The Lazarus Effect | |
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![]() Concillia Muhau, who is featured in the film, with an earlier picture of herself [1] | |
Directed by | Lance Bangs |
Country of origin | United States |
Original language | English |
Production | |
Running time | 30 minutes |
Production company | Red |
Original release | |
Network | HBO |
Release | May 24, 2010 |
The Lazarus Effect is a 2010 documentary film about the positive impact of free antiretroviral drug therapy on HIV/AIDS patients in Africa. It was directed by Lance Bangs, and executive produced by Spike Jonze, after an organizer from AIDS awareness group Red suggested the project to them. [2] The film features patients and medical staff in Zambia speaking about their experiences and was produced by Red and HBO. It was screened on HBO and Channel 4 in May 2010, and it is also available on YouTube. [2] [3]
Made in Zambia, the 30-minute film tracks several people who were seriously ill but return to a healthier condition in a relatively short period of time after starting free antiretroviral drug therapy. [4] HIV-positive patients and medical staff recount their experiences and the impact medication has made on their lives in their own words. [4] [5]
They include Constance Mudenda, a mother whose children all died of AIDS, and who now works as a peer education supervisor at an AIDS clinic; Paul Nsangu, a young husband and father; Bwalya, an 11-year-old girl who at the beginning of the film looks like a child half her age, because of her disease; and Concillia Muhau, a young mother who recovered from the brink of death, and now also works as a peer counselor. [1] [2]
Interviewees describe their illness and recovery; they also speak about the difficulties involved in persuading people to have themselves tested for HIV, given the severe social stigma that results from a positive test result, and in getting word about the available treatment out to remote rural areas, as well as the logistical problems of providing care to patients who may have to walk for four days and three nights to reach a clinic. [3]
Bangs and Jonze made the film after they were contacted by an organizer from AIDS awareness group Red. The organizer suggested they film a documentary in AIDS clinics in Zambia, where one out of seven people is HIV-positive, and one person's daily dose of antiretroviral drugs costs about 40 cents according to Red – a cost which many patients are unable to afford. [2] [3] [4] Red's member companies use 50 per cent of their profits from Red licensing products to contribute to The Global Fund to Fight AIDS, Tuberculosis and Malaria. This, along with the President's Emergency Plan for AIDS Relief, provides the majority of funding for AIDS programmes in Africa, including the provision of free antiretroviral drugs to some three million people. [1] [2] [3] Antiretroviral drugs, when taken regularly, are able to restore vitality to HIV-positive people, enabling them to lead normal lives. [3]
Executive producer Jonze asked Bangs to direct the documentary, as Jonze was still busy completing Where the Wild Things Are . [2] [4] Bangs then made three journeys to Africa in 2009 to make the film, determined "to let the people speak for themselves, rather than have a lot of earnest Western talking heads". [2] Explaining the film concept to the Portland Mercury , Bangs said: "I've seen enough horrible documentaries that objectify people or assign them victimhood status. That was pretty appalling to me, and was not the film I wanted to make. I wanted to talk to people directly and get them to open up and be funny or goofy or whatever personality traits they have that don't usually come out in AIDS documentaries." [4]
Bangs said he was profoundly moved by his experience in Africa: "I had lost friends and teachers to AIDS and AIDS-related illnesses, but at least in the West the drugs are available. In Africa I was shocked at how skeletal our interviewees’ faces were, how their eyes bulged from their sockets. After just a few months on their drugs they were transformed." [2] The film's title is based on the Biblical story of Lazarus, whom Jesus raised from the dead, and echoes the feelings of those who recovered thanks to drug therapy. [2] [3]
U2 singer Bono helped promote the documentary and associated campaign, and gathered a group of A-List celebrities to make an advertisement for it. [6] [7] This featured short scenes, filmed by French photographer Brigitte Lacombe, with stars like Penélope Cruz, Javier Bardem, Ludacris and others showing the trivial items that can be bought for US$0.40. [8] [9] The documentary itself premiered at the New York Museum of Modern Art on May 4, 2010. [9] Constance Mudenda and Concillia Muhau, two of the women portrayed in the film, travelled to New York for the premiere. [10]
The documentary was screened on HBO and Channel 4 on May 24, 2010, and also placed on YouTube. [10] [11]
The "Watch This" column in The Guardian stated, "It's hard to imagine that there could be a positive story to be told about HIV in Africa – if there is, however, The Lazarus Effect is probably it." [12] Paul Whitelaw, writing in The Scotsman , called the film "a surprisingly uplifting and quirk-free documentary about growing efforts to curb the scourge of HIV/Aids in Africa [...] A heartening story of hope." [5] Critic Noel Murray of The A.V. Club described the film as a "straight-up advocacy doc, designed to get anyone who watches it to open their wallets. And it’s remarkably effective at that." [13]
Sarah Mirk, writing in the Portland Mercury , praised the film for breathing "sincere life and inspiration into the often schlocky world of AIDS movies", saying, "There's no heavy-handed Western narrator here to explain the crisis. There are only the patients and their nurses, all HIV-positive, discussing their lives and laughing in joy at their successes, backed by a lively Chicago brass-band soundtrack rather than the cliché tribal drums or Graceland-style songs. It's a hopeful film. It's a vibrant film." [4]
The management of HIV/AIDS normally includes the use of multiple antiretroviral drugs as a strategy to control HIV infection. There are several classes of antiretroviral agents that act on different stages of the HIV life-cycle. The use of multiple drugs that act on different viral targets is known as highly active antiretroviral therapy (HAART). HAART decreases the patient's total burden of HIV, maintains function of the immune system, and prevents opportunistic infections that often lead to death. HAART also prevents the transmission of HIV between serodiscordant same-sex and opposite-sex partners so long as the HIV-positive partner maintains an undetectable viral load.
