Battles Won – and Lost – Against Aids Hold Valuable lessons for the management of Covid-19

World AIDS Day this year we are still deep in the midst of another pandemic – COVID-19.

The highly contagious new coronavirus swept across the world, destroying health systems and destroying economies when governments introduced drastic measures to curb the spread. Not since the HIV / Aids pandemic in the 1990s has countries had such a general threat to health.

This explains why UNAIDS chose the theme “Global solidarity, shared responsibility“for this year’s World Aids Day.

Infectious diseases like these remain a major threat to human health and well-being. Around 32.7 million people died of AIDS-related diseases in the last forty years. At the time of writing, 1.4 million people died of COVID-19 in just one year.

These diseases require incredible expertise, cooperation and dedication from all levels of society to detect, understand, treat and prevent.

The HIV / Aids response played out over a much longer trajectory than COVID-19. But it is in some ways an excellent example of what can be achieved if countries and people work together. The work of organizations such as the World Health Organization, UNAIDS and the International Aids Association helps coordinate rapid exchange of information and resources between healthcare providers and communities.

The Global Fund and PEPPAR mobilized resources that helped reduce diseases and deaths in low- and middle-income regions. AIDS-related deaths have decreased worldwide by 39% since 2010.

These and other groups have also fought against high drug prices that will make medicine inaccessible to many people in the developing world. In South Africa, the center of the HIV epidemic, a daily supply of the simplest antiretroviral drugs cost about R250 in 2002. Today easier, more palatable treatment taken once a day cost a few rand.

Collaboration and coordination have also led to medicines being developed and tested in populations around the world. And once available, global guidelines and training opportunities ensure that health care provision and quality are standardized.

Many of these achievements did not fight. Dedicated and sustained activism at the political and community level was necessary to reduce drug prices for the global South, and is constantly needed to ensure inclusive distribution of resources.

The conclusion is also true – areas where the world continues to struggle arise mainly where there is no lack of solidarity and agreement. This includes a lack of political support for the implementation of evidence-based protection mechanisms for vulnerable or stigmatized populations. For example, the legalization of homosexuality. This leads to ongoing but avoidable HIV infection and related deaths.

These lessons need to be taken on board as the world prepares for the next phase of COVID-19 management. All the interventions that have helped to curb and manage HIV and AIDS are critical to ensuring that no country, regardless of developmental status, and no population, especially those dealing with stigma and the struggle for access to health services , do not lag behind.

Build on existing systems

The lessons learned from HIV and AIDS can be used to inform the COVID-19 response, as the challenges are similar.

Many of the ongoing COVID-19 vaccine trials are taking place in various countries, including South Africa. The ability to conduct these studies, including clinical staff and trial sites, is well established as a result of decades of HIV / Aids research. There are fears that developing countries may be excluded from access to an effective COVID-19 vaccine. But there are now global mechanisms to avoid this and rather to encourage and enable global solidarity, some of which are advocated by the HIV / Aids response.

The Access to COVID-9 Tools (ACT) accelerator, Founded by the World Health Organization in April 2020 in collaboration with many other global organizations, governments, civil society and industry, they have committed themselves through the pillar known as Covax to the equitable distribution of a COVID-19 vaccine, as well as diagnostic tests and treatments. These global institutions and mechanisms require continued support.

With the introduction of an effective vaccine, an end to COVID-19 may soon be in sight. For HIV, the development of vaccines was more complicated and disappointing. The global community needs to remain committed to promoting access and support for the many incredible prevention and treatment options available. The unprecedented effort of the private industry with the COVID-19 vaccine response shines a light that can be achieved when all stakeholders become involved. The vaccination efforts against HIV and TB require a similar effort.

These are not the only pandemics facing the world. In fact, there are strong predictions that the rise of new pandemics will increase in the future. This is due to the effects of globalization, climate change and the proximity of wildlife.

The best hope for mankind is not to lose sight of what these pandemics cost us in terms of loved ones, in terms of freedom and economically. We must now jointly prepare across countries and at all levels of society. These preparations should be based on the lessons learned from HIV / AIDS and re-learned from COVID-19.

Social solidarity

The success of the global response to current and emerging pandemics will depend on the ability of less vulnerable people to acknowledge and respond to their shared responsibility.

An important truth of the HIV epidemic is that it does not discriminate. No contagious diseases recognize political boundaries and everyone is at risk of becoming infected or affected. If nothing else, therefore, we must continue to work together on a global scale in the knowledge that ‘no one is safe until everyone is safe’.

Carey Pike, executive research assistant at the Desmond Tutu Health Foundation, contributed to this article.

Linda-Gail Bekker, Professor of Medicine and Deputy Director of the Desmond Tutu HIV Center at the Institute of Infectious Diseases and Molecular Medicine, University of Cape Town

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