As we observe AIDS Awareness month this December, we find ourselves looking back on the most challenging year from a public health perspective in at least a century. The current pandemic places all of us at the direct crossroads of public policy and public health in a daily reality unrivaled in most of our previous experience. Thinking about the impact of school and business closures, restrictions on gatherings and travel, mask mandates, and how to distribute vaccines highlight just a few of the law and policy responses we now interact with to keep ourselves and each other safe. As we pause each year to recognize those living with HIV, and remember those lost to AIDS, the condition caused by the virus, we must also remember that we suffer many of those losses, especially the early ones, because of the original failures of the public health response to the HIV epidemic. These failures included but are not limited to a minimization of the government’s role in public health response and related delays to address the spread of HIV and AIDS.
It is through this lens of failures, missed opportunities, and of lessons learned — formalized in public health law research — that we are able to build a better understanding of how to use law and policy approaches to mitigate and prevent infectious disease epidemics like HIV, and now COVID-19.
The modern field of public health law has some of its deepest roots in the response to HIV. Temple University Professor of Law and Director of its Center for Public Health Law Research (CPHLR), Scott Burris, and colleagues like Larry Gostin, James Hodge, Zita Lazzarini, and Wendy Parmet were all engaged in early substantive public health law research related to HIV. The connection between the 1988 publication of AIDS and the Law: A Guide for the Public and 2020’s Assessing Legal Reponses to COVID-19, both edited by Scott Burris, tangibly illustrates the continuity of public health law research at play in responding to both of these public health crises. It was acknowledged during the 1980s that law and policy development were critical tools to better understand and respond to the HIV epidemic. Law is a powerful tool to change behaviors and environments systemically; essential elements when considering the management of the spread of an infectious disease. As with HIV, coronavirus has challenged us to innovate and respond to an enemy that, at the outset, was not fully understood, and continues to require novel medical and public health advances to meet the evolving threat. Law and policy must be on the front lines of this endeavor, and evidence and knowledge acquired through public health law research must support that innovation.
The response to COVID-19 involved a flood of state executive orders and other state actions. CPHLR staff members were able to adapt to and address this flurry of activity, and conduct the scientific legal research (what we call policy surveillance) needed to begin understanding the legal responses at play. CPHLR’s dataset on the state legal response to COVID-19 provides longitudinal insights into COVID-19 laws and policies through June 30, 2020. The availability of this dataset allows researchers to further analyze health outcomes data against specific legal responses, and provides critical insight to policymakers, advocates and public health professionals into how law and policy can effectively respond to a public health crisis of this nature and magnitude.
While many challenges remain before us, the earlier public health law research about HIV has gifted us with a robust mechanism with which to analyze the law and policy response to COVID-19. We owe a debt of gratitude to those who have blazed a trail, and plan to continue to utilize and expand on these tools to inform better policy development, and we must acknowledge the specific challenges faced by those with HIV and AIDS during the current crisis, and look to a future where both the HIV epidemic and the COVID-19 pandemic are defeated.