Thursday, February 21, 2013

‘Fire in the Blood’ (2012) directed by Dylan Mohan Gray

Fire in the Blood exposes some unsettling truths about the consequences of Western economic dominance.  It’s a catalogue of injustice and cruelty perpetuated without hate or malice, but, with a beady, utilitarian eye on maximisation of profits.  What we see in this film are the blunt and bloody consequences of capitalism: desperate people gasping their last breaths in a hospital bed, bodies thrown onto an enormous pile millions of corpses high: a sacrifice to the almighty free market.  

This documentary is about the supply of antiretroviral drugs (ARVs) to HIV/AIDS sufferers, with a focus on sub-Saharan Africa.  In 1995, millions of people across Africa had no future to look forward to a slow and painful death. Suddenly through this gloom shot a ray of hope - a new course of treatment with results that seemed nothing short of miraculous.  Skeletal, bedridden patients when administered ARVs began rapidly improving in health, a condition the doctors began to call “The Lazarus Effect”.  In Fire in the Blood we see South African High Court Judge Edwin Cameron's life transformed from utter misery to competing in a long-distance cycle race entirely through the effects of ARVs.  It’s not a cure, but ARVs make living with HIV/AIDS possible, to allow them to be able to work, exercise and appreciate life again.  In these sub-Saharan countries, with vast swathes of populace stricken with HIV/AIDS this was a light at the end of a very long, very dark tunnel.  

But there's a problem.  Though the drugs cost peanuts to produce, the price was strictly controlled by enormous, avaricious drug companies.  Treatment cost $15,000 dollars per year, a sum impossibly out of reach for the poor with HIV/AIDS.  The message from the developed West from companies like Pfizer and GlaxoSmithKline is clear - if you haven’t got the money then get ready to embrace death, sucker.  The resulting genocide of 10 million Africans is almost incomprehensibly horrific - men, women and children who died as a result of not having access to medicine that costs a few cents to make.

Much of Fire in the Blood is an impeccably and methodically researched argument explaining precisely why the price is so high and the moral contortions big pharma twists itself into to justify having the blood of millions on their hands.  We come to learn that the reason these drug companies behave like this isn’t because the individuals running them are monstrously evil, it’s because they are entirely beholden to a system of maximising profit.  Their reasoning was that if they lowered the price of ARVs in Africa, then they risk their US customers - their most profitable market - turning against them.  If they allow generic ARVs (chemically identical to the patent version at a fraction of the price) to be imported, they run the risk of setting a legal precedent against their patents, potentially lowering the worth of their intellecual property. If profits dip from the stratospheric to the slightly less stratospheric, shareholders will get antsy and the board will be held accountable.  The upshot is that on an accounting spreadsheet in an air-conditioned New York skyscraper, numbers are moved from one column to another.  As a result in Uganda, hundreds of thousands of people die needlessly.

It’s easy to see how people buy into the drug company’s rhetoric - at first they seem to have some good points, but Fire in the Blood systematically demolishes them.  These arguments range from the practical and vaguely plausible: "the reason these companies need to charge so much is to recoup what they spend in research and development".  The implication being that if they sell these particular ARVs at a low price, then future R&D will be affected adversely. Gray shows us that far from these companies leading the way in development, they tend to gobble up smaller companies that have developed drugs using public funds.  According to the film, they’re responsible for only 12% of R&d research worldwide.

The other end of the scale in the argument that poor Africans should be denied these life-saving drugs is far more insidious, dipping into outright racism.  Spurious arguments are made that Africans can’t be trusted to follow a course of drugs (it eventually turns out they can - better than Western patients) with reasons ranging from some kind of innate laziness, to not being able to comprehend the idea of a clock - “they tell time by looking at the sun!” bleats one particularly gormless looking US senator.  Even among HIV sufferers in developed countries there’s a fear that providing ARVs to poor Africans might lead to a drug-resistant strain of HIV/AIDS evolving, so, really it’s in everyone’s best interests if these Africans would just crawl off and die as quietly as possible, preferably without making too much fuss.  As they say: “fuck you, got mine”.

So we’re presented with a situation where, as Professor Peter Mugyenyi, specialist in the field of HIV/AIDS simply puts it, “‘the disease is where the drugs are not”.  To illustrate this we see cartoons of a skeletal man in a hospital bed reaching vainly towards a giant, locked pill bottle.  Fortunately there are those who stood up against the drug industry, working both within and outside the law to get the ARVs where they’re needed most.  The highlights are the Indian manufacturers of generic ARVs who devise a way to provide the medication for less than a dollar a day to HIV/AIDS sufferers - a yearly course costing just $350 rather than $15,000.  We meet committed political activists who risk their own lives and liberty, like Zackie Ahmet, co-founder of the Treatment Action Campaign (TAC) in South Africa who personally sacrificed his health in a boycott of ARVs until they could be provided for everyone.  The above mentioned Professor Peter Mugyenyi ordered low-cost generic ARVs from India, defying Uganda’s patent laws and challenging authorities to arrest him until the drugs were allowed into the country - an action which opened the floodgates of low-cost generic ARVS into Africa.  Some of the ‘good guys’ end up being quite surprising - for example it’s a pretty unique experience to think for a second “hey, maybe George Bush Jr wasn’t all bad...”.

Fire in the Blood is one of the clearest political arguments I've seen in a long time, but thankfully it works as a piece of cinema too.  It’s frequently quite beautiful, the African scenery popping with colour and framed with an expertly artistic eye.  There are some very clever cuts subtly linking ideas, like cutting from the grave of an AIDS victim in Uganda to the US Capitol Building in Washington DC.  We never dip too much into the abstract, and Gray's confidence in the importance of his material shines through - he always lets his interviewees speak rather than bombarding us with a blizzard of quick cut visuals.  Perhaps the only slightly disappointing aspect are some aspects of the score, which is a bit heavy-handed: long ominous bass tones when they’re telling us about terrible things, light orchestral triumphant pieces when something good has happened.  Perhaps this is simply the nature of the beast in documentaries, but it’s a tiny bit frustrating to be emotionally prodded rather than trusted to react to the material in a humanistic way. 

Fire in the Blood is a sober and eye-opening look at a topic so terrible, wide-ranging and complicated that many prefer to regard HIV/AIDS in Africa as “just one of those things”.  Gray has created a film that breaks the situation down into easily digestible chunks, building his case against the drug companies piece by piece into an incredibly compelling whole.  Apart from the central narrative, it becomes a searing indictment of free market capitalism.  The frantic race towards maximising profits literally leads to mountains of corpses, the deaths of millions justified as a necessary evil in protecting someone's bottom line.  A person that profits from restricting the supply of generic life-saving drugs to the world's poor should be on trial for crimes against humanity - they have consciously and coldly committed genocide for financial gain.  Before watching the film I assumed the title Fire in the Blood referred to HIV/AIDS.  It is, but it's also appropriate for the anger you'll feel when you learn about this senseless waste of life.


'Fire in the Blood' is playing at the Prince Charles Cinema on 22 February and across the country on the 25th of February.

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