The Role of Politics in the AIDS Crisis: Perry N. Halkitis, PhD, MS, MPH

In a recent podcast, Perry N. Halkitis, PhD, MS, MPH, dean of the Rutgers School of Public Health, offered a candid account of how political neglect shaped the early years of the HIV/AIDS epidemic and how community activism ultimately forced change.

Halkitis, who was an undergraduate at Columbia University during the height of the crisis, described watching friends and members of his social circle fall ill while government leaders at both the city and federal levels largely looked away. That indifference, he said, was not incidental.

“What was really remarkable about that moment, you can look back in retrospect and say that was a moment of great horror, and it was a moment of great horror, and it was a time of great fear and of great uncertainty,” Halkitis said.

He argued that HIV’s early spread among gay men, immigrants, and injection drug users—populations he described as marginalized by mainstream society—meant the epidemic drew a slower, weaker response than it would have if it had affected more privileged communities from the start. Halkitis drew a pointed contrast with COVID-19, noting that scientists identified the virus, developed testing, and produced vaccines within a remarkably short window. With HIV, by comparison, it took years to identify the virus and develop a reliable test, and a vaccine still does not exist more than 4 decades later.

What changed the trajectory, he said, was organized community pressure. Groups like ACT UP pushed government officials and scientists, including Anthony Fauci, MD, to include affected communities directly in the development of treatment. That advocacy led to AZT in 1987 and later to the combination therapies of the mid-1990s that transformed HIV from a near-certain death sentence into a manageable chronic condition.

For Halkitis, the lesson extends well beyond HIV: political will or the absence of it remains a central force in how public health crises unfold—a theme he says continues to inform his work today.

“It’s never an afterthought for me,” Halkitis said. “It’s always sort of the motivation for all the work I’ve been doing for the course of the last few decades.”