Ryan was soft‑spoken, steady, and quietly stubborn. He didn’t want fame; he wanted normalcy. His refusal to accept exclusion made adults confront their own behaviour. He once said: “I’m just like anyone else.” That sentence became a national argument.
Ryan struggled with HIV throughout high school, often confronting the ignorance and discrimination of parents, school and civic authorities, but inspiring his classmates and millions of others. Ryan died on 8 April 1990, aged 18, after spending nearly his entire adolescence navigating medical complications, school battles, and national media attention. His mother, Jeanne White‑Ginder, became a tireless advocate after his death, speaking across the United States about stigma, compassion, and the need for evidence‑based HIV education.https://humanist-world.net/wp-admin/post.php?post=19876&action=edit She remains one of the most respected voices in paediatric HIV advocacy.
Ryan’s funeral drew thousands — celebrities, politicians, activists — many of whom had learned from him that HIV was not a moral condition. Michael Jackson wrote “Gone Too Soon” as a tribute to Ryan’s life (no lyrics quoted here), capturing the sense of a life that ended before the world had finished listening.
Ryan’s legacy became structural. Four months after his death, the U.S. Congress passed the Ryan White CARE Act, the largest HIV treatment and support program in American history. Today, its modern form — the Ryan White HIV/AIDS Program — provides medical care, medication access, case management, and support services to hundreds of thousands of people living with HIV, especially those who are uninsured or under‑insured.
Ryan did not live long enough to see the program that bears his name. But its existence is proof of how profoundly he shifted public perception. Where AIDS had once been ignored or dismissed, Ryan forced the country to look directly at a child who simply wanted to go to school — and to recognise that the cruelty directed at him was indefensible.
Ricky, Robert, and Randy Ray
The Ray brothers grew up in Arcadia, Florida: three haemophiliac boys infected with HIV through contaminated Factor VIII. They were ordinary children — bikes, baseball, neighbourhood routines — until their diagnosis became public. What followed was one of the clearest examples of AIDS‑era discrimination in the United States.
Their school barred them from attending classes. Neighbours circulated petitions. Rumours spread faster than facts. When the boys finally won the legal right to return to school, their home was firebombed on 28 August 1987. The family fled the town. The boys were 8, 9, and 10 years old.
The Ray brothers’ story was not an isolated incident. It was part of a pattern: school exclusions, evictions, threats, and violence directed at children who posed no risk to anyone. Their case documented how fear becomes physical harm, and how communities can turn on families when misinformation is allowed to dominate public life.
This was not a uniquely US pattern.
Eve van Grafhorst
Australia had its own version of this story. Eve van Grafhorst was born in Sydney in 1982 and contracted HIV from a contaminated blood transfusion during her premature birth. When her status became known in 1985, she was excluded from her pre-school at Kincumber, New South Wales; she was eventually let back in only on condition she wear a plastic face mask, and parents still threatened to pull their children out rather than let a three-year-old attend. The family gave up and emigrated to Hawke’s Bay, New Zealand in 1986, where the community welcomed them. Eve died in 1993, aged 11. Afterwards, the mayor of the town that had driven the family out publicly apologised, admitting the community had been wrong.
Nkosi Johnson
A decade later, in South Africa, Nkosi Johnson met the same wall. Born HIV-positive in 1989 and raised by his foster mother, Gail Johnson, after his birth mother could no longer care for him, Nkosi was refused enrolment at a Johannesburg primary school in 1997 solely because of his HIV status. Gail fought the decision publicly and won, forcing a change in national policy so HIV-positive children could no longer be barred from school. At eleven, Nkosi addressed ten thousand delegates at the 2000 International AIDS Conference in Durban, calling for compassion instead of fear. He died in 2001, aged 12 — the longest-surviving child born HIV-positive in South Africa at the time. His foster mother later opened Nkosi’s Haven, a home for HIV-positive mothers and children, continuing the fight he’d started.
Today
A generation after Ryan White and the Rays, and decades after Eve van Grafhorst and Nkosi Johnson, the shape of the fear hasn’t changed — only its target. Today, children across the developing world are losing access to HIV medication because of the Trump administration’s cuts to USAID — will history call this the same neglect in a new decade? And fear keeps finding new targets among the already stigmatised: transgender children are barred from bathrooms, sports teams, and classrooms — and, in a growing number of US states, from the medical care their doctors recommend — because of who they are, not because of anything they’ve done. Different decade, different pretext, same instinct: isolate the child rather than sit with the discomfort. What, exactly, has the world learnt?
The summer of 1518 had come to Strasbourg behind the Plague, as it had come before and would come again: patient, and entirely without mercy. The Rhine ran low and brown beneath a sky that seemed to have forgotten the colour of clouds. In the tanneries along the Ill, the stench of curing hides rose through the heat in visible waves, and the beggars who normally slept in the cooler dark beneath the bridge had moved on to somewhere less likely to kill them. A baker’s boy was sweeping burnt crumbs from a stall, the day’s loaves already having sold at a higher price than the council allowed. Even the cathedral, that great sandstone argument with heaven, seemed diminished by the light, its famous spire pointing upward with less conviction than usual, as if God had been slow to respond and the stone had begun to have doubts.
Jakob Sattler had lived in this city for thirty-one of his forty years and had never learned to love July. This one, he already sensed, would give him better reasons than most.
He heard them before he saw them.
It was not only music, though someone had already had the ill-considered notion of providing a drummer and a fiddler as improvisation to what was already happening, both of whom looked as though they would rather be anywhere else on earth. The sound that reached Sattler first as he came through the Kronenburg Gate was something underneath the music. A shuffling. A rhythmic scrape of leather on cobblestone that had no regard for the beat being offered to it. As if the feet knew a different song entirely.
He rounded the corner into the Pfennigturm square and stopped.
The first one — the woman who had begun it all, five days before his arrival, on a narrow cobbled street not far from here — was not in the square. Her name was Frau Troffea. He heard that from three separate sources. He did not know yet what use a name was, but he wrote it down.
There were perhaps two dozen of them. Men and women both, though more women than men, ranging from a girl who could not have been fifteen to an old wool merchant Sattler recognised from the market on the Ill. They were not dancing together. That was the first thing that struck him; he had expected something communal, even festive, some collective madness he could attribute to bad wine or a saint’s day he had forgotten. Instead each person moved alone, in their own private rhythm, eyes fixed on nothing, faces carrying expressions he could not immediately name. Not ecstasy. Not pain exactly. Something between the two that had no word in Latin or in German.
The wool merchant’s feet were bleeding. He did not appear to notice.
Sattler stood at the edge of the square for a long time, his leather bag in his hand, and watched. A physician’s first duty, his teacher in Heidelberg had told him, is to observe before he theorises. He had spent twenty years trying to honour that instruction. He honoured it now, though everything in him wanted to look away. He was aware that standing here, at the edge of the square with his notebook open, was itself a kind of statement. He found that he did not mind making it.
He chose the girl first, because she was the least frightening and because he was, despite everything, a coward about some things.
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She was perhaps fourteen, dark‑haired, her dress good quality but torn at the hem from days of movement. There was a steadiness in her that belonged to older women, the kind of resilience that would make her formidable at thirty, if she lived that long. Her eyes were open but registered nothing in front of her. Sattler stepped into her path carefully, the way he might approach a horse that had been badly treated.
“Girl,” he said. Then, more gently: “Can you hear me?”
She danced around him without breaking rhythm, without any acknowledgement that he existed. He caught her arm — lightly, a physician’s grip, feeling for the pulse at the wrist — and she neither resisted nor responded. The pulse was rapid. Fever-rapid, though her skin when he pressed the back of his hand to her forehead was not especially hot. He released her and she continued her private rotation as if he were a post she had navigated around.
