Before we start, just a couple quick notes: Please refresh your browser every minute or so to see new comments, questions and answers. To reply to specific comment, hit the reply button underneath it and then type away. Always after a comment or question hit “send comment.”

Please stay on topic–in this case tonight’s film, The Lazarus Effect, our guest and his filmmaking career, and what he experienced re: HIV/AIDS and antiretrovirals, and related issues.

If you want to jump in about the economy, the budget, the debt etc., please find a post elsewhere on FDL to do so. Thank you.

Please be respectful of our guests and of each other. And yeah, I tpye badly…

Hello Lance, welcome to Firedoglake Movie Night. Thank you for being here tonight!

Hello, thank you for drawing attention to this issue and this film.

Hi Lance! Thanks so much for joining us. And fo rmaking The Lazarus Effect

Lance, Welcome to the Lake. Thank you for a great film.

This is the 30th year of HIV/AIDS, the strides that have been made are great, and the progress in Africa thanks to The Gobal Fund and PEPFAR are huge. And (RED) has played a tremendous part in The Global Fund’s HIV/AIDS efforts in Africa.

How did you get invovled with The Lazarus Effect? And how log were you filming in Zambia?

40 cents a day? That is a miracle. For less than some people spend on their daily Starbucks habit, you could save at least 10 people. That’s astounding.

Thank you for bringing this front and center

This IS a great film. Thanks for making it.

Lance,
Can you tell us what events in your life led you to make such a film? What was the most difficult aspect, and what were the most uplifting parts?

Wow, I just got a note on Facebook…a teacher I know says he is planning on showing The Lazarus Effect to his class as part of HIV/AIDS awareness.

It is quite amazing.

Back in the ’86 or so when AZT first came to the fore, it was a miracle drug; and the suggested treatment included waking up in the middle of the night to take the doses too, and no one knew then how toxic it could be, aside from the fact that it cost about $18k per year at the time.

Hi Lisa, Hi Lance –

Thanks for making this important movie. When ARV hit American cities big-time in the early to mid-nineties, we had our own Lazarus Effect as men thought dead or soon dead rose from their deathbeds and headed back into life, bigtime. Besides the incredible redeemed value of these lives our community garnered, as men returned to their activism, work, and play, we had a new challenge, too: people were suddenly long term survivors of HIV/AIDS and, as such, were living full lives — including full sex lives. While the previous challenges around HIV prevention had been knowing (and telling) your status in the early stages of infection, those of us in HIV prevention suddenly had an entirely new population to reach.

We needed to help newly alive people cope with their own sexual responsibility, and conjure up new prevention strategies for people who didn’t “look sick,” in the vernacular.

I wonder how HIV prevention in Africa has handled this challenge, since people on ARVs have low viral load which reduces the risk of transmission but far from eliminates it. Did you see evidence that these long-term survivors are developing new coping strategies around having full and happy sex lives with HIV negative partners?

Thanks again for chatting today (and thanks to Lisa for scheduling this important work).

Demi, I lost friends and teachers to AIDS and HIV related illnesses throughout the late 1980s and early 1990s. HIV was a dominating factor in my mind as I started dating and having relationships. I helped lay out the Quilt when the Names Project brought it to Georgia, and was releived as ARV treatment began to unfold in the United States. Most of the people I knew with HIV were US Citizens with access to health care or the money to afford some treatment. The side effects were often toxic, but as drug cocktails became less convoluted I watched friends resume their health and lives.

AIDS began to feel like less of a crisis among my social circle, and more like an ongoing public health issue that could be managed.

I was ignorant to how it actually felt on the ground in Africa where access to affordable ARVS didn’t exist until more recently.

Teddy, one of the challenges facing those living longer with HIV/AIDS in Africa (and elsewhere) are “standard” health care issues. In Africa, I just read there are issues of heart disease , nutrition and diabetes.

