It started with five cases in the United States. In 1981, an epidemic gripped the nation and then the world. Erroneously termed “Gay-related Immune Deficiency,” research later revealed that it existed long before the outbreak and its reach extended far beyond the gay community. Over the next four decades, HIV/AIDS snowballed into a pandemic that has claimed the lives of more than 30 million people worldwide, with just as many people living with it today. In the U.S., Black people are the most impacted by the disease, and the diagnoses transcend gender and sexual orientation. According to the CDC, despite only comprising 13 percent of the U.S. population, Black Americans make up 42 percent of new HIV diagnoses each year.

Which brings us to the latest pandemic. A report from Chicago found that 70 percent of those who died from COVID-19 are Black despite only being 29 percent of the population. Data from Milwaukee county, Detroit, Charlotte, Philadelphia, and New York all share the same news: Black communities are being hit the hardest.

COVID-19 is not a “Chinese virus,” despite the racist and xenophobic rhetoric coming from the White House, just as HIV/AIDS was never a “gay-related” illness. But it was a disease that was allowed to wreak havoc on our most marginalized communities, and the sad reality is that COVID-19 will do the same if we allow history to repeat itself. Congress has a choice. It can either pass comprehensive reforms in the fourth expected relief package, or it must choose a hill for us to die on.

Black people have been left behind in every epidemic—from H1N1 to Yellow Fever to polio—and we must act quickly to ensure we aren’t left behind again. The good news is that we have lived experience on our side. Black lesbian, gay, bisexual, transgender, queer, and same gender loving people like myself and members of the National Black Justice Coalition know what we need to survive an epidemic because we’ve been through this before. 

The solution must be more than a vaccine. Many political, social, and economic factors put Black people at heightened risk for the worst impacts of this novel virus. We are battling health inequities alongside wealth disparities and need solutions that address these issues at the root. We are less likely than white Americans to have private health insurance through an employer. When we do have access to medical interventions, implicit bias means that providers don’t take us seriously and we receive lower-quality care than white Americans. 

If we do contract the disease, pre-existing conditions like asthma, cardiovascular disease and diabetes are more prevalent in Black communities—all key risk factors for serious cases of COVID-19.

The economic crisis only exacerbates the health crisis. Our college students are being evicted en masse from schools, some with no homes to return to. Everyone from service industry workers to artists have lost work as venues, galleries, and restaurants close. Those who still have jobs are forced to risk their lives and the lives of their loved ones every day on the front lines just to pay their bills.

We must ask ourselves: are the resources being apportioned to address what we know about health disparities, racism, and homophobia in America? As stories abound of asymptomatic, wealthy, and famous people getting access to rapid testing while symptomatic, high-risk patients go without, it’s clear that the answer is no.

We need an immediate expansion to universal healthcare so that people are not scared to go to the emergency room just to be denied testing and sent home with a bill. We need to end mass incarceration and release the thousands of non-violent offenders who are sitting ducks in overcrowded prisons and ICE detention facilities. We need to freeze all rent and necessary utility payments and put a universal moratorium on evictions so that people are not forced to keep working out of fear of losing housing or getting the water shut off.

These measures may seem drastic, but we must meet the seriousness of this moment. Our lives are on the line. Black LGBTQ and same gender loving people like myself, our elders, and our babies were already living through the AIDS epidemic before the novel coronavirus was ever transmitted to a human. We know we don’t just need a vaccine. We need reforms that will fix these longstanding racial disparities.

The HIV/AIDS crisis wasn’t solved in a lab, and we know that the COVID-19 crisis won’t be either, because the true crisis isn’t a virus, it’s a society that has never invested in or cared for Black people. The new pandemic just shines a spotlight on the faultlines that were always there. Without comprehensive reform, a vaccine won’t change a thing.

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David J. Johns is the Executive Director of the National Black Justice Coalition, which works to end racism and homophobia so that all Black people can get free. He is an educator, researcher, federal policy expert and advocate.