He tried three more. An older woman who wept silently as she moved, tears running without any corresponding expression on her face. A young man, a tanner’s apprentice by the smell of him, who had danced his shoes entirely to pieces and was working now on the skin beneath. A broad-shouldered farmer type who moved with surprising delicacy, as if performing steps learned long ago and only now remembered.
None of them responded. None of them stopped.
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Sattler opened his bag and took out the small journal he used for case notes. He was aware of people watching him from doorways and upper windows: the non-dancers, the majority, the ones who had retreated behind wood and glass to observe the square with the particular Strasbourg expression that managed to convey both horror and mild disapproval simultaneously. A council notice hung crooked on a post nearby, the ink run in the heat, forbidding public music until further decree; a gesture so belated and half‑hearted it felt almost like an admission of helplessness.
He began with what he could establish. Names first, where he could get them, asking bystanders, pressing for answers when they shrugged. Then sex, approximate age, apparent social class from clothing. Duration… difficult without witnesses, but someone would know. He worked methodically, grateful for method, because method was the only thing standing between him and the feeling that had been building since he entered the square. The feeling had no clinical name. It was somewhere in the vicinity of dread.
It was the journal that saved him, in the end; not that day, but later. Because it was the journal that first showed him the pattern.
He had been noting addresses, asking bystanders where the afflicted lived, mostly out of habit. Cross-referencing was something his Heidelberg professor had insisted upon until it became instinct. He had noticed that the council’s dispatches referred to them as the afflicted, the dancing sick, the choreomaniacs. Categories. He used names. It was not sentimentality. It was medicine. You could not understand what was happening to a category. You could only understand what was happening to a person.
They were not from the same street. Not from the same parish, not the same guild, not the same church. The girl and the weeping woman lived on opposite sides of the city. The tanner’s apprentice had come in from a village three miles east. The wool merchant (old Georg Kessler, he had confirmed, forty years in the same stall) had been born in Colmar.
There was no obvious connection.
He almost closed the journal. Then something made him look again — not at the addresses, but at the column beside them. The apothecary marks. He had asked, almost without thinking, whether any of them had sought medicines recently. A physician’s reflex. Most bystanders hadn’t known. But three of them had — independently, without prompting — mentioned the same name.
Not an apothecary currently trading.
A widow on the Krutenau.
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The Krutenau was the poor quarter, pressed against the river on the eastern edge of the city where the smell of the tanneries was inescapable and the houses leaned toward each other across the lanes as if sharing a confidence. Sattler had visited it often enough in a professional capacity — fever, malnutrition, the usual catalogue of what poverty did to a body over time. On the corner of the lane before Anna Schreiber’s house a door had been marked with a red cross, fresh enough that the paint had run slightly in the heat. He noted it the way he noted everything now, which was to say he noted it and kept walking, because in Strasbourg in July of 1518 a marked door was not remarkable. That was the thing about plague. It became ordinary before you had finished being afraid of it. But he had never visited this particular house, a narrow three-storey building with a dried herb wreath on the door that was at least two seasons old.
The woman who answered was not what he expected, though he could not have said precisely what he had expected. She was perhaps fifty, solidly built, with the hands of someone who had spent a lifetime doing useful things and the eyes of someone who had spent the same lifetime watching other people do foolish ones. She looked at his bag before she looked at his face.
“Physician,” she said. Not a question.
“Jakob Sattler. The council has asked me to —”
“I know what the council has asked you to do.” She stood back from the door, “You had better come in.”
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Her name was Anna Schreiber. Her husband Heinrich had been an apothecary, dead four years of a chest complaint that she described with the clipped precision of someone who had watched it take a long time and had decided that the appropriate response was clarity rather than grief. The shop was closed now. She kept the stock because she knew its value and she kept the records because Heinrich had kept records the way other men kept promises — religiously, and as if his life depended on it.
Sattler sat at her table and accepted the wine she poured because refusing it would have been rude and he needed her to talk.
“Three of the dancers,” he said, “Possibly more. Their families mention your husband’s name.”
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“I know.” She sat across from him with her own cup and did not drink from it. “I have been expecting someone to come. I had not decided whether to send for someone myself or wait.”
“What were you waiting for?”
She looked at him steadily. “To decide whether telling you would help or make things considerably worse.”
Sattler set down his cup. “Frau Schreiber. There are thirty people in the Pfennigturm square who cannot stop moving. More joining them each day. A man I have known for twenty years is dancing on bleeding feet and does not know I am alive. Whatever you know, I need to know it.”
She was quiet for a long moment. Then she rose and went to the back room (the old shop, he guessed, still fragrant with dried things he couldn’t name) and returned with a wooden box, not large, bound with a cord that had been tied and untied many times.
She set it on the table between them.
“Heinrich received letters,” she said. “From a physician in Basel. This was perhaps fifteen years ago, perhaps twenty. I was not always privy to the correspondence, but I remember the man’s name because Heinrich spoke of him with a reverence he did not often extend to other men of his profession,” she paused, “And also because what the man was proposing frightened Heinrich a great deal. He did it anyway. That was Heinrich’s particular failing.”
“The name?” Sattler said.
“Murner,” she said. “Conrad Murner.”
II. The Letters of Conrad Murner
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The letters were written in a cramped scholarly hand, Latin mixed with German in the way of a man who thought in both languages simultaneously and had stopped caring which came out. There were eleven of them, spanning — as far as Sattler could establish from the dates — the years 1497 to 1503. The last one was different from the others. He set it aside and read the first ten in order, because order was what he had instead of understanding.
Conrad Murner wrote the way some men talked — at length, with digressions, and with the barely suppressed excitement of someone who has discovered something they know the world is not ready for. The early letters were theoretical. He had been studying contagion — not in the loose providential sense that most physicians employed the word, as a synonym for God’s displeasure made airborne, but in a precise and almost reckless mechanical sense. Disease, Murner argued, was a thing. A particular thing, specific to itself, that entered the body through particular means and did particular damage. Different diseases were different things. They could, in principle, be studied as a watchmaker studied the components of a mechanism.
This was not, Sattler reflected, entirely without precedent — Ibn Sina had gestured toward something similar five centuries earlier, but the confidence of it, the sheer systematic certainty, was unlike anything he had encountered in a contemporary. Murner wrote as if he already knew the answer and was working backward to the proof.
By the fifth letter he had arrived at his proposition. If disease was a specific thing, then exposure to a weakened form of that thing might teach the body to resist the stronger form. He used the word teach without embarrassment, as if bodies were students and pathogens were lessons. He had been experimenting, he wrote, with material taken from plague victims, all attenuated, modified by a process he described in careful detail, and had administered it to six volunteers in the Basel poorhouse. Three had subsequently been exposed to active plague. None had died. One had not sickened at all.
Sattler put the letter down and looked at the candle for a while.
He picked it up again.
Murner’s elation was visible in the handwriting of the sixth letter — wider, faster, the Latin abandoned almost entirely. He was distributing his preparation. Carefully, selectively, through apothecaries he trusted in Colmar, Sélestat, Strasbourg. Heinrich Schreiber’s name appeared, with a warmth that confirmed Anna’s account of the man’s reverence. He was saving lives, Murner wrote. He was certain of it.
The seventh and eighth letters were more subdued. There had been some adverse reactions he had not anticipated. Nothing fatal — or nothing he knew to be fatal — but some recipients had experienced tremors, confusion, brief episodes of involuntary movement. He had adjusted his preparation. He believed he had corrected the problem. He was monitoring.