HIV/AIDS denialism is the belief, despite conclusive evidence to the contrary, that the human immunodeficiency virus (HIV) does not cause acquired immune deficiency syndrome (AIDS). Some of its proponents reject the existence of HIV, while others accept that HIV exists but argue that it is a harmless passenger virus and not the cause of AIDS. Insofar as they acknowledge AIDS as a real disease, they attribute it to some combination of sexual behavior, recreational drugs, malnutrition, poor sanitation, haemophilia, or the effects of the medications used to treat HIV infection (antiretrovirals).
The spread of HIV/AIDS has affected millions of people worldwide; AIDS is considered a pandemic. The World Health Organization (WHO) estimated that in 2016 there were 36.7 million people worldwide living with HIV/AIDS, with 1.8 million new HIV infections per year and 1 million deaths due to AIDS. Misconceptions about HIV and AIDS arise from several different sources, from simple ignorance and misunderstandings about scientific knowledge regarding HIV infections and the cause of AIDS to misinformation propagated by individuals and groups with ideological stances that deny a causative relationship between HIV infection and the development of AIDS. Below is a list and explanations of some common misconceptions and their rebuttals.
The Treatment Action Campaign (TAC) is a South African HIV/AIDS activist organisation which was co-founded by the HIV-positive activist Zackie Achmat in 1998. TAC is rooted in the experiences, direct action tactics and anti-apartheid background of its founder. TAC has been credited with forcing the reluctant government of former South African President Thabo Mbeki to begin making antiretroviral drugs available to South Africans.
Stavudine (d4T), sold under the brand name Zerit among others, is an antiretroviral medication used to prevent and treat HIV/AIDS. It is generally recommended for use with other antiretrovirals. It may be used for prevention after a needlestick injury or other potential exposure. However, it is not a first-line treatment. It is given by mouth.
Lamivudine, commonly called 3TC, is an antiretroviral medication used to prevent and treat HIV/AIDS. It is also used to treat chronic hepatitis B when other options are not possible. It is effective against both HIV-1 and HIV-2. It is typically used in combination with other antiretrovirals such as zidovudine, dolutegravir, and abacavir. Lamivudine may be included as part of post-exposure prevention in those who have been potentially exposed to HIV. Lamivudine is taken by mouth as a liquid or tablet.
Nevirapine (NVP), sold under the brand name Viramune among others, is a medication used to treat and prevent HIV/AIDS, specifically HIV-1. It is generally recommended for use with other antiretroviral medications. It may be used to prevent mother to child spread during birth but is not recommended following other exposures. It is taken by mouth.
Efavirenz (EFV), sold under the brand names Sustiva among others, is an antiretroviral medication used to treat and prevent HIV/AIDS. It is generally recommended for use with other antiretrovirals. It may be used for prevention after a needlestick injury or other potential exposure. It is sold both by itself and in combination as efavirenz/emtricitabine/tenofovir. It is taken by mouth.
Emtricitabine/tenofovir, sold under the brand name Truvada among others, is a fixed-dose combination antiretroviral medication used to treat and prevent HIV/AIDS. It contains the antiretroviral medications emtricitabine and tenofovir disoproxil. For treatment, it must be used in combination with other antiretroviral medications. For prevention before exposure, in those who are at high risk, it is recommended along with safer sex practices. It does not cure HIV/AIDS. Emtricitabine/tenofovir is taken by mouth.
Darunavir (DRV), sold under the brand name Prezista among others, is an antiretroviral medication used to treat and prevent HIV/AIDS. It is generally recommended for use with other antiretrovirals. It is often used with low doses of ritonavir or cobicistat to increase darunavir levels. It may be used for prevention after a needlestick injury or other potential exposure. It is taken by mouth once to twice a day.
Efavirenz/emtricitabine/tenofovir, sold under the brand name Atripla among others, is a fixed-dose combination antiretroviral medication used to treat HIV/AIDS. It contains efavirenz, emtricitabine, and tenofovir disoproxil. It can be used by itself or together with other antiretroviral medications. It is taken by mouth.
