The Age of AIDS, Part I

>> It was a great mystery to all of us.

>> Before we knew what it was, it was already with us.

>> By the time the first cases of AIDS in the United States were diagnosed, 250,000 Americans were infected.

>> Before we knew how to halt it, it was with the world.

>> By the time the first cases were diagnosed in South Africa, millions were infected.

>> The story of AIDS is one of the most important stories of our age, the epic story of scientific battles... >> It's as if this virus has nine heads.

You cut off one, it still operates with the others.

>> Boycott, boycott, boycott!

>> ...political indifference... >> Because of the stigma, because of the shame, we've seen world leaders unwilling to accept the fact that H.I.V.

is a real issue.

>> ...moral dilemmas... >> Even if these drugs were available at cost, poor countries couldn't afford them.

>> ...and the perseverance of the human spirit.

>> People unified in action can achieve things.

>> Tonight, part one of a two-part special Frontline series.

>> One day, the age of AIDS will be over.

In the history books, we will be defined and described by how we did or did not respond to it.

>> NARRATOR: Until it is inside a host body, it is no more alive than a rock or a stone.

It is a protein-coated mass of genetic instructions 150 times smaller than the white blood cell it attacks.

After penetrating, it multiplies until the cell bursts and dies.

This continues for years.

Cell by cell, the virus destroys its carrier's immune system.

Untreated, the person becomes ill from a series of infections that are progressively serious and rare, and finally fatal.

This is AIDS.

>> I remember how AIDS entered my life in January of 1981.

The first patient I saw was a 31-year-old gay man.

He had been previously healthy and had lost 30 pounds, had fevers and a lung infection.

>> I remember that period vividly because the initial cases were a great mystery to all of us.

One day we had a young gay man who came into the hospital with all sorts of problems, but dominated by shortness of breath, and it was clear that he had pneumonia.

>> NARRATOR: It was pneumocystis pneumonia, a rare and fatal disease that had previously only been seen in patients whose immune systems were damaged.

>> And then, weeks later, another similar case would come in, again in a young homosexual man.

>> A sample of blood was sent to the laboratory, and we found that he had virtually no helper, or CD-four, T-cells.

When you wipe out the T-cells, it leaves the person open to infections like pneumocystis.

But there really was no underlying reason why a previously healthy guy should have an immune deficiency.

>> NARRATOR: Within months, the doctors in Los Angeles had documented five cases of the mysterious new disease.

>> We weren't able to do very much for these early patients.

They were very wasted away.

They looked like concentration camp survivors.

>> The early cases were all dying in a matter of a few months.

And so this was a lethal disease, the cause of which was completely unknown.

>> The CDC is best known for its epidemiology.

When a disease comes along and may be new, it's important to find out who gets it, how often do they get it, and is it really new?

>> NARRATOR: Jim Curran tracked infectious diseases at the CDC.

He was surprised by the report of the rare pneumonia.

>> What happened was a vast survey in the United States and elsewhere of other cases of pneumocystis pneumonia.

And we found, looking back in the previous 15 years, that there'd only been one case in the United States that we could find.

We thought this was new.

>> NARRATOR: In June 1981, those findings were published in CDC's Morbidity And Mortality Weekly Report, or MMWR, which is read by physicians around the world.

>> That was the first official publication of what is now termed AIDS.

>> NARRATOR: Just a month later, a young doctor was starting his first day of work at San Francisco General Hospital.

>> I remember my first patient incredibly well, a 22-year-old man who had disseminated Kaposi's sarcoma, had the skin lesions of Kaposi's across his body, an amazing wasting disease.

And I can easily see him today.

>> NARRATOR: The young man had a very rare skin cancer.

It was an opportunistic infection, like others the physicians would see, taking advantage of a weakened immune system.

>> Often, by the time they came into the hospital, they could only say two or three words in succession without needing to take a breath.

>> In the advanced form, it attacks the brain, causing unrelenting headaches.

>> Patients would die of their dementias the way 80-year-olds do, where they curl up in bed and die.

And these were young men.

>> I'd like to just take a check of your lungs mostly.

I'd like to have you take off your gown.

Combined with the stigma and isolation that a lot of patients had to endure, made it not just a terrible death physically, but a terrible death in every other way, as well.

>> NARRATOR: By that summer, the CDC had received reports of over a hundred new cases of the mysterious disease.

>> We were impressed that the cases seemed to occur in very large cities, which were the centers of gay lifestyle, rather than around the entire country.

(disco music playing) >> NARRATOR: Hunting for the cause of this new disease, which the media had begun to call "GRID" or "Gay-Related Immune Deficiency", CDC's epidemiologists wondered if it had to do with the gay lifestyle.

>> We were struck that all of the men were active gay men who had been mostly open in the gay community for ten years or more.

And we were also struck that they had a complicated social lifestyle involving a number of recreational drugs as well as a large number of sexual partners.

So it wasn't surprising that if a new infection were to come along, that it could be focused in the gay community.

>> NARRATOR: The mystery deepened when a doctor in Florida reported also seeing patients with Karposi's and pneumocystis.

>> When we were beginning to investigate the initial cases, we picked up the MMWR, and there were cases described in California, eventually New York.

And I'm reading it and saying, "This is exactly what we're seeing."

>> NARRATOR: What was unusual was that Dr. Fischl's patients were both men and women of Haitian ancestry.

>> We then immediately called the Center For Disease Control and said, "We think we're seeing the exact same thing in south Florida," and described the population that we were seeing.

Their first comment back to me was they didn't believe me.

>> NARRATOR: The CDC didn't know what to make of the Haitian connection.

>> They began looking at all different types of aspects.

Did they have unusual rituals in Haiti, voodoo rituals?

Did they inadvertently have homosexual contacts?

They were convinced something else was going on.

>> (translated): I was reading the report in the MMWR.

I read it very quickly, as a curiosity.

By coincidence, that same afternoon, I had a consultation with a patient.

He was gay.

He was suffering from pulmonary problems and fever that had lasted for weeks.

And when we made the link between this patient and the new phenomenon described in the United States, I looked to see if there were other people who had similar symptoms in France.

>> NARRATOR: Dr. Rozenbaum was surprised by what he discovered.

>> (translated): Among seven new patients, there were three women and a Portuguese man with three children.

He never admitted to having homosexual relationships, and it's probable, given what we know now, that he was infected by heterosexual encounters in Angola.

>> When I was working at the Institute Of Tropical Medicine in Antwerp, we started seeing patients with something that we had never seen before, and in every case people died.

I read of the report in the Morbidity, Mortality Weekly Report of CDC, and then we started thinking, "Well, that sounds really like the central Africans "that we are seeing in our hospital.

"But, you know, we have women, so it can't be only gay men.

It's different, but what is this?"

>> NARRATOR: As the disease continued its rapid spread through America's cities, it was now being discovered in a new setting.

>> I came to the Bronx in 1981.

We'd already heard that there was this new, unexplained disease in gay men.

And there were three men who were dying with pneumocystis carinii pneumonia, and they were not gay men; they were injecting drug users.

People who inject heroin generally inject two, three times a day.

People who are cocaine-addicted might inject five, six, seven times a day.

And the shooting gallery is a place where people would come in and rent a needle and syringe, finish using the drugs, return the needle and syringe, and it would be rented to the next person and the next person.

And you could not construct a social system that was better designed to transmit a blood-borne disease.

And that, in part, explains the explosion of H.I.V.

in the injecting drug use community in New York and other places.

>> NARRATOR: It was a highly efficient system of transmission for a disease, and one that would help drive the epidemic across the country and eventually around the world.

As word got out, addiction clinics like this one in San Francisco's Haight Ashbury were overwhelmed by frightened people like Cindy.

>> But I'm breaking out in sores all over my body, open sores.

>> Is there any counselor at all that could take her?

I'd be real interested in what she's got in the way of this infection.

>> Where do you go when you have no hope?

Where do you go?

Who helps you?

Nobody.

Nobody.

>> NARRATOR: The fear was everywhere in the city.

At San Francisco General, more and more gay men like Bobby Reynolds were confronting the hard fact of being diagnosed with a deadly new disease.

>> I remember laying in the front room one night and discovering that there were lymph glands under my armpit that hadn't been there before, and it just triggered something and I started crying.

I was afraid.

>> NARRATOR: With the diagnosis came the fear of rejection by friends and family, let alone the discrimination by society at large.

>> I don't know why I'm crying.

>> It's okay.

(chuckles) >> I have no idea.

>> When you are diagnosed with AIDS, very often you lose your support system, you lose your families, you lose your job.

I've lost the majority of friends that I had before my diagnosis.

>> I don't think there's any question that AIDS suffered and continues to suffer because of the stigma that is attached to the people that are the most vulnerable to it.

And the fact that this was a disease that was affecting, in this country, mostly gay men and injection drug users-- not exactly any administration's favorite target for visible support, but especially in a conservative administration.

