Melissa Harris-Perry: Welcome back to The Takeaway. I'm Melissa Harris-Perry and today is World AIDS Day. 35 million people have died from HIV or AIDS-related illnesses over the past four decades, a number that continues to climb. The same time during the past two years, COVID has claimed five million lives and those numbers also continue to climb.

Even though we don't always recognize and discuss it, we are living at a time of dual pandemics and both have disproportionate effects on the most vulnerable. Here to speak with us about World AIDS Day and the importance of addressing global inequities is Dr. Steven Thrasher, professor at Northwestern University, author of the upcoming book, The Viral Underclass: The Human Toll When Inequality and Disease Collide. Steven, welcome back to The Takeaway.

Steven Thrasher: Thanks so much, Melissa. It's always great to talk to you.

Melissa: In this moment as we are talking about the Omicron variant and travel bans out of Africa, talk to us about how the transmission and treatment of HIV/AIDS around the globe mirrors some of these COVID-19 transmission pathways and neglect.

Steven: Well, we see a lot of the same stigmas and fears particularly around borders in both pandemics and they run along colonial routes. If you want to see the inequities of health care and how disease is distributed, how it's treated, you can really follow these routes. HIV was first noticed in the United States in 1981, but then the United States also is the first country to get and widely distribute medication for it in 1996. That made its rate of death go down a great deal, but there was a long lag, seven, eight years until those drugs became available in the Global South, countries like South Africa, and so their death tolls continued to spiral.

We're seeing a lot of the same things now with vaccine inequity that countries in the West, people are getting two, three, four, sometimes five shots to make sure that they're boosted correctly while even health co-workers in the Global South have not gotten such medication. Then in the Global North, we're denying those countries the ability to travel while also making variants and transmission more likely in the Global South by denying sharing the medications that have been developed.

Melissa: I'm wondering if you see this as having failed to learn the lessons of global inequality in the context of HIV/AIDS, we make ourselves more vulnerable, right? In fact, the whole globe more vulnerable in the context of COVID-19 because it's obviously such a far more transmissible disease.

Steven: Very much so. There's no reason why anyone should die of AIDS. The virus HIV is actually pretty inefficient and relatively slow-moving. From the time someone becomes infected, it can be 10 or 15 years until they become very sick and pass away. We have a really big window of time to give them the support and care that they need. We have the medication. We have the technology to do it.

We have the ability to distribute it in mass to such a degree that it would help transmission rates fall to maybe imperceptible levels, but to protect the profits of pharmaceutical companies, that doesn't really happen. That's the same thing happening with COVID-19 medications and with vaccinations. We also haven't been taking, and particularly in the United States, good advantage of the time that we've been given available. Even though HIV was first noticed in the US, COVID-19 was noticed in China and moving quite rapidly through Italy months before it was really working its way through the United States.

The United States has not taken advantage of that time. We've also had a head start with vaccines. We had them on a large scale before most other countries. We haven't taken advantage of that to such a degree that the number of people who've died of COVID-19 has surpassed the number of people who've died of HIV/AIDS in the United States in less than two years. I'm talking about numbers over 40 years of AIDS deaths in the US. That number has been surpassed in less than two years with COVID-19 inside the United States.

Melissa: I'm wondering just if you can reflect, what do you think is going on there? I so distinctly remember watching COVID-19 approach the shore, right? The initial conversations, as though it was simply SARS that would largely impact China, maybe other parts of Asia but wouldn't have an enormous impact here.

Then watching it come to Europe and even as we were covering it in US media, in Europe, not quite catching that anything that moved at this kind of rate was clearly going to jump the Atlantic. I guess it did feel like almost as if the entire country had our head in the sand. I'm wondering if you're thinking that is connected in some ways to our understandings or our beliefs, our stereotypes about who gets infected with disease and who is protected from it.

Steven: It certainly does. We didn't have to have the level of death and destruction that we've had in the United States, but we've built a society that was prepared for it. We have a society full of kindling. When a match falls on it something like this, we'll move very quickly. Even though these viruses are quite different, they affect similar populations of people, people who don't have good housing, good ventilation, people who are incarcerated who live on the margins and don't have access to the needed tools of life for safe living.

