The 1993 book adaptation of Randy Shilts’ “And the Band Played On” mirrors current attitudes to funding HIV health measures. 

A little over three decades ago, director Roger Spottiswoode showed the world in film how the AIDS epidemic unfolded, focusing on the administrative hurdles under former President Ronald Regan that enabled the spread of the disease. The Trump administration is making similar decisions.

During the height of the AIDS epidemic, Dr. Don Francis — an epidemiologist who worked for the U.S. Public Health Service in 1992 — posed the question: How many deaths warranted uneconomical investments for handling the spread of AIDS?

In response to Blood bankers opposing screening donor blood to protect the nation’s blood supply, Francis said, “How many people have to die before it’ll be cost-effective for you people to do something about it? A hundred? A thousand?” 

Similar to the blood banks of the 80s and 90s, the State Department found the enduring issue of AIDS uneconomical but furthered the indifference by using medical resources as a bargaining chip for minerals: “We will only secure our priorities by demonstrating willingness to publicly take support away from Zambia on a massive scale,” a memo draft from the State Department’s Africa Bureau staff said.

The State Department’s backtracking on the President’s Emergency Plan for AIDS Relief, or PEPFAR, means the lives of around 1.3 million Zambians are at risk of a now-treatable disease.  

Despite HIV now being a treatable chronic illness, costs keep people from receiving adequate treatment in Zambia. 

One of possibly many victims of AIDS to come in the region includes a man in his late 30s from Northern Zambia. Saulo Kasekela, a security guard from Mpongwe, died on March 7 from tuberculosis that stemmed from an untreated HIV infection. Other victims include Lewis Chifuta, a 33-year-old, who had a high fever and was unrecognizable from his bony frame. 

Chifuta was one of four patients in the ward with AIDS. Just last year, Mpongwe saw two cases like Kasekela and Chifuta a month on average; there are already 28 new cases this year and counting.

Before Chifuta and Kasekela was Roger Gail Lyon. 

In the film, he makes it clear that what is holding him back from living is not AIDS but administrative choices. 

“This is not a political issue,” he said. “This is a health issue. This is not a gay issue. This is a human issue. And I do not intend to be defeated by it. I came here today in the hope that my epitaph would not read that I died of red tape.” 

Lyon succumbed to his disease before any breakthrough in AIDS treatment was available. 

Zambian officials have the option to give the U.S. access to their mineral resources in exchange for better system support, or be reminded of when there were not enough nurses to care for an overwhelming number of ailing patients, to the point that the AIDS epidemic caused their life expectancy to drop to 37.

Since the start of the epidemic, 44.1 million people worldwide have died of AIDS. Spottiswoode put faces to names and numbers at the end of the movie. 

He showed clips of people from all walks of life who found themselves afflicted with the disease, including AIDS activist Bobbi Campbell and Ryan White and Hollywood stars Rock Hudson and Freddie Mercury. He ends the movie by showing a banner from an AIDS organization, Act Up, that says “remember” before showcasing more victims of the disease.

“Courage… no. I’m scared to death,” Campbell said in the movie. “I just have this absurd determination to live. Don’t you?”