>> These are people who are socially unacceptable in most people's minds: I.V.

drug users, particularly those that share needles; homosexual men, and especially if you added those who engage in anal intercourse.

Of course, that really makes it even worse in much of the public's mind.

>> NARRATOR: As Assistant Secretary for Health, Dr. Edward Brandt says he had to deal with prejudice not just from the public, but from politicians as well.

>> The question of what to do about it became very controversial, as most things do when sex is involved, over the issue of these gay men who were bringing it on themselves and, "Why should my tax dollars go to help them?"

>> There was a convention, a Republican state party convention here in southern California-- I don't remember what year, but very early on in the epidemic-- and they had a bumper strip that said, "AIDS: It's killing all the right people."

You had the conservative pundits, the Jerry Falwells, the Pat Robertsons, saying things like, "It's not nice to fool Mother Nature."

>> I believe that when one breaks the laws of nature and the laws of moral decency-- and I do believe homosexuality is a moral perversion-- when we go against nature-- and God, of course, is the creator of nature-- we therefore pay the prices for that.

We do reap it in our flesh when we violate the laws of God.

>> NARRATOR: Many people continued to think that the disease would affect only gay men and I.V.

drug users, but in late 1981, there was a report from a doctor at Children's Hospital in San Francisco who discovered it in a baby.

>> And the baby required a large number of blood transfusions.

And when we saw the immunological profile, it was identical to what was being seen in the young adult men that was called "the gay syndrome."

And so we took the list of blood donors and said, "Of these donors that provided blood for this baby, are there any that have been reported to have this new disease?"

And there was one.

When we went back to try to locate him, that individual had already died of AIDS.

>> NARRATOR: That would mean the disease had entered the blood supply, and anyone needing a blood transfusion could be at risk.

>> And if this infectious agent got into the blood supply throughout the United States, and, in fact, throughout the world, we would have a big problem on our hands.

We were called "alarmist."

There were accusations that we were trying to create panic in the blood system.

>> NARRATOR: In fact, it was already too late.

That same summer, another group began to develop symptoms of immune deficiency.

>> The terrible outbreak of H.I.V.

in the hemophiliac community was really a very simple situation.

That is that clotting factor is obtained from blood or plasma that is donated, blood, or sold, plasma.

You take plasma from thousands of people and put it together, put them into a bottle and then send that out and inject it into other people.

>> NARRATOR: The clotting factor, Factor Eight, was concentrated from thousands of donors, many of them poor people willing to sell a pint of their blood for $10.

>> And what happened was that I.V.

drug users, people really at risk of AIDS, were selling their plasma, and the blood industry did not exclude gay men from blood donation.

And so you ended up contaminating, essentially, all lots of Factor Eight material that was used for... to treat hemophiliacs, and infected, essentially, all of the hemophiliac population with 100% fatal virus.

>> NARRATOR: The CDC now knew it had to be a virus.

It was the only particle small enough to get through the filtering process to make Factor Eight.

>> The impact was tremendous, that this syndrome was caused by a virus-- great concerns about the blood supply, great concerns about sexual transmission.

>> NARRATOR: It was now urgent to get to the blood-bankers, but it would take many months to get their attention.

>> We convened the leading members of the blood-banking community, the leading members of the gay community, leading members of public health to talk about a rapid and appropriate response.

>> CDC felt that the evidence was there.

And what we expected from that meeting is for the blood-banking community and others to say, "Yes, we've got a serious problem.

Now what do we do about it?"

>> NARRATOR: But the blood- bankers were resistant.

>> The evidence for this, in my view, is very weak and very early.

We don't really have any proof yet that the nation's blood supply is contaminated.

>> NARRATOR: With no test, the entire blood supply was at risk.

They faced huge financial losses, and they also didn't want to take on activists at the meeting who argued that screening was discriminatory.

>> There's not enough evidence to finger any population or subset of individuals and say, "This group should not be allowed to donate blood."

>> That was a public health disaster.

I pounded the table and yelled at them, asking them how many people they wanted to kill.

God, I just said, "Instead of having another meeting, just tell us the number.

You want ten dead?

You want 20 dead?

You want 100 dead?"

Well, that didn't go over very well.

>> NARRATOR: It would take two more years before safeguards were instituted.

>> And it's going to come out hopefully with a congressional hearing.

It's going to come out.

And I hope the world knows the truth before I die, because I'll tell you, I've got an appointment soon to die.

>> NARRATOR: More than 35,000 Americans would be infected from contaminated blood and blood products.

The epidemic had begun in the first months of the Reagan administration, which had come to power with a mandate to cut taxes and reduce the size of government.

>> It is time to get government back within its means and to lighten our punitive tax burden.

And these will be our first priorities, and on these principles there will be no compromise.

(applause) >> The budget was out of control.

I knew the country needed to have fiscal restraint.

The president was right.

>> NARRATOR: Margaret Heckler became Reagan's Secretary of Health and Human Services in 1983.

She says she was looking to the scientists to set her priorities on AIDS.

>> AIDS was a mystery.

It was a puzzlement even to the scientists.

And before we knew what to do or how much it would cost or anything like that, we needed to find out what the scientists could tell us.

And my goal was simply to expedite the process.

>> NARRATOR: But at the CDC, an agency Heckler supervised, officials said their efforts had been severely hurt by the budget cuts.

>> The Reagan administration had come in, and there was a mandate to cut all government activities.

But CDC was slated to be cut by at least 25%.

There was no travel allowed at all, and so, therefore, we virtually had our hands tied.

>> My area of responsibility at the time was to establish a laboratory to investigate the cause, develop the blood tests and do all of these things.

And we really had nothing for the first two years, essentially nothing.

That is, we had to steal equipment from the other laboratories, we had to dig out space, and we had to... this was not an appropriate response to a disease that had a mortality that looked like greater than most other infections that we had to deal with.

>> NARRATOR: In April 1983, four months into her term, Secretary Heckler told a congressional committee that all the federal agencies researching AIDS had adequate funding.

"In the AIDS situation," she said, "I really don't think there is another dollar that would make a difference, because the attempt is all-out to find an answer."

>> There were a lot of people who felt that more money should have been spent.

I disagree with that.

I think that we could not have gained anything more by increasing the cash expenditures.

We were in the right direction, we were placing the emphasis on those who could provide the answers.

And in a peculiar case, this was not a problem that money could solve; it was a problem that the scientists could solve.

>> NARRATOR: One problem scientists were trying to solve was where the disease had come from.

A team of epidemiologists from the CDC flew to Africa to follow up on reports about what they were now calling "AIDS," Acquired Immune Deficiency Syndrome.

Joe McCormick led the team.

>> I met a colleague who began telling me about these few Congolese who had come to Belgium with a disease that looked to him like the Acquired Immune Deficiency.

And so we went to the Congo and started looking for patients with typical symptoms of AIDS, and we found them on the wards of the Mamiama Hospital in Kinshasa.

>> It was quite a shock to see the poverty, the suffering.

The whole team was amazed at how immediately they could identify ten, 20 cases right away that would meet our definition for AIDS.

I'd never seen anyone before that was dying, and we stood there and watched them.

There was nothing we could do.

At the time, the world was thinking that this was a gay men's disease.

When we came up with the numbers that half of our patients were women, it started to make people think, "Well, maybe this could be a disease that could be transmitted to the general population," and I think it caused quite a bit of alarm.

>> NARRATOR: Back at the CDC in Atlanta, Joe McCormick and his team briefed their boss on what they had learned in the Congo.

>> He said, "We're going to call the assistant secretary for Health and give him this information.

He needs to know this."

>> NARRATOR: As assistant secretary of Health, Dr. Edward Brandt was the key administration official on the disease.

>> And so I got Dr. Brandt on the phone, and I gave him the data and information, and told him that our conclusion was that this was a... already at probably at epidemic proportions, and that it was hetero... primarily heterosexually transmitted.

And his response was, "There must be another explanation.

This can't be right."

>> My reaction was, "I don't understand what's going on."

You know, either they've got a different virus or we're not getting cases reported.

The latter seemed reasonable, because our focus up until then and most of the public noise we'd made and everything and my meetings with medical groups around the country and so forth had focused on homosexual men.

And maybe by doing that we were missing female cases.

>> NARRATOR: In fact, Dr. Gerald Friedland had reported a case of heterosexual transmission eight months earlier.

>> There was a woman who was a sexual partner of someone with AIDS.

And we had learned that AIDS was associated with swollen lymph glands, and I felt these massive lymph glands, and I said, "Oh, no, she's got it.

It is heterosexually transmitted.

This... this is the end."

That was a glimpse into the future.

>> NARRATOR: It was a future that Joe McCormick and his colleagues believed they'd seen in Africa, where they began asking questions about the history of the disease.

>> We now know, based on the advanced symptoms that we saw, that the disease had been circulating for quite a while, and therefore we had to understand better where it might have come from, and, in particular, where did it go.

Somehow, the disease had gotten into the U.S. and Europe.

