After reading Somebody to Love, the biography of Freddie Mercury which was heavily intertwined with the history of AIDS, I looked further into the history of the disease, and And the Band Played on by Randy Shilts came up repeatedly. It is a very engaging read, having dated little since its publication over thirty years ago. Gaeten Dugas’s status as archvillan of the scourge has since been tempered somewhat (rather than being the so-called Patient Zero, he’s been downgraded to a kind of Typhoid Gaeten, albeit a more malicious one that the original Typhoid Mary) and Ronald Reagan has been elevated in his legacy as a neo-conservative who did a lot of harm and little good, but beyond that, the writing feels as relevant today as it would have been in the mid-eighties.

Shilts, himself a gay man who was diagnosed with the virus shortly after finishing the book, tracks the early cases of this mysterious wasting disease from the Belgium Congo to impoverished islands nations such as Haiti and eventually to America, then the rest of the world. He talks about isolated incidents of what, in hindsight, were probably the virus but died out due to a particular village’s isolation from the world; knowing what we know now (and even what was known in the mid-eighties) this is a foreshadowing, even more so, reading it in 2017. How many diseases have in the past simply died out because geographical isolation contained them? With modern travel obliterating most of those isolations, what epidemics might we look forward to in the future?

Shilts was deeply damning of Reagan and the conservative politics he represented; Reagan’s refusal to recognise the severity of the disease as anything but the gay community’s problem (some almost gleeful at the thought that said community might wipe itself out with the disease) allowed the disease to get a foothold in the first world, and by the time it had started affecting the ‘respectable’ members of the community, it was too far gone. Shilts recalls how swiftly the government responded to the Legionnaire’s Disease and poisoned Tylenol scares, both of which infected and killed far fewer (and this was by the numbers of the time, when the AIDS death count was in the tens of thousands) but affected desirable members of the community – the wealthy, the respectable and children – so were dealt with in a swift and effective manner, namely with a lot of public government support and money. This goes back to AIDS being seen as a problem of the undesirable members of the community, so it was left to fester, until it was affecting more ‘desirable’ members, by which point it was too late.

He was also damning of the blood banks, who thought it would be too expensive to screen for the disease, and actively campaigned to have references to the disease being blood-borne removed from public consumption, which meant people remained ignorant for much longer than they ought to have been about the sexually transmitted nature of the disease.

Shilts’s last main villianous group is the gay community, who collectively refused to acknowledge the sexually transmitted nature of the disease and promote safe sexual practices. From a 2017, it is heartbreaking to read, over and over again, the attitudes of ‘they’re just trying to stop me having fun’ which allowed the disease to spread. Shilts singles out Gaeten Dugas to reflect this attitude and the tragic consequences of it, although later journalistic evidence has since conceded that not only was Dugas not the one who brought the disease into the US, but his remarkable memory when it came to his lovers is what allowed early doctors and scientists to create some of the earliest databases of patients. (Dugas’s refusal to believe he was sick, and later on his malicious infecting of others, hardly makes the man a saint, he’s just not guilty of all he was accused of.)

I found this book to be engaging, heartbreaking and infuriating – all in a good way. There has been little covered since that isn’t covered in this book, which may in itself be pretty damning, but makes it hold up well as a definitive authority on such as devastating disease and the medical and social reasons behind it.

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