[[link removed]]

PUBLIC HEALTH WAS A PLACE FOR WARRIORS ONCE. IT NEEDS TO BE AGAIN.  
[[link removed]]


 

Gregg Gonsalves
November 6, 2025
The Nation
[[link removed]]


*
[[link removed].]
*
[[link removed]]
*
*
[[link removed]]

_ It's time for us to reconnect with the radical, system-changing
spirit that was once at the heart of our field. _

The NationA sign at a protest outside the US embassy in Berlin on
October 18, 2025., Adam Berry / Getty Images

 

Bluesky
[[link removed]]

_This is an edited version of a speech I gave at a recent meeting of
the American Public Health Association in Washington, DC._

Ed Yong was the chronicler of our most recent plague years. His
reporting on Covid-19 for _The Atlantic _won him a Pulitzer, but
constant reporting on those who suffered the most during the pandemic
took its toll on him. He walked away from _The Atlantic_, and from
reporting on the disease, in 2023, with his final pieces largely
focusing on long-Covid sufferers fighting for their survival. You
should listen to a lovely and heartbreaking talk
[[link removed]] he gave for the XOXO
Festival last year, in which he explained why he walked away when he
did. It’s. It’s clear he needed to go, but Ed was central to
framing the pandemic in its larger social and political context for a
general audience and I miss his voice.

I want to talk about one of his stories
[[link removed]]—an
earlier one—that was before its time and is still very much of the
moment even now. It was in October 2021, and it was called “How
Public Health Took Part in Its Own Downfall.” In the piece, he makes
a case that Amy Fairchild and colleagues made before him in their own
article [[link removed]] “The
EXODUS of Public Health: What History Can Tell Us About the Future”
in 2010 in the _American Journal of Public Health_. Here’s the case:
We were warriors once. That is, for decades, those of us working in
public health were campaigners who fought for better sanitation and
clean water, better working conditions in the factories of the new
Industrial Age, better housing, and so much else that gave us the
longer and healthier lives we take for granted today.

And then we gave up the fight. Ed and Amy contend that the rise of
American medicine was the death of public health in some ways. Amy’s
piece quotes Hibbert Hill and his book _The New Public Health_: “The
old public health was concerned with the environment; the new is
concerned with the individual. The old sought the sources of
infectious disease in the surroundings of man; the new finds them in
man himself. The old public health…failed because it sought them
…in every place and in every thing _where they were not_.”

In the shadow of medicine’s ascendancy, we cast aside the explicit
and direct political nature of our work and became medicine’s poor
stepchild. We became scientists and clinicians first, and made our
solutions technocratic, based on interventions packaged like pills for
populations. Yes, this is overstated in some ways—but in other,
fundamental ones, it really isn’t. My own public health school only
recently emerged from the shadow of the school of medicine and from
under the thumb of its deans, who had little knowledge and even less
interest in what we did. And many in our profession repeated the
mantra of “public health should not be political
[[link removed]]” over the past
five years, including several deans of schools of public health who
bemoaned
[[link removed]]
the activist work that many of us have done and continue to do.

Clearly, we need to see ourselves once again as campaigners above all,
and join forces with the social movements of the day. But that is just
a first step. In 2020, another Amy, my colleague Amy Kapczynski at
Yale Law School, and I wrote a series of pieces for the _Boston
Review_. In these pieces, we laid the blame for our excruciating
vulnerability to this new pathogen not solely on the sorry state of
public health and healthcare infrastructure in the US (though
obviously they both played a part), but something more
fundamental—the economic basis of American life. This rapacious,
extractive, and exploitative system was already making us sick long
before SARS-CoV-2 emerged, keeping us from caring for ourselves and
for each other in the broadest sense and using institutions, from the
prison to the hospital, to manage the downstream effects of what the
system had wrought.

