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COVID-19, HIV, and Tuberculosis: Different Sides of the Same Coin

Pandemic is a word that many have heard, but few have expected to actually live through. It is so often reserved for times long ago, and for far off places, or at least that is how pandemics and epidemics are thought of in contemporary times. Now, living in the time of coronavirus, it is shockingly clear that pandemic is neither far away in time nor location. To say that this was “unexpected” goes into a deeper issue of humans trying to control nature, but it goes even deeper than the relationship between man and the natural world. It is a relationship between the natural world, the societies that have been conceived, and the people who are persecuted. To be shocked by the government's response, or lack thereof, reeks of lack of historical knowledge and understanding. Just forty years ago HIV/AIDS ravaged both the American and global population. Seventy years before that, tuberculosis wrapped its cold hands of death around millions of Americans causing an epidemic so deadly and consumptive of all life that it was given the moniker of “the great white plague.” Scientifically, these three diseases have little in common, but it is the social aspects of them that allow their commonalities to shine through. What COVID-19, HIV/AIDS, and Tuberculosis all have in common is when they ravage American society, they engage in a particularly barbaric attack on the most vulnerable Americans, and society is set up to allow it.

There are many examples to choose from if one wanted to look at the prevalence of inequality in the systems that run the United States. Ironically enough, a perfect exemplification of systemic American inequality is not presented in the systems, but rather the people. A nation as rich as the United States should surely have a healthy population, no? Such a rich, flourishing, country should be able to fight off disease, right? Not always. Not if the nation is tied to discrimination and its cruel past. One may wonder “what does this have to do with disease?” and the answer is, quite simply, everything. Does disease discriminate? No. Unless limited by certain anatomical features or age, disease doesn't choose its host because of their race or gender or sexuality, because these things are man-made, and disease is simply bound by nature. It is human beings who created these factors, who choose how well they will treat those who are associated with certain identities, and this has everything to do with illness, wellness, pandemics, epidemics, and everything in between.

The scene is so common in modern film, and it is easy to imagine. It starts with a cough. A young woman gives a violent raspy cough into a white handkerchief. As she raises the handkerchief from her mouth, the camera pans to the bloody cloth in her hands. It is obvious what ailment she is suffering from: tuberculosis. This disease was so deadly it, as explained previously, would be given the moniker “the great white plague,” but her disease is not the only marker of this past time. As the camera takes the place of their eyes, the audience sees five or six other family members crammed into one tiny tenement apartment somewhere in urban America. The camera then moves to the window, and one is able to see outside into the ethnic enclave in which the victim of this disease lives. There are a thousand more people from her home country packed on top of each other: a perfect breeding ground for disease. This cliché is so often used to place the audience in 1910's America, that many readers could likely visualize it. The problem isn’t that so many films use this banal scene of an earlier time—this article is not a film critique. The problem, rather, is that these settings are merely a surface level view, ahistorical even. They’re not wrong because of the setting or the disease or the specific victims—those details are correct. This scene is surface level because it shows the impact of social degradation. It shows the after effect of too many people in a too small space. It shows the after-effect of an overpopulated area, but the "after" is useless to witness if we never see the "before." The only reason there is an after in this case is because before there were government and social failures.

Go back to that image of 1910's America. There are still immigrants living in ethnic enclaves packed on top of each other in tenements, and tuberculosis continues to rear its ugly head and wrap its frigid claws around the lives of millions of Americans, but add a few things to this scene for historical accuracy. Add Black migrants moving up north to escape some of the vicious savagery left over from slavery. Add things like race science and Lawrence Flick’s House Infection Theory coupled with Jim Crow housing policies. Most importantly, add government neglect. Tuberculosis came at the wrong time for the poor, immigrants, and Black people, but it came at a time one could only describe as immaculate for those who practiced and preached racism, xenophobia, and race science. Physician Lawrence Flick created the house infection theory. This theory essentially says that if someone falls victim to tuberculosis, the very home in which they live is now infected. The problem with this—besides the obvious lack of associated scientific evidence—is that it perpetuates this idea that Black people and immigrants, from certain countries, are just inherently dirty, and liable to spread disease. This theory ignores, however, the ghettoization of Black and ethnic immigrant neighborhoods. In these new ghettos, families are packed on top of each other—a perfect breeding ground for disease. Flick's theory, and many other theories of his time, neglected to blame the government and the capitalist system for these conditions. These race science theories neglected to acknowledge the fact that the federal and many state governments allowed separate and unequal care for Black citizens in tuberculosis hospitals. These theories neglected to point out that many Black citizens did not have access to hospitals, because in this time of urbanization coupled with Jim Crow, many rural and low-income hospitals were closed, and the neighborhoods with hospitals were segregated. These theories ignored the system of capitalism that allowed the disease to spread. Just as people were packed together in homes, they were packed together in factories—spreading disease amongst one another and to the American people. As noted in the 1905 novel, The Jungle, which was released in the middle of the epidemic, the men described in the book were not only sufferers of the disease, but their bosses “...welcomed tuberculosis in the cattle they were feeding...” because to throw out sick cattle would be a waste of money. It would be these social failures that allowed the disease to have an even greater reach and control over the American public. Unfortunately, this would not be the last time that societal degradation and government neglect would harm the American people.