When a much more transmissible virus arrives, that's exactly what's happened. I've been thinking a lot about how we have surpassed the number of deaths in the United States with COVID-19 domestically of Americans who've died of this compared to AIDS. The global rate is much lower. About 5 million people have died of COVID-19 compared to 35 to 40 million people who died of HIV/AIDS.

I think that speaks to the ways that some societies were better at collectively agreeing to do what they needed to protect each other in the COVID-19 crisis. I think it also speaks to the ways that marginalized people who are affected by HIV/AIDS were quite prepared to do what they needed to protect one another. In the United States, the largest society has fought it in lots of ways.

When I look back on the history of HIV and AIDS, it's a really remarkable and beautiful thing when you study and see how gay men taught each other to start using condoms when they weren't needed for procreation in the 1980s. When you look at people who have used injection drugs or dealing with addiction, how they have taken to using sterile syringes and teaching one another to do so. You can really see these networks of care that have developed amongst marginalized communities.

The broader society sometimes would like to accuse in those early days of AIDS, gay people have "bug chasing," saying they were trying to get the virus. That never happened at the level of gay leaders or gay people doing public health. With COVID-19, we have very wantonly seen conservative politicians and conservative media figures encouraging people to bug chase, encouraging them to get COVID-19, and completely disregarding what we know needs to be done. I've been thinking a lot about how that is a dynamic and why we're having such a worse experience of COVID-19 in the US compared to the rest of the world.

Melissa: Even as you're reflecting on these ways that vulnerable communities and nations understood how the support had built certain kinds of social infrastructure even over and against these inequalities, I wonder if you can also reflect for us for a moment on this World AIDS Day about the importance of remembrance and of mourning.

Steven: It's really important to remember the people who have lived with HIV and who've died of AIDS. I think of specific people in my life, particularly my friend Henry who had HIV for several decades and had a very difficult life and had to fight, legally, discrimination that he faced. He was successful and helped to make life better for other people. I do think that as people think about COVID-19, I also think of an individual who died and the numbers can seem overwhelming.

Hearing that 800,000 people have surpassed dying of COVID-19 compared to 700,000 of HIV/AIDS can get hard to picture the individuals and the way that they need to be respected. I do think it's significant that the 700,000 people who died of AIDS did so over four decades. We're dealing with a larger volume of death in less than two years.

I think that we need to take World AIDS Day as a moment to think about the importance of mourning, of remembering, to look at the ways that people who cared for those who lived with HIV and who cared for those who died of AIDS did so in a way that made space to love those people and to remember them after they're gone. I don't feel like we just have had, in any way, the collective or individual ability to mourn the hundreds of thousands of people who've died in the United States and the millions of people who've died globally in this pandemic in less than two years. We really need to prioritize grief and mourning and remembrance in community.

Melissa: I keep wondering if just as we are, in our very American way, pushing towards, "Oh, tomorrow," and better and normal in the horizon just how much trauma we are leaving unresolved.

Steven: There's a huge amount of trauma. I have often been perplexed with the anti-vaccination movement when I think of, in the early '90s, how everyone who was losing people to AIDS if a medicine had come along to prevent that would have been dancing in the street. I also think a lot about how-- as people were losing and continued to lose loved ones to AIDS, I never feel them saying they want to get back to normal. There is no normal to go back to when you're losing one person you love or hundreds of thousands or millions of people to a virus.

You can't go back to normal. You are dealing with a loss that cannot be fulfilled and you often, I've noticed with activists, try to imagine a better world and a different world that led to the death of your loved one. The impetus to go back to normal is so strong in the United States that it disregards why we are having so many people die of this new virus. Those conditions, regardless of any virus, need to be changed to better the lives of the people who are likely to be infected by pandemics.

Melissa: Dr. Steven Thrasher, professor at Northwestern University and author of the upcoming book, The Viral Underclass: The Human Toll When Inequality and Disease Collide. As always, thank you for joining us.

Steven: Thank you so much, Melissa.

Copyright © 2021 New York Public Radio. All rights reserved. Visit our website terms of use at www.wnyc.org for further information.

New York Public Radio transcripts are created on a rush deadline, often by contractors. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of New York Public Radio’s programming is the audio record.