Soon after the 2024 presidential election, many epidemiologists were terrified about what was going to happen with U.S. public health policies under a second Trump administration, with Robert F. Kennedy Jr. at the helm of the Department of Health and Human Services. A group that emerged from that concern is a volunteer organization called Defend Public Health. It’s now building state chapters across the U.S. with the mission to “protect the health of all from the Trump administration’s cruel attacks on proven, science-based public health policies.”
The group came together when Gregg Gonsalves, an associate professor of epidemiology at the Yale School of Public Health, reached out to his extensive network and thousands responded. As a young gay man in the 1990s, he joined ACT UP, a direct-action group demanding HIV research and treatment for those living with HIV/AIDS. He worked on research and drug development and co-founded the Treatment Action Group. He also spent time in South Africa supporting that country’s battle against HIV/AIDS.
Between The Lines’ Melinda Tuhus spoke with Gregg Gonsalves, a recipient of a MacArthur fellowship in 2018, who describes Defend Public Health’s work over the past year and what he thinks the future prospects for repairing the damage done to U.S. public health policy.
GREGG GONSALVES: We initially focused on the appointments or nominations being made to key federal posts by newly inaugurated President Trump. So we opposed the RFK nomination and got thousands of letters to go into the U.S. Senate in opposition to his candidacy. Dave Weldon, who was supposed to be the CDC director, we also targeted him for rejection by the Congress and the Senate for confirmation, and he withdrew. So we’ve done straight up advocacy.
We’ve done the Blooper of the Week where we have our scientists and clinicians and residents talk about the bloopers of the week coming out of HHS and Secretary Kennedy’s office and the administration. We have a postcard campaign to let people know that clinicians and scientists don’t support the secretary of health and human services as a leader of health and science in America.
So we covered the waterfront, lobbying our elected officials on the budget to appointments, letting people know about what’s happening with different decisions being made by this administration, whether it’s the gutting of the advisory committee and immunization practices or the changes in the COVID vaccine recommendations. And as we’ve just been discussing, we’ve really begun to think that the action really is at the state and local level and want to start to organize at those levels because we think that’s where we can build power. It’s very hard to affect what happens in Washington, D.C. It’s a little less daunting to figure out what’s happening in Connecticut or states in which you live, where you have much more experience in real world contacts.
MELINDA TUHUS: What’s in the Advancing the Health of America report?
MELINDA TUHUS: Greg Gonsalves, your group also works with those most directly impacted by these cuts and changes in federal government policy. Right?
GREGG GONSALVES: In order to grow Defend Public Health are state teams. We need to understand what people care about. While cuts to NIH research or changes at the Food and Drug Administration or CDC are desperately important policy issues that we advocate for, what is really going to hit home with most people around the United States are cuts to programs they rely on: Medicaid, Medicare, the ACA premium subsidies, the cuts to food assistance and SNAP. The cuts coming down the line to housing, the restrictions on many kinds of public services based on immigration status, etc. And so, all of this is under the big umbrella of what we consider public health. Public health is not just sort of things that you think of directly as health-related like vaccines, but it’s what we call the social determinants of health, which include housing and nutrition and all these things that keep us healthy on a day-to-day basis.
MELINDA TUHUS: Do you have much hope of the U.S. coming out the other side of this very dark period we’re in?
GREGG GONSALVES: We’ve faced challenges before in the 1980s. I spent several years working as a volunteer at night with ACT Up and then started a group called the Treatment Action Group in the early 1990s, which focused specifically on scientific policy on research and drug development. Then in the 2000s, ended up in South Africa to fight for access to AIDS drugs, including the ones that are keeping me alive right now that were available in the United States in the mid-1990s, but really weren’t available until early this century in the rest of the world.
Nobody would’ve thought that a small band of men who have sex with men—gay men and their allies—would be able to change the world of biomedical research and drug development, or that the South Africans would get rid of their president and health minister and go from having a government that said, “HIV didn’t cause AIDS” and “AIDS drugs were poison” to having the largest antiretroviral AIDS drug program in the world.
And so we have a proud history of being able to beat the odds. And I think we’ll beat the odds and we’ll beat RFK and these people who are not there to defend public health, but destroy it.
For more information, visit Defend Public Health at defendpublichealth.org.
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