Time will always progress: that is a simple fact that can neither be ignored nor denied. Just as time progresses, parts of society will do the same. Thankfully, science is one of those things that often advances with time. Fewer Americans were stuck in the deadly grasp of tuberculosis because of scientific and social factors, like health codes which necessitated the construction of new apartments—livable apartments. Not only was housing improved, but also the workplace. Sinclair's novel not only exposed the horrific conditions of meat packing facilities, but it also prompted the government to launch what would later become the Food and Drug Administration (FDA). This story of a progressing America is wonderful, but like the cliche scene mentioned earlier, it is surface level and lacks historical analysis. Yes, life got better, but it got better for who? As is so often the case in the history of this nation, life got better for white people, and some of the benefits later trickled down to people of color. By 1970, there was a 6.4-year difference in life expectancy between white and Black individuals, but this has been a constant gap, persisting even to this day. The gap grows even more when factoring in economic differences. This gap is only able to widen, only able to negatively affect the health outcomes of Black Americans, because of government failure. People are going to be racist and classist. Factors, like race and class, have been created and so ingrained into society that it will take a lot of effort to be rid of them. But it is neither the job, nor is it possible resource-wise, for the average American to deal with these disparities: it is the job of the government. Of course, a government founded by slave owners, advocates of Indigenous genocide, and based in a capitalist economy, is not going to work in the favor of those who deviate from the “norm,” i.e. white men. As seen with tuberculosis, different identities are a cause for greater suffering. This inconsistency of treatment between who the country cared for and who it did not would only become more clear when the government was totally unprepared.

The 1970s were hectic. From a war, to cults, to a presidential impeachment, it was a wild time. After that roller coaster of a decade, former governor and then-current presidential candidate Ronald Reagan asked, "Are You Better Off Than You Were Four Years Ago?’" If not, he promised he was going to make “Make America Great Again” The question, then as now, is for who and how? Three little letters would answer that question. In 1981, the CDC (the Centers for Disease Control and Prevention), in its weekly journal, published an article which detailed a lung infection in five young white men. In many states that year, health officials would take notice of an uptick in patients suffering from Kaposi sarcoma, a rare form of cancer. What over half of these patients had in common was that they were male, and that they identified as gay or bisexual. As the disease captured more victims, many of whom identified as gay, the name changed to G.R.I.D (Gay-related immune deficiency). It would not be until 1982 that AIDS would be used as a moniker, because it became abundantly clear that the disease didn't just effect gay people (although they were disproportionately victims of it). The brunt of the disease, however, fell not just on gay individuals as a whole, but specifically on Black and brown, mostly poor, gay persons. So often, those markers served as a stamp of death in this country, and it would not be any different during this pandemic. During a press conference in 1982, when 853 Americans had died from AIDS related illnesses, Reagan’s press secretary, Larry Speakes, made continuous jokes about the disease. In ‘83, when the death toll was 2,304 by June, Speakes continued to make jokes, and when a reporter asked him about the disease and the president’s response, Speakes laughed, alluded that the reporter may be gay because of his interest in the topic, and called him a “fairy." While the common tale that Reagan did not say “AIDS” until 1987 is not true, what is true is the notion of his slow response and inadequate remedies to the disease. Rather than putting the full force of the government into stopping this crisis, he and his wife continued to advocate for practices like celibacy, and anti-drug campaigns like “Just Say No," even as health officials noted that those were neither enough nor even helpful. It would not be until well-known—usually rich and white—celebrities, like Rock Hudson, became affected, that the disease would become normalized, and an all-out effort would be engaged in to stop it. By the end of the 1980s, 202,520 people in the United States had been infected by this terrible disease. The majority were gay men, and, at the time, most were white. Now, the majority are still gay men, but they are predominantly Black. Once again, Americans who dared to deviate from the norm suffered. And, once again—like the tuberculosis epidemic—the onus of the disease is placed on the victim. This is especially true when the actions that lead to the contraction of a disease are looked down on. The problem with this, besides the obvious cruelty, is that it repeats the same pattern of taking the obligation of protecting its citizens from the government, and puts it on everyday people. Instead of telling people to just abstain from sex and “just say no” to drugs, the government needed to be providing clean needle programs and condoms and nationwide testing, but it didn’t. People were advised to see doctors, but not everyone can even see a doctor. The government not only denied universal healthcare, so people could pay for services, it was also not making efforts to put hospitals in low income neighborhoods, so people could access them. The government put the responsibility of care in the hands of the people, and that is where it failed. Just as the mistakes of tuberculosis were repeated during HIV/AIDS, the government would make similar mistakes just forty years later.

