On 11 October 1988, a fleet of chartered buses drew up alongside the Food and Drug Administration (FDA) in Rockville, Maryland, and disgorged 1,200 Aids activists on to the pavement. Some were dressed as corpses and carried mock tombstones. Others brought effigies of Ronald Reagan, the then Republican president. Facing them were a two-deep line of police officers wearing rubber gloves and, as David France recalls, an assortment of “slack-jawed” locals appalled by the sight of groups with names such as the Delta Queens and Queer and Present Danger within spitting distance of their homes. It is fair to say that suburban Rockville had never seen anything like it, and neither had the bureaucrats holed up inside the FDA.

The brainchild of a newly formed group called Aids Coalition to Unleash Power (Act Up), the protest was an inspired act of civil disobedience, the moment when people with Aids lost their patience with federal drug regulators and stormed the citadels of American science to demand access to life-prolonging medications other than AZT, the only treatment approved at that point. Or as the signs brandished by protesters put it, “FDA – Fucking Disaster Area”, and “AZT is not enough – give us all the other stuff”.

Now that much of that anger around Aids has dissipated and it is regarded as just another infectious disease – one that can be treated with an arsenal of anti-retroviral drugs that suppress, but never quite eliminate the human immunodeficiency virus (HIV) which is its cause – it is hard to recall the horror of the first wave of Aids deaths or the indifference with which the suffering of gay men was greeted by straight society. As David France explains in his subtle and searing history of this late-20th century plague and those who survived it, it took two years and almost 600 deaths before the New York Times printed a story about Aids on its front page, and a further seven years before the FDA agreed to relax the regulations on new drug approvals. Even so, by 2012 the official death toll in the US stood at 658,000, while worldwide Aids had claimed 35 million lives, eclipsing the devastation wrought by the bubonic plague of the 14th century.

The story of how Aids activists took on the FDA and leading scientific experts has been told before, most notably by the sociologist Steven Epstein. However, the great advantage France has is that as a journalist with the New York Native he was an eyewitness to many of the key moments during the spread of the disease and, as a gay man, shared in activists’ pain and suffering. It is a difficult balancing act, but France avoids hagiography. Instead, he uses his privileged access to put us in the heart of the action, or more usually, inaction. Thus, when a candlelit vigil is held in Central Park in June 1983 for a young lighting designer whose death from Aids was the first to make national television, France is rendered speechless by the sight of 1,500 mourners, many of them “so wasted they looked like caricatures of starvation”. In 1987, as patients die for want of access to a prophylaxis against the deadly opportunistic infection Pneumocystis pneumonia, he is moved to tears when he discovers the name of an old college roommate embroidered on the Aids Memorial quilt not far from the Vietnam Memorial in Washington DC, recording: “His death was an American loss. The sobs were ours.”

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However, this is mostly a book about the campaigners who, knowing next to nothing about immunology or the workings of the pharmaceutical industry, mastered the complexities of HIV and the clinical trials process to gain the respect of medical researchers. Many, such as Mark Harrington, the head of Act Up’s Treatment and Data committee, and Peter Staley, the closeted former bond trader who shamed Burroughs Wellcome into cutting the price of AZT, feature in France’s Oscar‑nominated 2012 documentary and may already be familiar to readers of this prose version, others less so. There are particularly fine portraits of Joseph Sonnabend, the hyperactive Manhattan doctor turned activist, and Michael Callen, the singer-songwriter who pioneered the tenets of safe sex and resisted being labelled a “patient”, which for him connoted passivity and helplessness. Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases and the senior federal official for the drug trials, emerges as a particularly mercurial character, as does Larry Kramer, the outspoken gay playwright and an Act Up founder. The heroes of those early days were not without their flaws, France suggests, but had it not been for their refusal to take no for an answer both they and thousands of gay men like them would not have lived to see the next wave of Aids medications.

As befits a Greek tragedy, France ends on a note of pathos, returning to the story with which he begins his book: the mysterious death of Spencer Cox, Harrington’s right-hand man who is widely credited with the trial innovations that helped bring new Aids drugs to market in record time. I won’t give away the details here; suffice to say that while many activists went on to enjoy productive lives after bending the FDA to their will, others, nostalgic for those vital days of protest, sank into a spiral of depression and drug abuse. “In countless ways,” France concludes, “survival, unexpected as it was, proved as hard to adjust to as the plague itself.”

• How to Survive a Plague by David France is published by Picador (£25). To order a copy for £20.50 go to bookshop.theguardian.com or call 0330 333 6846. Free UK p&p over £10, online orders only. Phone orders min of £1.99