When I saw a series of photographs that (RED) had produced of patients in Africa in their weakened, emmaciated state and then how radically their health transformed in 3 months of having access to the medication I was stunned.

Those appeared in an article in Vanity Fair under the same title “The Lazarus Effect.”

(RED) knew that they wanted to make a film and get it out into as wide a viewership as possible to show how this progress is being made, and that smart targeted aid can be effective.

They approached the filmmaker Spike Jonze whom I often collaborate with. We responded immediately to the issue, and to the energy of a woman named Sheila Roche who works at (RED) and who we knew from her previous music industry work as part of the management team for PJ Harvey and U2.

Spike was finishing Where The Wild Things Are, so he produced while Sheila and I flew over to Lusaka in Zambia to begin meeting people in clinics as they came in to seek treatment.

TB and malaria are also on the rise, hence the expansion of The Global Fund in those areas.

While htis article is three years old, it gives insight.

I know you went to zambia several times for the film. What were you prepared for and what was the most unexpected part of this experience for you?

Teddy, what I saw in Zambia in particular was definitely taking measures to counsel and inform patients about not just avoiding death, but also how to responsibly live long term and avoid spreading HIV to partners.

The process began with testing being done in neighborhood clinics throughout the countryside, not just in the major urban center. There was also testing available at large free events like soccer/football matches, dance events, recreation centers, schools, and a large music festival.

Counselors were available at each place to inform people of risk reduction through condoms and safer sexual practices, as well as abstinence.

For those who were positive and had low CD4 counts who qualified for ARV treatment, the clinics that you go to pick up your medication also counseled each patient and reinforced risk reduction to reduce transmission.

How did you decide upon the subjects?

I’m wondering if the people used in the film to illustrate the theme were compensated in any way? This isn’t meant to be an intrusive question. I’m hoping that perhaps the film makers got the drug manufacturers to donate meds. Thanks.

I had never spent time in Africa prior to flying with Sheila Roche in May of 2009. Spike and I had read and researched Zambia, which is a landlocked country that has historically avoided armed conflict and has a young average population. I was hoping to explore on my own and find young people and talk to them about what their lives were like, what music they were listening to, what it was like dating and having sex in the context of such high prevalance of HIV.

We ended up shooting primarily in the more rural areas served by clinics outside of Lusaka, and while English had been declared the official language by the government most of the people we were getting to know spoke several different tribal languages.

I thought I had braced myself, and have spent time in other situations with poverty and health issues in the world, but seeing the impact on children at the clinics was piercingly acute.

The film has a sequence about a young girl named Bwalya who was 11 years old, but came into the clinic looking shorter and lighter than most 6 year olds I am used to seeing in the US. HIV and othe rmedical complications had stunted her development.

Coming back throughout the rest of 2009 I was genuinely amazed at her progress and health once she began her treatment, which we see on camera.

Lisa – which celebrities in the US do you think helped promote education and understanding of the aids epidemic?

{ Welcome Lance, Lisa and attendees }

To all the folks involved– seen and unseen– good job!

As far as the most unexpected thing, I met and filmed several young women who were pregnant. I assumed that this meant their children would be born HIV positive. They spoke about their plans for reducing the risk of mother-to-child-transmission, and there are steps that can be taken to minimize the risk of transmission, which turns out not to be automatic. I filmed this process but it didn’t quit fir into the focus of the completed film, but I encourage people to read about it, it is remarkable how it works and is a major goal for reducing the number of children born with HIV for future generations.

(RED) are mobilizing around this particular goal now.

Demi, the film came out of (RED) an innovative economic idea:

Make unique (RED)-branded products (PRODUCT) RED and direct up to 50% of their gross profits to the Global Fund to invest in African AIDS programs with a focus on the health of women and children. (RED) is not a charity or “campaign”. It is an economic initiative that aims to deliver a sustainable flow of private sector money to the Global Fund.

I hadn’t read your links. Sorry. But, thanks for the info. This is great news. And, many of us crave that these days.