Currently, in 2020, there is a pandemic. Like the pandemics and epidemics before it, COVID-19 is ravaging American communities, and showing the inequalities in American society and the failures of the American government. In many states and localities, the Black population is overrepresented in COVID-19 deaths. Like HIV, and tuberculosis before it, many people are using this rate of death to blame victims rather than the system itself. Some pundits are saying Black people are dying from the disease because of higher rates of obesity and heart disease. Yes, prior health complications can lead to death if one falls victim to coronavirus, but the question becomes, why do Black individuals have these health issues at higher rates in the first place? What is not being pointed out is that stress, given the moniker “the silent killer," can lead to heart disease? For Black people, a lot of stress is caused by racism. Whether it's fear of state sanctioned violence by the police, or being followed in stores, those are stress inducers that are faults of the government, but are not being solved by the government. Another marginalized group, Indigenous Americans, are once again victims of American genocide against their people through biological warfare. The Navajo nation has the third highest rate of COVID-19, but only six hospitals on their entire reservation. This lack of hospitals, and stress caused from factors ranging from generational trauma to food insecurity, are all caused by the government, but are not being taken care of by the government. This is the same story for low-income and working class Americans. They are often having to go into work for income because the government will not care for them otherwise. This rate of death and sickness, and who it is happening to, is not a new story. In fact, it is a story that is constant in American history—a story that tells this country's people “if you are of the other, die.”

Coronavirus is not the “great equalizer,” as many privileged individuals have called it—no disease is. Like most tragedies that have wreaked havoc on the United States, it has only shown how unequal this nation is, and how much of a failure its social systems and government are. This nation was founded by rich slave owners by killing the Indigenous peoples and taking their land. Due to this history, the government reflects the men who created it. The government was created by wealthy men, so its capitalist economy works in favor of wealthy men. The government was created by white men, so the government works in favor of white men. The problem with this is that nature does not work that way. These inequalities have no hold in nature, and nature cannot be fought; therefore, the government must decide if it is going to continue to try and fight nature, or will it do what it can to soften the blow when the next pandemic comes?


Please contact author, Kay Dickerson, for sources by email (

  1. Commissioner, Office of the. “When and Why Was FDA Formed?” U.S. Food and Drug Administration. FDA, March 28, 2018.

  2. Dangremond, Sam. “Who Was the First Politician to Use ‘Make America Great Again’ Anyway?” Town & Country. Town & Country, November 14, 2018.

  3. Friedler, Delilah. “Navajo Nation Is behind Only New York and New Jersey in Rates of COVID-19 Infection. What Happened?” Mother Jones, May 5, 2020.

  4. “History.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, December 12, 2016.

  5. “HIV and AIDS --- United States, 1981--2000.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention. Accessed May 15, 2020.

  6. Lopez. “The Reagan Administration's Unbelievable Response to the HIV/AIDS Epidemic.” Vox. Vox, December 1, 2015.

  7. Roberts, Samuel. Infectious Fear: Politics, Disease, and the Health Effects of Segregation. Chapel Hill: University of North Carolina Press, 2009.

  8. Sinclair, Upton. The Jungle, 1905.

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