If the coronavirus were to spread in America, we would do well to remember the lessons, and victories, of the fight against HIV / AIDS.
Thirty years ago this summer, we were in the HIV / Aids pandemic for a decade and more than 100,000 Americans had already lost their lives. The nation was politically and socially divided because the virus decimated homosexuals and people of color. Our nation stigmatized and abused the individuals, families and communities that suffered the most.
Some people thought that HIV was only for gay men. Then we came to understand that African Americans were also hit hard. Both communities could easily rely on a government that had not protected them in the past and also did not have the resources to address the challenges of HIV on its own. The disease also spread rapidly within indigenous populations and other communities of color.
Unfortunately, as now, too many people who were not immediately affected by the disease felt that they had no interest in fighting for it. They believed it only happened to other people.
In the United States, in large part because we initially saw HIV as a disease of gay men, we did not succeed with the required speed and urgency. This homophobia-driven indifference, compounded by racism, contributed to the deaths of tens of millions of millions of heterosexual men, women, and their children worldwide because one nation completely positioned itself to stop it in its tracks failed.
Then, on August 19, 1990, after years of intense litigation, George HW Bush signed the White Care Act. Senator Ted Kennedy, the Liberal Democrat from Massachusetts, and Senator Orrin Hatch from Utah, equally known for his conservative Republican Orthodoxy, had sponsored the legislation. It was named in honor of a brave Indiana boy who contracted HIV from a treatment for his hemophilia and became a powerful public face for people suffering from the disease. The legislation passed both the House and the Senate by an overwhelming majority of Republicans and Democrats.
Bitter rivals – who represent polar opposing ideologies – had, on the whole, reached out, cooperated and made the legislation the nation needed to fight the pandemic effectively.
Today, the Ryan White Care Act represents a nationwide framework for responding to a viral pandemic. It not only provides access to health care and medication for people with HIV, but also access to food, housing, dental care and mental health services to address as many health obstacles as possible. It is an undeniable success and demonstrates the power of federal leadership in tackling public health challenges. While our national response to HIV still has a lot of work to do, rescue programs and clinics funded by the Ryan White program would save lives that would otherwise be lost.
There are, of course, differences between HIV and the coronavirus, chief modes of transmission among them. But it is remarkable how many parallels there are: HIV and coronavirus were first identified in America in large coastal cities where thousands soon died. Both diseases spread to marginalized communities, especially color communities, where the impact is disproportionate and deadly. Once again, we see state and local governments overwhelmed as hospitals fill with desperately ill and dying patients.
Thirty years ago, gay people were blamed for the pandemic. Today, President Trump owes it to the Chinese. The concept of a “gay virus” then made no more sense than that of a “Chinese virus” today. And both faiths betrayed a deep ignorance and bigotry that had deadly consequences.
Traditional and social media live with nasty conversations from all sides of the debates about masks and economic recovery. It’s easy to make fun of people with whom we disagree, but snarky memes and tweets do not move us forward. Our conversation should focus on who is dying, why they are dying and how we can save them while we focus on effective treatments and vaccines.
Service workers, first responders, teachers, food supply and processing chains, the elderly and immigrants are dying because society thinks they are discarded. In our rush for economic recovery, too many workers – afraid of losing both income and health insurance – have been forced to return to jobs that are unsafe. These are the people who cannot work from home but provide essential services to those who can.
A compassionate and equal response should replace anger and politically motivated division. Access to testing, treatment, and health care should not be determined by income, skin color, language, gender, sexual orientation, or geography. Real economic support for troubled families and businesses such as local governments should not be delayed any further.
We must also accept education and trust public health officials. When political and advisory leaders mock scientists and base their recommendations beyond ground, they endorse our best efforts to slow down the transmission of the virus.
The daily, if not hours, soundbites of sensationalist news should be replaced by sober, scientific information and guidance on coronavirus. Politics must bow to public health. We need to depoliticize masks and mandates as we once did with condom distribution and needle exchange. In American society, we deserve individual rights and freedoms. But that focus on individualism can lead us to collective disaster.
Some of us are old enough to recall another ugly national debate over the use of fabric to save lives, in which one side claimed belts for cars were too uncomfortable to wear, while the other pointed to research and studies for their effectiveness to be seen in saving lives. Many Americans opposed the government’s requirement to use belts and called all kinds of pseudosciences to discredit them, presenting them as an obstacle to personal freedom. The debate was remarkably acrimonious, but today almost no one would ask the question about the simple fact that belts save lives.
As we did 30 years ago, we need troubled lawyers. In the early days of the HIV pandemic, we shouted “Silence = death”, scaled research buildings and hijacked meetings to get our point across: action and political posture were unacceptable. We marched in the streets and through the halls of Congress for funding, research and support.
The current political bottleneck that sets out action to save lives must be broken. We all have a responsibility to tell our elected officials – Democrats and Republicans – that they need to do better.
For those of us at the forefront in the fight against HIV in the 1980s and 1990s, it felt very much like we were at war. Today, we have a self-proclaimed war president, but he has left every state to merge for itself without a coordinated national strategy. It’s a recipe for disaster. Proponents of HIV understood the need for accurate, timely and regular testing, without having any data or map to tell us where to allocate resources, no idea what prevention strategies worked and only a limited idea of how the virus worked worked. Today, without better testing, we can not know for sure whether coronavirus antibodies will confer immunity, and if so, for how long, and our understanding of how the virus mutates will be hindered.
Professional athletes and career politicians have ready access to accurate and rapid tests, while most of the rest of us wait for tests that offer inaccurate readings or deliver results days or weeks later, making them ineffective. Public health intelligence is just as important as military intelligence. President Trump may choose to ignore both, but we cannot. It’s time we funded public health services – for this crisis and for the next one.
Worldwide, 35 million people have lost their lives to HIV, and the pandemic is not over. We have no cure and no vaccine. But we have learned that if we build our differences, if communities work together, if the federal government leads – with decisions based on science, compassion and common sense – we can save lives.
Even without cure as a vaccine for HIV, we have been able to lower the rates of infection and death than previously thought through life-saving medications that also prevent transmission. This is because we demanded and helped to create a sustainable, long-term, science-based approach to tackling HIV. The Ryan White Care Act was a crucial part of our response then and is still alive today.
The thinking, long-term approach to tackling HIV, explicitly by the Ryan White program, needs to be replicated to address today’s coronavirus pandemic, as well as the unavoidable health challenges of the future. Our whole lives — and those of our family members, friends, and neighbors — depend on it.
The president assures us that we will soon have a coronavirus vaccine, possibly on election day, but I remember well in 1984 when former US Secretary of Health Margaret Heckler told us that a vaccine for HIV would be ready within two years. Thirty-six years later we are still waiting. Low promises will not protect us from the threat of coronavirus, but deliberate action can.
I was there 30 years ago and experienced the horror of HIV. I also saw the power of two-partisan leadership once it was finally exercised against HIV. That is what we need today from the President, Congress and people of the United States of America. The Ryan White Care Act offers us a proven way forward. We need government and local communities to come together again and do the right thing to save lives.
This will almost certainly be a long-term challenge that requires ongoing solutions, but we have shown that we can do it. There’s a way forward.
Cleve Jones is a longtime worker and LGBT organizer, founder of the Aids Memorial Quilt and author of When We Rise: My Life in the Movement
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