The ninth letter did not mention the adverse reactions at all. Sattler noticed this the way he noticed everything now — with a cold, steady attention that was not quite fear.
He reached for the tenth letter and Anna Schreiber put her hand briefly on his wrist.
“Read the eleventh first,” she said. “Then read the tenth. I found it made more sense in that order.”
He looked at her. She withdrew her hand and looked at the table.
He picked up the eleventh letter. It was shorter than the others and the handwriting was not Murner’s… or rather, it was Murner’s hand, but changed; older. A hand that had recently been through something.
Heinrich, he wrote, I must tell you about the manuscript.
III. What Murner Knew
He was still holding the eleventh letter when the hammering came at the door.
Anna Schreiber did not startle. She rose with the unhurried competence of a woman who had long ago decided that unexpected visitors were simply part of the texture of life, and went to answer it. Sattler heard voices: hers, level and uninformative, and a younger male voice with the clipped impatience of official business. He looked down at the letter in his hand and did not read it.
He was thinking about the Pied Piper of Hamelin.
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He had heard the story as a child — everyone had, it was over The name gave him pause — brother to the Franciscan satirist, if he remembered correctly, though the two had not spoken in years. she said two centuries old and had the worn, inevitable quality of things that persist because they contain something people cannot quite look at directly. A man with a pipe. A town that would not pay its debt. Children who followed music into a hillside and did not come back. He had always understood it as a moral tale, the kind Germans told their children about the consequences of broken promises. He had never thought to ask what the children heard. What the music promised them. Whether they followed in joy or in compulsion or in some state that contained both and could be distinguished from neither.
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The Children’s Crusade. He had read about it in Heidelberg — thousands of children, some accounts said, marching toward the Holy Land in 1212, driven by a certainty that God would part the sea before them as he had for Moses. The sea had not parted. Most of them had died or been sold into slavery before they reached it. Historians called it mass delusion. Sattler had always thought that was too easy a word for something so enormous and so strange.
And before that — the dancing plague of 1374, here in the Rhine valley, in the aftermath of the Black Death when a third of Europe lay in its grave. Hundreds dancing through Aachen and Cologne and the river towns, unable to stop, crying out for relief from something they could not name.
Always movement. Always compelled. Always the poor, the desperate, the ones already standing at the edge of what human beings could endure.
Always a music nobody else could hear. Always the powerful counting bodies while someone else, usually one person, usually without authority, wrote down names.
Anna Schreiber returned. Behind her, looking deeply uncomfortable in the low-ceilinged room, was a young council clerk in the livery of Sebastian Brant, secretary to the Strasbourg city council and, in Sattler’s considered professional opinion, the most obstinate man in Alsace.
“The secretary sends his respects,” the clerk said, in a tone suggesting the secretary sent nothing of the kind. “He requests your report by the morning of the tenth of August. The council intends to decree a ban on music and public dancing. They also wish to discuss the matter of the shrine of Saint Vitus.”
“The shrine,” Sattler said.
“The dancers are to be conveyed there for healing. It is the secretary’s view that this is a matter of divine punishment and that medicine has had sufficient opportunity to demonstrate its—” The clerk paused, clearly reciting. “—its limitations in this regard.”
Sattler looked at the boy for a moment. He thought about thirty people in the Pfennigturm square, shuffling in their private rhythms, following their private music. He thought about the wool merchant Georg Kessler’s bleeding feet. He thought about the girl who had danced around him as if he were a post.
He thought about a man in Basel, fifteen years dead, who had read something — some thing, some text that should not have existed — and had understood it well enough to attempt the impossible.
“Tell the secretary,” Sattler said carefully, “that I am making progress. Tell him I will have a report. Tell him also that Saint Vitus is a child martyr associated with uncontrollable movement, and that sending people who cannot stop moving to his shrine seems to me to be asking the fire to cure the burning.”
The clerk absorbed this with the expression of a man calculating how much of it he could safely repeat. He settled on a bow and left.
Anna Schreiber sat back down. She looked at the letter in Sattler’s hand.
“The manuscript,” Sattler said. “What did Heinrich tell you about it?”
“Very little. He was frightened of it, I think, though he would not have used that word.” She was quiet for a moment. “He said Murner had not written it. He said Murner described it as something that had come to him — those were the words Heinrich remembered. Came to him. Not found, not received. Came. As if it had arrived of its own volition.”
Sattler looked down at the letter.
Heinrich, Murner had written. I must tell you about the manuscript. I have not spoken of it before because I did not know how to speak of it honestly without appearing to have lost my reason, and I could not speak of it dishonestly because you would have known. You have always known.
The preparation is not my idea. I want to be clear about this, though I suspect it will not comfort you. The concept — of introducing a weakened disease to prevent the stronger one — comes from a text I cannot fully explain. I found it, or it found me, in the winter of 1496, among a collection of manuscripts I purchased from the estate of a physician in Freiburg who had died without heirs. Most were commonplace. This one was not.
It is written in Latin of a strange kind — correct, but with a flatness to it, a precision, that does not read like a man thinking but like a man transcribing something that was not originally in Latin at all. It describes the mechanism of disease in terms I did not have words for and have since had to invent. It describes the preparation in exact detail, as if the author had performed it many times. There are marginal notes in a different hand — older, I think, though I am no judge of such things — that reference earlier attempts. Earlier iterations. The dates in the marginal notes, Heinrich. One of them is 1212. Another is 1284.
I think someone has been trying this for a very long time. I think I am not the first person to read this manuscript and attempt what it describes. I think the others also failed, in their own ways and in their own times, and that the failure is recorded in the margins as a kind of — I do not have the word. A kind of patient notation. As if whatever wrote this expects to wait as long as necessary.
I believe the preparation works. I believe the principle is sound. I also believe I have made an error somewhere that I cannot locate, and I am afraid, Heinrich, that I will not live long enough to find it.
Burn this letter. Keep the preparation. Someone after us will understand it better than we do.
Yours in God and in science, which I have come to believe are not as different as we were taught,
C. Murner. Basel, November 1503.
The candle had burned low. Outside, distantly, Sattler could hear the scrape of feet on cobblestone. The dancers did not stop for night. He had already known this but it struck him again now as a fact with new weight.
He set the letter down very carefully, as if it might break.
“The manuscript,” he said. “Does Heinrich still have it?”
Anna Schreiber looked at him with her steady, unsentimental eyes.
“No,” she said. “But I do.”
IV. The Manuscript
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It was smaller than he expected. He had imagined something imposing — a great folio, perhaps, the kind of volume that announced its own importance through sheer physical weight. What Anna Schreiber placed on the table between them was barely larger than his own journal. Bound in leather that had once been brown and was now the colour of old skin. No title on the cover. No mark of any kind.
He reached for it and stopped.
“It won’t harm you,” Anna Schreiber said. “I have handled it many times. Heinrich handled it for years.”
“I know,” Sattler said. He was not sure why he had stopped. Some instinct older than his training. He picked it up.
The leather was oddly smooth under his fingers. Not worn smooth — smooth in the way of something that had never quite had the texture of ordinary things. He opened it.
The parchment was thin and browned at the edges, the script tight and careful. In the lower margin a thin, bone‑coloured figure moved beside the text, the familiar danse‑macabre flourish scribes added out of habit, no more meaningful than a decorative knot.
The Latin was as Murner had described. Correct, precise, and somehow airless — the Latin of a man, or something that wrote like a man, that had learned the language perfectly and understood none of its music. He had read legal documents with more warmth. But the content…
He read slowly. Then he went back and read again.
