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The Lazarus Effect

Coverage by Nobuhiro Hosoki

 

Interview with Director Lance Bangs

Story :‘The Lazarus Effect’ follows the lives of four people in Zambia who have AIDS, and the effects on their lives when treatment is available to them.

 

Q: So how did you get involved in this project?
 
Lance Bangs: I think that RED knew that they wanted to make a film. They had done such a great job with the magazine article in “Vanity Fair” several years ago, that was also called “The Lazarus Effect” that showed the photographs of people before and after they began treatment.

So Sheila from RED approached some film production companies and was trying to see how do you make a documentary, how do you get a film going. A great producer named Steve Golin put her in contact with Spike Jonze and then myself. I’ve directed a bunch of things with Spike over the years and the idea was we just needed to get me on a plane to get over to Zambia right away to film people while they were beginning treatment.
 
Q: The medications, ARVs, when did they start using that?
 
Lance Bangs: I think that people were experimenting with different combinations of drug cocktails, at least in the West, throughout the late ‘80s and it became more effective in the ‘90s. It’s the sort of thing that has helped to keep Magic Johnson alive for quite a while. It was incredibly expensive and originally you would need multiple different medications that you were combining and taking at different times a day.

It could kind of take over most of your life and your schedule when you’re making time to take medications and there were side effects. And then with the advancements they’ve had in ARV medications they’ve reduced it to the simplicity of for most people one or two pills a day taken twice a day is what’s an effective treatment that can make the difference between being alive or passing away.
 
Q: So the twice a day one is probably somewhere in the mid-90s actually?
 
Lance Bangs: I should get someone to confirm that, but that would be my understanding.
 
Q: You talked to Constance. In her clinic she freely talks about HIV. How important is it to create the circumstances like that to talk freely in a clinic?
 
Lance Bangs: She herself is a very brave woman, so that’s part of it. But at a certain point so many people in Africa have already lost friends and relatives to HIV and AIDS that there is less stigma and less fear about talking about it openly. Because the stakes are so high and everyone at this point basically has had it touch their lives directly people are less afraid to be open and talk about it now.
 
Q: Does she also go around talking to people in town? Leaving the clinic and talking to people individually to talk them into getting tested? I imagine that there are a lot of people still afraid to do so.
 
Lance Bangs: Yeah I have to say that her job is to be at three different clinics supervising them. Whenever we were out with her socially just going around town or to different markets she was very open and would talk to people in those circumstances as well, and I would imagine she probably does talk to people in her community and try and encourage them to go in and get tested and go to a clinic.
 
Q: Constance also talked a little bit about it in the film, but how tough for her to listen to the neighbors talking about her after she lost her child and she’s the one still living.
 
Lance Bangs: Yeah. To imagine the kind of personal loss and the sadness that she’s lived through; that’s a very intense, very heavy thing to have experienced. To see how she’s able to turn that into energy to go work and help other people is very inspiring and very exciting.
 
q: I was a little confused. You just talked to me about the medication; they only need to take it twice a day. But doesn’t it say in the film it only lasts for a few hours or something?
 
Lance Bangs: It works for about 12 hours in the body.
 
Q: Okay. So it’s not actually a few hours then.
 
Lance Bangs: Oh no. It’s pretty much every 12 hours, and then if you don’t take it consistently then the virus can sort of adapt or mutate or find ways to weaken your immune system.
 
Q: It costs about 40 cents a day; that’s a daily supply we’re talking about or it’s only one medication which you then have to take it twice?
 
Lance Bangs: My understanding is that it’s about 40 cents per day for the total day’s worth of what you would need for each person to keep them alive.
 
Q: If they have a couple people with HIV in the family and then we’re talking about let’s say three people in the family, that would probably take $1.20, right?
 
Lance Bangs: That’s correct, right.
 
Q: Let’s say they have to take it for 30 days or whatever; that might probably take up a lot of their income because the average income in Africa isn’t exactly as high as the United States.
 
Lance Bangs: Oh yeah. So for the people that are in Africa, they don’t have to pay 40 cents for the pills. The Global Fund to Fight AIDS, Tuberculosis and Malaria is buying the medication from the drug manufacturers and providing it to the people there for free. So the value of it is it would cost about 40 cents per day, is what the cost is down to.
 
Q: Oh, so cost the company is getting it for is 40 cents but actually they are getting them for free.
 
Lance Bangs: That’s correct. And that’s what’s so great about the work of the Global Fund. That’s where the money from RED goes, to support the Global Fund and give them money to buy the medications.
 
Q: Were you a little bit surprised that the people who are taking this medication after 40 days that they make an amazing transformation? Were you surprised initially?
 
Lance Bangs: I’d seen the photographs of what it can do, but when you’re really with someone in person they’re so much more than what’s just in a photograph. Their voice is different, they are funnier, they have more personality, they’re more excited to talk to you. All these other things that come across in real life and on camera for a movie that you don’t get in a still photograph were what surprised me.

Q: Timely diagnosis and treatment are also very important.

Lance Bangs: Yeah absolutely.
 
Q: So there are a lot of people still testing in that country?
 
Lance Bangs: It’s more that there are people in very remote, rural areas who don’t really get to the clinic. They’re the ones that are most at risk for going too long without receiving treatment and then being in a very ill, weakened state that it’s hard for the body to rally and get healthy again.
 
Q: Right. I was quite surprised that pregnant women, after drinking this medicine, they have a chance to have a baby without HIV.
 
Lance Bangs: Yeah that was something that I didn’t know before I made the film. I just assumed that the virus would pass from the mother to the child while it was being born. But it turns out that the way the body works is the virus actually doesn’t get transmitted. The greatest risk is sort of at the end and at the actually time of birth the blood can pass from one to the other. And so they can do things to try and minimize the risk or to avoid that. Several women that we filmed who are not even in the movie that we just met and spent time with were all able to deliver children that tested negative.
 
Q: So it doesn’t really matter the stage of the pregnancy. Of course the sooner the better but will there be a significant difference between three months and six months or eight months?
 
Lance Bangs: I’m not positive about the different that it makes with the timing. All the women that we met that had gone through that who had gone and started getting treatment and being aware once they found out they were pregnant, each of them were able to have the baby be born and test negative.
 
Q: What did you take away from this whole experience?
 
Lance Bangs: For me personally just seeing that it really works and that smart, targeted aid can be effective. In the past in the West we would read about other social causes or AIDS organizations over the decades that you would find out that the money had been poorly spent or mismanaged or embezzled by a corrupt government or ended up in the hands of some bad organization that didn’t really get it to the people that needed the help.

So in this case, the way that the Global Fund has held people accountable and used smart, targeted aid to really get the money directly to the people that need it was so much more effective and so exciting to see. And it’s such a visual thing to see someone that looked like they were on the verge of death and then you go back and see the same person 40 days later or three months later and they’re so much healthier and they’re up on their roof fixing things for their kids. It was a really amazing thing to see in real life.

End.