How to Fight for Public Health

**Brian Lehrer** (0:10)
It's The Brian Lehrer Show on WNYC. Good morning again, everyone. So public health continues to be a major battleground during this Trump administration. From trying to jail Anthony Fauci while downplaying the 1.2 million recorded COVID deaths in this country, to Trump's executive order yesterday, have you heard this yet? Which, if it stands, would break up the MMR vaccine for kids into three separate shots, despite all the evidence that the current shots are not harmful. He also wants the Justice Department to pressure school systems not to require any vaccines before most kids are admitted to school. So public health is politics as well as science. But not just from the right. A new book argues that every fight for a more just and equitable New York City is a fight for public health. Nicholas Freudenberg is Professor Emeritus at the City University of New York School of Public Health, and he's the author now of Fighting for New York, Activism for Health and Social Justice since the 1960s. He has organized campaigns around issues from childhood lead poisoning to AIDS prevention, HIV prevention, to urban food insecurity, among others. In the book, he argues that fights for housing, higher wages, climate change and other things are all fights for health. Without them, he writes, the city would be a less healthy, less just, more polluted and less safe place to live. Professor Freudenberg, congratulations on the book. Welcome back to WNYC.

**Nicholas Freudenberg** (1:44)
Thank you. It's great to be here, Brian.

**Brian Lehrer** (1:46)
I will ask you about some of the public health stories in the news right now, but why tell the story of New York through public health in your book?

**Nicholas Freudenberg** (1:55)
Well, I think there are two things. One, New York has been the starting point of many of the most serious public health crises facing this nation, the AIDS epidemic, COVID, the gun violence that you were talking about just a few minutes ago.
And so I think focusing on New York City gives us an insight into many of the most serious public health problems facing the nation and the world. But also, New York is the incubator of many innovative solutions to public health problems and the birthplace of social movements to fight around health and social justice. So I thought a focus on New York City would both help us understand patterns of health and disease in this city, but also perhaps reveal some lessons that would be helpful for activists working in other parts of the country and other parts of the world.

**Brian Lehrer** (2:51)
And to that point, you structure the book around strategies that activists have used to organize around their goals and then you highlight a group you think embodied that particularly well in various instances. So let's take ACT UP, for whom the focus you chose was how the activists decided to fix the problems that they identified with the HIV response back in the 80s.
Can you give a few specific examples of ACT UP actions and what they set the template for for others?

**Nicholas Freudenberg** (3:24)
Sure. And ACT UP, I think, was both controversial and provocative, but remarkably effective group in dealing with the HIV epidemic that hit New York in the late 70s, early 80s. I think there are a few things that stood out for me around ACT UP.
One was their ability to attract different constituencies, men who have sex with men, drug users, family members of people with AIDS, and to forge common ground in identifying the problem and solutions across those different constituencies. And that really I've seen as a characteristic of the effective social movements around health. They can bring together different groups. I think another characteristic that made them effective was their ability to work on multiple levels.
One of their early actions was a demonstration at the Food and Drug Administration in Washington. They were willing to go beyond New York City to act on the federal level to urge the FDA to go through a more expeditious review of new drugs, because at that time people with HIV infection felt that they had a death sentence. And so if there were new drugs coming up, they wanted to be able to get them quickly. And so they, through demonstrations but also through talking with scientists, they were able to convince the FDA to expedite that process. So those are a few of the things that I think ACT UP did both to define the problem and to come up with realistic solutions they could work on.

**Brian Lehrer** (5:15)
By the way, I don't know if anybody who didn't come up at that time knows that ACT UP stood for something. It was an acronym and it was AIDS Coalition to Unleash Power, A-C-T-U-P, ACT UP, AIDS Coalition to Unleash Power, just as a footnote to history.