Staying vigilant in the wake of assaults on public health, science
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* José Ramón Fernández-Peña

I have spent much of this year talking about the similarities between the HIV and COVID-19 pandemics. My fundamental premise is that pandemics have an uncanny ability to expose the cracks in the structures and systems societies build to address them, and the inequities of the social constructs we establish.

For example, during the AIDS pandemic, the limitations of employment-based health insurance left thousands uninsured when they needed coverage the most. Entrenched homo-phobia and bureaucratic constrictions delayed the development of effective medications and broad prevention strategies. And the lack of rights for the partners of people dying of AIDS oftentimes resulted in homelessness and poverty among the survivors, or in their exclusion from any decisionmaking.

The COVID-19 pandemic has shone a light on some of the same cracks in systems and structures, as well as on the social inequities that fuel the spread of the disease. But even more shocking is the role of politics in the persistence of this pandemic. Yes, politics has always played a role in what gets funding or attention. But I do not recall another situation where politics were so specifically focused on advocating for unhealthy behaviors.

At the beginning of the AIDS pandemic, there was little interest in addressing a disease that was predominantly killing gay men and injection drug users. But then-Surgeon General C. Everett Koop sent a brochure with AIDS prevention information to every household in the United States. Koop’s conviction to stand up against treacherous and misguided politics pertaining to public health within his own party is sorely missing today.

Our public health leaders are being demeaned and insulted and some are receiving threats of violence against them and their families. The recent dismissal of Michelle Fiscus, MD, FAAP, former medical director for vaccine-preventable diseases and immunization programs at the Tennessee Department of Health, for sharing information on vaccination exemplifies the nonsensical political decisions that will further feed COVID-19 cases.

![Figure1](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/51/7/3.1/F1.medium.gif)

[Figure1](http://www.thenationshealth.org/content/51/7/3.1/F1)

How do we stop this madness? The spread of lies is relentless, and nothing good can come of it. As Surgeon General Vivek Murthy said this summer in an official advisory, misinformation is costing us lives. We’ve gone from vaccine hesitancy to outright vaccine rejection — all while most of the world struggles to even get COVID-19 vaccines.

We need to continue to work on developing clear messages for different audiences that reinforce the importance of vaccination and the low risks associated with the vaccine — compared to the dangers and long-term consequences of the disease — so that communities can make decisions based on science and not on politics. We must also remain vigilant in responding to the assault on evidence-based policies and practices.

To read and share this column in Spanish, visit [www.thenationshealth.org/URLTBD](https://www.thenationshealth.org/URLTBD).

*   Copyright The Nation’s Health, American Public Health Association