Trump and Reagan’s Willful Incompetence During Epidemics

For a long time, there were no places to get reliable information on HIV. TheBody came online in 1995, yes; but before that, access to trustworthy information was limited to groups such as AIDS activist Ron Simmons’ Us Helping Us and Larry Kramer’s Gay Men’s Health Crisis, print publications such as The Advocate and the short-lived Outweek, and Kiyoshi Kuromiya’s Critical Path web page. Compared with what the world has now, it was a barren wasteland wherein misinformation reigned, even among doctors. Being gay was taboo—and the inability to discuss sexual health openly damned tens of thousands of people to slow and painful deaths.

This was an era largely defined by President Ronald Reagan’s refusal to acknowledge that the virus was destroying lives due to social determinants or to intervene in ways that were necessary. Though his administration was aware of the epidemic, it was not until 1985 that he would even say the word AIDS publicly. When he did so, it was to resist calls for greater funding than the $126 million that he’d offered for developing a cure.

In December of that same year, a Los Angeles Times poll of 2,308 people found that 51% of respondents supported quarantining people with AIDS and criminalizing sex between a person with an AIDS diagnosis and another person, while 48% supported identification cards for anyone who tested positive for AIDS antibodies.

At the time, it was not widely understood that AIDS was a condition caused by HIV. Greater funding for research and disseminating accurate information among the public could have resolved this misunderstanding. Unfortunately, the U.S. Senate echoed Reagan’s opposition to providing greater resources in October 1987, by approving Sen. Jesse Helms’ amendment to the fiscal 1988 appropriations bill for the departments of Labor, Health and Human Services, and Education prohibiting the Centers for Disease Control and Prevention (CDC) from funding AIDS programs that ‘‘promote homosexual activities.’’ Helms explained his change by saying, “We have got to call a spade a spade and a perverted human being a perverted human being.’’

That year, Reagan reiterated this religiously dogmatic approach while unveiling his educational policy on AIDS.

‘‘I think that that particular subject should be taught in connection with values, not simply taught as a physical, mechanical process. … The federal role must be to give educators accurate information about the disease. How that information is used must be up to schools and parents, not government. But let’s be honest with ourselves. AIDS information cannot be what some call ‘value neutral.’ After all, when it comes to preventing AIDS, don’t medicine and morality teach the same lessons?’’

Values and medicine do not teach the same lesson. Regarding HIV, this is especially true when those values adhere to an abstinence-based ideology instead of prioritizing condoms and “explicit” sexual education, as was recommended by then–Surgeon General C. Everett Koop, M.D.

In explaining his resistance to Koop’s advice, Reagan told reporters, “I think that abstinence has been lacking in much of education. One of the things that’s been wrong with too much of our education is that no kind of values of right and wrong are being taught in the education process. And I think that young people expect to hear from adults ideas of what is right or wrong.”

This concentration on “right and wrong” further perpetuated stigma against the LGBTQ community. It also motivated the CDC and National Institutes of Health to reject requests for greater funding of research on HIV from its own scientists even as the virus continued to decimate marginalized communities.

Some people responded to this lack of leadership by turning to charlatans such as “Dr.” Sebi, who profited off of the backs of desperate individuals by peddling false promises and hoaxes.

Sebi was further assisted by medical mistrust—particularly in the Black community, which is still haunted by the Tuskegee Syphilis Study—and debilitating side effects from early antiretrovirals, which proved just as painful as living with the virus without treatment for some people. Even AIDS activist Michael Callen rejected AZT, while equating it to Drano in pill form.

Issues with antiretrovirals continue today. Though advances in medical care mean that people living with the virus are now able to take one to three pills a day instead of 30, new impediments—such as interrupted medical care—have emerged. These ongoing disruptions reveal troubling parallels between the way that the Reagan administration responded to the AIDS epidemic and how the Trump administration continues to handle the COVID-19 pandemic; by flouting science and ignoring how social determinants drive infections.

Marginalized communities remain vulnerable to both viruses and are condemned for their disproportionate rates of infections. Early on, HIV/AIDS was pejoratively referred to as “gay cancer,” and LGBTQ people were—and still are—blamed for its spread. Similarly, during a public hearing on COVID-19 in June 2020, rather than offer viable solutions to the problem, Ohio state Sen. Steve Huffman—who is also a medical doctor and vice chair of the state Senate Health Committee—indulged in bad-faith, racist arguments that blamed Black communities for their high infection rates of COVID-19, suggesting that they had high rates because they do not wash their hands or wear masks.

In August, during two Zoom town hall meetings with faculty and family members of students, University of Michigan President Mark Schlissel echoed President Trump’s refusal to expand COVID-19 testing by creating a homophobic lie that blamed gay men for using their sexual health tests to spread HIV. He falsely described a time during the early “HIV epidemic, when people got a negative test and they presented it to their sex partners and spread disease, nonetheless.”

Unlike the period of limited information that defined the ’80s and ’90s and fueled AIDS hysteria, the world now has access to seemingly unlimited knowledge. And yet, President Trump has used his privilege in speaking directly to hundreds of millions of listeners around the world to promote hoaxes such as injecting oneself with bleach as a treatment option, exaggerated the effectiveness of hydroxychloroquine as a cure, downplayed COVID-19’s deadliness even though he knew otherwise as early as February 2020, mocked and dismissed the importance of wearing face masks in public and following social-distancing guidelines, and encouraged citizens to break common-sense harm reduction protocols.

Ethics aside, where the current Republican administration differs from Reagan’s in addressing viral outbreaks is in how it has diverted resources to do so. For Reagan, “fiscal responsibility” meant devoting unlimited funds to bankrupting the USSR during the Cold War, even as AIDS ravaged his fellow Americans. It is not yet known how Trump is diverting the country’s tax base. What is clear is that his rush to secure a COVID-19 vaccine has pushed other equally important issues, such as HIV/AIDS, to the wayside.

This desire to defeat the COVID-19 epidemic is admirable, especially after so many people have died. It leaves one wondering how many lives would have been saved if Reagan had invested the same energy into AIDS, or if this administration, in pursuing its plan to end the virus by 2030, would make the same investment. COVID-19 has debunked the rationale that it is too expensive to do so. What remains to be seen is if conservative compassion will ensure that another 200,000 people are not killed by either virus.

To date, an estimated 770,000 people in the U.S. have died since the start of the AIDS Epidemic. After three years and 10 months, whether that compassion suddenly materializes or not, if this president continues his policies of denial and calls for herd immunity, then even victims of the AIDS epidemic will look back on Reagan’s senility with fondness.