And so the question is, well, who would have been at risk and could have taken the disease out of the Congo?

There were a few choices: Europeans living there-- Belgians primarily, but French and others; and Congolese, who were leaving the country to go abroad; and Haitians, who... who I had already experienced contact with back when I was a school teacher in the 1960s.

>> NARRATOR: When independence came to the former Belgian Congo and the Europeans left, the new government contracted with Haiti to bring French-speaking professionals-- teachers, nurses and doctors-- to fill the jobs left behind.

>> We found very few of the Haitian community still there.

It's quite feasible that a number of these people immigrated, not knowing that they had H.I.V.

We have evidence that some of them, at least, got this disease, and we know that some of them went to Europe, to North America and back to Haiti.

>> NARRATOR: Haiti, one of the poorest countries in the world, would prove to have few defenses against the disease.

(band playing) It was in the late '70s and early '80s that local doctors noticed that more and more young Haitians were coming to them or seeking healing spells from a local priest for a new wasting disease.

>> Some of those first patients had the look of death on their face.

They were so skinny that you could see their bones.

This was something totally new to us, and we were not sure what we are dealing with.

>> NARRATOR: In one of the roughest parts of Port-Au-Prince, Dr. Jean Pape started the first AIDS clinic in Haiti.

>> The men we saw, many of them had more contact with women than men.

So, very early on, the profile... social profile and sexual orientations were totally different from what was happening in the States.

>> NARRATOR: Yet Dr. Jean Pape was convinced the disease had first been brought to the island by homosexual tourists from America.

>> Haiti was a haven for homosexuals because sex with a male Haitian was very cheap.

But they didn't call themselves homosexuals, because the same Haitians would also have contact with many more women.

>> NARRATOR: As the virus was spread heterosexually, it turned up in blood transfusions and, confined to the island, it took hold.

>> The disease was spreading very fast, and within three years, we are not talking about a disease that was affecting homosexuals anymore.

It was a disease that had extended through all strata of society.

This was very, very scary.

>> NARRATOR: It was also a time when thousands of Haitians were fleeing the island's poverty and corruption.

The U.S. media were doing stories about "boat people."

And now there were reports of sick Haitians showing up in Dr. Margaret Fischl's hospital in Miami.

>> One of the local channels called me up and was almost whispering on the phone, said, "Is it true Haitians brought in a deadly disease in the United States?"

And I said, "That better not be your headline in tomorrow's paper."

>> NARRATOR: But those were the headlines when the CDC sent out a warning to physicians about the reports of Haitian immigrants with the disease.

>> The entire Haitian community was very upset, and I don't blame them.

>> NARRATOR: In the press, it became a label-- Haitians were a "risk group"-- and the impact was felt immediately back on the island.

>> It killed tourism in Haiti.

Goods manufactured in Haiti could not be sold in the U.S., and Haitians in the U.S. suffered a lot.

>> NARRATOR: Even today, Haitians remain defensive about the course of the disease and how it came to the island.

>> I don't think that it was any one thing.

I think there were multiple things.

>> NARRATOR: Margaret Fischl went to Haiti in 1982.

>> The diversity of what we were seeing was incredible.

There were gay men vacationing in Haiti, there were Haitians going to Africa, there was likely drug use.

So it just really reinforced that there was nothing that was different about a Haitian that was different about an American, for that part.

It was really, you know, how this virus was being transmitted.

>> NARRATOR: Back in the United States, it was still being seen primarily as a gay disease, which, in San Francisco, made it highly politicized.

The community was both scared and defensive of their newly gained civil rights, and no more so than when the city tried to close the gay bath houses.

>> Although, it looked like a disease of gay men, it was not.

It was a disease of sexual transmission, and it just so happened that at the time of the evolving of the permissiveness of sexuality among the gay community back in that period of time after they had just essentially been able to win their freedom to express themselves sexually as they wanted to do in society.

Unfortunately, it came at a time when a virus was introduced.

So the bath house culture was a perfect breeding ground for a sexually transmitted disease.

>> NARRATOR: The "bath house culture" was both a symbol of gay community and a place of sexual freedom.

>> In a bath house, there were orgy rooms.

These were rooms where there was music, the lights were down low, even maybe so low that you didn't even know who you were with.

What was unique here was that people could come there and have multiple partners, as many as 20 or 30 a night.

If you had 30 partners and one or more of those partners was H.I.V.-positive, there was a good chance you were placing yourself at great risk for getting infected.

>> When the bath house controversy hit San Francisco, I was ambivalent.

I was one of the people having a lot of trouble deciding what to do about it.

You have to understand that the whole concept of a gay community was still brand-new.

It had not been tested.

All of the institutions we take for granted today were just being created.

>> One day, Cleve called me up, and he says, "I can't defend if you close the bath houses."

And I said, "How can you say that?

You've always said that, you know, you wanted them closed."

He said, "I do, I did and I do.

"But if you, the director of health "in the most liberal-appearing city in the country, do this, "think of what the impact that's going to have on less tolerant communities."

>> There was a great fear that if we allowed the government to close these establishments, what was next?

The... the people who opposed closure of the baths were very frightened that this was the first step.

You know, how far into our bedrooms will the government be going?

And those were not unrealistic fears in this country then nor now.

>> These 14 establishments are not fostering gay liberation; they are fostering death and disease.

>> I was trying to work with the gay community, and I failed.

And I acknowledge that I failed, but that would have been the perfect way to have dealt with this in the early years.

And, literally, what we're talking about is playing Russian roulette.

>> NARRATOR: Silverman did close the baths, but a local judge reopened them two months later.

I said in 1983 that AIDS was the most political disease I had ever seen or read about.

It was so discouraging to me because here we had a medical mystery that even without any political interference would be a tremendous thing to try and solve and deal with.

>> NARRATOR: At the NIH, research scientists were trying to identify the mysterious agent that was causing the epidemic.

>> Well, it was a period of evolving mystery.

You couldn't see it, you look in the cells.

You couldn't grow it, at least initially.

And most everybody thought it was a virus.

>> NARRATOR: And many people thought that this man at the NIH, Dr. Robert Gallo, had a head start in the race to identify the virus.

>> I arrived at Bob Gallo's lab in 1983, and it was a time of extraordinary excitement.

>> NARRATOR: Four years earlier, Dr. Gallo had achieved a scientific breakthrough when he isolated a specific virus, a retrovirus which caused leukemia.

>> They were called HTLV-1-- for human T-cell leukemia virus type one-- and HTLV type two.

Those viruses were actually prime candidates for... for the cause of AIDS.

>> NARRATOR: Dr. Gallo and his team, convinced the AIDS virus was related to the HTLV, began probing the blood from an AIDS patient using the same techniques he had used to discover the leukemia virus.

>> We were looking for HTLV relatedness.

We were looking for the AIDS virus to be related to the leukemia virus, a retrovirus-- same family, but different.

>> NARRATOR: But when Gallo cultured T-cells from the blood of the AIDS patient, he could find no markers of the HTLV.

To Gallo, the idea that the AIDS virus could be anything except a variation of the HTLV seemed unthinkable.

>> I should have followed exactly what was in front of me.

I should have had more imagination, when I think about it.

You... you see, all the trouble of proving one retrovirus class existed.

Could you possibly imagine two?

>> NARRATOR: Within a few weeks, all the T-cells in the culture had disappeared, killed by the mysterious virus Dr. Gallo could not find.

In Paris, Dr. Willy Rozenbaum thought Gallo was looking in the wrong place.

>> (translated): My hypothesis was that he would have been better off looking in the lymph nodes, because they are a more accurate indicator of illness.

>> NARRATOR: So in January 1983, Rozenbaum sent a biopsy to Luc Montagnier's lab at the Pasteur Institute.

Francoise Barre-Sinoussi did the tests.

>> (translated): The biopsy was put in a culture, and we checked it regularly every day, every second day, every third day.

>> NARRATOR: If the French were to find the virus, they needed to keep the culture of T-cells alive, something Gallo's lab had been unable to do.

>> (translated): We observed that there was cell death in the culture.

The virus itself could be responsible for the cell death, but there wasn't time to reflect.

Above all, we had to try to restart this culture and restart production of the virus.

>> NARRATOR: They decided to "feed" the virus by adding additional white blood cells.

>> (translated): We saw the solution.

All we needed to do was to add cells to the culture.

>> NARRATOR: In barely three weeks, Montagnier's team had isolated a new virus.

And when they produced an electron micrograph, they knew that the virus they had discovered was distinct from Gallo's HTLV.

>> (translated): The electron microscopic image showed that the photo of this virus was different from the photo of the HTLV.

>> NARRATOR: This photograph, taken in the summer of 1983, marks the moment the French researchers first saw the virus that causes AIDS: H.I.V., the human immunodeficiency virus-- the virus that would, from its first passage, be passed on person-to-person to more than 70 million people.

From the beginning, scientists would look for the origins of the virus.

