Continental Drift (2007)

Continental Drift: The Imaging of AIDS by Richard Fung and Tim McCaskell

“We’ve got a desperate population here. This is the first time in history where the infected population is actually taking control of the epidemic.” —Larry Kramer, ACT UP founder, Testing the Limits

Watching the 1987 AIDS activist documentary Testing the Limits 20 years after its release, what strikes us most is the confidence of the people on screen. It isn’t that a cure seemed just around the corner or that the spread of the infection appeared manageable; the sense of barely controlled panic is palpable throughout. Nevertheless, speaker after speaker either echoes or illustrates Kramer’s pronouncement. At a time when the cultural politics around identity fostered an acute sensitivity to questions of voice and representation, these activists exude the conviction and certitude that come from speaking in one’s own interest when the stakes are high. “We are fighting for our lives,” chant demonstrators in the one segment.

The year 1987 was a key year in the history of the epidemic. It saw the founding of the definitive AIDS activist group ACT UP (AIDS Coalition to Unleash Power), and the Silence=Death Project, which produced one of the iconic logos of the 20th century. These organizations, like the Testing the Limits project, were formed in New York City, which at the time had the highest number of reported AIDS cases in the world. In Toronto, where we live, AIDS Action Now, roughly modeled on ACT UP, made its debut early in 1988 and soon grew into the leading AIDS activist organization in Canada. In 1989, a group of Canadian and American activists hijacked the opening ceremony of the international AIDS conference in Montreal to protest government inaction and the absence of people with AIDS in the conference program. When we look at the footage of Tim’s unauthorized address from the occupied stage, captured in John Greyson’s 1989 video The World is Sick (Sic) and recycled in Richard’s Sea in the Blood (2000), we are similarly struck by his assurance: “On behalf of people living with AIDS in Canada and around the world, I would like to officially open the fifth International Conference on AIDS.”

At the birth of AIDS activism, AIDS had only just stopped being referred to as GRID (Gay Related Immune Disorder). The infected were seen to be gay men largely contained in the cores of cities like New York and Toronto, a location they shared with others under suspicion: Haitian immigrants, IV drug users, and sex workers.

The social contract that had traditionally allowed gay men continued access to gender, race, and/or class privilege was the closet—the original don’t ask, don’t tell. As long as homosexuality was private, everyone could pretend it wasn’t there. Stonewall was the thunderclap that had announced the beginning of the renegotiation of that contract. The outcome of the subsequent gay rights strategy was to allow some gay men to be public about their homosexuality without losing social entitlements.

But AIDS blew the closet door open for many of those still content with the old arrangement. HIV did not discriminate, and people of status found themselves or their loved ones turned into pariahs and treated like the underclass. The dying bodies of some, like Rock Hudson and Liberace, slumped out of the closet in shame or ambiguity. Others were radicalized. For example, Brian Farlinger, one of AIDS ACTION NOW’s most prominent members, had been director of commercial affairs for the Canadian Bankers Association before coming out as both gay and HIV-infected. Unlike other grassroots movements, AIDS activism was able to draw on skills, information, and networks usually reserved for the elite. Looking back at the clip of the Montreal conference, we now see not only the desperation and righteous anger at people living with AIDS being overlooked at the opening ceremonies but also how privileges of class, race, gender, and geography came into play to enable the action.

The initial government and institutional response to AIDS, what little there was, fell within a purely public health paradigm. The goal was to stop the spread of the plague to “the public.” Those who were already infected and sick and the communities they belonged to were ipso facto not part of that public. They were the “reservoir of infection,” a danger, a swamp that needed to be mapped, put under surveillance, and, once delineated, its shores policed. If policing succeeded, if high enough walls could be erected, then the public would be safe, the epidemic would burn itself out. The reservoir would slowly evaporate.

