Grim Reaper stemmed AIDS tide
EVERYONE over the age of about 30 remembers the Grim Reaper campaign of 1987, which terrified and offended Australians in nearly equal measure. But that TV campaign — one of the most memorable and successful health awareness campaigns ever devised — was just one of the strategies that saved the country from a far worse epidemic of HIV/AIDS.
While the Grim Reaper campaign is still sometimes criticised — on the grounds that it overstated the threat of HIV to the heterosexual population — a TV documentary to be screened next week argues that without this and other measures, the virus could well have begun circulating among injecting drug users, prostitutes and the general community to a much greater extent than in fact occurred. The one-hour program, called Rampant:How a City Stopped a Plague , starts with the first diagnosis of AIDS in Australia — at Sydney’s St Vincent’s Hospital in 1982.
Based on archival footage and interviews with key figures — including then federal health minister Neal Blewett — the documentary charts the shock that the advent of AIDS wrought on Sydney’s newly liberated gay community, and the cultural, political and other hurdles that nearly confounded the attempts to keep the disease from spreading out of control.
The responses included breaking a number of taboos and even laws — such as setting up an illegal needle exchange program in Sydney to limit likely spread of the infection among drug users, a move that put the health workers involved at risk of prosecution. A group called the Australian Prostitutes Collective also received federal funding, which it used to drive a campaign promoting condom use by clients, and gay groups were also left to devise safe-sex advertising campaigns, most of which left little to the imagination.
As a result, just under 6700 people have so far died of AIDS in Australia — a fraction of the 50,000 predicted in the early 1980s. The rate of AIDS is 1.3 per 100,000 population, a fraction of the about 14 per 100,000 seen in the US, which under the Republican leadership of Ronald Reagan cut off federal funding for awareness campaigns directed at gay men and refused to allow needle-syringe programs.
How Blewett and others walked the tightrope of political tensions and community concerns, such as by gaining the support of the federal Liberal opposition for their policies, is one focus of the documentary.
Interviewee doctor Rob Finlayson, director of the Taylor Square Private Clinic in the heart of the city’s gay strip in Darlinghurst — which, once a test was developed, had to tell hundreds of clinic patients they had HIV — says the program ‘‘ conveyed the sense of being overwhelmed that nearly everybody felt’’ at the time AIDS appeared.
In 1982, HIV had not been discovered, and it was not even known if a virus caused AIDS or how the disease was transmitted. Experts initially acted on hunches — later proved right — that the infection was transmitted in blood and that condoms were protective.
The message that gay men ought to start using condoms did not initially go down well in the hedonistic world of Sydney’s gay nightclubs, which had boomed in the short time since repressive public attitudes towards homosexuality had started to shift.
‘‘ You still get the sense (watching the program) that it’s a very difficult thing for all of us who were around at the time to remember,’’ Finlayson told WeekendHealth . ‘‘ I think it’s been a huge lesson for public health — that if you don’t include the affected population, you are not going to have a successful (public health) campaign.’’
Doctor Alex Wodak, now director of the alcohol and drug service at St Vincent’s Hospital, and colleagues risked their jobs by setting up the needle exchange program. He says the program is ‘‘ powerful’’ and Australia’s success in implementing a harmminimisation approach, rather than the zerotolerance policies of forced detention and testing advocated by some religious groups, were not only vindicated but taken up internationally, including by the World Health Organisation.
‘‘ It shows how fortunate we were at the time that the Liberal Party was ruled by the liberal wing, and not the group that has been running the Liberal Party for the last decade or more,’’ Wodak said. Rampant:HowaCityStoppedaPlague will be shown on ABC TV on Tuesday, December 3, at 8.30pm
Remembers: Robert Finlayson believes the AIDS campaign proved a huge lesson in how to handle public health issues