It would take more than a decade of investigation to find out that it had evolved from a simian or chimpanzee virus somewhere in central Africa.

>> In the central part of Africa, there are people who were descended from hunter/gatherer populations, and many of those populations still do a lot of hunting, particularly in these really remote areas.

I believe that, in the process of hunting, the hunters encountered primates, particularly chimpanzees... (chimpanzee screaming) ...and perhaps other monkeys that carry simian viruses.

>> NARRATOR: Hunting and butchering a chimpanzee would almost certainly involve blood-to-blood contact.

>> They encountered these viruses particularly when they were preparing the meat, and they periodically would become infected.

And this was probably happening in various places in central Africa.

It wasn't high frequency, but periodically, and often it would probably die out.

The hunter might die, he might transmit it to one or two people, but there were a few places where it would still continue at this low level that we found in the villages.

>> NARRATOR: At first, the human immune system would fight back the chimpanzee virus.

But on each transmission, the virus replicated.

It adapted and evolved and, eventually, one of those adaptations was successful.

>> There's no question that H.I.V.

came from chimpanzees.

There are, in fact, now known several examples of cross-species transmission, as we call it, between chimpanzees and humans.

It's just that one of those took off like none of the others.

>> NARRATOR: George Shaw is a scientist who has studied the evolutionary origins of H.I.V.

>> There is a clear family tree of the family of viruses that we call retroviruses, and within that family are viruses that infect humans and monkeys and chimpanzees that are grouped in this sub-family that we call human or simian immunodeficiency viruses.

>> NARRATOR: By genetically comparing the chimpanzee viruses and H.I.V., scientists were also able to determine how recently the simian virus had crossed the species barrier to humans.

>> Investigators who specialize in that area suspect, plus or minus a decade, that the transmission event leading to H.I.V.

happened some time around the 1930s.

>> NARRATOR: The scientist who discovered the animal source of the AIDS virus was Beatrice Hahn.

She traced it back genetically to its origins in a particular species of chimpanzee.

>> It is not known what has to occur for a newly transmitted chimpanzee virus to then become an epidemically spreading pathogen.

There are a number of speculations that people have been putting forward which are quite reasonable and have to do with the basic biology of this virus as we understand it today.

And those speculations are increased partner change-- if this person who has the chimpanzee virus gets introduced into a population with sexual promiscuity.

>> What happened in Africa is the urbanization of Africa, so where, instead of living in the bush, that one now, especially males, migrated to their urban centers for work.

Now the infected chimpanzee butcher comes into a larger city in Africa, now has sex with a woman who has sex with a lot of other people.

And now the woman gets infected and thousands of other people get infected, and then it goes on and on and on.

And this virus just searches out, and when there is an amplification system, it takes off.

>> During the time period when we think that this transmission might have occurred, there were medical campaigns in west-central Africa of pox virus vaccination that would go from arm to arm.

>> NARRATOR: Using the same needle was an unwitting but very efficient system of transmitting the virus widely.

>> It would have to be something that explains a sudden spread.

And the more the virus replicates, the more changes can occur, the more it adapts to whatever new environment it's confronted with.

>> NARRATOR: A sample of frozen plasma showed that the first confirmed death from AIDS occurred in 1959 in the Congo.

By the 1960s, people in central African towns were dying of a mysterious disease.

>> It has become incontrovertible that the epidemic that we understand to be the most important pandemic affecting humankind in this past century arose as a consequence of a single transmission event from a single chimpanzee in west-central Africa to one human.

>> NARRATOR: In April 1984, Margaret Heckler called a momentous press conference.

>> The probable cause of AIDS has been found.

The credit for these discoveries belong to many.

In particular, credit must go to our eminent Dr. Robert Gallo, who directed the research that produced this discovery.

>> NARRATOR: Gallo's team, using samples of the French virus, as well as their own, had succeeded in growing enough in a continuous cell line to describe it in detail and develop a blood test.

It had been over a year since the French discovered the virus.

>> I was not well-briefed on the French claims, and I had confidence in Gallo.

He was a brilliant investigator, so I really did feel that he had been the actual identifier of the virus.

>> Do you think he misled you?

>> No.

Not at all.

No.

>> There has never been any fights or controversies between us and the group in France.

I came back from a meeting astounded to see this kind of discussion.

>> (translated): It was necessary that another team confirm the discovery.

What's a shame is that they presented it as an original discovery, but there we go.

>> NARRATOR: The dispute between Gallo and the French would fester for nearly a decade until an out-of-court financial settlement gave each team credit for its work.

But in May of 1984, there was a great sense of hope.

>> Finally, we also believe that the new process will enable us to develop a vaccine to prevent AIDS in the future.

We have... we hope to have such a vaccine ready for testing in approximately two years.

>> There was a lot of optimism that, once we identified the agent, we will figure out a way to conquer it; that science would come up with the tools to make drugs and certainly would come up with the vaccine.

>> NARRATOR: But at the NIH, scientists were worried.

Gallo's important contribution, the new blood test for the virus, revealed deep problems.

>> The serological test indicated that the problem was much more extensive than you would have thought.

>> It became clear that H.I.V.

could infect, but doesn't cause problems until some years later.

And there is a period where one is symptom-free but H.I.V.-positive and potentially infectious to others.

>> So we had a skewed appreciation of what this disease was all about, because we thought that you get H.I.V.

infected and you were deathly ill and that was it, not fully realizing the vast numbers of people who were incubating this illness for years and years.

As we described back in the '80s, it was like an iceberg, and what we were seeing was the tip of the iceberg.

>> I want to see what the lymph nodes are doing today.

>> It invades a community much like it invades a person, so that by the time the first cases of AIDS in the United States were diagnosed, 250,000 Americans were infected.

By the time the first cases were diagnosed in persons with hemophilia, half of the population of hemophiliacs in the U.S. were infected.

Until there are people dying in the streets, people don't want to believe it.

>> NARRATOR: By the mid-1980s, the number of deaths was doubling every year.

Doctors could offer little hope.

>> After I got to about 15,000 patients that died, I stopped counting numbers.

One of my patients that I had followed for a long period of time just asked me, "Should I just stop?"

I said, "I can just give you the same medicines, but you're not going to get much better than that."

So he said, "No, then I want to stop," you know.

And... and then he said, "Well, I guess this is then good-bye."

And I will never forget the expression on his face-- I mean, just the total loss of life, you know, that his young life was over.

I mean, that expression is something I will take with me forever.

>> When I think back, it seems like it was just an avalanche.

It was like one week we'd never heard of it, and then the next week everybody started to die.

People began to vanish.

I was having coffee in the cafe, the Cafe Flore, and I looked up and saw what I thought was an old man leaning against a telephone pole.

And I thought, "Oh, look at that old man.

He needs help."

And he fell down, and we went over, and he was dead.

And he wasn't an old man; he was my age.

By 1985, almost everyone I knew was... was dying or already dead.

It was also the people I saw every day but whose names were not known to me-- the bus driver, the mail delivery person, the baker, the guy I would see walking his collie every day in the park on my way to work, you know.

One by one, all these familiar faces disappeared.

(cheers) >> NARRATOR: By 1985, at the beginning of the second term, the Reagan administration was still distanced from the disease.

>> There was an open neglect, if you will, and the failure of the president for many years to even mention the term "AIDS."

One of the most difficult things for us at the CDC was feeling like the communities that were at greatest increased risk didn't trust us because we worked for an administration which wouldn't mention the word "AIDS."

>> Hey, hey, ho, ho.

Ronald Reagan's got to go.

Hey, hey... >> NARRATOR: The disease was still seen by politicians and the public as a gay problem, in part because gay activists had become so organized and so vocal.

>> We're fired up.

We won't take it no more!

We're fired up.

We won't take it no more!

We're fired up.

We won't take it no more!

>> The early activists in this disease were H.I.V.-positive gay men.

They were fighting for their life.

This was not just something to go out and rabble rouse just for the fun of it.

>> What do we want?

>> Money for AIDS.

>> When do we want it?

>> Now!

>> These people really felt their life was on the line, and that what the Health Department did, what the Food And Drug Administration did, what the administration in Washington, D.C. did truly affected whether they were going to live or die.

>> NARRATOR: But still, they couldn't seem to get the public's attention.

>> On both coasts, gala premiers of a new hit, View Eyes' "Pillow Talk."

Rock Hudson, star of the new screen comedy, and Tallulah Bankhead... >> Rock Hudson was a very handsome man and a gifted Hollywood actor who was beloved by the American public.

And a rumor started spreading that Rock Hudson was very sick and nobody knew what was the matter with him.

>> Liz and Rock, today's two most exciting stars in the only picture big enough to bring them together, "Giant"!

>> He was the all-American male... >> Go ahead, zip!

>> ...and had all the all-American females.

>> He could snare two bunnies with a single line.

>> I'll be over some time tonight.

>> Here was somebody that people related to.

>> NARRATOR: The rumors that were circulating in Hollywood went into overdrive when Hudson appeared at a press conference to promote his friend Doris Day's new television show.

