May #47 : When Plagues Return - by David Drake

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May 1999

When Plagues Return

by David Drake

Laurie Garrett and Esquire magazine plot against complacency

When the mainstream media mentions the epidemic, people tend to notice. Last March, with a splashy cover—Madonna, Tom Hanks, amfAR’s Sharon Stone and Mathilde Krim and four other stonefaced celebs holding placards spelling out, “The four letter word we all forgot about”—Esquire magazine made a a preemptive strike on the “End of AIDS” swarm. The centerpiece of this special “New AIDS Crisis” issue was Pulitzer Prize–winning AIDS reporter Laurie Garrett’s feature, “The Virus at the End of the World,” which predicts the imminent collapse of HAART.

These days, the mainstream AIDS narrative is ripe for a revision. With the general public believing the epidemic is under control, ASOs desperate for donations, prevention wonks grasping for new strategies and activism at a standstill, the issue is anything but hard copy. But do we really want Garrett’s forecast to be the next plot turn?

For it is beyond grim. With a pocketful of medical reports from front-line doctors and their drug-failing, lipodystrophy-laden patients, Garrett’s piece concludes flatly: “Unless fundamental breakthroughs are made in anti-HIV science, the miracle of 1996 is finished.” It gets worse. In plain yet passionate prose, Garrett describes a “new AIDS crisis”—the collapse of combo therapy coupled with the rising rates of transmission of drug-resistant HIV. And while this worst-case scenario isn’t news (Mike Barr broke the “supervirus” story in POZ in August 1996), what makes it a media event is the enormous energy with which Esquire has packaged it—along with amfAR’s not-so-subtle nod lending it credibility.

The bad news was received by many HIVers as a welcome clarion call. Our AIDS Savanorola, writer Larry Kramer, gave his approval. “In the past Laurie Garret has been very right,” he says. “Her opinions matter. We must listen!” But not everyone was enthusiastic. “It was an idiotic piece of journalism,” says writer Andrew Sullivan. “It had no real evidence to back up its central argument.” Instead “it used every bad trick in the propaganda book of setting up straw men and then apparently deflating them with anecdote, rather than presenting a real argument and demolishing it by evidence.”

There’s irony in Sullivan’s easy dismissal of “The Virus at the End of the World.” As the author of the most recent plot point in the AIDS narrative, a 1996 New York Times Magazine cover story called “When Plagues End,” Sullivan himself suffered severe attack by critics because of his own speculations. This piece, too, was long on personal stories and short on dependable data. In contrast to Garrett’s naysaying, however, he dangled a dazzling forecast: Singing the praises of the protease revolution in his own life and in the gay community, Sullivan spoke so eloquently to our desire for an end to the crisis that if he didn’t exactly answer our questions, he certainly answered our prayers.
True transcendence of HIV, however, requires a return to reality. So will “The New AIDS Crisis” create the buzz that gets people off their butts? Although Garrett calls the response she has gotten “overwhelmingly positive and truly amazing,” it remains to be seen whether Esquire’s effort will spark further coverage and public awareness. Sadly, the Hearst publication—whose last AIDS feature was written by Randy Shilts in the late ’80s—is widely regarded as a has-been glossy. “That’s the tragedy,” says Kramer. “Very few read this very down-at-the-heels magazine.” Still the Esquire special issue—backed up by the AIDS community’s chants of “AIDS isn’t over”—is as close to an activist intervention as 1999 is likely to see.

Whether Garrett’s take is a bellwether or a cry of wolf, only time and science will tell. “A piece either contributes to the narrative because it deals with something true and real,” Sullivan says, “or it is a flash in the pan, and melts away as the evidence proves to be unsubstantiated.” Garrett, who has been walking the HIV beat since 1981, has the last word. “Frankly, I would love to be proved wrong,” she says. “It would mean that hundreds of my friends and colleagues need not worry about their futures on HAART.”

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