Don’t Mourn. Organize.
By Gregg Gonsalves
Vito Russo was a celebrated film historian. He was a gay man. Living with AIDS. In 1988, he gave a speech, “Why We Fight”, at one of ACT UP’s first demonstrations, in May, in Albany, the capital of New York State, and then later that year at the Department of Health and Human Services in Washington, DC, where a new coalition of activists from around the country descended on the agency. Two years later, Vito was dead. The speech is remarkable, but its closing still resonates almost 35 years later. He may be gone, but the words here cut like a knife:
We're so busy putting out fires right now, that we don't have the time to talk to each other and strategize and plan for the next wave, and the next day, and next month and the next week and the next year. And, we're going to have to find the time to do that in the next few months. And, we have to commit ourselves to doing that. And then, after we kick the shit out of this disease, we're all going to be alive to kick the shit out of this system, so that this never happens again.
After three years of the COVID pandemic, all I can think about is how we’ve rushed to put out fires once again. The urgency of the crisis kept those of us focusing on the local, national or global response and its deficiencies, the failures, busy day-to-day, with little time to meet Vito’s challenge to think of the bigger picture, how we got to where we are, how it all got so bad.
Health is a human right. Yes. I believe it. But the problem right now isn’t one of taxonomy. More than half of all nations around the globe have some specific, guaranteed right to health written into its constitutions and many of them fared terribly during the current pandemic. Naming health as a human right, even in the presence of legal instruments to pursue that right, is not enough. Vito points the way: our fates are in the hands of a system where we do not matter, our lives are disposable. We’ve got to look upstream to the social, economic and political factors that make us sick, keep us from being, getting well and, as Paul Farmer has framed it, we need to see it all in the context of pathologies of power.
But then what do we do? Paul’s work was in service of the poor, showing how we could do better, using academic institutions to press the case for doing more. These are all important, but where I end up after three decades doing this work is we need more than this, we need, for lack of a better term, more shit-kicking. We are locked into a political economy of health that is killing us. We need to break free. This means developing a political analysis, developing strategies to confront those inflicting structural violence in the world, building power to resist and wielding that power to make change. It takes us out of academic and healthcare settings, and makes all of us who want to make a difference, first and foremost, political actors. It’s uncomfortable for many working in clinical care and public health to consider themselves activists, but to do anything less cedes the playing field to those who made this mess, who create misery, suffering and death. There is a lot to mourn over these past three years and deeper into the past we have lived through together. But as the labor activist Joe Hill said before his execution in 1915: Don't waste any time mourning. Organize!" We’ve got to band together, in numbers that matter, to kick the shit out of this system, so that none of this ever happens again.
Gregg Gonsalves is an Associate Professor of Epidemiology at the Yale School of Public Health and Associate Professor (adjunct) at the Yale Law School. He is also the co-director of the Yale Global Health Justice Partnership. He is a 2018 MacArthur Fellow. Twitter: @gregggonsalves. Mastodon: gregggonsalves@med-mastodon.com.