>> Rock Hudson had been ill with AIDS for a long time during a time period when there were essentially no effective therapies for the disease.

He went to Paris to receive therapy.

>> (translated): Rock Hudson came to Paris because, since 1983, we had been having some trials with a new treatment, which later turned out to be ineffective.

He was in a very, very advanced clinical state.

>> NARRATOR: Hudson was too ill to take the drug and was rushed to the American hospital in Paris, where officials denied that he was being treated for AIDS.

>> He has not been treated for AIDS while at the hospital.

>> NARRATOR: The press followed his every move as his staff chartered a 747 and flew him back to Los Angeles and the UCLA Medical Center.

>> I was standing on the eighth floor of the medical center watching as his helicopter landed.

He gave me permission to confirm that he had AIDS.

He asked if I thought it would do any good that I should do it.

Mr. Hudson is being evaluated and treated for complications of Acquired Immune Deficiency Syndrome.

And that was a bombshell for most of the world.

He was the first major figure, well-known, famous person diagnosed with AIDS.

>> This had such an effect.

I remember my mother-in-law calling me up and saying, "I didn't realize AIDS was such a problem."

I mean, I'd been talking to her about this for years, but Rock Hudson had it.

>> NARRATOR: 90 days after his last public appearance with Doris Day, Rock Hudson died.

>> The Rock Hudson story brought it to the national consciousness in a way that all the AIDS reporting up until then had been unable to do.

And it also frightened everyone into realizing that this wasn't just something that was happening to a small group that they could ignore; it was happening to a lot of people.

And unfortunately, it also created a big backlash of fear.

>> The message was "Everyone's at risk."

This was the time when bus drivers wore rubber gloves 'cause they were afraid to get AIDS, when people thought they could get it from toilet seats, and people didn't know.

Even in Washington, D.C., early on, when there was a demonstration, the police wore rubber gloves to arrest people.

There was a lot of ignorance.

People were afraid of losing their housing, people were getting thrown out of apartments, people were getting fired, people were getting denied health care.

So all of their worst fears were coming true.

>> NARRATOR: And that discrimination drove the long controversy about the use of the new blood test.

>> Am I afraid to be tested for a condition for which there's no cure?

For a condition which I will be labeled not only to myself but to the entire community as carrying a fatal virus, a virus that killed Rock Hudson?

Do I want to be tested for that?

And then who else will know my results?

Will they go to the government?

Will they go to the IRS?

Will they go to my insurance company?

Will they go to my loved ones?

Who will decide who they go to?

>> I have to park the kids!

>> NARRATOR: The fear of AIDS was spreading into America's heartland.

In Tennessee, panicking parents forced Dwayne Mowery, a 12-year-old hemophiliac infected with H.I.V., to leave school.

>> It's like putting a loaded gun in this school and just hoping and praying it don't go off.

>> Read that, baby!

Read that!

Trying to kill everybody else!

But y'all not going to kill my baby!

>> Go to hell!

>> NARRATOR: In Kokomo, Indiana, a 14-year-old hemophiliac, Ryan White, was forced to leave school.

Someone even fired a bullet at his family's home.

>> And perhaps the most egregious discrimination occurred among a family in Florida whose home was burned down because their children were hemophiliacs with AIDS.

>> NARRATOR: Before they were burned out, the Ray brothers, who had hemophilia, had also been forced to quit their school.

>> "Dear Mr. President.

"Hi, my name is Richard Ray.

"I have two brothers, Robert and Randy.

"We are hemophiliacs.

"We are having a hard time now.

"My mom and dad can't find a job.

We don't have a place to live."

>> The president should have done the same thing that President Franklin D. Roosevelt did, and that is have fireside chats, trying to dispel the fears about what was a very serious situation.

If you don't have any magic bullet and you don't have any vaccine, you don't have any drugs, education is the only thing that you have to try and stem the tide.

>> NARRATOR: In September 1985, President Reagan's advisers knew he'd have to answer questions about public fears.

A briefing paper was circulated which advised sympathy for parents and children and emphasized that there was no danger from casual or routine contact.

>> Mr. President, if you had younger children, would you send them to a school with a child who had AIDS?

>> I'm glad I'm not faced with that problem today, and I can well understand the plight of the parents and how they feel about it.

>> NARRATOR: But at his press conference, instead of assuring the public that the AIDS virus is not transmitted through casual contact, the president said this: >> And yet medicine has not come forth unequivocally and said, "This we know for a fact, that it is safe."

And until they do, I think we just have to do the best we can with this problem.

I can understand both sides of it.

>> NARRATOR: What had happened was that before the press conference there'd been a memo from a White House lawyer-- now Chief Justice John G. Roberts.

He'd written: "I would not like to see the president "reassuring the public on this point.

"We should assume that AIDS can be transmitted "through casual or routine contact until it's demonstrated that it cannot be."

Public health officials responded immediately.

>> I would like to stress that AIDS is a blood-borne, sexually transmitted disease that is not spread by casual contact.

>> NARRATOR: The head of the CDC and the top scientist at the NIH called their own press briefings.

>> The guidelines represent no change in the basic message about AIDS that the public health service has been conveying all along.

>> NARRATOR: But for all the politics around the virus, the government was still putting its faith in science, that the solution to AIDS was a vaccine.

But that was proving harder than anyone expected.

>> When H.I.V.

came along, people said, "Well, let's make a vaccine against it."

That was the first thing.

Margaret Heckler, when she announced that Bob Gallo had discovered the virus, said, "We should now have a vaccine in two years."

She couldn't have been more wrong, but she was not wrong about the history of virology, because once we knew viruses caused diseases, we could often then develop vaccines for them.

>> NARRATOR: Several major vaccine efforts, using the methods that had worked in the past, were failing.

>> And none of it worked because H.I.V.

has somehow figured out how to hide most of its surface behind a layer of sugar.

And the sugars are actually self constituents of the body, and, therefore, the immune system doesn't react to them because they are not foreign.

The immune system is looking for things that are foreign.

The foreign parts of H.I.V., which are the proteins, are all hidden behind this sugar.

And our bodies are unable to find any crevice in that virus that we can attack and kill it with.

H.I.V.

is amazing in the number of ways that it has found to protect itself against our immune defenses, and that's why it is what it is.

>> NARRATOR: By 1985, just four years after the first cases of AIDS were diagnosed, H.I.V.

had already infected at least 500,000 Americans.

The virus was moving quickly, infecting over two million people around the world.

Most of them were in Africa.

Lake Victoria is the largest lake in Africa, bordered by countries like Kenya, Tanzania and Uganda.

>> By mid-1980s, Uganda had the highest incidence of H.I.V.

in the world, way and above any other country in Africa or any other country in the world.

>> NARRATOR: In Uganda, the disease had first concentrated in the southeast.

It had traveled with trade into the Rakai District, a busy crossroads.

>> The long-distance drivers who traveled from the Kenyan coast of Mombassa on their way to Congo, Burundi and Rwanda used to stay there overnight.

And therefore it became popular with commercial sex workers, and the nightlife was very lively.

It was non-stop happiness, later to turn into misery.

By 1982, it was clear that people were dying of this mysterious disease.

People were thinning down and melting away, so they called AIDS "slim."

And it didn't matter whether they went to hospital or not, they inevitably died.

So it looked like a curse had descended on their town.

>> NARRATOR: With the curse came stigma.

>> The stigma was to do with the fact that it was sexually transmitted.

Sex is a taboo subject.

And it was also to do with the early information related to the disease that linked it with white homosexual men, and homosexuality is stigmatized.

>> NARRATOR: A personal tragedy would propel Noerine Kaleeba into a central role in Uganda's struggle against AIDS.

>> My husband was infected through a blood transfusion.

Relatives were invited to donate blood, and one of those people who donated blood was his own brother, who later turned out to have been H.I.V.-positive.

>> NARRATOR: But Christopher Kaleeba showed no symptoms until years later, when he was studying in England.

>> I traveled there and went to see him in hospital and found a completely different person.

He had left as a tall, proud, dark, handsome young man, but what I met in the hospital was skin and bone, frail, very, very ill, hardly able to lift his arm.

So within the space of time from when he was diagnosed and when I went to see him, he had completely disappeared.

>> NARRATOR: Desperate to save her husband's life, she made an impulsive trip to Geneva.

>> I had read that the World Health Organization has appointed a man, Jonathan Mann, to lead the first global program on AIDS, and this man was in Geneva.

And my interpretation of that was that he must have a cure if he was within W.H.O.

So I went straight to the main building of W.H.O.

and I asked to see Dr. Mann.

His secretary asked me if I had an appointment, and I said no.

And she said, "Well, you can't see him," and I burst into tears.

I don't think she had ever seen a big, African woman dressed and in tears in her office.

She didn't know what to do.

And as... as she was fumbling, Jonathan comes in through his office and finds me in tears and he asks me, "What is it?"

