Street Medicine, Health Equity, and Global Justice: An Interview With Dr. Tyler Evans
Author(s): Scott Douglas Jacobsen
Publication (Outlet/Website): The Good Men Project
Publication Date (yyyy/mm/dd): 2025/11/04
Tyler Evans, MD, MS, MPH, AAHIVS, DTM&H, FIDSA, is CEO, Chief Medical Officer, and Co-Founder of the Wellness Equity Alliance. A physician trained in infectious diseases and global health, he has dedicated his career to bridging medicine and justice. From the streets of American cities to conflict zones in Africa, his work challenges structural inequities that dictate health outcomes. He has led large-scale vaccination campaigns, advanced care for people living with HIV, hepatitis, and TB, and advocated for gender-affirming and migrant health access. He is the author of Pandemics, Poverty, and Politics: Decoding the Social and Political Drivers of Pandemics from Plague to COVID-19.
In this interview with Scott Douglas Jacobsen, Evans is an infectious disease physician and CEO of the Wellness Equity Alliance. His work spans street medicine, pandemic response, and global health equity, with a focus on HIV, hepatitis, TB, and gender-affirming care. He emphasizes justice-driven healthcare, human-centered emergency responses, and systemic reforms to dismantle barriers to access.
Scott Douglas Jacobsen: What first drew you to street medicine and health equity?
Dr. Tyler Evans: I started my career in some of the most resource-constrained environments in the world, and I saw how structural barriers, not biology, decide who lives and who dies. Street medicine is about flipping the script. Instead of asking people to come to systems that were never designed for them, we bring care directly to sidewalks, shelters, and schools. It is about justice as much as it is about medicine.
Jacobsen: How does that mission guide your daily decisions?
Evans: Every choice I make comes back to access. If a decision does not open a door for someone who has been historically locked out of care, it is probably not worth making. Health equity is not a line item in a budget. It is the filter I run every action through.
Jacobsen: From HIV to hepatitis C and TB, where are we losing ground?
Evans: We have the tools such as antivirals, direct-acting agents, and diagnostics, but we keep leaving people behind. Housing insecurity, incarceration, and stigma continue to fuel these epidemics. We do not fail because science falls short. We fail because our systems decide some lives are expendable.
Jacobsen: What lessons from vaccinating millions against COVID-19 should shape any of the next emergency responses?
Evans: Trust is as critical as the vaccine itself. You can airlift pallets of doses, but if communities do not trust the messengers, uptake will stall. During COVID, we saw that community health workers, local leaders, and grassroots partnerships moved the needle more than any federal press conference. The next response has to be human-centered, not just logistics-driven.
Jacobsen: Which policy changes would expand access to gender-affirming care?
Evans: We need federal protection that treats gender-affirming care as essential healthcare, not optional or elective. Insurance mandates, provider training requirements, and anti-discrimination enforcement must be codified. Otherwise, geography and politics will continue to decide whether someone can access life-saving care.
Jacobsen: How are health systems adapting to the needs of transgender and nonbinary patients?
Evans: Slowly, and often superficially. A rainbow on a hospital website does not mean much if intake forms still misgender patients or if there is no endocrinologist trained in hormone therapy within 200 miles. True adaptation means redesigning systems with trans and nonbinary voices at the table, not as afterthoughts but as architects.
Jacobsen: What practical steps reduce barriers for migrants, refugees, and people experiencing homelessness?
Evans: Three things: mobile care, legal protections, and cultural competence. If we do not meet people where they are, whether in encampments, detention centers, or border crossings, we miss them entirely. Pairing medical care with immigration advocacy and trauma-informed practices is what truly moves the needle.
Jacobsen: Your current work in the DRC focuses on women affected by conflict-related sexual violence. What mental-health supports actually work in that context?
Evans: Healing does not come from parachuting in Western models of therapy. What works is building layered systems of care such as peer support groups, trained community health workers, spiritual resources, and when available, formal counseling. Mental health in these contexts is not about erasing trauma. It is about restoring agency, dignity, and the possibility of a future.
Jacobsen: Thank you for the opportunity and your time, Dr. Evans.
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