World AIDS Day and the Tragic Politics of Health

Each year for World AIDS Day, the Harvard Global Health & AIDS Coalition gathers on the steps of Memorial Church in Harvard Yard to mourn the 35 million lives lost to HIV/AIDS. As the number of people living with HIV today nears 37 million, the vigil reminds us of how far we have come and how much work we have yet to do in the fight against this disease and the social inequities that perpetuate it.

While our coalition has no political affiliation, we view policy and progress through the lens of health justice. During the 2016 election cycle, we spoke to Democrats and Republicans alike to urge them to pledge to end the AIDS epidemic. We partnered with student groups in Iowa and New Hampshire and connected with candidates at town halls, state fairs, and backyard pig roasts during primary season. Along the way, we conversed with Marco Rubio, Hillary Clinton, Bernie Sanders, Ted Cruz, and Jeb Bush. Each candidate had a plan for an AIDS-free generation; each candidate could speak to the importance of bilateral funding streams like PEPFAR and the Global Fund.

We remained hopeful that if we kept the pressure on we could make sure that the next President of the United States would support and expand the lifesaving programs that guarantee access to treatment for people around the world. At the time, we did not believe that Donald Trump could win the Republican nomination, let alone the general election. This assumption was our loss, and had we been able to anticipate his success, we would have pressed harder on his global health agenda. We would have asked Trump over and over again to fight AIDS with us.

AIDS activists of the 1980s and 1990s saved their own lives with treatment advocacy, demanding that life-saving medicines be released at affordable prices. Access to medicines remains a crucial issue in healthcare today. Both during his campaign and his first months in office, President Trump took a strong pro-patient position on drug pricing and the lobbying power of large pharmaceutical companies. He claimed that major drug companies were “getting away with murder” and advocated for government-negotiated drug pricing.

Then, last week Trump nominated Alex Azar to be the Secretary of Health and Human Services. Azar worked as Senior Vice President of Eli Lilly, a nearly $90 billion pharmaceutical company, whose most recognizable products are insulin treatments for diabetes. Under Azar’s leadership, the company raised the prices of its most popular insulins by 7 to 20 percent each year between 2014 and 2016. The effects of Azar’s greed are fatal; diabetics who rely on insulin to manage their blood sugar have died as a result of the price hikes.

The tone deafness of Trump’s nomination of Azar in the context of America’s healthcare politics is not unusual. Trump has shown complete disinterest in listening to the voices of America’s most vulnerable: those suffering from illness or disabilities and their caregivers. The administration has encouraged repeated attempts by congressional Republicans to repeal the Affordable Care Act, which has insured nearly 20 million Americans. The new tax reform bill now threatens Medicare, the insurance that serves as the lifeline for our aging and ailing.

Attacks on women’s health are also centerpieces of the Trump agenda. So far the administration has backed bills that could reduce access to contraception, instate a ban on abortions after 20 weeks, and threaten women’s lives around the world with a dramatic expansion of the Mexico City Policy, also known as the Global Gag Rule. Moreover, Trump has placed Jared Kushner in charge of addressing the country’s opioid crisis. Kushner—having little political experience and no background in public health—is woefully unprepared to address an epidemic that affects over two million Americans.

All of these issues—access to medicines, women’s health, and substance use policies—intersect with AIDS, in that they disproportionately affect marginalized populations who lack access to robust health care systems. In order to curb the HIV/AIDS pandemic and prevent future health catastrophes, we must build the systems and the attitudes that will prevent such a fate. The U.S. is the biggest donor to the global AIDS response. When our politicians lack the courage to save the lives that we have the tools to save, it is our job to follow them, from Iowa to New Hampshire to the White House, to shake them out of their deadly complacency.

While we resist—this year, this presidential term, and for the rest of our lives—we must remember that although HIV/AIDS may feel like a crisis of the past, 37 million people depend on bilateral funding for treatment and prevention. Their lives cannot depend on the conceits of one politician in the Oval Office.

This year’s vigil will be held today, Friday, December 1 at 7:30 p.m. on the steps of Memorial Church in Harvard Yard.

Katie L. Blanton ’18 and Shayla B. Partridge ’18 are History & Science concentrators in Leverett House. They are members of the Harvard Global Health & AIDS Coalition.