And I say, "I have to see you.

"I have to see you.

My husband is dying of AIDS and I have to see you."

He apparently was going to a meeting, which he never went to, by the way.

He... we sat for four hours, and he talked with me.

At the end of that time, I was calm, I was collected.

He told me that my husband was probably going to die because, at the time, there was no cure.

But he also said, "There is a prejudice that is attached "to this disease that we have to fight, and will you help me fight it?"

Jonathan Mann was a star, the first scientist I met with a heart of gold.

>> NARRATOR: Jonathan Mann had first encountered AIDS in Africa in 1984, when he went to Zaire to direct a major CDC study of the disease.

>> I saw him working from day until evening, trying to get this project up and running.

And then you would see him come home at night and just talk about the people that he saw on the wards that were dying, the suffering that he was dealing with every day.

>> And I think it's when we enter into the human reality of this disease that we understand, and that we understand why it's important not to discriminate and stigmatize, why it's important to prevent this from spreading further.

>> NARRATOR: Late in 1986, Mann was asked to lead a W.H.O.

global program on AIDS to get governments to pay attention to the growing threat.

>> He began collecting a group of people who were really pioneers.

They went to the developing countries, began seeing the spread of the epidemic, and sounded the alarm.

>> We have to do better than we've ever done before.

It's a matter of simple equity, of justice.

>> The guy just fizzed with energy.

He established AIDS programs in over a hundred countries in a remarkably short space of time.

>> It's a worldwide epidemic.

There are now 148 countries that report cases of AIDS.

There are problems virtually all over the world, the same kinds of deep problems that the United States is facing.

>> NARRATOR: After months at her husband's bedside in England, Noerine Kaleeba honored his dying wish and took him home to Uganda.

>> I knew that when he went home, he would die, and he knew that, too.

During the time that Christopher was admitted in a Malaga hospital, the health care workers did not care for him.

They were scared.

They never even stepped into the room where he was.

>> She encountered so much stigma, so much discrimination, and she swore that, when her husband died, that never again.

She realized that this was not just a medical disease; this was a social disorder that created all kinds of reactions in society.

>> NARRATOR: To fight that response, Noerine Kaleeba formed Uganda's first grassroots effort, known simply as the AIDS Support Organization, TASO.

>> We soon found that unless we make a difference in... in the levels of understanding basic information about this disease among health care workers and within the community, that the compassion that we are seeking so much and what we found was useful was not going to be possible.

So we mounted a vigorous campaign to work with the government.

(shouting) >> NARRATOR: Noerine found a powerful ally in Uganda's new president, Yoweri Museveni.

>> He was a hero.

He had just delivered us as Ugandans from the era of dictatorship.

He said, "I have just led you from one evil, "but there's another evil waiting.

"Ugandans, you know that if we rise and challenge an evil, "we can succeed.

Now I'm calling upon you to rise and challenge AIDS."

>> NARRATOR: President Museveni traveled the country speaking frankly about AIDS.

>> On the other hand, it is not so dangerous because it does not infect easily.

>> NARRATOR: Museveni preached tolerance and told his people they should not be afraid.

>> You can greet somebody with AIDS; it will not catch you.

You can sit next to somebody with AIDS; it will not catch you.

You will only get AIDS if you go and look for it where it is hiding itself.

Especially since there was no treatment, I could not keep quiet on this.

There was no... no other option, and any other option would have been murder, would have been criminal.

We evolved a model known as "ABC": abstinence; be faithful to your partner; but if you can't do the other two, use a condom.

(women singing) >> NARRATOR: In time, TASO groups would crisscross the country offering both entertainment and very direct instruction on how to avoid infection.

>> You went out without taking anything this morning, and now you are very drunk.

>> I'm not drunk!

I'm a bit tired.

I'm ready.

Let's go in the bedroom.

>> No condom, no sex.

Good night, Daddy.

(singing) >> This has been one of the key successes of the Ugandan response to H.I.V.

: positive people, families who have been affected who share their experience and exude hope, because hope is a key ingredient to survival.

>> NARRATOR: Uganda's campaign against AIDS would have a dramatic impact.

It was one of the very first countries in the world to demonstrate that prevention could work, and rates of H.I.V.

infection declined.

In the mountains north of Bangkok, there is a shrine to AIDS.

(gong rings) In the Buddhist tradition, the bodies of the dead are cremated, and these are the unclaimed ashes of dead AIDS patients placed here by the local abbot who nursed them in their final days.

>> (translated): This pile of bones serves as a reminder to people to have more awareness that AIDS patients shouldn't be left behind.

During the early period that this epidemic was spreading, there was a problem with fear-- fear of infection from H.I.V.- positive people.

It caused discrimination against the patients.

They were abandoned and kicked out of the community.

>> NARRATOR: AIDS had first come to Thailand in 1985.

But it wasn't just Bangkok's famous sex tourism that spread the infection; it was also heroin.

In Thailand's overcrowded prison system, drugs were readily available.

Many prison guards were dealers.

Needle-sharing was common.

>> (translated): Sharing a needle is sort of a tradition.

It meant we belonged in the same group.

We were close to each other.

>> NARRATOR: Seree Jintakanan is a former heroin addict who was H.I.V.-positive when he went into prison.

>> (translated): I used drugs when I was in jail.

I think, because living in jail created a lot of pressure.

So people tried to get something to help them feel better, and they didn't care about getting infected.

>> NARRATOR: The disease was widespread in the prison population when, in 1987, Thailand's king granted amnesty to over 37,000 prisoners.

Within six months, the infection rate among I.V.

drug users rose from 2% to 40%.

And by the late 1980s, the Thai army found that one in ten of its new recruits was testing positive.

The new prime minister decided to take action.

>> I was convinced that it had to be on a national agenda because the threat of AIDS, H.I.V./AIDS, and the... and the repercussions on our society would be tremendous.

>> NARRATOR: He was convinced by his friend, Mechai Viravaidya, who for years had been promoting condoms to prevent AIDS.

>> Well, I'd already been doing it in family planning since 1974.

I wasn't embarrassed by the condom.

I wasn't afraid by it.

I'd just say that the condom is clean as your mind, it's not dirty.

And then I realized that the condom is, in fact, a girl's best friend.

>> NARRATOR: The prime minister put Mechai in his cabinet.

>> I changed the regulations on advertising by saying that, from now on, every radio station, every television must have half a minute of AIDS education, AIDS information on every hour of broadcast.

We had AIDS education in all the workplaces, in all the villages.

So there was just H.I.V./AIDS information at every level.

>> He conducted a campaign of free condoms.

We distributed the condoms to every brothel, every known entertainment house in Thailand.

>> This work, it's like being a motorcycle rider, you know; you need a crash helmet.

So the condom's your crash helmet.

So use it.

>> NARRATOR: The Thai condom campaign would show dramatic results, reducing H.I.V.

infection among sex workers by as much as 90% over the next decade.

But the government was not as tolerant about drug addiction, and with few intervention programs, the virus would keep spreading among addicts and beyond Thailand.

(chanting) And even in a country with a Buddhist tradition of tolerance and compassion, fear and stigma did not disappear overnight.

>> (translated): Even though the government tried to convince its people that we could all live together, people were still afraid.

>> NARRATOR: Abbot Alongot, who had faced outright hostility from local villagers when he created a hospice for AIDS patients, slowly won their trust.

>> (translated): It took a couple of years for the people and community to grow softer about this.

One thing that made people calm down and feel better was the government's continuous distribution of information and sharing knowledge about AIDS.

Another factor was that AIDS was spreading now to the community itself.

>> NARRATOR: The abbot turned no one away.

>> The religious institutions of this country have been extremely helpful.

Luckily, we didn't have the church that kept on saying, "Don't use the condoms, don't use the condoms."

That just shows you, with good leadership, real political commitment and financial commitment, and great common sense, things can happen.

>> NARRATOR: When it came to political leadership, no two politicians were ideologically closer than Ronald Reagan and Britain's Prime Minister Margaret Thatcher, but the way their two conservative governments approached AIDS was radically different.

Norman Fowler was Thatcher's Minister of Health.

>> The safest course for a politician to take is to step back from it and pretend it's not there.

In a sense, that's exactly what President Reagan did in the United States.

Margaret Thatcher allowed me to get on with the job.

>> NARRATOR: In Britain, a major cause of infection was I.V.

drug use.

In cities like Edinburgh, the virus was spreading rapidly among addicts.

>> Heroin was in big supply.

It was easy to get heroin, but getting needles and syringes was difficult.

So people would go to one or two flats, one or two houses in the city, and they would share equipment and would pass it around the group, and everybody would inject a little bit of it.

And by the time you got to the last person, there was, you know, 20 types of blood in that syringe.

>> NARRATOR: Dr. Roy Robertson had been working with heroin addicts and taking blood samples from his patients for many years.

In 1986, with the new blood test, he could go back and find out how high the rate of infection had been.