The mechanism of disease described in the first pages was not the mechanism he had been taught. It was not the mechanism anyone had been taught, as far as he knew. It spoke of agents too small to see — he paused on this, read it three times, accepted it and moved on the way he had learned to accept difficult diagnoses — that entered the body through specific channels and multiplied within it according to specific rules. It spoke of the body’s response to these agents as a form of memory. Not thought. Not humour or spirit or divine intervention. Memory. The body, once exposed to a thing, remembered it. And remembering, resisted.
It was, he thought, the most terrifying thing he had ever read. Not because it was wrong. Because he could not find a place where it was wrong.
The preparation was described in the middle section with a precision that made Murner’s letters look like approximations. Which, Sattler now understood, they were. Murner had done his best with the instructions and his best had been extraordinary — a man of the fifteenth century reading a text written in no century he could identify, implementing a procedure for which he had none of the necessary tools or understanding, and getting close enough to right that some people had been genuinely protected.
Close enough to right. Not right.
The error was in the margins.
He almost missed it — a note in that second hand Murner had described, cramped and precise, in Latin that was subtly different from the main text. Older, he thought, or perhaps just written by someone for whom Latin was even less natural than it was for the primary author. He had to tilt the page toward the candle to read it.
The interaction with prior resistance is not accounted for in the base preparation. Those who have survived previous exposure carry a modified response. In these subjects the preparation does not teach. It conflicts. The result is neurological. We have observed this in previous iterations. It must be corrected before distribution. This is the third notation of this error.
Sattler read it twice. Then he sat back in his chair and looked at the ceiling of Anna Schreiber’s kitchen for a long time.
The third notation.
He looked at the margin again. Below the note, in the same hand, were two dates. Just the years. Nothing else.
1212. 1284.
He thought about children marching toward a sea that would not part. He thought about a piper and a hillside and a town that woke one morning to silence. He thought about the dancing plague of 1374 and the bodies along the Rhine. He thought about whoever had written that marginal note — calmly, precisely, the way a physician notes a complication — and had written it not once but three times across three centuries and had apparently not stopped trying.
“Frau Schreiber,” he said, without looking away from the ceiling. “Do you know where this manuscript came from before the Freiburg physician?”
“No.”
“Do you know how old it is?”
A pause. “Heinrich tried to establish that. He could not.”
Sattler nodded slowly. He looked back down at the manuscript. At the end of the final page, below the last line of the preparation’s instructions, there was one more marginal note. He had not seen it before — it was small, almost flush with the binding, easy to miss.
It was not in Latin.
He did not recognise the script. He was an educated man — he had Greek, he had some Hebrew, he had passing familiarity with Arabic letterforms from his study of Ibn Sina. This was none of those things. It was precise and regular and utterly foreign and it was clearly, unmistakably, a script designed to carry meaning.
He stared at it for a long time.
Then he closed the manuscript carefully and placed it on the table and looked at Anna Schreiber.
“Murner was right,” he said. “The principle is sound. The preparation works. The error is identifiable and in theory correctable.” He paused. “Someone knew this before Murner. Long before Murner. Someone has been attempting this for at least three hundred years and possibly considerably longer.”
Anna Schreiber looked at him without expression. “And the dancers?”
“The dancers,” Sattler said carefully, “are the proof that the principle works. They received the preparation. Their bodies responded to it. The response is catastrophic and it is killing them, but it is a response — a specific, identifiable, biological response to a specific intervention.” He heard his own voice as if from a distance, steady and clinical, the voice he used when the diagnosis was very bad and the patient needed him not to flinch. “They are not cursed. They are not punished. They are not mad.”
He looked at the manuscript on the table between them.
“They are the third attempt,” he said. “And whoever is making these attempts has been noting the error for three hundred years and has not yet managed to correct it.”
Outside, distantly, the feet scraped on the cobblestones. Sattler listened to them for a moment — that rhythm with no regard for any music offered to it, following something nobody else could hear — and felt, for the first time since he had entered the Pfennigturm square, that he understood what he was listening to.
Not madness. Not God’s punishment. Not the vengeance of Saint Vitus.
A message. Sent by something with the patience of centuries, to bodies that could almost but not quite receive it. The dancers were not following music.
They were trying to answer it.
V. What Remains
The report Sattler delivered to Sebastian Brant on the morning of the tenth of August was four pages long, written in his clearest hand, and contained almost none of what he knew.
It described the dancing sickness as a fever of the blood, origin uncertain, likely exacerbated by the heat and the prevailing conditions of want and anxiety that had burdened Strasbourg’s poor for three consecutive years of failed harvest. It recommended isolation of the afflicted, cessation of the musical accompaniment that had demonstrably worsened the contagion, and a ban on public dancing. It said nothing about Conrad Murner. It said nothing about apothecary preparations distributed through the Rhine valley twenty years ago. It said nothing about a manuscript written in no hand he could identify, in a script that belonged to no language he had ever encountered, with marginal notes spanning three centuries of failed attempts to save human lives.
He was not a coward. He had thought carefully about this.
A physician in Strasbourg in 1518 who presented the city council with evidence of a non-human intelligence attempting to inoculate the population against plague across multiple centuries would not be heard. He would be burned, or he would be committed, or — most likely — he would simply be ignored, which was in some ways worse. The manuscript would be destroyed. The letters would be destroyed. The error that had now been noted three times in those cramped precise margins would remain uncorrected for another generation, or another century, and whatever was making these attempts would make them again into a world that still lacked the framework to receive them.
He had one advantage that the author of those marginal notes apparently did not. He was here. He was inside the time in question. He could read the manuscript and he could read Murner’s letters and he could hold both against each other and see, with the clarity of a man who had spent twenty years looking for patterns in suffering, exactly where the calculation had gone wrong.
The interaction with prior resistance. Those who had survived previous exposure. The preparation did not teach them. It conflicted.
It was, in the end, a problem of dosage and sequencing. Murner had understood the principle and misread the instruction. The manuscript’s Latin was flat and precise and translated imperfectly into the assumptions of a fifteenth-century physician. Murner had done what any man of his training would do — he had interpreted the text through what he already knew, and what he already knew was not enough, and people had died for the gap between the two.
Sattler had spent three nights at Anna Schreiber’s table, with the manuscript open beside Murner’s letters, working through the preparation step by step. He had Heinrich Schreiber’s stock still in the back room — old, some of it degraded, but enough to work with. He had his own training. He had, more importantly, the error itself, noted in the margin in that cramped second hand, which told him not just that the mistake had been made but approximately where to look for it.
He thought he could correct it.
He was not certain. He was a physician in 1518 with no understanding of the mechanisms the manuscript described, working from a text he could only partially interpret, attempting to repair the work of a dead genius who had himself only partially interpreted it. The probability of success was not something he could calculate. But the probability of anyone else attempting it, in this century or the next, seemed to him considerably lower.
He had made Anna Schreiber a promise. He had told her what he intended and she had looked at him for a long moment with those steady unsentimental eyes and then she had said: Heinrich would have wanted this. Which was not quite the same as saying she wanted it, but was enough.
Art by CoPilot AI
The dancers were gone from the Pfennigturm square by the time he walked back through it on the evening of the tenth. Some had collapsed and been carried home. Some had been transported, per Brant’s eventual decree, to the shrine of Saint Vitus on the hilltop, where the priests had given them red shoes sprinkled with holy water and crosses drawn in consecrated oil, and had prayed over them in Latin, and where — whether through divine intervention or simple exhaustion or the mercy of cooler air at altitude — some of them had stopped. Old Georg Kessler had died four days ago. The girl with the formidable eyes had survived. He did not know yet what that meant, medically speaking. He intended to find out.
