Will We Be Smarter About the Next Epidemic? Two Experts Break it Down.

Please note: This transcript has been automatically generated.

Brittany Packnett Cunningham: Hey, y’all it’s Brittany.  So, it’s been almost two and a half years of COVID and I cannot possibly be the only one who was praying that something, something good would come out of this. You know, that maybe the crisis of COVID would finally give us, I don’t know, like a crisis of consciousness. I mean, against literal centuries of American history to the contrary, I, an eternal cautious optimist figured we’d finally get some of those workplace accommodations the disabled people have been fighting for, for ages. 

Or, you know, at least we’d realize that we could actually provide healthcare free of charge like we did COVID tests. Or maybe we’d realize we had the ability and the money to meet people’s needs after all, the way we sent those stimulus checks. Yeah. I was tripping cuz a lot of those accommodations went away after the corporations wanted us all back to work and those tests suddenly seemed to have dried up and those stemies did not come monthly like we thought they would. Then checks was real light. 

Back in 2018, I taught a study group as a Harvard Institute of Politics fellow, and I taught on power and elements of white dominant culture. And my class and I discussed individualism, perhaps the crowning jewel of white supremacy culture and how it is going to be the death of us all. It is antithetical to the kind of community minded, collective care and policy making that COVID should have taught us we need now more than ever. So, no, we do not make it on our own. No, I am not free unless you are. And no, our government cannot simply allow, you know, the fittest to survive.  

In community, our success is determined by how the most vulnerable people are doing. And by that standard, we’ve got a whole hell of a lot of work to do. We are UNDISTRACTED.

On the show today, we’re talking about the virus that it’s time for us to all stop calling monkeypox and start calling MPV. 

Dr. David Johns: So much of what we’re experiencing right now at this moment with looks like Covid, which looks like HIV. Well, all of this is built upon the most insidious of all diseases, which is white supremacy.

Brittany: I’ll be joined by Dr. David Johns of the national Black Justice Coalition and Dr. Monica Gandhi, director of AIDS research at the University of California, San Francisco. That’s coming up, but first it’s the news.

If you feel like your medical needs and overall general well-being took a hit during the pandemic, you are not alone. And now there’s data to back up what we also felt, that the hardest blow was dealt to marginalized and isolated communities. NPR, the Robert Wood Johnson Foundation and Harvard School of Public Health.

They all conducted a poll to try to understand how healthcare access changed during the pandemic and they found that one in five households that experienced a serious illness within the past year said they had trouble accessing care. 

Tomeka Kimbrough-Hilson: So unless you’re dying or you need this to live, you couldn’t get an appointment.

Brittany: That’s Tomeka Kimbrough-Hilson, a 47-year-old Black woman who told NPR she wasn’t able to get treatment for a uterine growth even after the crisis period of the pandemic in 2020 passed. Providers were too backed up dealing with deferred care and unfortunately, Kimbrough-Hilson‘s story is not an outlier. The polling also reflects the inequity baked into our healthcare system of those polled, more than a third of American Indian and Alaska native households and a quarter of Black households had trouble accessing care for serious illnesses.

Only 18% of white households reported the same. Doctors anticipate the impact of delayed diagnoses to last for years. And the data is a good reminder that COVID has not happened in a vacuum. The reality is that it is still better to be a white patient than a patient of color in America.

And before sharing this next story, I want to mention that it details abuse and sexual violence. So if you need to take a break, come back and join us in about two and a half minutes. If you’re active on Twitter, it’s likely that you’ve seen Dan Price go viral more than a few times over the last few years. As CEO of the payment processing company, Gravity Payments, his tweets ranged from criticism of President Trump to advocating for women’s rights to bragging about cutting his own pay in order to create a minimum salary of $70,000 a year for all his workers. It got him a lot of positive attention. Inc. Magazine called him the best boss in America and former Secretary of Labor Robert Reich called him a, quote, moral CEO. But that glossy coverage was hiding some really ugly truths.

According to the reporting from The New York Times, Price is accused of sexual assault and, what the Times called, a pattern of abuse in his personal life. He denies these accusations, but in one particular case, a 26-year-old woman reportedly told the police he attempted to kiss her and grabbed her throat.

