Ready: Community groups started farmers markets to address food deserts, places where people don’t have easy access to fresh, healthy food. One example is Double Up Food Bucks, which began in Detroit in 2009. It matches SNAP dollars spent on fruits and vegetables, helping families stretch their budgets while eating healthier. The program has since expanded across Michigan and into more than 25 states.

Set: These local efforts grew by connecting with federal programs. The 2014 Farm Bill created funding for nutrition incentives, and the USDA helped standardize things like SNAP payment systems at markets. Investments in tools like wireless EBT machines made it easier for vendors to accept SNAP, increasing access significantly.

Action: These programs work, but only if people know about them and can use them regularly. Next steps include expanding year-round access, improving outreach (especially in multiple languages) and securing stable funding so programs can last long-term.

Health Outcomes Impact: Programs like this help people buy more fruits and vegetables and improve overall diet quality. Longer participation is also linked to lower food insecurity.

Sources: (USDA, 2023); (USDA, 2019); (USDA, 2014); (USDA, 2021); (Congress.gov, 2026); (USDA, 2025); (NPR, 2014); (Fair Food Network, 2021); (Double Up America, 2023).

Ready: Syringe Services Programs (SSPs) began in the 1980s as grassroots efforts to stop the spread of HIV among people who inject drugs. Community members and public health workers recognized early on that providing clean syringes could prevent infections, even before there was widespread political support.

Set: Over time, strong evidence showed these programs reduce HIV and hepatitis C without increasing drug use. Many places began formally supporting SSPs and expanding services to include HIV testing, vaccinations, naloxone (to reverse overdoses) and connections to treatment. What started as small exchanges became full-service health hubs.

Action: Despite their success, SSPs still face barriers like stigma, legal restrictions and inconsistent funding, especially in rural areas. Expanding access, strengthening policies, and connecting these programs to treatment services are key next steps.

Health Outcomes Impact: Comprehensive SSPs are linked to about a 50% reduction in HIV and hepatitis C transmission among people who inject drugs. They are widely recognized as cost-effective and essential for disease prevention.

Sources: (HIVgov, 2019); (CDC, 2017); (NHRC, 2020); (CDC, 2024); (NOPN, 2020). 

Ready: In the late 1980s, during the height of the AIDS crisis, community activists formed ACT UP to demand faster access to treatment. At the time, drug approval processes were slow, and many people were dying without options. Activists pushed the government and pharmaceutical companies to act faster.

Set: Their efforts led to major changes. The FDA created “expanded access” policies so patients could try experimental drugs, and later introduced faster approval pathways for serious illnesses. These changes helped balance safety with urgency, and are still used today for diseases like HIV and cancer.

Action: Today, it’s important to keep these systems fair and effective. That means making sure clinical trials include diverse populations, keeping decisionmaking transparent and continuing to involve communities in the process.

Health Outcomes Impact: Once effective HIV treatments became widely available in the mid-1990s, AIDS deaths in the U.S. dropped sharply, by about 47% in just two years. Globally, HIV is now considered a manageable chronic condition for many people.

Sources: (CDC, 2001); (FDA, 2021); (HIV.gov, 2022); (ACLU, 2023)