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It's been 40 years since the first cases of AIDS were reported. While science has made advancements for its prevention and treatment, close to 700,000 people still died from AIDS-related illnesses in 2019.
“What is the difference between countries that have, [and] countries that have not reached the 95 [targets]? I don't think it's just about financial resources,” Adeeba Kamarulzaman, president of the International AIDS Society, told Devex in an interview.
She was referring to the UNAIDS treatment targets to diagnose 95% of all people living with HIV, have 95% of those diagnosed on antiretroviral therapy, and to get 95% of those treated to reach viral suppression by 2030.
Despite the science — from the availability of condoms to pre-exposure prophylaxis — the HIV response continues to be set back by stigma and discrimination, lack of urgency to put effective programs in place, and punitive laws that prevent people from coming forward to get tested or treated.
“It is a timely opportunity to remind member states that, hey, there's that other pandemic that we still haven't solved as well.”— Adeeba Kamarulzaman, president, International AIDS Society
But the response can be reinvigorated by reminding political leaders that “HIV is still here,” and that HIV prevention is “always better and cheaper than cure,” said Kamarulzaman.
That speaks to the goal at next week’s U.N. High-Level Meeting on HIV and AIDS, taking place from June 8 to 10. Kamarulzaman said the world is off-target on HIV prevention and in preventing deaths caused by AIDS, and the situation has worsened since the COVID-19 pandemic.
“It's an important opportunity for member states to refocus and recommit attention to HIV,” she said.
“There’s been unprecedented political attention to public health with COVID-19. The whole world is looking at public health and global health, and so it is a timely opportunity to remind member states that, hey, there's that other pandemic that we still haven't solved as well,” she added.
It’s also an opportunity to remind leaders to “follow the science” and commit to a “visionary political declaration” to guide the next five years of the response, she said.
What COVID-19 can learn from HIV/AIDS response
There are a few key lessons the current COVID-19 response can learn from 40 years of the HIV/AIDS response.
The new global AIDS strategy tackles some of the biggest issues in HIV response.
“Unlike COVID, we had a much slower start,” Kamarulzaman said, from disease recognition, virus isolation to having tests for HIV available. But in the last 20 years, all the research and investments that have gone to HIV has paid off.
There’s still much work to do to implement what science has proven. But one of the “hallmarks” of the HIV response that the COVID-19 response can heed is respecting human rights.
“I think that's also something that's really needed in the COVID response because as you know, COVID just highlights social inequities and those left behind … So underpinning the response on the respect for human rights as what we [in] the HIV world [have] championed all these years is a very important principle in the COVID response,” she said.
Other lessons include adopting a response that's not exclusively focused on health, and engaging communities — from encouraging people to get tested to convincing them for vaccination, she added.
The role of IP
Today, countries are fighting out a battle to suspend intellectual property rights at the World Trade Organization in hopes to boost COVID-19 vaccine production and address inequities in access.
Kamarulzaman also sees the issue of IP posing a barrier in accessing some of the newer HIV therapies.
“Obviously, it's not just an IP issue, isn't it? It's also the … whole production chain that requires consistent effort and collaboration, working together,” she said.
But “in terms of HIV, yes, because I think, you know, although now many of the HIV drugs are coming off patent, but we've also got some ... new treatments coming on board like the long-acting cabotegravir,” she said. “So perhaps now is the time to also … look at how these IPs play out in the HIV world.”