He stood in the empty square for a while. The cobblestones were worn smooth where the feet had been. Someone had removed the stage the musicians had played on. There was no sign remaining of what had happened here except the worn stones and a single shoe, small, a child’s, abandoned at the edge of the square near the fountain.
He thought about 1212. He thought about 1284. He thought about whoever had written those dates in the margin and what it meant to attempt something across such an expanse of time — to fail, and note the failure, and wait, and try again. He did not know what that entity was. He did not think he had the vocabulary to know, or that the vocabulary existed yet in any human language. He knew only that it was trying to do what he was trying to do, which was to keep people alive in the face of a disease that did not care about them at all.
He found, to his surprise, that he felt something close to kinship with it.
Art by CoPilot AI
He picked up the child’s shoe and set it on the edge of the fountain so that whoever had lost it might find it again. He stood there for a moment. It was a small thing. It was not nothing. He did it carefully, the way you do something when it is the only thing left to do for a person, and you know it, and you do it anyway. Then he walked back through the Kronenburg Gate toward the Gerbergasse, with the manuscript under his arm and Murner’s letters in his bag and a head full of calculations he would not share with anyone alive.
Behind him the square was silent. The stones remembered the rhythm for a while longer — or perhaps he only imagined that — and then the city settled back into its ordinary noises, the river and the tanneries and the distant sound of the cathedral bell counting out the hours, and Strasbourg went on the way cities do, carrying its dead and its living together in the same narrow streets, not knowing the difference.
Published on the anniversary of Ronald Reagan’s death, and in memory of my friend Kate Doolan, who was an enthusiastic student/author of US and NASA history.
Those of us who lived through the 1980s might remember them fondly despite ourselves. It was the decade when hippies became yuppies, when “greed is good” stopped being a punchline and started being a philosophy. The stock market report appeared on the nightly news for the first time, as though share prices were suddenly everyone’s business. A fictional teenager named Alex Keaton — conservative, ambitious, briefcase-toting — became one of the most beloved characters on US television, and audiences on both sides of the Pacific adored him.
The actor who played him, Michael J. Fox, also played Marty McFly — a kid who travels back to the 1950s and finds it charming, wholesome, and full of promise. Back to the Future was the highest-grossing film of 1985. It also contained one of the decade’s quieter jokes: when Marty tells Doc Brown, living in 1955, that the President of the United States in 1985 is Ronald Reagan, Doc Brown reacts with comic disbelief. An actor? President? Impossible.
US audiences laughed, then went home to a country where it was true.
What neither Marty nor the decade’s nostalgia registered was what else the 1950s contained: McCarthyism, segregation, the systematic exclusion of women and other marginalised groups from public life, and a conformity enforced by fear. The past looked wonderful only once you’d edited out everyone it had harmed. That selective memory wasn’t a movie plot. It was a deliberate political choice.
The mood crossed oceans: Thatcher caught it in Britain; Jeff Kennett in Victoria caught it too, dismantling public services with the same breezy conviction that government was the obstacle rather than the solution. Reagan didn’t just reshape the USA; he exported a worldview: one built on the promise of restoring a greatness that had somehow been stolen and could be reclaimed. Versions of Reaganomics surfaced elsewhere: Thatcher in Britain, Mulroney in Canada, Kennett in Victoria, and Rogernomics in New Zealand, each advancing the same conviction that government was the problem and the past held the answers.
This piece asks what that worldview cost. Not to fight old battles or mock the people who found it genuinely hopeful — many did, reasonably — but because the bill from those choices is still arriving, and it helps to understand who is paying for it.
The Myth Before the Reckoning
Ronald Reagan’s presidency is often remembered as an era of renewal: the optimism, the rhetoric, the promise of a “shining city on a hill.” But the reality beneath the mythology tells a different story. His administration marked a decisive turn in US life, away from collective responsibility and toward a politics built on deregulation, moral panic, religious nationalism, and the erosion of public institutions.
The consequences did not end with the 1980s. They shaped the economic, cultural, and political landscape that produced the crises of the twenty‑first century, culminating in the rise of Trumpism. This is the story of how decline begins long before anyone notices it happening.
When Ronald Reagan died in 2004, the obituaries were reverential. The New York Times described him as a leader who “restored the nation’s confidence” and embodied a uniquely American optimism. The Guardian called him “the great communicator,” a president whose genial style reshaped the political landscape. Across memoirs and retrospectives, Reagan was celebrated as the man who won the Cold War, revived the economy, and rekindled national pride.
Even his critics often conceded the power of his image: the Hollywood polish, the reassuring voice, the fantasy of a country made whole again — a sentiment that would later return in a cruder form under a different president. Over time, Reagan became less a political figure than a national myth, invoked by those who longed for a simpler, more certain America.
From Hollywood to White House (Art by CoPilot AI)
But mythology is not memory. And the record beneath the glow tells a different story. Behind the rhetoric of renewal lay policies that reshaped the country in ways that were less visible at the time but far more consequential: the dismantling of public institutions, the rise of moral panic as governance, the retreat from civil rights, the fusion of religion and politics, and the elevation of ideology over evidence.
This article looks past the eulogies. It examines the structures Reagan weakened, the movements he empowered, and the long tail of consequences that stretched far beyond the 1980s — consequences that shaped the crises of the twenty‑first century and helped pave the way for Trumpism. To understand the present, we must first look clearly at the past, without the soft focus of nostalgia.
The Economic Pivot That Broke the Middle Class
From the 1940s through the 1970s, the United States built a broad middle class through strong unions, high taxes on the wealthy, public investment, and a robust social safety net. Inequality shrank. Mobility rose. Life expectancy climbed.
By the late 1970s, the economy faltered — and voters turned against the postwar consensus.
Reagan promised renewal. What he delivered was decay.
He slashed taxes on the rich and corporations, gutted regulations, weakened antitrust enforcement, and championed supply‑side economics — the idea that prosperity would “trickle down.”
It didn’t.
To be fair to Reagan’s supporters, the stagflation of the late 1970s was real and painful. Carter-era interest rates crushed small businesses and family budgets. Something had to change, and the argument for deregulation and tax cuts was not irrational given that context. The tragedy is not that people believed it, it’s that the evidence since has been so consistently disappointing, and the promised correction never came.
Recent analysis underscores how deep this rupture ran. As The Atlantic observes, the broad middle‑class prosperity of the mid‑twentieth century was not organic or inevitable; it was the product of deliberate New Deal structures that “made the middle class possible.” Those foundations began to erode in the late 1970s and were aggressively dismantled under Reagan, accelerating a shift toward a winner‑take‑all economy. What followed was a slow, measurable collapse in mobility, wage stability, and shared prosperity — a trajectory that continued across subsequent administrations and helped create the political volatility that later defined the Trump era.
Inequality soared. Living standards stagnated. Life expectancy fell behind peer nations. No other advanced economy pivoted so sharply to free‑market ideology, and none experienced such a dramatic reversal in mobility and public health.
A child born today in Norway or the United Kingdom has a far better chance of outearning their parents than a child born in the United States.
Reagan’s economic worldview did not stop at US borders. Through the influence of the IMF and World Bank, it became the backbone of what economists later called the Washington Consensus: a global program of deregulation, privatisation, weakened labour protections, and shrinking public sectors. Throughout the 1990s and early 2000s, these policies were imposed on developing nations as conditions for loans and debt relief, reshaping economies from Latin America to Eastern Europe. The result was a worldwide shift toward market fundamentalism whose social consequences — rising inequality, fragile public institutions, and declining mobility — echoed the trajectory already unfolding in the United States.
This was not an accident. It was a choice — and it reshaped economic realities.