In another incident, a woman he was dating reportedly told the police that he initiated sex with her while she was under the influence and falling asleep. But the Times also reported that in 2015, his ex-wife did a TEDx talk where she claimed that she had been abused by her former husband. Now that talk was never broadcast.

This is the thing, though. This was not hidden. There was that Ted talk and a piece in Bloomberg Business Week in 2015 that included the domestic violence accusations. Now Price lost a book contract as a result, but using social media he was able to just tweet his way through it, right back to the top of the search results.

Our memories are short these days and harm can often hide in plain sight. Yes, even at the hands of those we think share our worldview. So, I hope that the survivors get justice or at least some of the accountability that they deserve and that we hear their stories in the same way we were so eager to listen to Dan Price in the first place.

Now, I wanna close the news by honoring a seminal work of historical journalism. This month, we celebrate the third anniversary of the 1619 Project. The launch of the project in August 2019 acknowledged a different anniversary, 400 years since 20 kidnapped Africans were brought to Point Comfort, small port in Virginia and sold into enslavement.

The 1619 Project completely reframed American history by focusing on the consequences of enslavement and the work of Black Americans to fight for a better nation. At the heart of this project is the acknowledgement that every aspect of our country has been touched or shaped in some way by the institution of slavery and by the enslaved. There were essays, a podcast, articles, and a curriculum that more than 4,000 educators have reported using. The project was a full work by dear friends of mine and was created and developed by Nikole Hannah-Jones of The New York Times. She won a Pulitzer Prize in 2020 for the project’s introductory essay.

We of course had the great honor of interviewing Nikole last year.

Nikole Hannah-Jones: The America we actually live in is explained by 1619. It is explained by a country that believes that you can commodify human beings, that bases economic systems, it’s political systems on the idea that certain human beings can be deprived of all rights and all liberties.

Brittany: Y’all some stories change the world and once you hear them, you can never go back, only forward. And that’s what the 1619 Project did for us. We are so grateful it’s in the world.

Coming up, I’ll be talking to Dr. David Johns and Monica Gandhi about getting to a more just healthcare system, right after this short break.

And we are back. So, it is truly the same old story every single time. We just talked about it in the news, that Black and Indigenous households had more trouble accessing medical care during the pandemic than white households. We saw it with COVID. Data from the Kaiser Family Foundation shows that Black, Latine, and Indigenous Americans were, and still are, about twice as likely to die from COVID as their white counterparts.

And now of course, we’re seeing it with the thing that’s being called monkeypox. Data from New York City released last week shows that Black men have been getting vaccinated against the virus at far lower rates than other populations. According to the city health department, 31% of the folks who are most at risk of infection are Black, but they’ve only received 12% of the doses so far. 

That’s because the vaccines initially were only available by appointment and wealthier folks with more flexible schedules, were able to spend time tracking down a slot. It’s the exact same thing that happened with COVID vaccine appointments at first. I wanted to dig into why this keeps happening. So, I got in touch with two folks who can talk about this from different perspectives.

Dr. David Johns is a sociologist. He’s the executive director of the National Black Justice Coalition, which strives to empower queer Black folks and those living with HIV and AIDS. Dr. David, Dr. Monica. We have so much to talk about. I’m so grateful to you all for being here. I wanna talk about so-called monkeypox, that even calling it that is a conversation which we will have.

I wanna talk about pandemics in general. I really wanna talk about how we build a culture and community of care and having both your public health expertise, Dr. Monica and your education and queer community expertise, Dr. David, I think is the right combination to have this conversation and I really wanna start by setting the table for our listeners. So David, I wanna start with you and then Monica we’ll come to you. I’m curious, what you think is the most important thing to understand about what the world is calling monkeypox right now, 

David: First, friend, let me say thank you for having me in this space. It is a privilege and an honor to share with you. And to you Dr. Monica, I’m excited to join in this discussion with you, as well. So, I don’t use a term that you’ve used. I’m gonna use MPV throughout the course of this conversation. It is what the National Black Justice Coalition, the civil rights organization that I have the pleasure of quarterbacking and the team for, has advocated that the White House, that the World Health Organization, and others use to get away from stigma. 

And so that’s a really long way of saying the following, which is that is not an African disease. It is not a gay, same-gender loving, or MSM disease. But it is an infectious disease that is transmitted by close, personal contact. That does not necessarily have to be intimate or require exposed lesions. 

