Looking back on 2024 I am grateful for the spring morning spent at the Frostburg Center For Literary Arts in Northwestern Maryland. The Center's Director, Jen Browne, runs a range of marvelous and varied literary programs on the FSU campus and in town. As part of the "Coffee with a Writer" series, we had a conversation around poetry and access to medicines on April 6. I thank Jen and Nina and every person present for their wisdom, attention and hospitality. 

I love strong editorial artwork. This detail from Sara Gironi Carnevale's illustration for Science's  "2024 Breakthrough of the Year" literally illuminates the wow-factor potential for one injectable HIV drug. It suits what lenacapavir, as a pre-exposure prophylaxis (PrEP), could mean for controlling HIV infections. The question, as usual, is about access. Let's hope it will be as accessible as possible, as soon as possible. Read the article by Jon Cohen here. 

The exhibit Prescriptions for Change: Value Voting in Healthcare rotates one work per month in the West Virginia University Health Sciences Library in Morgantown during the 2024-25 academic year. Organized by WVU Art in the Libraries Curator Sally Brown, each piece is accompanied by a brief written response from a member of the WVU community. "Dirty Laundry: Drug Formulary Exclusions" is on display in November. This mixed-media piece was previously published in AMA Journal of Ethics.

Prescriptions for Change relates to a larger initiative on campus for value voting. The exhibit Our Votes, Our Values runs from September 6-December 15, 2024 at the Art Museum of WVU. This exhibit is co-curated by Erik Herron, Professor of Political Science and 2023 Art Museum Faculty Fellow, Robert Bridges, Curator, Art Museum of WV and Heather Harris, Curator of Education, Art Museum of WVU. The works explore how the values we maintain influence our voting.

As the days grow darker I am reminded of this photograph from Protect Our Care's Lite-Brite Action in Washington, D.C. on September 28, 2021. Read about it in the February 24, 2023 Time article by Tahir Amin and David Mitchell. It is an illuminating reminder of progress made by the Biden Administration. This progress is under threat.

This month I remember the September 30, 2018 vigil T1International organized at the Eli Lilly Headquarters to honor lives lost from insulin rationing. This was before blockbuster weight loss drugs came to market, the passing of the Inflation Reduction Act (IRA), the signing into law of the Alec Smith Insulin Affordability Act, the increased scrutiny into the role of pharmacy benefit managers (PBMs), the release of the documentary Pay or Die, and many other developments. Progress and stubbornness continue. Here is the postcard I brought to the 2018 vigil. 

This weekend I saw Suffs at The Music Box in New York. Final events of the Summer Olympics in Paris – also live – included track and field relay races. Suffs is about women’s suffrage in the U.S. It is not comprehensive, of course, as it took many years before women of color in all states could vote. It was an intense, uphill battle for any females to legally vote in this country.       

Why did I think about relay events from my seat in the back of a dark theater? I was struck by the importance of the hand-off in group achievement. There were moments in the musical when heroes of the movement admitted their exhaustion. There were differences of opinion and conflicts in the face of an incredibly powerful opponent. I was reminded of the volunteers, patient organizations, certain policy-makers and individuals who spend incredible amounts of their time and energy working for access to necessary drugs in our era of monopolies and dizzying profits. 

Passing the baton happens in seconds, or years, or decades. We give each generation or teammate or fellow advocate their time to take it further. I want to honor all efforts for this access. It is very much like the right to vote. Depending on your illness or circumstance, it is about the right to breathe, to digest food, to not be in crushing pain, to move, to fight infection, to stop bleeding, to stop deadly allergic reactions.

I was pleased that Shaina Taub, creator of the musical, performed in the role of Alice Paul when I attended on August 10. A Broadway performance does not guarantee the cast for that night. This is part of the thrill. No live performance is identical.  

We cannot take our freedoms or accessibility for granted. We must contribute to the momentum for progress when we can, and to hand over decision-making when it makes sense. 

I enjoyed the closing reception for Pyramid’s Member Mash-Up exhibit on Sunday. Pyramid Atlantic Art Center runs a lovely, well-utilized space with workshops, exhibits, artist opportunities and a community presence in and beyond Hyattsville, Maryland. My mixed-media piece addressed drug formularies and pharmacy benefit managers (PBMs). Last week The New York Times ran a front page article on the role of PBMs by Rebecca Robbins and Reed Abelson. “A Shadow Industry: How pharmacy benefit managers inflate the cost of prescription drugs for millions of people” is very much worth a read.    

If you missed it, I also recommend the April 1, 2024 episode of The Daily Show. Jon Stewart's interview with Lina Khan, Chair of the Federal Trade Commission (FTC) offers refreshing straight-talk about monopolies.

July 1 started the week and the new fiscal year. “Fiscal” relates to the public treasury and government expenditures. The term may sound wonky, but the lived results of FY decisions most certainly are not. Tonight, fireworks will fill our horizons. From your own backyard to rodeo arenas, to city waterfronts, they punctuate the Fourth of July. One type of firework, a skyrocket, uses solid fuel for a quick rise. When I look up, I will hear and see the echoes of rising drug prices. "Skyrocket" is the go-to word for journalists to describe what drug prices do. I yearn for the day when it is not.   

I'm happy to have "Wolves in Sheep's Clothing IX: Prescription Drug Formularies" included in this year's open member exhibit at Pyramid Atlantic Art Center. View all of the pieces here or visit the Gallery in Hyattsville, Maryland. The show is up through June 30, 2024. Check out Pyramid's fabulous workshops, events and store.

Psychiatrist and artist Eric Avery gave a wonderful plenary address at the 2024 Health Humanities Consortium (HHC) Conference in Phoenix. In "Art as Medicine/Medicine as Art" he shared examples of collaborations and solo projects. With ingenuity and compassion Avery has ignited the "space between" medicine and art for decades. Many of his prints, drawings, books, ephemera and arts activist pieces relate to AIDS.    

While listening to his address, I thought about PEPFAR and the 1-year, rather than 5-year renewal that passed with the omnibus funding bill in March. This renewal means we're skating, but skating on thin ice. The President’s Emergency Plan for AIDS Relief (PEPFAR) has functioned as an international beacon for effective public health funding. It includes access to antiretroviral drugs (ARV). It is essential to keep PEPFAR going strong and to protect it from partisan attacks. 

Learn more about Dr. Avery's work at ericaveryartist.com. Get a refresher about the significance of PEPFAR legislation from Kellie Moss and Jennifer Kates's KFF article "PEPFAR’s Short-Term Reauthorization Sets an Uncertain Course for Its Long-Term Future."

On Saturday I was in Washington, D.C. to join T1International’s Global Day of Action for #insulin4all. Participants in Paris, Indianapolis, Islamabad, and other locations advocated for the cost of insulin and glucose testing supplies to represent no more than 5% of a person’s income in any given country.

Fresh from hearing patient stories on the Mall I visited the exhibit Dorothea Lange: Seeing People at the National Gallery of Art. Alongside other portraits “Street Demonstration, San Francisco, 1934” certainly resonated. Access to jobs and medicines hinges on access to the eyes and ears of decision-makers. Moving through the space, I read the following statement of Lange’s: "Five years earlier I would have thought it enough to take a picture of a man, no more. But now, I wanted to take a picture of a man as he stood in his world."

His world. His circumstances. His reality. This kind of seeing is the origin of public health.