The Educational and Civil Rights Retreat
Reagan’s hostility to public education was ideological, not fiscal. He viewed schools as battlegrounds for moral instruction, not engines of equality. His administration pushed for a return to “traditional values,” aligning with organisations like the Heritage Foundation and the Family Research Council.
He attempted to dismantle the Department of Education entirely — a department originally created after the Civil War to educate formerly enslaved people, and revived in 1979 to enforce civil rights and equal access. Historical documentation confirms this origin and purpose.
Reagan’s administration:
undermined desegregation orders
opposed affirmative action
intervened in court cases to dismantle busing
weakened federal civil rights enforcement
In 1982, the U.S. Commission on Civil Rights accused the administration of deliberately retreating from the nation’s commitment to educational equality. Commissioner Clarence Pendleton warned that Reagan’s policies would “lead us back to a separate‑but‑equal society.” He was right.
The Human Cost Reagan Ignored
Reagan’s response to AIDS cannot be separated from his administration’s broader hostility toward LGBTQ+ people. The Religious Right had already framed queer existence as a moral threat (Britannica overview), and the White House absorbed that framing through silence and omission. By the time Reagan first mentioned AIDS publicly in 1985, thousands of gay men had already died (ACT UP timeline). Funding was delayed, warnings were dismissed, and public health was subordinated to the culture‑war belief that some lives fell outside the nation’s moral concern — a belief rooted in Christian nationalism and the New Right coalition that shaped the administration’s moral priorities.
Reagan’s presidency unfolded against a widening social divide. His administration cast poverty as a matter of personal failure rather than structural neglect, attacking welfare programs while cutting the supports that kept millions afloat. His cuts to mental‑health funding deepened the emerging crisis of homelessness, shifting care from hospitals to the streets and, eventually, to prisons. The rhetoric of “welfare queens” and “dependency” hardened public attitudes and narrowed the nation’s moral imagination. By the mid‑1980s, homelessness surged, child poverty rose, and the social ideals that had defined the postwar decades began to fray.
The administration’s “Just Say No” campaign reduced addiction to a matter of personal virtue, treating drug use as a moral failure rather than a public health issue. It ignored structural causes — poverty, trauma, lack of treatment — and reinforced the punitive logic of the War on Drugs (DEA historical overview). The irony grew sharper as Reagan himself began to show signs of cognitive decline, later diagnosed as Alzheimer’s disease (New York Times), while Nancy Reagan’s reliance on prescription medications was widely discussed in Washington (Washington Post). The rhetoric of purity masked a reality of dependency and deterioration. What the campaign offered was not policy but performance: a moral narrative that justified punishment while deflecting attention from the social conditions that made addiction a crisis in the first place.
As AIDS spread through communities already pushed to the margins, the White House remained silent. For years, tens of thousands died without acknowledgement from the president. Public health agencies were constrained. Funding lagged. Activists begged for action while the administration treated the crisis as a moral problem rather than a medical one.
“By the end of 1989 and the Reagan years, 115,786 women and men had been diagnosed with AIDS in the United States, and more than 70,000 of them had died.” — ACT‑UP
Writer and activist Larry Kramer captured the fury of those years with devastating clarity. In a 1988 speech, he said: “Our government has the blood of thousands on its hands. Ronald Reagan is responsible for more deaths than any president in history.” (Village Voice)
It was not until April 2, 1987 — deep into his second term — that Reagan finally addressed AIDS publicly. Even then, he used the moment not to mobilise resources or acknowledge the scale of the crisis, but to moralise:
“How that information is used must be up to schools and parents, not government… AIDS information can not be what some call ‘value neutral.’ After all, when it comes to preventing AIDS, don’t medicine and morality teach the same lessons.”
This was the truth about his presidency: suffering was a moral failure, public health was a matter of personal virtue, and government intervention was suspect unless it enforced traditional values. The result was predictable and devastating. A generation was lost. Trust in public institutions collapsed. And the administration’s silence became part of the tragedy itself — a political choice that allowed a preventable catastrophe to deepen unchecked.
The Rise of the Religious Right and the Culture Wars
Reagan’s presidency cemented the alliance between conservative politics and evangelical Christianity. He recognised the growing electoral power of the Religious Right and aligned himself with its agenda. In return, he championed:
opposition to abortion
prayer in public schools
“traditional family values”
the moralisation of public policy
The most influential of these groups was Jerry Falwell’s Moral Majority, founded in 1979. It mobilised millions of conservative Christians around a narrative that framed social change as moral decline. Alongside the Southern Baptist Convention and the broader New Right coalition, it provided the organisational machinery that powered Reagan’s rise and reshaped the Republican Party.
This movement did not emerge in a vacuum. It was built on the demographic realignment produced by the Southern Strategy — a political shift that drew white evangelicals into the Republican coalition through appeals to cultural grievance, states’ rights, and racialised moral panic. Together, these forces created a durable political bloc that fused religious identity with conservative governance.
Reagan often grounded his politics in explicitly religious terms. He praised the Ten Commandments as superior to “millions and millions of laws,” presenting them as the foundation of legitimate governance. This was not a neutral appeal to heritage; it was a declaration that public policy should reflect a specific religious morality.
This was not a neutral appeal to tradition. The Ten Commandments, examined objectively, are a narrower moral framework than the civil and human rights principles democracies have spent centuries building through careful, methodical debate and reason. Invoking the Ten Commandments was a political claim about whose values counted… and whose did not.
This merger of religion and conservative politics laid the groundwork for the culture wars that define US politics today. Attacks on LGBTQ+ people, bans on teaching Black history, and the policing of gender and sexuality all trace their lineage to this moment. Reagan mainstreamed a form of Christian nationalism that would later become a defining force in the Republican Party.
The culture wars did not begin with Trump. They began with Reagan. His moral politics reshaped the nation’s cultural landscape, and the consequences of that ideology soon collided with science, engineering, and public safety — with catastrophic results.
This moralised worldview extended into foreign policy. Reagan cast global conflict as a struggle between righteousness and evil, solvable through willpower, military spending, and technological spectacle. The Strategic Defense Initiative, quickly nicknamed “Star Wars”, promised a missile shield that physicists warned was unworkable. It glamourised Hollywood‑style sci‑fi militarism and absorbed billions of dollars that could have strengthened social programs hollowed out by budget cuts. SDI functioned less as a defence system than as an ideology: a belief that US ingenuity could override scientific limits. The diversion of resources and attention into an unworkable fantasy reflected the same confidence in story over evidence that would soon collide with the realities of engineering and risk.
Reagan, Abortion, and the Politics of Selective Morality
Reagan’s stance on abortion is one of the clearest examples of the selective moral framework that defined his presidency. As governor of California, he signed the 1967 Therapeutic Abortion Act — at the time one of the most liberal abortion laws in the United States. Yet by the early 1980s, he had become the political figurehead of the anti-abortion movement.
This shift was not theological; it was strategic. It aligned him with the Religious Right and the broader New Right coalition, which framed abortion as the central moral crisis of modern America. Reagan’s 1983 book, Abortion and the Conscience of the Nation, became a foundational text for the movement. In it, he argued that abortion represented a national abandonment of moral responsibility — a claim that mirrored the rhetoric of the Moral Majority and the Southern Baptist Convention.
The contradiction was stark. Reagan defended the sanctity of “innocent life” while supporting the death penalty, a position that exposed the selective nature of his pro-life stance. Life was protected only within certain moral boundaries; outside them, the state retained the right to kill. This was not a universal ethic but a political theology shaped by the Southern Strategy and the rise of Christian nationalism.
The anti-abortion movement that Reagan championed was never solely about the protection of life. It was a mechanism for defining who counted as morally legitimate, and who did not. This narrowing of the moral circle would have profound consequences for public health, civil rights, and the federal response to emerging crises. It set the stage for the administration’s catastrophic inaction during the AIDS epidemic and shaped the culture-war politics that followed.
