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Transcript of As the Band Played on Paper
As the Band Played On and the AIDS Epidemic: How Far Have We Come?
Khalid Sheikh
HON 3301: Readings in Medicine & Society
Dr. Stephanie Meyer
4/26/2016
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The AIDS epidemic of the late 20th century was unlike any health crisis America had
experienced before. Between 1981 and 1990, 160,000 cases and 120,000 deaths were reporteda
staggering mortality rateand yet it took the president nearly five years to officially
acknowledge its presence. The public’s relative disinterest in the disease during its earlier years
was largely due to the prevailing dislike of homosexuals, who initially had the highest
prevalence of the disease. As the Band Played On tells of the story of the Center for Disease
Control’s (CDC) quest to identify, understand, and combat the epidemic during a time when
disinterest and resentment towards those with the disease was highest. Both dedicated health
officials and individuals with the disease faced challenges in raising awareness of the epidemic,
overcoming the hostile political climate, and receiving appropriate medical care. In the current
time, many of these challenges have been addressed through modern developments. Though
certainly still imperfect, our current society much better equipped to handle an epidemic of equal
proportions.
A major theme throughout the movie is the lack of media attention towards the epidemic.
Proper media coverage is needed in order to properly inform the public of the epidemic’s nature,
presence, and urgency. The lack of such awareness only perpetuates the culture of resentment
towards the afflicted and prevented substantial political or social change from occurring. To raise
attention of the epidemic in the face of public disinterest, Bobbi Campbell became the “self
appointed KS posterboy” (And the Band Played On). By putting his face on posters and openly
sharing his story with the public, Bobbi added a dimension of humanity to the epidemic that
many in the public had been unaware of or ignored. In a culture so openly hostile to the gay
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community, Bobbi was integral in instilling courage to openly seek treatment and demand
response (Wright 2).
With the advent of social media, nearly anyone can bypass traditional media and spread
awareness of an issue. With Facebook and Twitter, a campaign like Bobbi’s likely would have
reached far more people and generated a higher level of discussion than he did through posters.
Additionally, many forms of social media allow for a great degree of anonymity, such as forums
and chatboards. This anonymity allows an even larger proportion of society to be engaged in
discussion and would be particularly important for victims of a disease as stigmatized as AIDS.
Though it does offer significant advantages, social media also has the potential to be
quite dangerous. During the Ebola outbreak of 2014, a nationwide panic in the United States
broke out as inaccurate reports spread like wildfire through various social media channel.
Following the diagnosis of the first patient with Ebola in the United States, many reports spread
by social media falsely stated that the virus could be spread through air, water or food, which led
to irrational behavior throughout the country (Luckerson 1). To combat the misinformation, the
CDC was able to to disseminate its own information via social media, such as updates on
infected patients’ progress. With social media, victims of an epidemic as large or negatively
perceiveed as that of AIDS would have much greater ability to independently sway public
opinion, although the same is true for any opposing side. As for the CDC, the ability to
communicate with the public through social media is only significant if it can agree on what is
appropriate to report. As Dr. Francis and Dr. Curran’s adversarial relationship in the movie
demonstrates, political and other pressures can greatly impact the flow of information, and this is
true of both social and traditional media.
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The political climate of the 1980s pervaded every dimension of response to the epidemic.
The conservative, antihomosexual attitude of the thenpresiding administration discouraged the
media from acknowledging the crisis and prevented many government agencies from fully
confronting the epidemic. In the movie, Dr. Francis and Dr. Curran have a heated argument after
a press conference over the latter’s failure to make a strong statement on the nature of the
disease. Dr. Francis, passionate for social justice, believes the public should be given all
available information, while Dr. Curran pragmatically does not wish to anger those in charge of
funding the Department.