And there have been so many previous examples of problematic language use to describe health crises and outbreaks and diseases that have existed for a lot longer than I’ve been alive, but have now only become problems that they’ve affected white Western privileged communities, in particular white gay men, but the lack of thoughtfulness around framing and communicating the virus, how it’s transmitted, how we can take vaccines and engage in other behaviors to reduce the likelihood of transmission, to increase rates of survival for those who become affected often result in so many Black, brown, and Indigenous and poor and disabled dying and or suffering in ways that do not have to be our reality.

Brittany: Yeah, you bring up so many important points. When we talk about MPV, we know terms like MSM, which means men who have sex with men is commonly used in public health, but can be problematic in other ways. I’m just curious, your thoughts, Dr. Monica, what is the most important thing for us to understand about MPV right now?

Dr. Monica Gandhi: Yes. I mean, it’s a great point, David, but one issue is that all infectious diseases seem to have all these disparities in them and it really got revealed for us during COVID and we are not working hard enough to address. So, let’s just go to MPV. I like that. I’m gonna use that name from now on. 

Brittany: There we go. We’re connecting dots already. Let’s do it. 

Monica: But this is an orthopoxvirus. It’s a DNA virus that its cousin is smallpox, meaning they’re both in the same family. And what that means is that we didn’t actually start seeing outbreaks of problems with this virus until we stopped mass vaccinating the world for smallpox, indicating that probably smallpox vaccine works against it.

And then after the smallpox vaccinations ended, cuz we eradicated smallpox in 1980. Then we come to May 13th. May 13th is the first day that there’s this new kind of outbreak being described to the WHO and now it’s over 40,000 people who have been infected during this outbreak over 103 countries. And you’re right, now all of our attentions on it, because it did end up affecting at the beginning more white gay men.

And then actually, if you really drill down, there are higher and higher proportion of Black and Latino gay men being infected. So that just means to me that you’re right, we’re not working hard enough on messaging to the right communities, getting the vaccines out to the right communities, ensuring that people are okay saying that they come into a clinic and say, Hey, I may be at risk, so I’d like the vaccine, please. These are very important, like de-stigmatizing ways to talk about the pandemic. And I just keep on watching it look like HIV at the beginning where we didn’t message right and it’s not being messaged right here. 

Brittany: First of all, we’ve already gotten a great push on our messaging, right? I know that the WHO, the World Health Organization, is currently accepting submissions for a new name. And so hopefully just like I was pushed and just like you adopted this, that we see the World Health Organization go with MPV very soon. When you talk about framing, that of course has an impact on policy.

Monica, you wrote back in June in The Atlantic that the U.S. is underreacting to MPV. Do you feel like that is still the case right now in August? 

Monica: Yes, we are underreacting. The reason I say that is that unlike with COVID, when the infection started growing, we had a vaccine that we could have just used right out of the gate because the smallpox vaccine is effective for monkeypox at maybe 85%.

We don’t know the exact number and we didn’t have to develop a new vaccine from scratch. So, Quebec and Canada had already figured this out. They looked at this and they said, oh, this is spreading. We’re gonna go buy this vaccine from this Denmark company and already in Quebec, in Canada, they’re at 0% growth with new cases. In the United States, we have the highest percentage, about a 25% increase every week.

So, we’re not slowing down yet, but the UK, Europe, Canada, places that just got on it with the vaccine, they are slowing down already. And that’s what I wrote in June 24th. And that seems like a lifetime ago. That was two months ago. We’re still not there.

Brittany: So, clearly we’ve had time. 

Monica: Yes.

Brittany: To figure this out and have not made the choice to, and I’m curious, David, how much you think that has to do with the perception by some, the intentional and unfortunate implication, I would say by certain outlets and certain people that this is a queer or gay disease. We know that pandemics often first spread in specific communities, right. Either demographically or geographically. And yet some people will take this to create a narrative that is very dangerous for marginalized people.

So, I’m curious if you feel like, David, part of the hesitancy to solve this has to do with how the narrative has been driven around this disease and how people perceive it. 

David: Absolutely. Quickly, three things come to mind to the point of naming it a significance. I recently returned from Ghana and that the disease originated in west Africa is not lost on me. Again, I make the point that MPV existed for a lot longer than I have been alive, but there was a lack of focus on it in part because African descendants are thought to be disposable.