>> We were able to go back and look at those samples and identify which had H.I.V.

as well and were able to draw that graph, which showed that it went from 0%, from no people infected up to more than 56% infected within the space of 18 months.

And that was... that was just extraordinary.

I mean, that was something that really hadn't been described anywhere else in the U.K. >> NARRATOR: Alarmed at the high rates of infection, Robertson and his colleagues published a report recommending that the British government establish needle exchanges.

>> There was no question that H.I.V./AIDS was being transmitted by shared needles.

But then came the issue: well, if you provided clean needles, weren't you condoning the criminal offense of kind of taking heroin in the first place?

>> NARRATOR: In the face of public opposition, Fowler argued to support the idea.

>> My argument to my colleagues would be that the crucial thing is to prevent the transmission of disease and to prevent people dying.

>> NARRATOR: Fowler's committee authorized pilot needle exchanges across the U.K. >> And the interesting thing is, the fact that we've had needle exchanges has kept transmission from the use of shared needles.

That has been a very, very small part of the problem in the U.K. ever since.

If you continue to have shared needles, then people go on dying.

>> Bleach, water, cotton, cooker, condoms.

The bleach... if you got to share, you clean the works twice.

>> NARRATOR: In the U.S., activists who tried prevention efforts ran into trouble.

Most states had tough laws on the books.

>> And one law they had was a law against needles, injection paraphernalia.

They thought that if that was available, more people would... would use drugs.

And that happened before AIDS.

That law was before AIDS.

>> NARRATOR: A former addict, Jon Parker tried radical action to get attention to the need for both drug treatment and AIDS intervention.

>> We'd put a table out and we would openly exchange needles in the presence of the media, the public and the police.

Now I'm going to give you a set of works.

Cops down there.

I don't want to get busted by them cops.

I've been arrested 40 times-- New York, I was arrested six times; in Massachusetts, I was arrested 26 times.

But we tried to use those arrests to educate the public, to gain attention.

>> NARRATOR: Without intervention, the virus was spreading deep into the I.V.

drug community.

>> Try hard to stay AIDS-free and just know that there's some hope out there, you know.

>> Thank you, you know.

It helps out.

Thanks a lot.

>> NARRATOR: Despite these efforts, as much as 40% of H.I.V.

infections have been I.V.

drug-related.

And although some states began to allow needle exchange, no program could, or can, receive federal funding.

>> ♪ Well, I might be crazy... ♪ >> NARRATOR: Aids educators had proven that prevention worked if it was targeted and explicit.

In a Denver, Colorado bar, volunteers made the rounds, handing out condoms and advice.

>> There's rules of the roads for safe sex on the back and a phone number on the front that you can bring your questions to, all right?

>> Do you have your condoms on you?

>> NARRATOR: These local campaigns had the best chance of bringing down the infection rates.

They had almost no government support.

>> The subject matter is so obscene, so revolting, that every Christian, religious, moral ethic within me cries out to do something.

This is embarrassing for me to stand here on the Senate floor.

>> NARRATOR: The most famous example was in 1987, when Senator Jesse Helms was angered by a brochure created by the Gay Men's Health Crisis in New York, which had received some federal funds.

To promote safe-sex techniques, the brochure dealt frankly with a gay sexual encounter.

Helms showed it to President Reagan.

>> The president opened the book, looked at a couple of pages, closed it up and shook his head and hit his desk.

And I hit this podium with the same feeling of revulsion and disgust.

>> NARRATOR: Although the brochure was for limited New York distribution and was not paid for with tax dollars, Senator Helms pushed for a ban on federal funding for any AIDS educational material that "promotes or encourages homosexual sexual activities."

>> Until we are ready to discourage and do our dead level best to eliminate the types of activities which have caused the spread of the AIDS epidemic, I don't believe we're ever going to solve it.

>> May I suggest you've got a large problem here.

You're limiting the dissemination of knowledge.

For the time being, science does not have the answer.

We're working toward it.

The only answer is education, and if you're going to censor that education, you have no solution.

>> NARRATOR: Despite the argument, Helms' ban passed by a vote of 94-2 and today is still the law of the land.

>> Due to Senator Jesse Helms, we could not fund anyone who would talk about homosexual sexual activities in their prevention activities.

That's like saying we want to try and stop alcoholic-related deaths on the highway, but we can't talk about booze and we can't talk about cars.

I mean, you can't do that.

Without question politics has been one of the driving forces in the spread of this disease.

>> NARRATOR: At the National Cancer Institute, scientists were looking for drugs that might slow or cure the disease.

They began by testing compounds that had already been developed for other diseases.

>> And that's how the first effective drug against H.I.V.

was discovered, by screening off-the-shelf compounds such as AZT.

>> NARRATOR: AZT was an early cancer drug from the 1950s that produced an unexpected response.

>> Okay, we have your BWA compound... >> NARRATOR: Patients who took the drug started to get better.

Their immune systems regenerated.

>> It actually blocks the virus in its ability to rebuild itself.

It was considered an amazing breakthrough that happened very quick.

It moved very quickly after that, the whole drug development against this virus.

>> NARRATOR: Bobby, a nurse who'd been infected with H.I.V.

through a blood transfusion, was like many people who experienced dramatic improvements.

>> I've put on quite a bit of weight.

>> How much have you gained?

>> I've gained... well, today, I'm 50.3 kilograms, which I've never weighed that in my life before.

>> So what about your fevers?

>> NARRATOR: Doctors cautioned them about toxic side effects, but it was the first hope they'd had.

>> I don't care what anybody else says, it's the drug.

>> NARRATOR: AZT had been developed with public money, and the drug was in the public domain.

But after Burroughs Wellcome showed its promise in an early trial, the government gave them a use patent.

>> The company had the gall to charge the highest price for any pharmaceutical in history, $10,000 a year-- obviously, way beyond the means of most of the people who needed it.

>> NARRATOR: Patients like Patrick were impoverished by the disease, unable to pay for their medical care.

>> You can't work.

You're very ill. What are you supposed to do?

My medical bill for last year was $125,000.

>> NARRATOR: Often weak and disoriented, AIDS patients also had to fight the bureaucracy to get disability and Medicaid.

>> You need to go down... are you going down to Medicaid now?

>> Yeah, today, yeah.

>> You need to, because it'll take them a week... >> NARRATOR: To protest the high price of AZT, the AIDS activist group Act-Up went to confront Burroughs Wellcome.

>> We met with the head of research-- "Mr. AZT" David Berry-- who really confronted us and said, "You should be happy that we priced it.

"This will allow us to do more AIDS research.

"We are the only company that's come up with the drug.

You should be appreciative of what we've done."

So just... we met a complete brick wall.

>> Boycott, boycott, boycott, boycott, boycott!

>> And had to apply our traditional forms of pressure.

We demonstrated on Wall Street, and we shut down trading in the New York Stock Exchange.

>> Boycott, boycott, boycott, boycott, boycott!

>> Three days after that demonstration, they did lower the price.

(cheers and applause) >> I'd say this was the birth of AIDS treatment activism-- something that didn't exist before in, I think, generally, in other diseases, where the patient community would get so directly involved with the pharmaceutical industry and the Food and Drug Administration.

>> We die!

>> They do nothing.

>> We die!

>> They do nothing.

>> We die!

>> They do nothing.

>> NARRATOR: Act-Up wanted to speed up the approval process for new drugs.

>> One of our greatest demonstrations and most famous was at the FDA.

>> We are the experts, let us in.

We are the experts, let us in.

We are the experts... >> And it was over a thousand demonstrators, almost all people with H.I.V.

demanding to be heard.

>> I know that there are drugs out there that can save my life, and I want to know why they're not being tested more quickly.

>> Seize control!

Seize control!

Seize control!

>> I began to get beyond the rhetoric and the theater of the demonstrations and to really listen to what it is that they were saying.

So I invited a group of them up to my conference room, and we spent a couple of hours talking about their concerns.

And again, it just confirmed in my own mind that most of their concerns were really quite valid.

>> NARRATOR: Their biggest concern was to gain access to new experimental drugs.

Now, the FDA agreed that although they would still conduct standard drug trials, they would allow other AIDS patients to try them, as well.

>> They have tried virtually everything, and everything is failing them.

And they are at the point now where they are trying this as literally their... it is their last resort.

>> The doctor wanted to see what's happening with me.

>> NARRATOR: But in the end, most of the experimental drugs failed... >> ...doesn't really see much difference.

It's still difficult, and it's scary, you know.

I'm pretty scared by all of it.

>> NARRATOR: ...and AZT was not the cure it had first seemed to be.

>> The virus wasn't totally knocked down, and as long as the virus could still replicate or grow, it pushed against that drug and developed resistance so that drug did not work any more.

>> NARRATOR: The virus had managed to adapt, but AZT was still a breakthrough drug and gave researchers hope that in combination with other drugs they could have an impact on the virus.

But that was years in the future.

>> When we discovered that this virus quickly developed resistance, we could then see the utter disappointment and almost anger in some of those patients, because here they suddenly had a success story and it was taken away from them.

