Fear, greed, and cowardice have a way of sullying things like medical breakthroughs. In the mid-1990s, the antiviral drugs that checked the AIDS crisis separated the meaning of “HIV positive” from full-blown AIDS because, for the first time, the existence of the virus in the blood was not a death sentence. That was a triumph of an unprecedented amount of focused research, largely paid for by government agencies like the National Institutes of Health. But it felt like a miracle.
In Fire in the Blood, his documentary on the pharmaceutical keep-away that perpetuated the AIDS emergency in Africa and elsewhere, director Dylan Mohan Gray describes how protective patent laws guaranteed not only profits for drug companies but also the deaths of more than 10 million AIDS sufferers. He maintains a merciless calm throughout, aided by William Hurt’s low, slow, careful narration, as he documents a case of stupendous disregard for humanity.
Because miracles are wondrous and rare and patents are ironclad, drug companies could charge $15,000 per person per year for the new cocktail. That gouged anyone who could pay it—health insurance companies, the well-off and well-insured, government programs like Medicaid and Medicare—and left out anyone who couldn’t. Yet even if they had charged just five cents per pill, the companies would have still seen a profit, a fact that is just one of many maddening details in this story.
Gray’s images are exquisite and unsparing, in the style of the best National Geographic photography. Especially disheartening is the helplessness of doctors, who knew about the combination therapy but couldn’t offer it to their patients. “There were nonstop funerals taking place on a daily basis. The orphan population had exploded,” says Peter Mugyenyi, a Ugandan physician. “I saw so many people who’d have lived. I saw them die painfully, excruciatingly, and yet their death was not inevitable.”
The film’s sources maintain impressive composure in relating the repeated obstructions, sophistries, and obfuscations they faced, but their frustration is palpable. The drug companies cowed the United States, the United Nations, and us all, really, with ludicrous arguments that stoked fears and abetted inaction. It took years and a great deal of stubbornness for a coterie of smart, caring, connected people from all over the world, including Bill Clinton and Nelson Mandela, to finally begin to deliver the drugs to stem what was, essentially, a genocide. (In the film, Clinton pulls a fast one that helps turn things around.) While it’s hardly a joy to watch, Fire in the Blood is artful in nearly every frame, perhaps so we don’t avert our eyes. We can’t; Big Pharma is relentless and, thanks to a new international trade agreement that once again favors its patents, this isn’t over.