Joycelyn Elders, M.D.

Turning from the Course of Division
Toward a More Perfect Union

This is the edited transcript of the opening remarks by Joycelyn Elders to the Schiller Institute conference on September 6. Dr. Elders was Surgeon General of the United States, 1993-1994. Subheads have been added.

Thank you so much for this opportunity to address the Schiller Institute conferences. The conference today is to address a New Paradigm, united toward the common aims of humankind.

In a whirlwind of disasters, we’ve been barraged by a worldwide pandemic of the new virus, medical unpreparedness, shortage of PPEs, hospital space and medical personnel, government unpreparedness, economic recessions, unemployment, huge numbers of hungry, helpless people, and police brutality. We’re witnessing disparities in the U.S., and around the world, that we have tried for many years to wish away. We won’t be forgetting 2020 anytime soon.

It is as though all the trauma from the diseases surrounding us, and almost consuming us, have torn away the shackles from our eyes, and now we see with 2020 vision. How did we not see these disasters coming? The huge numbers of people are dissatisfied with disparities and inequities. They are now seeing with 2020 vision in all areas—economic, social justice, and medicine.

Whole countries have essentially shut down. The world’s people are on hold. Now all of those people on hold are wondering: What do we do in this new world?

So, what can we do?

We’ve done the groundwork already, when we looked at all areas of economics, social justice and medicine, all aspects of a person’s life, and labeled it “the social determinants of health.” We know that a person’s health is more than just a germ or an injured organ. Rather, health is determined by an interconnected system of all that is in a society. We know that the social determinants of health are facts, rather than a political stance.

We’ve not trained our people about the difference in belief and fact. Many do not seem to understand the importance of public health and welfare. A person is only as healthy as the least healthy and wealthy person. Healthcare and wealth must be extended to everyone for public health to be good. Every person in humankind needs the same things to be whole and healthy. The social determinants of health addresses these needs.

Of course we must address the pandemic of COVID-19 that is killing people all over the world. We’ve applied procedures and principles developed over centuries, and we know what to do about this infection. Discovering that it is airborne, we know to wear masks, to distance ourselves physically from others, to not gather in groups, to stay at home, to use Zoom. We are in the process of developing better tests and vaccines, and are slowly learning about treatments and existing medications that are effective in treating COVID 19.

This is a short-term solution to the immediate problem. The anxiety we feel, is from more than COVID 19. Most of us realize that disparities and inequities cost lives, that we are only as healthy as our least healthy person. Those who have money are just as vulnerable as those who have not. The higher castes are just as sick as the lower castes. We must change our health system, and to do so involves changing our social system.

But is this the right time to tackle a huge change in the middle of a pandemic?

Medical science can offer—I think we like to offer—better health and welfare systems to the whole world. We already know what needs to be done. The how-to-accomplish-this is still waiting. Many seem to be thinking about how to accomplish a great change.

The Coincidence of Opposites

After education, we must decide what to do next. We know our goal—a great change in our society to make the social determinants of health a realization for all. I think we all want to turn to developing public health systems that will be armies for equitable health and welfare. We need whole armies to bring about these changes. Helga LaRouche has called for the formation of the Committee for the Coincidence of Opposites. This initiative will establish an international chorus to advocate the creation of a kind of Apollo Project in world health care, as sudden, yet inspiring, as was John F. Kennedy’s seemingly impossible Moon Project.

And it isn’t as though we are proposing something new, as public health workers were abundant and were a fixture in much of the United States back in the 1860s. We are proposing that young people, worldwide, from high school, college, and post-college age groups, be incorporated into an international “health extension service,” which will supplement the inadequately staffed medical needs of governments worldwide.

As I said at an earlier Schiller Institute conference, when the idea of the Committee was first proposed by Helga, you have tiers of people, from the community healthcare workers, to their immediate supervisors, to people with some medical education, all the way up to nursing assistants, nurse practitioners, doctors, and right up to the highest level of super-specialist neurosurgeons. We often do too much specialized care, and we do not do enough basic public health care, to improve the health of our nation. A public health workforce would do far more to maintain our health, than 100 surgeons.

Public health workers in these public care health systems are not doctors or nurses. Giving out masks, taking temperatures, and even contact tracing and some diagnostics, does not require one to have a medical degree, or to go to school for 12 years. This would be a public health corps that could be interfaced with the Army Corps of Engineers, and many other agencies throughout a government. We need millions of public health workers in the United States, and the world need tens of millions.

This is one of the most efficient economic investments that can be made anywhere in the world, especially when millions are out of work. Public health systems in each country, connected into a global public healthcare system, could achieve better healthcare and better welfare for hundreds of millions of people.

The African Union has devised plans to tackle many aspects of a continent-wide health plan. Ethiopia and many other nations have successfully created a large number of community health workers and have developed entire curricula on how to teach community health workers. Much has been tested. The global concern for one another will be the beginning of a public healthcare system, because that is what public health does—care for one another’s welfare. To survive this, and future pandemics, we need to secure the freedom of health to all people, everywhere in the world. We need to all work together, no matter how opposite we are, from all over the world.

A Determined Boldness

It’s a tall order. The disparities in health, education, housing, work, and social areas must be not only addressed, but eliminated. Equity can be the word for 2020. We are striving toward an equitable world.

Today’s world health situation may be fearful, but need not be our fate. To say otherwise, is to speak falsely, and with fear. The world can turn from the course of division long enough to save tens of millions from death. To survive the surely oncoming pandemics, we need to secure the freedom of health to all people, everywhere in the world. We need to all work together no matter how opposite we are, from all over the world. That is what we mean by a coincidence of opposites—a higher alliance, based on the principles of malice toward no one, and charity toward all. That can ensure our durable survival, and health as a human race.

Perhaps, in the future, children will study the watershed year of 2020 and see that the outstanding event was not the pandemic and ensuing disasters, but that the world began to change to a better place for humankind.

We must be the leaders. In order to be the leaders, we must learn what the community needs, to make sure that we understand what’s going on, so that we can provide for them what must be provided. We have to educate and empower all the people, and educate and empower our youth, so that we can all be involved, and so we can all plan to do what we need to do to make a difference. We have to have what I call “determined boldness”—boldness to go out and meet the problems where they are, tackle them where they are, and do what we need to do to make a difference. We can do this. We know how, and we must get started. Thank you.