A world health evangelist is shocked to hear that he is a "genius"

Gregg Gonsalves took a wild and winding path up to the ivory tower. His career as a teacher at Yale began with street protests and spread around the world.

On Thursday, he was honored with a prestigious MacArthur Fellowship.

Gonsalves is one of MacArthur's "geniuses" this year. The award from the John D. and Catherine T. MacArthur Foundation is accompanied by an unconditional grant of $ 625,000.

Gonsalves says that he was shocked to learn that he received this award. "I did not know someone would scrutinize what I was doing recently," the 54-year-old laughed.

This national honor for creativity could buy him back with his parents, who were disappointed when he left college in the mid-1980s and drifted to the waiting table.

"It was about the same time I came out and realized I was gay," said Gonsalves, who grew up in a conservative family of Portuguese and Italian Catholics.

"Then I met an HIV-positive person and that changed my life.There was no treatment for the disease at the time and it was terribly scary to think about the future. that we both had to. "

This moment has put him on a path for which he is now considered one of the country's leading thinkers in global health and social justice. In the 1980s, he only wanted to understand HIV and discovered that there was very little information about the disease.

"It was before the Internet," he says. "And if you wanted information about medical objects, you had to slip into medical libraries or ask medical students."

He eventually joined the legendary activist group ACT UP (Coalition Against AIDS to Free Power) in the late 1980s and settled in New York while the epidemic was exploding.

"I've been swept by this movement," he says. "I joined the ACT UP New York Data Processing Committee and worked on science policy and clinical research, as well as on basic test design and immunology. I taught myself all kinds of things that I had never bothered to study at school. "

In the midst of protests in the street and handcuffed at the doors of drug companies, Gonsalves was trying to reform the way HIV research was conducted in the country's largest research institutions. They demanded better treatments and a broader understanding of the disease.

In 1992, still without a university degree, he co-founded the Treatment Action Group or TAG.

"One of the first advocacy projects that Gregg and I did was to review the entire National Institutes of Health's AIDS research portfolio," said TAG co-founder Mark Harrington. "And we have made radical recommendations to reform it and create a more powerful AIDS research office with the power to create a research agenda."

Their review led to major reforms at the NIH.

But NIHs were not the only obstacle to getting treatment for people with AIDS. The disease was much more than a disease. AIDS was political and he was polarizing. Reverend Jerry Falwell described the virus as "God's punishment for homosexuals". People with the disease have been described as "whores, fags and drug addicts," says Gonsalves, explaining how critics have fired the victims and downplayed the importance of the epidemic.

"You know in a strange way that the HIV epidemic was an x-ray of the pathologies of American society and the global society," Gonsalves said. "There has been a lot of debate about who lives and who dies, who has social value and who does not die."

He says the epidemic has shaped his views on global health.

"AIDS has been an awakening for me," he says. "It was not just a virus, the epidemic was human, it was the result of the federal government's inaction and slow responses, and all you have to do." is to go from the front to the 2018 horizon and you can see that everything is going on. " Whether it is Ebola or other infectious diseases such as cholera in Haiti, we are witnessing these epidemics of infectious diseases that are again caused by humans. Infectious diseases will always be with us, but epidemics are a human creation. "

What he says, is that the problem is not only about the disease, but also the reaction of people to these outbreaks. He has adopted a similar approach focused on social justice to solve other problems.

In 2015, while working in a city in South Africa, he analyzed the correlation between the distance traveled by women to get to the outdoor toilet and the rates of sexual assault.

"The city of Cape Town said that it could not afford to improve sanitation in [the township of] Khayelitsha, "he said about the study.Municipal officials, he said, explained:" It's too expensive. We can not do it. "

Gonsalves has developed mathematical models analyzing assault rates and the cost of sanitation modernization. He found that installing more toilets would save money.

"It made sense to increase the number of toilets in Khayelitsha to reduce sexual assault, but it would also allow the city to save money on the downstream consequences of sexual assault for which they did not think they were paying, but they were paying for medical care, strengthening law enforcement activities, unemployed people, families without work, all because of sexual violence. "

Nicoli Nattrass, economist at the University of Cape Town, worked with Gonsalves in the late 2000s in South Africa. says one of his greatest strengths as an activist is his calm attitude.

She remembers in 2008, when they were trying to convince a group of World Bank experts that it was worthwhile to fund an effort to increase the number of HIV-positive people on antiretroviral therapy – and that it would slow down the epidemic.

"He had those personal skills that I often missed," says Nattrass, "which allows him to talk rationally and convincingly to people, even when they're rude and hostile."

The concept of "preventive treatment" introduced by Nattrass and Gonsalves more than ten years ago is now widely recognized as one of the most important strategies against the global HIV pandemic.

It was only when Gonsalves was in his forties that he finally decided to go to university. He applied to Yale and has been there ever since. He is now Assistant Professor of Epidemiology.

In 2012, he co-founded the Global Health Justice Partnership, a project hosted by both Yale Law School and its School of Public Health.

Recently, he examined the link between the fight against drugs in Brazil and the problem of tuberculosis in that country. The World Health Organization has ranked Brazil among the countries most affected by tuberculosis and the problem is particularly serious among prisoners. Another recent article he has been working on is examining the factors that have made an HIV epidemic among opioid users in Indiana as serious as it had been before. The paper shows that if more medical services had been made available to drug addicts, the epidemic could potentially have been significantly reduced.

"Much of my work is about how you get services for those who need them – and they are often marginalized and poor people," he said.

And these people could be anywhere in the world. For Gonsalves, global health is about social justice. It has become an approximation to who has access to resources, who gets sick and who does not, who lives and who dies.

He does not say anything about what he thinks of nationalist movements in the world, including President Trump's America First ideology.

"The whole world is moving towards a much more brutal system of cruel corruption, and you know that everyone's health will not come out very well, because health care is not included in the list. list of priorities of the oligarchs. "

The MacArthur Foundation, which has named Gonsalves as one of this year's scholars, said it could well be part of a movement to tackle global health inequities. In a statement announcing the awards, the Foundation praised Gonsalves' current role at Yale.

"Gonsalves is training a new generation of researchers who, like him, work in the areas of public health and human rights, in scientific research and in activism to correct health disparities. world public, "said the Foundation.

Gonsalves believes that correcting these disparities is important, whether or not political leaders realize it.

"We can not isolate ourselves from these closed communities," he says, "and think that what is happening in the rest of the world does not matter".

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