And we had to work together.

Telling them that it wasn't the answer, it wasn't the cure, it didn't mean we wouldn't stop looking for a cure, but it was a step, a critical step.

>> NARRATOR: By 1987, when the AIDS quilt went on display in Washington for the first time, more than 40,000 Americans had already died of AIDS.

>> Back in 1985, when I had the idea of the AIDS memorial quilt, I saw that picture in my mind so clearly.

I saw the entire National Mall, Washington Monument to the steps of the Capitol.

In my mind's eye, I could see it just as clear as day.

>> NARRATOR: Activist Cleve Jones had created the quilt project to draw national attention to the crisis and to remember the dead.

>> It worked on so many levels for people, you know.

It was therapy.

It was a way to encourage people to talk and share memories.

It was a weapon to shame the politicians for their inaction.

What a perfect symbol.

What a warm, comforting, middle-class, middle-American traditional family values sort of symbol to attach to this disease that's killing homosexuals and I.V.

drug users and Haitian immigrants.

And maybe, just maybe we could apply those traditional family values to my family.

>> NARRATOR: One evening earlier that year, President Reagan had finally agreed to speak about AIDS at the American Foundation for AIDS Research.

>> Elizabeth Taylor wrote, inviting him and Mrs. Reagan to come.

She says, "I am writing from my heart to ask "if you both would attend the dinner, and if you, Mr. President, would give the keynote speech."

So it was her personal appeal that got the president there.

>> NARRATOR: Nancy Reagan had insisted that her favorite speechwriter, Landon Parvin, work on the speech.

>> Mrs. Reagan was concerned, I think, how the AIDS speech might go if it was left in the White House.

>> NARRATOR: As Parvin began his research, he discovered just how disengaged the president had been.

>> I talked to the president, I talked to White House people, I talked to Surgeon General Koop, and he told me that he hadn't met with the president on the issue of AIDS.

So I got to thinking, "Well, how can the president go give "a speech on AIDS and not even have talked to his Surgeon General about it?"

So I called Mrs. Reagan, and I said, "You know, I think this could be an embarrassment," and that the Surgeon General and the president should meet.

>> NARRATOR: But the Surgeon General still had to deal with the White House staff.

>> Well, one of the things that the Surgeon General wanted the president to do was to dismiss some of the fears-- that you can't get it from drinking fountains or you can't get it from swimming pools or any number of things.

So I had it in there you couldn't get it from mosquitoes, and someone had said, "Well, that hasn't been proven."

So I had to take out "You can't catch it from mosquitoes."

It really didn't make much sense to have White House staff second-guessing a medical doctor, but that happened.

>> America faces a disease that is fatal and spreading, and this calls for urgency.

>> NARRATOR: Dr. Merv Silverman had been one of Parvin's advisers.

>> I sat with Reagan's speechwriters and gave them what I thought was going to be the speech.

And I remember standing there after I introduced him, and my wife was sitting down in the front row, and he started talking, and I'd sort of look over to her and say, you know, basically with a little sign, "I...

I gave...

I... that was mine."

>> It calls for compassion, not blame, and it calls for understanding, not ignorance.

(applause) >> He was talking about compassion.

He was talking about "the enemy is the virus, not the individuals," all these wonderful words.

>> You don't get it from telephones or swimming pools or drinking fountains.

You don't get it from shaking hands or sitting on a bus, or anywhere else for that matter.

Education is critical to clearing up the fears.

>> And then the whole thing changed, and the rest of the speech talked about testing and all of these kinds of things.

>> I've also asked HHS to add the AIDS virus to the list of contagious diseases for which immigrants and aliens seeking permanent residence in the United States can be denied entry.

(audience booing) >> There ended up being a demonstration inside, with people standing up and turning their backs to him, because what he was saying was counterproductive and not going to be very helpful in dealing with this epidemic.

>> Thank you.

(applause) >> There were forces in the administration wanting him to talk about abstinence.

There were other forces wanting him to talk about condoms.

And so we threaded the needle and didn't talk about either.

>> NARRATOR: Any positive messages in the speech were lost in the political arguments and reactions.

It was Reagan's only speech on AIDS.

He would appoint a presidential commission, which gave strong recommendations, particularly on prevention programs.

But the report had little impact.

The years of inaction would continue into the first Bush administration, and, by 1990, as many as a million Americans had been infected with the virus.

Under pressure, Congress finally responded.

>> The House Of Representatives approved a bill authorizing more than $4 billion over five years.

>> This legislation converts the millions of dollars of federal research into treatments that are available to the public.

>> NARRATOR: It funded comprehensive care for people with AIDS who couldn't afford medical insurance.

>> ...my nephew in the wheelchair, my four kids and my mother in four rooms.

So we stay in the living room on the floor.

>> NARRATOR: It was called the Ryan White Care Act, named for the young man from Indiana who had campaigned against discrimination and had died a few months earlier.

In Washington, other parts of the government were now giving serious attention to the threat of a coming global AIDS pandemic.

>> We are all trying to understand the implications for the economies, for the militaries, for society, and even for political stability in Africa.

>> NARRATOR: In 1991, a classified CIA report predicted with uncanny accuracy how AIDS threatened the world.

>> "A time bomb for the 1990s.

"AIDS is now global.

"Africa, getting worse.

Thailand, Brazil, India, the Caribbean."

And then it goes into implications for the United States.

The prediction writing in the early 1990s was that there would be as many as 45 million infections worldwide by the year 2000.

>> NARRATOR: Jonathan Mann had been issuing the same warnings from the W.H.O.

in Geneva, but now his global campaign against AIDS had a severe setback.

>> Jonathan Mann's departure from the World Health Organization, I think, was a watershed moment in the history of our response to H.I.V./AIDS.

He left, as far as I can tell, because of personality conflicts, and this is really the tragedy.

That when you're battling an epidemic that's this big and that's this devastating, everyone should have to check their egos at the door.

>> NARRATOR: Jonathan Mann's high-profile work had led to a bureaucratic battle with his boss, W.H.O.

president Hiroshi Nakajima.

>> I think that he may have been getting too much visibility.

He actually had become public face of world health, and that may not have been appreciated by his bosses.

And it was also about control.

>> NARRATOR: Nakajima had watched as Mann built his program into a $100 million a year organization, much of which Mann had raised himself.

>> There was a tremendous amount of money coming in.

And at one point, Jonathan Mann's global program on AIDS accounted for one-third of the budget of the World Health Organization.

>> It was pretty clear to all of us that the new director of W.H.O.

felt that he was being totally overshadowed by this media superstar.

He actually limited Jonathan's travel.

There were instances when he wouldn't let him go to a meeting.

He wouldn't sign off on travel.

Whether Jonathan should have stayed and weathered the storm or whether he made the right move, I think that's an arguable point.

The fact is he made that decision to resign.

>> And we were totally shocked.

We all gathered and lined the stairs leading from the room where he was in a meeting.

Jonathan came out, and we burst into applause.

(applause) You could see he was visibly moved, and he sort of half trudged, half skipped up the stairs and then turned around and saluted the people there and left.

>> The impact was immediate.

>> We have a chart that shows the number of employees in H.I.V./AIDS in W.H.O.

since 1986 or so, and it was as high as 250 during the height of Jonathan Mann's time here.

Then it went down to four.

And there was really very little activity going on here.

>> NARRATOR: It would take years for a new agency, UNAIDS, to begin to replace Mann's operation.

In the next decade and a half, the epidemic became a pandemic, and a further 60 million people were infected with the AIDS virus.

>> ♪ Why?

♪ Why me, why you, why her, why him, why me?

♪ ♪ We are wondering why this came to us ♪ ♪ Why, Lord?

Why me?

♪ >> ♪ Oh, why me?

♪ >> NARRATOR: In part two of "The Age of AIDS": the dramatic story of how the virus traveled across Africa and around the globe... >> ♪ We are wondering why this came to us ♪ ♪ Why, Lord?

Why me?

♪ >> NARRATOR: ...the extraordinary hope of new medicines and the deep moral questions about who gains access to them and whether the lessons of history would be learned to prevent the further spread of the epidemic.

>> ♪ ...why her, why him, why me?

♪ ♪ We are wondering why this came to us ♪ ♪ Why, Lord?

Why me?

♪ ♪ We are wondering why this came to us ♪ ♪ Why, Lord?

Why me?

♪ >> Tomorrow night, part two of "The Age of AIDS."

>> The people who are dying from AIDS are black and brown, and the people who control the money are white.

>> The price of life-extending drugs creates a global divide.

>> This pandemic was running its natural course without any intervention from the rich world.

>> The dramatic story continues.

>> It's not only the West and Africa; it's the whole world now.

>> "The Age of AIDS," tomorrow night on Frontline.

>> To order Frontline's "The Age of AIDS" on video cassette or DVD, call PBS Home Video at 1-800-PLAY-PBS.