If you are looking for two great public health movies to snuggle up with your family on the couch or to buy for your woefully public-health-history-ignorant friends this holiday season I have two recommendations: Dr. Ehrlich's Magic Bullet, a Hollywood biopic made in 1940 starring Edward G. Robinson, and How To Survive A Plague, a 2012 documentary.
These Oscar-nominated films (the first for best screenplay, the second for feature documentary) deal with the battle against what were once called venereal diseases and are today referred to as sexually transmitted infections (STIs) or diseases (STDs). They deliver a similar message: ignorance can be the greatest enemy of public health. That's a message we can all embrace this holiday season, right?!?
In Dr. Ehrlich's Magic Bullet, the valiant German Jewish scientist Paul Ehrlich confronts repeated failures and professional skepticism to develop the first cure for syphilis in 1909 -- arsphenamine (Salvarsan). While the movie doesn't do full justice to the real Dr. Ehrlich's many brilliant scientific contributions, for which he won a Nobel prize in 1908, the film's release was in itself a triumph over ignorance. In bringing the subject of syphilis to the screen, Warner Brothers took a bold step. Venereal disease was a subject thought unfit for polite discussion, much less for mass media. The producers managed to get around the Motion Picture Production Code (Hays Code), which stated that "Sex hygiene and venereal disease are not subjects for motion pictures" by rarely using the term syphilis and focusing the film on scientific discovery and on Ehrlich as scientist. Despite their boldness in mentioning a venereal disease, the film's producers shied away from mentioning Ehrlich's religious background, even as the United States was engaged in fighting a Nazi regime that purged all mentions of Ehrlich's work because he was Jewish.
Syphilis treatment with penicillin replaced arsphenamine in the late 1940s and the number of reported cases of syphilis in the United States fell dramatically. Nevertheless, syphilis remains a global health problem today, with 12 million cases worldwide. The figures for sexually transmitted infections are stunning. According to the World Health Organization an estimated 500 million people become ill each year with one of four STIs: chlamydia, gonorrhea, syphilis and trichomoniasis.
Death haunts both films. Dr. Ehrlich's Magic Bullet opens with a young man's suicide after he learns his diagnosis and that he can never be cured and therefore able to marry his sweetheart. How to Survive a Plague shows individual deaths and presents statistics about the number of deaths worldwide. It focuses on the efforts of members of ACT UP (the Aids Coalition to Unleash Power) and TAG (the Treatment Action Group) to force the public health establishment to respond to the AIDS crisis and to demand that political leaders invest the needed resources into research and treatment. The inaction of American presidents Ronald Reagan and George H. Bush, as well as the homophobic vitriol of Senator Jesse Helms, are presented. The real story, however, belongs to the men and women, many of them HIV positive, who confront the establishment and demand that the National Institutes of Health, the Food and Drug Administration, and elected officials change their research agendas and drug approval protocols to respond to what activists correctly called a plague. (The work of these activists and researchers is also chronicled in an online exhibit from the National Library of Medicine.)
What began with a 1981 report of a rare lung infection in five previously healthy young gay men is now known as a global health crisis. Since the beginning of the epidemic, more than 75 million people have contracted HIV and nearly 36 million have died from HIV-related causes. In the United States today, there are nearly 1.1 million people living with HIV/AIDS, with approximately 50,000 new infections each year. Those horrifying numbers remind us that the battle continues. Information on HIV/AIDS is available from the Centers for Disease Control and Prevention.
Although more than six decades separate the two films, both speak to the lethal effects of stigmatizing sexually transmitted infections. What visually unites the two eras are the "Silence = Death" signs with pink triangles created by activists to draw attention to the AIDS crisis. The pink triangles reference the Nazi regime, which forced homosexuals to wear an inverted pink triangle. On the signs today, the triangles stand up, just as the activists are standing up and demanding action. Popular films typically present heroic scientists battling dangerous bacteria or viruses and saving the public from certain death by conquering disease outbreaks. While Dr. Ehrlich's Magic Bullet leans in that direction, it also offers a critique of the silence surrounding syphilis. How to Survive a Plague, while much more direct, presents the same message. Sometimes the first step in securing the public's health is conquering ignorance and fear.