjee and Maylis de Kerangal will be discussing their books at events in London this weekend and some tickets are still available. Five more bloggers are reviewing the other shortlisted books this week – do check out their posts too.