So for the gay men who were the early core of ACT UP and AIDS ACTION NOW, being both “out” and part of “the public” took on a new life-and-death significance. To be part of the public was to claim rights—to medical care, treatment and research, and to be treated with dignity. To remain the other was to be isolated, quarantined, left to die. Activists on both sides of the border shredded the contract of silence with theatrical media-savvy tactics like staging mass die-ins on city streets, occupying drug company headquarters, and disrupting legislative proceedings.

But the struggle and the epidemic soon overflowed the confines of gay identity. More and more central to AIDS activism was the emergence of a new “poz” identity—a brotherhood (and soon sisterhood) of infection located within, but also outside, the gay communities. Activists demanded inclusion, and soon HIV-positive representatives were required for boards and advisory committees of AIDS service organizations—even gay ones—as well as government panels and advisory committees for pharmaceutical trials. Coming out as “poz” might be modeled on coming out as gay, but its soundscape was amplified. Positive people spoke, shouted, whistled, and chanted for themselves.

The insurgent liberating vision of this new identity claimed to reach beyond the divisions of race, gender, and class. At times it almost did. Impending common death tended to intensify the need for solidarity. The imperatives of prevention furthered this embrace of difference. Sex demanded talking about, in all its wild and wonderful permutations. Different races, body types, and practices required public eroticization if messages were to reach target audiences. It was a heady moment, expressing a defiant optimism as the epidemic continued to take its toll. Some of the most important artistic production and intellectual thought of the late 20th century was produced in response to the AIDS crisis.

Twenty years later, the map of AIDS has changed. The cities, once a place of danger, have become gentrified. In North America, most of the infected who survived the tsunami of the epidemic now float in a lifeboat constructed by pharmaceutical companies. In Canada, provincial drug programs, the ultimate victory by AIDS activists, make treatment accessible to all citizens, regardless of income.

But the demographics of infection have changed. The quintessential PWA is no longer a white, gay man in urban North America, but more likely to be a black heterosexual woman in rural or township Africa, and as with the sinking Titanic, the lifeboats have not been distributed equitably. For the “new” person with AIDS, access to adequate nutrition and sanitary living conditions may be as crucial—and elusive—as medication. Dying has been outsourced, like manufacturing or telecommunications, to countries and peoples on the periphery.

While most people living with AIDS now reside in the third world, global political and economic disparity means that those who speak about and for them on the world stage are still based mainly in the first world: the scientists, policy makers, funders, even to some extent the activists. At the 16th International AIDS Conference held in Toronto in 2006, Bill and Melinda Gates advocated on behalf of poor women and sex workers. Stephen Lewis spoke out for African grandmothers. French and American activists protested the President’s Emergency Plan for AIDS Relief (PEPFAR) and bilateral U.S. free trade agreements that limit access to generic AIDS medications. It isn’t that there were no participants from Africa, Asia, or Latin America—Indonesian PWA Fricka Chia Iskandar addressed the opening ceremonies—but the media was more interested in celebrities like Richard Gere, Bill Clinton, and Alicia Keys. If the face of AIDS is increasingly coloured, its global public voice is still largely white, and increasingly heterosexual and HIV negative.

There is nothing wrong with actions of solidarity by the rich and famous or “ordinary” people, negative or positive, in the developed world. Philanthropic work is often effective and necessary, especially in the absence of support from impoverished or indifferent governments. However, altruism comes at a price. When American and Canadian PWAs are unhappy with policies or delivery of care that affect them, they can lobby, demonstrate, and confront decision makers. As part of the public and as citizens they have rights and officials can be held accountable. But if in Zambia or Cambodia the main source of support is not local, if it is based on charity and not a right, if priorities and delivery methods are not decided in the regional or national capital but in Seattle or Geneva, making demands, or even feeling one has the right to do so, is much more difficult.

