At the 1996 International Conference on AIDS, an American scientist named David Ho presented data showing that a person infected with HIV produces billions of virions every day they are alive. The heavier a person’s viral load, the weaker their immune system becomes and the weaker a person’s immune system becomes, the more likely it is that they will catch an infection that will kill them. Ho’s data suggested that one way of preventing HIV from turning into full-blown AIDS is to impede the production of virions. This insight led scientists to develop a treatment plan based on the use of three retroviral drugs (the so-called triple cocktail) that results in a 60% to 80% decline in rates of AIDS, death and hospitalisation. In fact, the treatment is so spectacularly effective that doctors often talk about the cocktail having a ‘Lazarus effect’ on the people who take it. The only problem with the cocktail is that it costs somewhere in the region of $15,000 per year, meaning that millions of people in the developing world simply cannot afford to continue living. Dylan Mohan Gray’s Fire in the Blood is a documentary about the attempts to find a way of making cheap drugs available to HIV-positive people in the developing world.
As you might expect, Fire in the Blood begins by presenting us with the human dimension of the problem: We are shown people dying of AIDS, we are shown people in the west who were close to death and we are shown these very same people who reclaimed their lives with the help of retroviral drugs. The fact that the only difference between the people who die and the people who live is that the people who live can afford the drugs is already a scandal that speaks ill of humanity as a species but Gray’s investigation does not end there.
The problem is not that the drugs themselves are expensive to produce – Indian pharmaceutical factories are now capable of producing triple cocktail drugs at a price closer to $100 dollars per year – but that the companies that own the patent on the drugs want to keep selling those drugs to the West at $15,000 per person per year. Thus, the only way for the Indian pharmaceutical companies to sell the drugs at the lower price point is by breaking patent law and producing them without the permission of the legal owners. Much of Fire in the Blood is given over to describing how a small cadre of public health officials, industrialists and activists worked to find a political compromise that would allow them to sell low-cost Indian drugs in Africa without Western governments cutting off aid and invoking trade sanctions as retaliation. As a direct result of this political compromise, the number of people receiving the triple cocktail in Africa went from only 8,000 to over 8,000,000. Horrifying and fascinating in equal measure, this story alone could easily have supported an entire documentary film. However, to Dylan Mohan Gray’s enduring credit, Fire in the Blood does not stop there.
Since Michael Moore’s Bowling for Columbine demonstrated the existence of a large potential audience for documentary film, many have tried to use film as a means of raising awareness about particular injustices and so bringing pressure to bear on people with the power to make a difference. The problem with this approach to documentary filmmaking is that if the film becomes merely a means to an end then there is little incentive to put anything in the film other than what is strictly necessary to change minds and win support. As a result, films like Louie Psihoyos’s The Cove and Morgan Spurlock’s Super Size Me are often little more than rhetorical exercises that manipulate audiences into agreeing with their point of view rather than seeking to educate them about the nature of the world at large.
Fire in the Blood may begin by showing us moving footage of people wasting away in underfunded African hospitals but the more the film progresses, the further it moves away from emotional manipulation and towards education. Indeed, the film does not end with cheap drugs going on sale in Africa as pharmaceutical companies used this setback as an excuse to lobby for the introduction of international trade agreements making it much harder for their prices to be undercut in future. It is here that Fire in the Blood is at its most effective as the real reason that people in the developing world are dying from preventable diseases is that humanity has opted to use capitalism to organise the distribution of limited resources and capitalism will always prioritise the creation of wealth over the prevention of suffering and the safe-guarding of human lives. Deftly narrated by William Hurt, this Indian documentary ranks alongside Alex Gibney’s Enron: The Smartest Guys in the Room and Charles Ferguson’s Inside Job as one of those documentaries that shows us how broken our financial system really is.