And so it is not until privileged Western white populations, that it became a crisis. And we should be more mindful of that, especially considering how rich and diverse and important the continent of Africa is and how opportunities to get ahead of infectious diseases results in increased success on the back end. 

The second thing is the way that we’ve talked about it here too, for the kindergarten teacher in me thinks that adults often make things much more complicated than they need to be.

And it should be lost on no one that the same way in which early conversations about COVID, which reflected early conversations about HIV, which suggested that it was a disease that was specific to a group of people. And if you are not a member of that community, then you didn’t need to care about it or be concerned about it.

And one of the things that has resulted in, to go back to the HIV AIDS epidemic, is that Black people, not just Black gay, same-gender loving men who have sex with men continue to be disproportionally impacted, but Black cisgender heterosexual women, as well. And it’s because the narrative is still that it’s a gay disease.

And if you are not gay, then you don’t have to be concerned about it. And then the last thing that I think about now is that because Black people like native people and Indigenous people engage in intimate, romantic, and otherwise relationships with each other we’re in proximity with each other, we’re in community with each other. We are more likely to transmit diseases to one another. 

And for folks who don’t know, the CDC said some time ago that if rates continued as they have that one in every two of us, Black gay men, same-sex loving men, men who have sex with men, would become HIV positive. One in every two, like it’s been a crisis for some time. And that is still the case, not because we engage in riskier, sex behaviors or sexual behaviors, in fact, that data suggests otherwise. But it’s because we love on one another. And so while I started with naming that it’s not an African disease, it’s not a gay, I want to be clear that it’s affecting us in a particular way.

In New York city, the cases amongst Black men was 25%, which is roughly the same portion of our population there in California, where I’m from 11.5% of MVP cases, our Black men, which is twice our population in the state. Georgia, the Department of Public Health found that 82% of cases affected Black gay and same-sex and loving men.

And roughly two thirds of those are also affected with HIV. In North Carolina, with 70%. I could go on, but the point I wanna make here is that it is a crisis in our community for all of the reasons that have to do with white supremacy, anti-Blackness, justified distrust of the medical industrial complex.

And because we still don’t engage and democratize healthcare practices that give people the information and access to resources that can be life saving and life affirming and all that’s within our control. 

Brittany: You bring up these, what I hope for most people are obvious parallels between COVID and HIV and AIDS, specifically our response to both of them, this fact that we often attribute it to some kind of pathology or moral failing in a particular community.

I’m curious though, when we talk about getting it right, what are the lessons that both of you want leaders to learn from these previous pandemics? Monica, I’m curious about the lessons from COVID specifically that you want, and then David, I’m coming back to you as well. 

Monica: This is where you could see that there would be quite a bit of cynicism in Black and brown communities about the monkeypox response.

Cuz look at what happened. This is a vaccine preventable infection. So, the fact that there’s been circulating monkeypox in Western central Africa in different outbreaks, including Ghana for the last decade. They’ve been rising in prominence over the last decade. The fact that we had 20 million doses of MPV vaccines sitting here in the U.S. and destroyed them when they could have been used in places like Western central Africa to stop it there.

Brittany: Oh goodness. 

Monica: It’s just so hard to hear.  I can’t even, that just sounds so colonialist and awful. I don’t know what to say.

Brittany: Cuz it is. 

Monica: Yes. And then why wouldn’t you have distrust in the public health community if it feels like something isn’t happening fast enough? So, what happened with COVID is that because it affected everybody though it was disparate, but because it affected everyone, it moved fast on a vaccine.

Nine months, got a vaccine. Here, there was a vaccine and they’re still not moving fast. Is that because it’s affecting more gay male communities, more Black and brown communities? Where’s the urgency around this because it’s actually extremely uncomfortable. There’s lesions that are in very sensitive places and people are feeling awful.

And so it feels like there’s not an urgency because this is a more dispensable population in some way. That is how it can be perceived. And that’s profoundly disappointing because to me, it reminds me of HIV, which is that is HIV it took years and years to get to a good antivirals to treat it. It took until 1996.

And if it affected everyone, including the president and the first lady and everyone else who gets COVID, it’s possible, we would’ve moved faster on that. 