January 1986: The Challenger Disaster and Reagan’s Denialism
Challenger mission patch (NASA photo)
On 28 January 1986, the Space Shuttle Challenger broke apart just 73 seconds after launch, killing all seven crew members. That evening, President Reagan addressed the nation, closing with a line from John Gillespie Magee Jr.’s wartime poem High Flight: they had “slipped the surly bonds of earth… and touched the face of God.”
What Reagan did not acknowledge was the context behind the tragedy. Engineers at both NASA and Morton Thiokol had warned that the freezing temperatures made the launch unsafe, with the O‑rings at risk of catastrophic failure. Their concerns were overruled by management under schedule pressure and political expectations.
Reagan framed the disaster as an act of fate rather than the result of ignored science. He did not address his administration’s broader pressure on NASA to maintain an aggressive launch schedule, nor the culture that prioritised political optics over engineering judgement.
His refusal to confront the systemic causes of the disaster foreshadowed a larger pattern: the elevation of ideology over evidence, the sidelining of experts, and the denial of responsibility. The Challenger explosion became a grim metaphor for the trajectory of his own nation: a system pushed beyond its limits, warned repeatedly, and ultimately undone by choices its leaders refused to face.
The Challenger disaster was not an isolated failure. It was an early warning of a political culture that would, decades later, embrace conspiracy, reject expertise, and elevate ideology over evidence.
This is perhaps the most politically neutral tragedy in Reagan’s record, because it transcends ideology. The engineers who raised alarms were not liberals or conservatives; they were professionals doing their jobs, and they were overruled by institutional pressure and schedule politics. Any honest conservative who believes in competence, accountability, and getting things right should find the management failures here as troubling as any critic does. The Rogers Commission report, which Reagan himself commissioned, confirmed everything the engineers had warned. Credit where it is due: he ordered that inquiry. But the culture that silenced those engineers predated the disaster and outlasted it.
What Reagan Got Right — And Why It Makes the Failures Harder to Accept
Before tracing that long tail of consequences, honesty requires a pause.
Reagan restored a genuine sense of national confidence after the malaise of the late 1970s, and that mattered. His rhetorical optimism was not purely cynical — many who knew him personally attested to his sincere belief in America’s promise. The Cold War did end on his watch, and while historians debate how much credit he deserves, his willingness to negotiate directly with Gorbachev in his second term showed more pragmatism than his rhetoric suggested. These things are real.
Which is precisely why the failures cut so deeply. A presidency with genuine strengths that nonetheless chose to ignore the AIDS crisis, silence its own engineers, and build an economic model that hollowed out the working class it claimed to champion… that is a more troubling legacy than simple villainy would be. Villainy is easy to dismiss. Wasted potential is not.
It is because these genuine achievements existed that the longer legacy demands such careful examination — because a presidency capable of real vision was also capable of choices whose consequences are still unfolding.
The Long Tail: From Reagan to MAGA and RFK Jr.
Reagan’s legacy is not confined to economics or education. It extends into the collapse of public trust, the rise of conspiracy culture, and the erosion of democratic norms.
Reagan’s own relationship to science was uneasy. After the 1981 assassination attempt, Nancy Reagan began consulting astrologer Joan Quigley to advise on the president’s schedule, travel, and public appearances, a practice later confirmed by former Chief of Staff Donald Regan in his memoir and reported widely in the press. Decisions about timing and security were sometimes shaped not by intelligence briefings or expert risk assessments but by astrological charts. It was an early sign of a political culture willing to subordinate evidence to belief; a pattern that would deepen across the decades and culminate in today’s conspiracy‑driven attacks on science and public health.
By the time Donald Trump entered politics, the ground had already been prepared. Trump did not invent this worldview. He inherited it.
The modern anti‑science movement — antivax conspiracies, climate denial, attacks on public health — is part of this lineage. The appointment of Robert F. Kennedy Jr. to oversee U.S. health policy is not an anomaly. It is the predictable outcome of decades spent undermining expertise and elevating ideology over evidence.
Reagan set the direction. Trump revealed the destination.
The Anti‑State Doctrine: From Reagan’s Smile to Trump’s Hostility
Reagan entered office declaring that “government is the problem,” a line that reshaped American political identity. His administration weakened regulatory agencies, cut public services, and framed civil servants as obstacles rather than guardians of the public good. This rhetoric did not merely shrink government; it delegitimised it.
He reinforced this worldview through appointments designed to undermine the missions of their own agencies: James Watt at Interior, Anne Gorsuch at the EPA, Clarence Thomas at the EEOC. Their mandate was not stewardship but dismantling. Legal scholarship documents this strategy.
Trump inherited this anti‑state doctrine and intensified it. Where Reagan weakened institutions through policy, Trump attacked them directly: the “deep state,” the FBI, the CDC, the courts, the press. Inspectors general were purged, scientific agencies pressured, and loyalty demanded over competence.
The result is a nation where public institutions are no longer seen as shared assets but as partisan battlegrounds; a political culture that began with Reagan’s casual distrust and matured into Trump’s open hostility.
This attitude resurfaced a generation later when Trump promised to “drain the swamp” and cut foreign aid on the false grounds of corruption and fraud, continuing the same anti‑state narrative Reagan had normalised.
The Information War and the Rise of the Leader‑Cult
Reagan mastered the art of media control. His administration restricted access, staged photo opportunities, and bypassed critical journalists through friendly outlets. The press was framed as elitist and out of touch — a soft war waged with charm and discipline.
Trump escalated this into open conflict: “fake news,” “enemy of the people,” banned reporters, and disinformation as strategy. Where Reagan cultivated distrust, Trump weaponised it.
Reagan also pioneered the modern Republican personality cult. His image — the cowboy, the optimist, the father‑figure — became a political brand. The “Reagan Revolution” was not just policy; it was identity.
Trump inherited a party already primed for leader‑worship and amplified it into a movement defined by personal loyalty rather than principles or institutions. The shift from party to persona — from ideology to identity — began with Reagan’s mythmaking and culminated in Trump’s grievance‑driven cult of personality.
The Legacy: From Reagan to Trump: The Downfall of the USA
Reagan claimed credit for the collapse of the Soviet Union, a superpower that ultimately fell under the weight of its own internal decay rather than any external triumph. In doing so, he overlooked the uncomfortable truth that he had set his own nation on a similar path.
The United States did not collapse suddenly. It declined through a series of deliberate choices: to deregulate, to defund, to divide, to moralise, to privatise, to forget.
Reagan accelerated the shift. Trump completed it.
The downfall was not a moment. It was a trajectory — one that began with a president who preached morality while ignoring suffering, who dismantled the institutions that held the country together, and who empowered a movement that would one day turn against democracy itself.
The consequences are now visible: a nation fractured, mistrust entrenched, public health weakened, and a political culture defined by grievance, conspiracy, and fear.
By Emile Prisse (1878) , digitally enhanced by rawpixel.
The United States built something remarkable in the mid-twentieth century: broad prosperity, rising life expectancy, a growing middle class. That was not a left-wing achievement or a right-wing one. It was a national one. The argument here is simply that the choices made from the 1980s onward eroded it — and that naming that clearly, across partisan lines, is the first step toward rebuilding it.
The thought was already forming in my mind in 1988, while visiting Britain, standing among the remains of a late‑Roman villa dating from the early fourth century — the final decades before Rome withdrew its legions and left its provinces to fend for themselves. I tried to imagine the villa’s last occupant watching the departing ships, knowing he lived on the edge of an empire collapsing from internal decay. Then and there, I recognised the same pattern across the Pacific: a modern empire beginning its own long decline for many of the same reasons — rot from within, and a trajectory no individual could likely alter.