This informal limiting of the CDC and the formal, obvious omission of funding for AIDS
are the result of religious ideology and stigmatization playing a role in public policy. The role of
these two forces have continued to play a significant role to the present day, although significant
progress has been made in ensuring the evidencebased practice is placed first. In 2003, George
W. Bush authorized the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), which
allocated an unprecedented $15 billion to combat the AIDS menace on an international scale
(Kaiser PEPFAR 1).The passage of the Act indicates the progress that has occurred in removing
the stigma associated with AIDS. However, the policy did require a significant portion of the
funding to be used exclusively for abstinenceonly sexual education programs as a means to curb
transmission. Similar to what occurred in the 1980s, this topdown stipulation is an attempt to
force one particular set of values on a particular population through legislation. Once the
stipulation was proven to be ineffective, though, it was removed for the 2008 reauthorization
(Kaiser PEPFAR 1). These recent events suggest that policy addressing a modern epidemic may
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indeed still be influenced by religious or other moral ideologies, but such policy would be
considerably more likely to yield to scientific evidence and suggestions.
In the earliest days of the outbreak, AIDS (then dubbed GRID, or GayRelated Immune
Deficiency) was perceived to be a disease exclusively for homosexuals. As the epidemic
escalated, it became increasingly apparent that the disease could affect anyone: men, women,
and even children. Although As the Band Plays On centers around the gay community, where
the epidemic begins, the movie does portray the discovery that IV drug users and Haitian
migrants are also affected. AIDS was, and continues to be, an epidemic that afflicts the most
vulnerable members of society: the impoverished. Poor access to healthcare among the
impoverished serves only to perpetuate epidemic. Without proper medical access, those at
highest risk do not receive preventative care, those in the early stages of disease do not catch it
quickly enough to prevent spreading to others, and those in an advanced state cannot seek
treatment. In the 1980s, those with AIDS faced a lack of care options and extremely limited
insurance coverage.
With the recent Affordable Care Act (ACA), much has been done to improve access to
healthcare for the impoverished. Among many other provisions, the Act calls for an $11 billion
investment into community health centers (Kaiser ACA 1) . With preventative care more readily
available, diseases can be caught and treatment can be administered in a more timely manner that
ever before. As for affording treatment, stipulations such as the prohibition on limiting
preexisting condition coverage and banning of the lifetime cap allow for better containment of
incurable diseases. Even if an epidemic occurs of an allnew disease, like AIDS was, these
community health centers and other healthcare expansion provisions will allow for the
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identification of such a disease to occur much earlier and provide valuable time for
epidemiologists to act.
According to Charles Rosenberg, a leading medical historian, “disease does not exist
until we agree that it does, by perceiving, naming, and responding to it”. Since the 1980s, much
advancement has been made in the arenas of medicine, science, and technology. In the event of
an epidemic of similar proportions as AIDS, we are technologically better equipped to handle it.
But this is not what truly matters. As As the Band Played On demonstrates, the key to
successfully combating epidemic is not just science or technology: it is perception. What makes
the AIDS epidemic unique is not that it was an allnew disease. In the past, we have faced novel
diseases and cured them. Rather, it is that the epidemic challenged our culture's perceptions and
understanding of reality. Without acknowledging an epidemic as such, we cannot hope to solve
it. With recent developments of evidencebased practice and an understanding, not demonizing,
approach to healthcare for the impoverished and marginalized, it is hoped that in the presence of
an epidemic, we, as a society, can set aside preconceived notions and focus on what medicine is
truly about: to treat patients and restore health.
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Bibliography
And the Band Played on. Dir. Roger Spottiswoode. HBO, 1993.
"Summary of the Affordable Care Act." Summary of the Affordable Care Act. Kaiser Family
Foundation, 04 Apr. 2013. Web. 26 Apr. 2016.
"The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR)." The U.S. President’s
Emergency Plan for AIDS Relief (PEPFAR). Kaiser Family Foundation, 5 Nov. 2015. Web. 20
Apr. 2016.
Wright, Joe. "Medscape Log In." Medscape Log In. N.p., 1 Mar. 2013. Web. 20 Apr. 2016.