Brittany: Hello. David, what are the lessons that you’re hoping are picked up from COVID or from HIV AIDS on this? Cuz my thing is, I remember in 2020 feeling like maybe we’ll finally understand how to care for one another.

Maybe we’ll finally understand how to set better health policy. Maybe we’ll finally understand how to properly resource people and all my little hope feels like it just keeps floating out the window because the lessons are so obvious and they don’t seem to be being learned. So, what are the lessons that you hope are picked up now and that you are pushing to have picked up now and that you are pushing to be picked up now?

David: Yeah, I was smiling to literally keep from crying. Anyone who knows me, knows that I care deeply about our babies, none of whom asked to be born. And the older I get, the more I struggle with the question of why we simply don’t heed the lessons that we’ve had so many opportunities to learn. Three things come to mind in this regard, in terms of lessons that we can apply in this moment.

One is democratizing vaccine access and other resources to guard against not only MPV, but polio, which there are recent resurging cases of and other things that we don’t talk nearly enough about, especially given the way that so many of our immune systems have changed as a result of COVID and the way that it’s forced us to live our lives differently.

And this especially is important for me, it’s small, rural, and isolated communities. Brittany, we’ve talked about this before and Dr. I’m sure you know that like most Black queer trans and non-binary people live with other Black people, we are not necessarily located all of us in neighborhoods or major metropolitan spaces that are most likely to be prioritized by the CDC and state health departments looking to Institute PSAs or campaigns or provide resources to mobilize community members to be able to do important work.

And to be mindful of how MPV and related viruses are showing up in day cares, where we are trusting that our babies are going to be safe and a part of their development requires physical, nurturing, and affection, as well as on college campuses where young people are engaging with each other in intimate ways.

Related to that, it’s important for us to focus on overcoming misinformation and disinformation. This goes back to the conversation we’ve been having about stigma, but for me also means requiring that professionals in particular, those who have platforms in the media are required to be culturally competent.

Such that people are not making the kinds of mistakes that newsrooms apologize for when all of their early coverage is of darker-skinned or African descended people. And again, that’s something that we should be beyond at this point and we clearly are not. And then the last one is working with community navigators. That’s a term that exists in federal legislation that the CDC has funded. And these are people who work in the kinds of communities that I have just named and that we’ve been talking about where people have the greatest needs and are least likely to have access to literal care. And this is especially the case as there have been so many attempts in Southern states to prevent people from having access to life-saving and life-affirming care. 

And so prioritizing and compensating again, equitably people who do work for what Howard Thurman called the disinherited. Is another lesson that we should have been applying at this point in our history.

Brittany: You know, I joke all the time and to your point, David it’s I laugh to keep from crying. They’re like individualism is gonna kill us. COVID has made that very clear. Our response to MPV is once again, making that very clear, because one of the biggest lessons I’ve personally taken away from both how we’ve treated Covid and how we continue to treat HIV and AIDS is that we both need proactive government leadership and individuals to make specific choices.

That it is a both and not an either or. Because right now, it feels like we’re living in the either or. It feels like the government has chucked up the duces and the support, the resources are waning at best. And the onus now is being primarily put on individuals. Do either of you feel like that’s the case? And if you do, does that worry you? 

Monica: You know, one thing I will say is that there is an article about our fractured healthcare system in the United States and how we have had the highest per capita death rate of COVID than any other high income nation. And it is so tragic. It is so embarrassing, but this article, which I’ll share with your audience, was actually about the fractured healthcare system that we have a system by, which people are hanging on by a thread.

Obamacare has been threatened numerous times. There were governors that didn’t do Medicaid expansion, which was necessary for people to be on insurance and places where there is universal healthcare and it’s not such a fight. If you look at, like the Nordic countries, places where there’s universal healthcare, their rates of death were so much lower.

Like, how are you supposed to take care of your own ability to get a vaccine for MPV if there is not a vaccine for MPV? How are you supposed to get over the doubts of the long history of what the U.S. has done in terms of marginalizing communities? If we did not figure out with COVID how to fix these health inequities, we were lost because COVID was so dramatic. Was so on the world stage, we didn’t do well enough and this would be the exact right time to say what are all the things we did wrong? 

David: I agree. And I think in threes, as you can tell three things come to mind.

Brittany: Like a preacher. 