Wealthy people and wealthy nations and have always felt comfortable with the apparatus of charity. By giving, they garner praise, feel good about themselves, and stay in control. Philanthropy functions differently from taxes; indeed, it is often used to avoid paying taxes. Similarly, much foreign aid ends up subsidizing industry in the donor country. The West is perversely content to maintain African, Asian, and Latin American countries as recipients of benevolence. The ability to give—and the need to request—aid reinforces the neo-colonial status quo.

A crucial victory in the discursive war around the pandemic was the excision of the terms “AIDS victim” and “AIDS sufferer.” “People Living with HIV and AIDS” insisted on their agency. But in the recent reporting on AIDS in Africa and elsewhere we see the reemergence of the AIDS victim, the suffering subject who stares motionless from the cot in a photogenic act of dying.

And it is not only in the popular media. In the first decade of the epidemic, artists and activists created a deluge of film and video that combined criticality, social urgency, aesthetic innovation, and novel approaches to building audiences. They deployed a variety of approaches in a range of genres, but common to all the work was the notion of personal investment by makers and intended viewers alike. Collectively the films and tapes posit a shared community of interest. By contrast, when Richard previewed work for the AIDS 2006 Film and Video Festival, held in conjunction with the International Conference, he was struck by a curious bifurcation among the submissions. Work about North American subjects tended to rehearse the genres of AIDS media established in the 80s and 90s, and were mute about the global context. Work about the rest of the world, often produced by Western filmmakers and/or Western-based international agencies, addressed the viewer as both HIV negative and foreign to the circumstances depicted on screen. There was little sense that makers, subjects, and viewers would constitute a common community of interest.

A startling exception was Siyayinqoba Beat It, a South African TV magazine program “for everyone living with HIV and AIDS, our partners, families, friends and colleagues.” Because it is produced by South Africans for South Africans, and because all the presenters are HIV positive, the tone of Siyayinqoba Beat It is unlike anything that normally reaches North American audiences about AIDS in Africa. The program, which has run since 1999, does not shun the suffering endured by people with HIV and AIDS, not just resulting from the disease, but also because of the violence they face due to the fear and stigma. But Siyayinqoba Beat It documents the battles people go through to protect themselves and their loved ones. Upbeat and full of humour, it fearlessly challenges government policy while giving tips on nutrition or personal relationship management. Siyaninqoba Beat It also portrays the complexity of race and class in post-Apartheid South Africa, one segment featuring a spontaneous debate between two HIV positive people about whether yoga is just a middle-class option.

But while South Africa now has the highest number of people living with AIDS in the world, it is atypical of other countries in southern Africa because of its relative wealth, democratic stability, and developed infrastructure. It also has a tradition of mass struggle forged during the fight against Apartheid, which has inspired a highly developed and effective activist movement in the Treatment Action Campaign (TAC).

The emblematic TAC T-shirt defiantly and boldly announces its wearers as HIV POSITIVE. A “poz” identity has developed along with AIDS activism in South Africa. But what does this identity have in common with the one that emerged in America and Europe in the 80s and 90s? Given the relatively stable health that anti-virals offer, does Tim’s “poz” status make him somehow closer than Richard to that African woman with AIDS with no access to treatment? Does she have more in common with him, or with her neighbour, HIV negative but fighting tuberculosis and malaria?

These questions have generated a crisis of legitimacy for the North American AIDS movements, already fatigued, depleted by the loss of comrades, and lulled because individual needs have been met. Kramer’s assertion no longer rings true, as the epicenter of the pandemic has dispersed to other continents. Even those here most acutely affected by the disease lack the resources of the earlier generations of AIDS activists. In Canada, undocumented migrants and refugee claimants face major barriers to care, and the seroconversion rate is highest among youth, intravenous drug users, and Aboriginal people. While the desperation and anger survive, the confident voice of AIDS activists speaking from their own experience and in their own interest has been muted. The original AIDS activist organizations are now faced with the difficult task of reinventing themselves and struggling with questions of solidarity and voice unnecessary when they were at the centre of the holocaust.

Originally commissioned for the Finger Lakes Environmental Film Festival, 2007.