The situation with the spread of HIV/AIDS in Russia is described by some researchers as an epidemic. The first cases of human immunodeficiency virus infection were recorded in the USSR in 1985-1987. Patient zero is officially considered to be a military interpreter who worked in Tanzania in the early 1980s and was infected by a local man during sexual contact. After 1988—1989 Elista HIV outbreak, the disease became known to the general public and the first AIDS centers were established. In 1995-1996, the virus spread among injecting drug users (IDUs) and soon expanded throughout the country. By 2006, HIV had spread beyond the vulnerable IDU group, endangering their heterosexual partners and potentially the entire population.
HIV/AIDS is considered the deadliest epidemic in the 21st century. It is transmitted through sex, intravenous drug use and mother-to-child transmission. Zambia is experiencing a generalized HIV/AIDS epidemic, with a national HIV prevalence rate of 11.3% among adults ages 15 to 49 as of 2018. Per the 2000 Zambian census, the people affected by HIV/AIDS constituted 15% of the total population, amounting to one million, of which 60% were women. The pandemic results in increased number of orphans, with an estimated 600,000 orphans in the country. It was prevalent more in urban areas compared to rural and among all provinces, Copperbelt Province and Lusaka Province had higher occurrence.
HIV disease–related drug reaction is an adverse drug reaction caused by drugs used for the treatment of HIV/AIDS.
Fig Trees is a 2009 Canadian operatic documentary film written and directed by John Greyson. It follows South African AIDS activist Zackie Achmat and Canadian AIDS activist Tim McCaskell as they fight for access to treatment for HIV/AIDS. It was also inspired by Gertrude Stein and Virgil Thomson's opera Four Saints in Three Acts. The film premiered at the 59th Berlin International Film Festival where it won the Teddy Award for Best Documentary.
Whoonga is a form of black tar heroin, sometimes mixed with other substances, that came into widespread use in South Africa in 2009.
The cost of HIV treatment is a complicated issue with an extremely wide range of costs due to varying factors such as the type of antiretroviral therapy and the country in which the treatment is administered. The first line therapy of HIV, or the initial antiretroviral drug regimen for an HIV-infected patient, is generally cheaper than subsequent second-line or third-line therapies. There is also a great variability of drug prices among low, middle, and high income countries. In general, low-income countries have the lowest cost of antiretroviral therapy, while middle- and high-income tend to have considerably higher costs. Certain prices of HIV drugs may be high and difficult to afford due to patent barriers on antiretroviral drugs and slow regulatory approval for drugs, which may lead to indirect consequences such as greater HIV drug resistance and an increased number of opportunistic infections. Government and activist movements have taken efforts to limit the price of HIV drugs.
Julio S. G. Montaner, is an Argentine-born Canadian physician, professor and researcher. He is the director of the British Columbia Centre for Excellence in HIV/AIDS, the chair in AIDS Research and head of the Division of AIDS in the Faculty of Medicine at the University of British Columbia and the past-president of the International AIDS Society. He is also the director of the John Ruedy Immunodeficiency Clinic, and the Physician Program Director for HIV/AIDS PHC. He is known for his work on HAART, a role in the discovery of triple therapy as an effective treatment for HIV in the late 1990s, and a role in advocating the "Treatment as Prevention" Strategy in the mid-2000s, led by Myron Cohen of the HPTN 052 trial.
HIV in pregnancy is the presence of an HIV/AIDS infection in a woman while she is pregnant. There is a risk of HIV transmission from mother to child in three primary situations: pregnancy, childbirth, and while breastfeeding. This topic is important because the risk of viral transmission can be significantly reduced with appropriate medical intervention, and without treatment HIV/AIDS can cause significant illness and death in both the mother and child. This is exemplified by data from The Centers for Disease Control (CDC): In the United States and Puerto Rico between the years of 2014–2017, where prenatal care is generally accessible, there were 10,257 infants in the United States and Puerto Rico who were exposed to a maternal HIV infection in utero who did not become infected and 244 exposed infants who did become infected.
Treatment as prevention (TasP) is a concept in public health that promotes treatment as a way to prevent and reduce the likelihood of HIV illness, death and transmission from an infected individual to others. Expanding access to earlier HIV diagnosis and treatment as a means to address the global epidemic by preventing illness, death and transmission was first proposed in 2000 by Garnett et al. The term is often used to talk about treating people that are currently living with human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) to prevent illness, death and transmission. Although some experts narrow this to only include preventing infections, treatment prevents illnesses such as tuberculosis and has been shown to prevent death. In relation to HIV, antiretroviral therapy (ART) is a three or more drug combination therapy that is used to decrease the viral load, or the measured amount of virus, in an infected individual. Such medications are used as a preventative for infected individuals to not only spread the HIV virus to their negative partners but also improve their current health to increase their lifespans. When taken correctly, ART is able to diminish the presence of the HIV virus in the bodily fluids of an infected person to a level of undetectability. Consistent adherence to an ARV regimen, monitoring, and testing are essential for continued confirmed viral suppression. Treatment as prevention rose to great prominence in 2011, as part of the HPTN 052 study, which shed light on the benefits of early treatment for HIV positive individuals.