HIV/AIDS in Africa was bubbling under as an issue in the early 2000s. President Bush announced PEPFAR during his State of the Union address on January 28, 2003

PEPFAR is the largest commitment ever by any nation for an international health initiative dedicated to a single disease — a five-year, $15 billion, and multifaceted approach to combating the disease around the world. The United States now leads the world in its level of support for the fight against HIV/AIDS.

The way that access to the medication worked in Zambia as well as many other African countries is that the patients don’t have to pay for the medication. The Global Fund to Fight AIDS, Malaria, and Tuberculosis sets goals and standards for clinic systems in each country. Instead of turning funding directly over to the local governments they work with health care providers, church groups, and agencies throughout the country. They hold them to targets and standards.

This has reduced the sort of mismanagement that has complicated relief efforts around the globe in the past, where corruption or graft within governments could siphon off aid.

These clinic systems test, counsel, and provide health care to the communities and can distribute medication at no cost to the patients. The ARV treatment we saw most commonly involved two pills a day that cost less than 40 cents total. To work effectively people need to take them with food and clean water, acces to which is still difficult ion many areas, so the clinics coordinate with other relief programs to help clean wells and distribute food through USAID as well as other organizations.

In terms of celebrity power, Bono.

Bono has pulled in major star power, celebrities to help raise awareness, edited an entire issue of Vanity Fair dedicated to Africa and efforts there in terms of health care, economics and social issues. Bono has gotten celebrities in every country involved.

Bono on Oprah announcing (RED) in 2006 –the next day entire shops were sold out of (RED) merchandise, and wow am I happy I bought multiples of those waffle weave tunics. I LIVE in those. Fashion notes aside, when you combine passion, energy and star power with such a major idea (“let’s save lives for under 40 cents a day)…how can people–famous or otherwise–not line up behind it.

There are currently six HIV and AIDS grants in the Global Fund (RED) Portfolio in Rwanda, Swaziland, Ghana, Lesotho, Zambia and South Africa. 100% of all (RED) contributions to the Global Fund goes to the implementation of these grants, no overhead is taken out. These grants support locally-designed programs that provide antiretroviral therapy for HIV positive individuals, support HIV prevention, feed and educate children orphaned by AIDS and provide the low-cost treatments needed to reduce the risk of transmission of HIV from mother to child.

I went to various clinics and visited as patients came in. If they were willing to talk I would explain the film I was making and ask if they were comfortable being interviewed. I returned several times throughout 2009 to shoot updates as people responded to their treatment.

I have two children, and perhaps most identified with the younger patients and what they were living through.

How are the four subjects of The Lazarus effect doing today?

This is wonderful to read. I’m glad that people have figured out that giving aid directly to people is the way to go. Great. Thanks.

Thanks!

I wonder if community-based responses (as we were able to develop in SF, for instance) will go a ways toward knocking down some of the rumors in Africa about AIDS transmission. One of the hardest myths to break about HIV in SF was that “tops don’t get AIDS.” Are there particularly difficult myths about “slim” to break down in Africa as well, I wonder, particularly when dealing with a newly long-lived HIV+ population?

What more, in the name of love.

I’ve said this before and I’ll say it again. I always learn something at FDL. What I’m going to do with the “tops” info, I don’t know. But, now it’s in my head. Thanks.

In response to Lisa Derrick about how the 4 main subjects are doing today:

I would encourage people to see the film before reading this, and it is available for free in it’s entirety on youtube here:

http://www.youtube.com/watch?v=l16YH6xCN4c&feature=relmfu

Concilia is thriving, and takes care of her daughter and continues to work as a peer counseler in the clinic. She was recently a finalist in the Miss Stigma Free Competion in Lusaka.

Constance Mudenda is incredibly busy working to help others, and travels between different clinics in Lusaka, Mongu, and recently went to South Africa with a Communities delegation.

