Politics / August 29, 2024
These are concrete steps Harris could take to undo the damage done by her current boss.
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Kamala Harris receives a booster dose of the Moderna COVID-19 vaccine on Saturday, Oct. 30, 2021, at the White House.
(Kent Nishimura/Los Angeles Times via Getty Images)
We are approaching the fifth year of living with COVID-19. Anyone who has read my articles on #selectionorinsertioncontent# knows that I think the Biden administration's response to the virus has been terrible. The government has essentially backed away from anything other than an aggressive vaccination drive after a year or so. Many commentators, from David Wallace-Wells (many of his New York Times colleagues downplayed the pandemic) to editors of leading medical journals, have pointed out that even in the face of potential threats like H5N1 (bird flu), we have locked COVID-19 in the “memory hole” and refused to learn the lessons it has shown us.
Even putting COVID-19 aside, the picture is not so bright: the country's life expectancy ranking lags behind other countries, putting it in the same place as Albania, Panama and Chile.
Kamala Harris needs to try harder. A few weeks ago I was wallowing in gloom as I wondered how to resist the next Trump administration, but now I am cautiously hopeful that Harris will have a chance to do so in January.
Where do we start? The first step should be to implement a “moonshot” or a “Marshall Plan” or whatever you want to call it for our public health infrastructure. The Centers for Disease Control and Prevention has almost always been mistreated when it comes to federal funding, and much of the CDC's funding has gone to local health departments, so our towns and cities suffer as a result. It's hard to believe, but even after the worst pandemic in a century, Congress had the audacity to take hundreds of millions of dollars back from the CDC in a recent budget deal, even hindering efforts against old foes like syphilis, which is on the rise in the United States. We have a crumbling public health infrastructure across the country, and we need to fix it.
If we continue to ignore this crisis, Americans will get sicker and die younger than many people in much poorer countries. No amount of better health care can solve the root of America's dilemma: that many of the factors that drive health risks and health outcomes operate beyond the level of the individual patient and are the so-called social determinants of health. Only a committed and well-funded public health system can address these.
Next, we must address the scourge of political interference in public health. During the AIDS epidemic, many of us helped fight off ideologues like Jesse Helms who opposed HIV prevention efforts. During the COVID-19 epidemic, we fought the Trump Administration's nonsense about hydroxychloroquine and herd immunity. But to our surprise, the Biden Administration has continued the pattern of political interference.
Biden's team pivoted from their original plan of a strong, comprehensive plan for SARS-CoV-2 because they decided it would be politically easier to simply “win” and declare mission accomplished. The blame for this lies squarely with White House political operatives like Ron Klain and Jeff Zients, and career con artists like me. Public health took a backseat to political machinations, and the CDC and other health agencies were under intense White House scrutiny for everything from testing to vaccine access.
One way to protect public health from political interference is to make the CDC an independent agency, a point Sohail Shah of Brigham and Women's Hospital and Howard Forman of Yale University made in the Journal of the American Medical Association early in the pandemic, and Harris should consider doing just that.
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There are plenty of other proposals that could improve the overall health of Americans that should be a central focus of a Harris-Walz administration.
I was heartened to see the campaign stress the importance of a “care economy.” If we can’t take care of our loved ones, we can’t take care of ourselves. Harris understands the need for the basics of survival: housing, access to food, child care, and elder care. These are all part of the “social determinants of health,” and really investing in these areas would have a huge impact on people’s lives. In fact, the Boston Consulting Group suggests that ignoring the “care crisis” would be economically foolish, putting at risk “$290 billion in GDP after 2030, equivalent to the combined GDP of the U.S. state of Connecticut.” But Harris has a tough road ahead, with experts like The New York Times’ David Brooks calling Harris’ proposals “economically ignorant” and my news colleague Reed Epstein criticizing the campaign for being light on policy, as if these weren’t fundamental policy issues. We need her to address these issues from day one.
Harris has wisely ignored conventional opinion over the past month and made her own decisions based on her own vision and instincts. As her campaign slogan states, move forward. I feel optimistic that a Harris Administration may take bold new steps to ensure the public health of all Americans for future generations. Now we all need to “let them do it,” even if they may hesitate once (hopefully) they are in the White House. We must save the energy, the excitement that many of us are feeling now, for the months and years to come, because the changes we need don't depend on Kamala Harris or Tim Walz, they depend on us.
Can I count on you?
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Greg Gonsalves
The Nation's public health reporter Greg Gonsalves is co-director of the Global Health Justice Partnership and an associate professor of epidemiology at the Yale School of Public Health.
