For his own part, Larry Kramer, at 75, makes it known he still has a clear mind and "tons of energy." These days, he chooses to focus it on the 2011 multiple Tony Award-nominated Broadway revival, and a forthcoming movie production, of his 1985 play The Normal Heart, about the early years of the AIDS epidemic in New York. As for his AIDS activism? The co-founder of GMHC and father of ACT UP, the man who became the angry voice of a gentle but frightened people in the darkest of the plague years, told me in his Washington Square apartment -- a sacred space in gay American history -- on a sweltering day in July 2010 that he'd recently had "a lot of interaction with Dr. Fauci." Kramer said he pushed his old nemesis, Anthony Fauci, long since a friend, to aim higher in the research he oversees as director of the National Institute of Allergy and Infectious Diseases (NIAID), to go for a cure.
Words matter for a man like Kramer, who has wielded them like a surgeon's scalpel, able to heal or cut to the quick as needed. He chooses his own words carefully, intentionally, in full consideration of their denotation and connotation. "I've been after him to use the word 'plague,'" said Kramer of Fauci. "It's a useful tool, it scares people." In fact, Kramer dared me to use 'plague' in this book "from beginning to end." A plague, he said, "is out of control, which it is."
When I asked him about it, Fauci said, "I understand what Larry is getting at." He said he has used the word "plague" himself, depending on the audience and the point he wants to make. He said, "Larry wants to use the word plague because he wants to put it into the historical perspective of the handful of diseases throughout the history of mankind that had an enormous impact." Fauci said that when he talks about HIV to the White House or Congress or OMB (Office of Management and Budget) or constituencies, "I always put it in the context that we are living through a historic period from the standpoint of public health. There have only been a couple other periods where there have been such horrendous pandemics against the human population -- bubonic, flu, smallpox."
As for a cure, Fauci said, "The numbers make it almost unfeasible to sustain a situation where you have 2.7 million getting newly infected every year." For every one person that receives HAART, two or three others get newly infected. "More people are getting infected than we are able to put on therapy," said Fauci. He said there are two choices: Do a better job with prevention, or "get to a point where you can get people off therapy." As it is now, he said, we face "an economically unsustainable situation."
There was a renewed push for a cure in the wake of stunning news from Berlin in 2006, that an HIV-positive American man also diagnosed with acute leukemia appears to have been cured of HIV infection. He was the beneficiary of a complex, expensive, and experimental stem cell transplant from a very rare donor with a genetic resistance to HIV infection found in only about one to two percent of white Americans and Western Europeans, about four percent of Scandinavians, and in no Africans, African-Americans, or Asians. The man's leukemia was successfully treated after the donor cells essentially replaced his immune system. To everyone's astonishment, the man also has remained HIV-negative since the procedure.