David: How my papa I would be proud. One is the words of Freeman Hrabowski, the former president of UMBC and a member come to mind and it’s really important for me to name that we should not be beholden to the tyranny of either or, but be liberated by the beauty of both ends. So, I just wanna underscore that, yes, I think that the way that you framed the challenge. As it has been constructed is flawed and problematic and should not be the cases we think about solutions.

The second is I’m a sociologist by training and I chose sociology because I’m fascinated about the ways in which individuals exist in community. And I understand as a student of African theology that we exist and thrive in healthy community where we understand that none of us are disposable. And so I just wanna name that for me what’s vexing about this is that it’s not even frustrating. So much of what we’re experiencing right now in this moment, which looks like COVID, which looks like HIV, but all of this has built upon the most insidious of all diseases, which is white supremacy. 

Brittany: There it is. 

David: And a lesson until we do a better job of naming with greater precision, this is Ayala talking about name a thing beloved, and creating institutions that allow us to disrupt how systems function as they are designed to, we will continue to have versions of conversations that sound like this. 

Brittany: Yeah. David, something that you tweeted recently is really sitting with me as I’m listening to both of you talk, you said white supremacy is being afraid to hope. That is resonating with me in this moment, because if the root virus is white supremacy, and we have not made any indications that we have much interest in solving that, curing that anytime soon.

And therefore that means that we are going to keep having this conversation again, then like, how do we not be afraid to hope? 

David: I think that our legacy, and in this moment I’m thinking about a brother, professor Henry Lewis Gates, who helped me to appreciate that our legacy is one of hoping in spite of, and so I think that the fear is something that we acknowledge as real and present and omnipresent in the way that Black feminists teach us white supremacy has always been. And we appreciate the teaching of our ancestors and elders who help us to appreciate that like, we know how to overcome, like we know how to respond to this. 

And we celebrate things like you, Brittany, having this platform where you teach the babies that there are folks like the good doctor who were in the community doing work that even by her share presence is disruptive.

When we think about the ways that white supremacy and anti-Blackness, and LGBTQIA stigma phobia and the like are designed to operate. 

Monica: I wish I could say something more hopeful, but I would say this, is that I remember after the George Floyd protest, listening to Cornel west saying I have never felt more hopeful.

And then there was this very kind of backtracking on that, that occurred in this country. But one thing I would say, and this is from my viewpoint from health is I’m not a sociologist, I’m someone who works with gay populations and infectious disease, which always occurs in a disparate fashion.

Infectious disease has always been littered with disparities and shame and stigma and all of this that should never happen. And I would say that COVID played out in such a visible way. The U.S. is such an outlier in terms of its outcomes that I do think that from this lens of health and from infectious disease, we’re all very alert to infectious disease right now, I’m hoping these conversations will center around something as simple as if we have poorer outcomes and other high income nations. We should have a commission on why were all the reasons that our outcomes were worse with COVID it was a visible respiratory virus that anyone could get and that I’m hoping could redirect the conversation to more justice.

I think that’s as hopeful as I can think of as an outcome from this. 

Brittany: Yeah. I wanna stick with hope and give it a bit of a plan because we know without it, it’s just a wish. Because I find myself driving around and getting more and more depressed when I see these tents that advertise COVID testing and the banner on the tent will have a big blacked out word before COVID testing, because what they’ve taped over is the word “free”.

Cuz the federal government is no longer funding rapid testing, never mind that the testing they’re doing are like often just kits that you can buy at the pharmacy. The idea was supposed to be that there was some place where you could access this for free. And now I just see this as such a grim picture of how much to your point, Dr. Monica, our healthcare system is really built for profit and not for people. 

Monica: Yes. 

Brittany: It feels like we really missed the very clear opportunity to implement universal healthcare during COVID if at no other time, this seems like the most obvious time it would’ve been done. So, I’m curious, Dr. Monica, how we create the political will to get this where it needs to be?

Monica: Even profit would say, even profit motors would say that we had a really inefficient and really expensive response because we didn’t have universal healthcare. And as a physician, all I can think of is that universal healthcare should have been automatic from this because then we wouldn’t be commercializing testing and vaccines and treatment that will leave out so many people who don’t have healthcare access.