Paul is harder to get regular updates from as he and his family stay in a rural area but he sounds like he has adhered to his program of treatment and continues to do well.

Tragically, Bwalya had medical complications that overcame her, and passed away. it is important to remember that despite recent progress AIDS remains a devastating force and access to additional medical care isn’t available to everyone who needs it, and that there is still plenty of work to be done to improve conditions around the globe while we all work towards a cure.

We made an update that contains additional information, which you can view here:
http://www.youtube.com/watch?v=947pdJu3kVI

The myths about (how to cure/not get) HIV/AIDS world wide are horrific. Education, as we learned in the US is the key. Sadly, here in Los Angeles and elsewhere, kids born post 1981 have no idea what things were like pre-ARVs.

The educational/counseling component of the work being done in Africa through The Global Fund is key.

Lance, what is next for you and could you tell us please a bit about your other projects including the BANGS series of documentaries and short films and Family Portrait?

And also Lance, I wanted to ask you about Coachella! How was it? Did you you see Ceelo? (and if you want ot stay on and answer more questions, please do)

One of the things I was impressed with was how diligent people were about taking their medications. It loses effectiveness if you don’t take it every day at the prescribed times, so people were setting wristwatches or alarms or having systems of family members and friends reminding each other about times.

I recently shot a series of public service announcements and lifestyle profiles for the Center for Disease Control and the Kaiser Foundation all across the United States aimed at teenagers about increasing awareness of sexual health and testing for status. These have begun airing on MTV and are available online as well, under the name GYT for “Get Yourself Tested.”

This weekend I documented Coachella, focusing on Arcade Fire’s project with Chris Milk designing 1250 balls which dropped on the crowd, then lit up and became controllable light sources.

I’m back home and preparing to care for my two children while my wife Corin Tucker tours the West Coast of the US performing with her band.

Awesome. You make me want to watch MTV just to see your spots.

Bono is the huge public face of (RED) but credit where it’s due: Bobby Shriver brought the crisis to Bono’s attention and is the ‘back office’ of the movement.

Teddy, thank you. The two make an amazing team.

And also, were it not for Dame Elizabeth Taylor… a moment of silence for her and her efforts and generosity on behalf of all with HIV/AIDS.

Abstinence ‘education’ that overlooks STDs, including HIV, is killing our kids. It’s amazing to me to see the progress in fighting this disease in the poor rural areas of Africa while our affluent suburbs succumb to talibangelical demands for ‘education’ that kills.

How rude that microbes don’t respect theology.

Lance, thank you very much for being here and for making The Lazarus Effect. It’s easy to forget–especially on tax day–that we are the wealthiest nation in the world, and for parking meter change, we can save lives. How you spend your dollars can make difference.

Speaking of spending dollars, next week, we have GASHOLE, about Big Oil and the high price of gasoline.

Lance again, thank you and a huge thanks to (RED) for their part in The Global Fund and for making The Lazarus Effect possible.

One of the biggest struggles for HIV+ people is adherence: taking your drugs. Missing doses allows the virus to mutate around a lower dose in your system, and allows drug-resistant strains to get a foothold quickly. Do the people in your movie struggle to keep to their regimen, or do they have a once-a-day regimen now?

Also: it is difficult for women to get their married partners to protect them, despite their having tested HIV+. This happens in Africa and elsewhere. Is there any progress that you know of in Africa with jellies that kill the virus? Putting the woman in control of her health, despite cultural barriers, seems to provide progress, and an anti-HIV spermicidal jelly has been hailed as being able to do that.

Microbes, and virons, actually mock theology by targetting theology-trained minor children for horrible diseases they could have avoided with science-based education that adheres to community-developed standards.

Thank you, Lance.

Thanks, Lisa.

I think you might be confusing theology with religion. Two different things. But, I agree that what evangelical fundamentalists do is dangerous. It’s a bad combination. People die.

I’m not confused about anything.

Ha!