And The Band Played On: Politics, People and the AIDS Epidemic (Book Review)

Guest blogger: Barbara Waldorf, RN
For everyone concerned about public health, HIV-AIDS, MSM and human rights are key issues. Homosexuality is illegal in 80 countries worldwide. A major battle is brewing in Uganda, with a virulent anti-homosexuality bill in parliament and donors like Sweden threatening to cut all aid if it is passed. There are implications for all public health projects. Randy Shilts wrote eloquently about these issues at the beginning of the AIDS epidemic. Despite the extraordinary progress that has occurred over the last 30 years, what he explored is as relevant today as it was when it was written.

Marginalized groups of people die while the world does nothing, despite key players being able to stop the slaughter. Randy Shilts states he wrote this book, so “…it will never happen again, to any people, anywhere.” “Never again” was said after the holocaust in Europe. The AIDS epidemic can be seen as another holocaust. The overarching issues this book reveals are universal. It forces us to contemplate: What would I do? What is the impact of our prejudices? How do we treat the “other”? And how do we care for those that society has disenfranchised – whether they were Jews in Europe in the 1930s, American gay men in the 1980s or undocumented aliens today?

And the Band Played On is a compelling account of the first five years of the AIDS epidemic. Shilts takes us on a journey, starting with an unknown disease in Africa, to the first CDC case report of unusual pneumonia appearing in young gay men, to the growing awareness of the disease by the mainstream society. The breadth of research is staggering, covering the growing controversy within the gay community; the scientists researching a cause while competing for fame; the politicians more worried about popularity than people dying; and the impact of the conservative fiscal policies of Ronald Reagan that cut funding for the CDC and government health facilities, just when they needed to engage the biggest pubic health threat of the century. Shilts delineates the complex response to the emergence of AIDS that was impacted by prejudice against gays and other marginalized people. He was a journalist, and wrote this book to catalogue the lack of response, that caused a huge number of deaths and allowed the virus to spread virtually unchecked for years.

His premise was that because the virus emerged in groups the mainstream culture wanted to ignore, scientists, doctors and politicians were blinded and failed to halt the spread of AIDS. Shilts forces us to question the social and political milieu this medical crisis arose within, which prevented any unified response. It always takes enormous energy and commitment to see our own blind spots. For anyone interested in public health, the important questions that arise are: Who is the “other” now? Do I have the vision and courage to respond to the next crisis, no matter where it arises? Given these questions, this book becomes a contemporary cautionary tale. Shilts warns us to chronicle the ways that AIDS was ignored so that we can have the humility not to repeat history with the next disease that appears among the disenfranchised. He makes the point that despite apparent differences, we are all human beings, intimately connected. He leaves us to contemplate how to create a world where there is no “other.”

Barbara Waldorf is an RN and working on her MPH at Boston University School of Public Health with a concentration in International Health. Having lived and worked in Asia, Europe and Australia, her current interest is in the emerging field of Global Health nursing and learning from other nurses who are active in this field.

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