So, this is to me, a perfect springboard to point out that if we didn’t have Obamacare to begin with, it would’ve even been worse. And Obamacare wasn’t exactly universal healthcare as practiced in Europe and Canada. So, I still think it will end up being more expensive to have had this emergency response where you plug holes instead of a nice clean everyone got healthcare access.

And when we do a commission on this, cuz we need a commission, we need to recirculate back to those conversations that Obama started so long about, about universal healthcare. 

Brittany: David, give us some more marching orders because your background is in policy. You used to be one of the few Black senior staffers on the Senate side, right?

You worked for health education, labor and pension, that committee? Who do I need to call? Whose doorstep do I need to show up at? What does my sign need to say at the protest? Put us to work because we still aren’t getting it right with COVID. We’re clearly not getting it right with MPV. What does our plan of action need to be?

David: It is so much more challenging to strip a right from people after it has been granted to them than to stay in the space of knowing that something is important and you haven’t done everything that needed to be done. And in this moment, what’s precedent for me is the sad reality of having witnessed fundamental rights that have been long and hard fought for, be stripped away from so many people and that we’re having this conversation about people not having access to fundamental forms of care after the overturning of Roe v. Wade and the presumptive challenges to things like same-sex marriage.

I still wrestle with knowing that there’s a through line between the war on drugs was designed to strip communities and families of Black and brown and Latinx and native men, and similar attempts to do that around birthing people, particular Black and brown and Latinx and native women. And that we continue to see the implications of a non-existing in terms of functioning for the people healthcare system and allow it to happen is our fault.

Bell Hooks talked about the importance of schools and size of democracy. And in her book, Teaching Critical Thinking, she reminds all of us that it is our responsibility, every generation, to teach the babies that we gotta defend democracy. And so for me, the marching orders is a space that we share, Brittamy, which is to ensure that our babies understand what is happening and how systems right now are functioning as design.

And to identify the elected officials, the people who are elected and appointed and in positions of privilege who see them as disposable, like the lieutenant governor in North Carolina, who stood in the pulpit of a Black church and called LGBTQ kids trash, and empower them and the adults who care for and about them to vote and to overcome the challenges to our ability to vote and to run for office and to do the things that we know work for democracy. Now, to be clear, they’re not easy things to do. And I know a whole bunch of people right now are rolling their eyes like keep talking that same old institutional stuff. But, we have seen evidence of opportunities for folks like me and people we know and love to serve as evidence of shifts and possibilities.

And so I, I hope that’s helpful for folks in terms of what we can and should be doing right now.

Brittany: Absolutely. Our health and our healthcare in this country have always been political. I think people see it as now becoming politicized about the controversy, so to speak over masks and we’ve seen the abortion bans.

We’ve seen government ending gender affirming care, and yet health and healthcare, particularly for populations of people who’ve been marginalized intentionally has always been deeply politicized. And so before I let both of you go, we talked a little bit about the policies and the practices that we have to push for at the government level. But when it comes to creating communities of care and infusing how we treat one another, what we expect from our government with ideals and prescriptions that come to us from an understanding and belief about community and togetherness.

Dr. Monica, and then we’ll close with you, Dr. David, what are those community based mindsets that you think we need to move into this next chapter with to turn the corner into community wellbeing and really thriving?

Monica: That Is such a great point, cuz I, I wrote this piece during COVID for Newsweek called “Four Things HIV Activists Did to Influence COVID”. And one thing that HIV activists did is not only did they really push the EUA process there should not be a drug out there that can save lives and we take a long time to approve it.

But the main thing they did was community based messaging to get people to take antiretroviral therapy or prep. And so community-based messaging. community-based. Yes. 

Brittany: Thank you very much, Vanna Black. Yes.

Monica: We’re seeing the PrEP of HIV being shown. Community-based messaging. That is so much more effective than even when Ronald Reagan took five years to mention HIV when so many people had died. I don’t think people wanted to take advice from a unique community based messaging to get to people to take a vaccine or people to take a drug or to people to take PrEP or so. This is, has to be built into our, when we talk about universal healthcare, which is what I’m gonna be pushing for after these two pandemics, it should pay for community messengers.

It’s so much more cost effective to have people take a drug than just throw it at them and not have the community and advocates come, who look like you, come and tell you why it’s a good idea. So that’s gonna be my push.