Reagan promised a shining city on a hill. Then he began to extinguish its lights.
Centers for Disease Control and Prevention. “HIV and AIDS — United States, 1981–2000.” CDC, 2000.
Chetty, Raj, et al. “The Fading American Dream: Trends in Absolute Income Mobility Since 1940.” Science, vol. 356, no. 6336, 2017. https://doi.org/10.1126/science.aal4617
Committee to Protect Journalists. “Trump’s Attacks on the Press.” CPJ, 2020.
Congressional Research Service. “Removal of Inspectors General: Legal Issues.” CRS, 2020.
Published in the lead-up to commemorate Africa Day on 25 May
by Charity Austin
Charity is an activist, writer, and community leader, and the founder of Trans Inclusion Group (formerly Trans Initiative Gorom). Her work focuses on human rights, social justice, displacement, resilience, and amplifying marginalized voices through storytelling and advocacy. Through her writing and activism, she brings attention to the lived experiences, struggles, and resistance of LGBTQ+ communities in East Africa.
Kakuma (photo supplied)
For many people living safely in wealthy countries, foreign aid may sound like a political debate or a government budget issue. But for refugees in Africa, especially LGBTQ+ refugees, foreign aid is often the difference between life and death.
Under the U.S. administration led by President Donald Trump, major changes to foreign aid and humanitarian funding have been introduced. One of the most significant shifts has been the restructuring and severe reduction of the United States Agency for International Development (USAID), which was formerly the world’s largest foreign aid agency. In 2025, USAID’s operations were significantly cut back, with many of its functions reduced or transferred into other government structures, including the U.S. State Department.
For refugee communities across Africa, these changes have had immediate and life-threatening consequences.
In already under-resourced refugee settlements, people are now facing even deeper shortages of food, clean water, shelter, and essential medical care. For transgender refugees and other LGBTQ+ people, who already experience discrimination and exclusion within these systems, the impact has been especially severe.
Reality on the Ground
According to Trans Inclusion Group (TIG), a trans-led initiative supporting LGBTQ+ refugees in displacement, reduced humanitarian funding has directly worsened the living conditions of transgender refugees who rely on aid programs for survival.
Many transgender refugees live with HIV/AIDS and depend entirely on donor-funded clinics and humanitarian health programs for antiretroviral medication. When funding is reduced or programs are disrupted, access to treatment becomes unstable. Missing medication is not a minor interruption—it is life-threatening.
The mental health impact has also been devastating. Many LGBTQ+ refugees fled persecution, violence, and arrest in their home countries, only to find themselves trapped in overcrowded and unsafe refugee settlements where protection is limited and stigma is widespread.
At the same time, reductions in refugee resettlement pathways to the United States have worsened the crisis. For many LGBTQ+ refugees facing ongoing threats, resettlement is not a privilege, it is often the only route to safety. When these pathways are slowed or suspended, people remain stuck in dangerous environments with no realistic exit.
Some transgender refugees previously escaped extreme violence in places such as Kakuma Refugee Camp in Kenya, hoping for safety through resettlement programs. Instead, many now remain stranded in other settlements with shrinking international support and increasing vulnerability.
These policy decisions are not abstract. They directly determine whether a person receives HIV medication, whether someone eats that day, or whether a refugee survives another attack.
For many refugees in Africa, daily life is already a struggle for survival. Reducing humanitarian funding and restructuring key aid institutions like USAID only deepens that crisis.
Trans Inclusion Group (TIG) continues to highlight these realities and calls for urgent international attention, renewed funding, and stronger protection mechanisms for LGBTQ+ refugees who are being left behind in global policy shifts.
LGBTQ+ refugees deserve dignity, healthcare, protection, and the chance to live safely. Their lives should never be treated as collateral damage in political decisions about foreign aid.
“I was thirsty”
In Kakuma refugee camp (Kenya), water has become a daily struggle for many refugees following cuts to humanitarian support. These photos capture people digging into dry ground in search of water, filling jerrycans by hand because formal water systems are under severe strain. With reduced USAID funding affecting essential services, families are forced to spend hours searching for unsafe and scarce water sources just to survive. Access to clean water is not a privilege, it is a basic human right.
Searching for water in Kakuma (photos supplied)
I can personally testify that this crisis is real because I experienced it myself together with other transgender refugees before being resettled. In Kakuma refugee camp, there were days when my friends and I would wake up very early and spend hours searching for water because the normal supply points had run dry or were overcrowded. Sometimes we had no choice but to dig shallow holes in the ground and wait for dirty water to collect so we could fill our jerrycans. The water was often unsafe, but when people are desperate, they use whatever they can find. For transgender refugees who already faced discrimination, violence, and exclusion inside the camp, the struggle for clean water became even more dangerous and exhausting.
(Photo supplied)
This situation is not only happening in Kakuma. Many transgender refugees in Gorom refugee settlement in South Sudan are also facing severe water shortages and humanitarian neglect. People walk long distances under extreme heat just to access a small amount of water for drinking, cooking, and bathing. In some cases, refugees are forced to rely on unsafe water sources – even from swamps – that expose them to disease and other health risks. These experiences show that the humanitarian crisis affecting transgender refugees is not abstract — it is happening to real people every day, across different refugee settlements, where survival itself has become a daily struggle.
Human Stories, Not Statistics
For many transgender refugees, the impact of aid cuts is not just political, it is deeply personal and life-threatening
One transgender woman living in the refugee camp had been relying on antiretroviral medication (ARVs) to manage HIV and stay healthy. But when she recently went to the clinic for her routine refill, she was told that the medication was no longer available. With humanitarian health services under strain and supplies running low, she returned home without the treatment she depends on to survive. She now lives in fear, uncertain when or if she will be able to access the medicine again.
I also have a friend who stopped taking the ARVs he had before the aid was cut, because he wasn’t sure that he would get another dose of medication.
Trans Inclusion Group advocates for queer refugee safety
Such stories reflect the reality facing many vulnerable refugees whose lives depend on consistent medical care. For transgender refugees, accessing healthcare is already difficult because of stigma, discrimination, and insecurity inside refugee settlements. Now, with funding cuts affecting clinics and humanitarian programs, many are being pushed into even more dangerous situations. These are not just statistics or policy discussions — they are real people losing access to food, clean water, and lifesaving medication every single day.
Looking the Other Way
Searching for water (photo supplied)
What makes this situation so painful is that these decisions were made by political leaders and administrations who chose to cut foreign aid despite knowing that millions of vulnerable people depend on that support to survive. The reduction of humanitarian assistance under the Trump administration has had devastating consequences for refugees already living in desperate conditions. Today, people are struggling to access food, clean water, shelter, and lifesaving medication, and many feel abandoned by the very countries and leaders that had the power to help.
I have painful news for those who made these decisions: people are now dying because of these cuts. Refugees who were already vulnerable are being pushed beyond their limits, with some unable to access medicine, food, or safe water. For refugees, this is not a political argument — it is about survival. The suffering taking place in refugee communities is real, and the world should not look away from the human consequences of these decisions.
Refugee Rights
Read other human rights contributions from Charity:
Protection Briefing
Published: 20 December 2025
Protection Challenges and Advocacy Engagement for LGBTQ Refugees in Gorom Refugee Settlement, South Sudan
Kakuma Pride 2023
Published: 11 July 2023
A report from Kakuma Refugee Camp in Kenya, possibly the only refugee camp in the world to ever have a Pride March, brutally shut down by homophobic Kenya Police.