Pandemics and politics: Lessons from the HIV/AIDS crisis

Pandemics and politics: Lessons from the HIV/AIDS crisis
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In 1988 I took a job helping eight AIDS service organizations assemble a coalition to demand a better response to a national epidemic largely ignored by our government. The group was small, underfunded, politically naïve, and had collectively never worked in policy at any level. Yet by 1991 it gave rise to one of the most effective and innovative public health responses of our time.

Having been on those front lines to witness one of the darkest moments of a deep failure of politics and then the pivotal change to systemic reform, I believe there are valuable lessons to be learned — many replicable to fight against the COVID-19 pandemic we now face.

Pandemics expose systemic failures; therefore, systemic solutions are required if we hope to respond effectively. COVID-19, like its cousins HIV, SARS and Ebola, is a merciless teacher of weakness — perhaps more so in our political system than in any other.

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You can see the parallels clearly between HIV/AIDS and COVID-19. What went wrong in the response to the HIV/AIDS crisis from 1983 to 1991 was a massive failure of politics, but what went right was the subsequent political movement that funded science, treatment, prevention, civil rights protection and health care access. When we sought solutions for HIV/AIDS, we didn’t look at band-aids to systems, but rather at reforming and innovating the public health system that had failed millions of people.

This is exactly what must happen now with COVID-19.

These situations are not perfect analogies, but the pivotal role politics has and will play before, during and after their emergence reveals a few hard lessons learned that can be applied to our current crisis. 

The public health imperatives for COVID-19 mimic the recommendations made for HIV/AIDS — namely massive testing and contact tracing. Yet before we could test the most vulnerable populations and seek their cooperation in contact tracing, we needed trust. Trust that a positive test didn’t mean a death sentence, unemployment, eviction or isolation from family and friends. Systemic failures and inadequate support drives people away, underground and anonymous — it also spreads a deadly virus.

There is an alarm bell going off in the disparities the impact COVID-19 has on vulnerable communities across America right now. And that’s exactly what happened between 1983 and 1991, when the government only sowed distrust and alienation, leading to the erasure of entire communities. This is not an easy truth, but it is an essential one that we must heed in our response to COVID-19.    

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The turning point of the HIV/AIDS epidemic was when political forces that had denied it and stigmatized it changed their tune. That moment was the passage of the Ryan White CARE Act — the nation’s first and still most comprehensive response to the care and treatment of people with HIV/AIDS. The bill was written by the front-line leaders I worked with at AIDS Action—the eight organizations on the ground every day serving the sick and suffering. Their insight into policy solutions and the practical demands of service are the cornerstone of the bill’s continued success.  

The same should be the case for our policy responses to COVID-19. Enough with throwing fluffy accolades at first responders and health care workers; instead, invite them to the policy table and ask them how the government can address this pandemic more effectively and with lasting results. The answers are there if politicians listen. 

In these moments, three things must prevail: sound policy formed by experts in close alignment with science and facts; mature politics by leaders who set aside ideology, take responsibility and unite us under comprehensive legislation; and public knowledge of facts, not spins on stories that propagate more confusion and distrust. There will be accountability when these trying times are over, as there was with HIV/AIDS. Today’s politicians should understand that, throughout our present pandemic, the country is watching them.

History is our best teacher; actions are our best hope for the future. Politics and pandemics are inextricably linked, and our future lies in the balance, once again.  

Thomas F. Sheridan is a 30-year veteran lobbyist, with advocacy efforts including Bono’s ONE Campaign, AIDS Action and Save the Children. He served as lead lobbyist for the Americans with Disabilities Act and is author of “Helping the Good Do Better: How a White Hat Lobbyist Advocates for Social Change.”