David: Yeah, for folks who couldn’t see that moment as Dr. Monica made that reference to PrEP, I held up a bottle of Truvada, which is a pill I take daily to reduce the likelihood of becoming HIV positive.

Monica: Excellent. 

David: And it wasn’t easy for me to come, like to this point, right, where I have Truvada pills around my home and take them out and take my pills publicly in part, because I want people to ask me questions and I do that, Brittany, because I have had so many people who I know and love become HIV positive in the time that I’ve known about and have had access Truvada.

And when I think about the fact that it doesn’t have to be the case, it makes me mad. And so to Dr. Monica’s point, empowering folks who are of and from who work on behalf of and love our community and not just some of us, but all of us is incredibly important. And then creating spaces where we have the language and the support to have sometimes uncomfortable, but lifesaving and affirming conversations about HIV. 

We have a whole toolkit called Words Matter HIV to get people, the literal language, to engage in the discussion, to know, for example, that none of us should be saying things like full-blown HIV, a term created by the media.

That’s supposed to conjure up this Ghostbusters image of HIV as this thing that is anything other than a virus that can be managed, but we use a term stage three HIV. right. So, we reduce stigma. We invite people who are living with HIV to feel seen and centered in ways that are much more humane. And we otherwise create spaces where people can talk about things that if left in the dark can kill them.

And then the last thing for me is demonstrating, like radical compassion. I think often about a series of conversations between James Baldwin and Nikki Giovanni, uncle Jimmy and Nikki in Paris, what they debated and disagreed about so much in terms of the challenges we faced and what the solutions would be, but what they agreed most often is that what was required to overcome white supremacy and anti-Blackness was love. 

And in this moment, I hope that we can get over the superficial things that get in the way of us demonstrating compassion for the disinherited, the least of these, those who we celebrate in June, when it’s cute, but disregard for the balance of the year or for women identify folks for whom some male identify folks don’t care about them until they birt one of their own, right? 

Like finding ways to actually get beyond the socially constructed and politically constructed barriers that only work to the benefit of white supremacy is the thing that I fundamentally believe will get us through. And the lesson that I hope all of these attacks on our lives will lead us to learn in ways that allow us to shift the way that we show up for one another.

Brittany: Absolutely, Dr. Monica Gandhi, Dr. David J. Johns. I ain’t know doctor, but I definitely feel much smarter after having heard from the both of you. And I know our UNDISTRACTED community will feel the exact same. Thank you for this conversation and most certainly for everything you do. We’ll talk soon.

Dr. Monica Gandhi teaches medicine at the University of California, San Francisco. You can find the paper she referred to in our show notes and you can follow her on Twitter @monicagandhi9. Dr. David Johns is the executive director of the National Black Justice Coalition and he’s on Twitter @mrdavidjohns. Gotta get that Mr. changed to Dr., friend. So if, as David said, white supremacy is being afraid to hope, then we have to be the antidote. 

And we have been, you have been, we’ve been giving folks rides to vaccine clinics and dropping groceries off at our neighbor’s doorsteps. We’ve been engaging in mutual aid and still masking up indoors, even when the CDC gives us the Kanye shrug. We’ve been showing up, we’ve been showing each other that honest to God’s subversive and revolutionary love because that’s been our only life blood. So I’m not giving up on policy and politics, quite the opposite. I’m simply hoping that if we build it, they will come because if we can manage to build the communities we need on the ground, perhaps, perhaps it will be a model for the policy we deserve.

Let’s get to building y’all.

That’s it for today, but never, ever for tomorrow.


UNDISTRACTED is a production of The Meteor and Pineapple Street Studios. 

Our lead producer is Rachel Ward.

Our associate producers are Alexis Moore and Marialexa Kavenaugh.

Thanks also to Treasure Brooks and Hannis Brown.

Our executive producers at The Meteor are Cindi Leive and myself, and our executive producers at Pineapple are Jenna Weiss-Berman and Max Linsky. 

You can follow me at @MsPackyetti on all social media and our team @TheMeteor.

Subscribe to UNDISTRACTED and rate and review us, y’all, on Apple podcasts or most places you check out your favorite podcasts.

Thanks for listening. Thanks for being. And thanks for doing.

I’m Brittany Packnett Cunningham. Let’s go get free.