Five years later, we’ve seen this system metastasize into its most
fulminant form, into pure extraction, exploitation, plunder, ramping
up the carceral state into a hypertrophied internal security apparatus
to manage all of us. If SARS-CoV-2 was the plague of the first part of
this decade, the Trump administration, this Congress, the Supreme
Court, and all the hangers-ons, enablers, fellow travelers, and
cowards in civic institutions, from the media to big business to our
own universities, are the plague of its second half.

So where do we go now? Yes, as I said, we need to be campaigners
again, to center our work in the fight for political change. That
alone will chafe for some. Those of us who depend on grants or work
for state institutions are clearly not paid to be political, and the
demands of our jobs make that political work extracurricular. But the
problem goes deeper than that. I don’t think we can focus on public
health alone any longer (if we ever could). I’ve worked on HIV/AIDS
for over 35 years. We made some great strides, amazing ones—I am
living proof of what we achieved as I’d be dead long ago without the
drugs I take every morning—but all the programs we fought for were
concessionary victories
[[link removed]].
Yes, they were real and had tangible effects on millions of lives. But
we now know that one man can make all of this go away. The destruction
of PEPFAR, the CDC, NIH, SAMSHA, NIOHS, the FDA—all of it can go up
in smoke in an instant.

This means we have to strike at the heart of the beast. And this is
where I’ll lose more of you still, and in more than one way. If what
ails us is the fundamental nature of racial capitalism and patriarchy,
some of you will check out. These things are base and
superstructure—they are not going away anytime soon. And yet, we
cannot ignore them if we want a better future. I am not asking you to
“smash capitalism” or try to “escape” from it into your own
private Idaho. The late sociologist Erik Olin Wright suggested that
the idea of smashing and escaping capitalism is not realistic,
practical, or even useful. But he offered us alternatives
[[link removed]]:

_If you are concerned about the lives of others, in one way or another
you have to deal with capitalist structures and institutions. Taming
and eroding capitalism are the only viable options. You need to
participate both in political movements for taming capitalism through
public policies and in socioeconomic projects of eroding capitalism
through the expansion of emancipatory forms of economic activity._

This is something we can all do—in fact, I would suggest that many
of us already are working in these registers. But where and how do we
do it, more of it? I think it leads us to organizing.

_Nation _public health correspondent GREGG GONSALVES is the codirector
of the Global Health Justice Partnership and an associate professor of
epidemiology at the Yale School of Public Health.

Home to tenacious muckraking, provocative commentary, and spirited
debate about politics and culture, _THE NATION _empowers readers to
fight for justice and equality. By providing a deeper understanding of
the world as it is—and as it could be—we drive bold ideas into
the conversation and ignite debates far beyond our pages.

We believe in intellectual freedom. We value facts and transparency.
We argue that dissent is patriotic and we hold the powerful to
account, no matter their political persuasion. We raise up the
promise of a radical tomorrow while we agitate for meaningful change
today. Above all, we aspire to galvanize a more informed public—one
equipped with a more profound understanding of events, ideas, and
history.

Founded by abolitionists in 1865, _The Nation_ has long believed that
independent journalism has the capacity to bring about a more
democratic and equitable world. Our writers shift paradigms and open
minds. Our deep investigative reporting launches congressional
hearings, forces policy change, and shapes news cycles. Instigating
progress: It’s not only our legacy, it’s our continued commitment
to future generations of torchbearers.

Support The Nation [[link removed]]

* public health
[[link removed]]
* sanitation
[[link removed]]
* clean water
[[link removed]]
* working conditions
[[link removed]]
* Housing
[[link removed]]
* envornment
[[link removed]]
* Social Movements
[[link removed]]
* capitalism
[[link removed]]

*
[[link removed].]
*
[[link removed]]
*
*
[[link removed]]

 

 

 

INTERPRET THE WORLD AND CHANGE IT

 

 

Submit via web
[[link removed]]

Submit via email
Frequently asked questions
[[link removed]]
Manage subscription
[[link removed]]
Visit xxxxxx.org
[[link removed]]

Bluesky [[link removed]]

Facebook [[link removed]]

 




[link removed]

To unsubscribe, click the following link:
[link removed]