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Tale Of Two Pandemics: Follow The Science And Do Not Forget One At The Cost Of The Other


Covid-19 has posed innumerable health, economic, and
social challenges for all, including people living with HIV.
It has exposed the fragility of health systems around the
globe and has diverted political attention and funding from
other infectious diseases like TB and HIV. The opening
session of the 11th International IAS Conference on HIV
Science (#IAS2021) held virtually from Berlin, saw a lively
panel discussing the tale of the two most horrendous recent
pandemics in the history of our civilisation: Covid-19 and
HIV/AIDS.

Here is a glimpse of what the scientists,
politician and activist had to
say:

Intersectionality of Covid-19 and HIV

Dr
Anthony Fauci, Director of National Institute of Allergies
and Infectious Diseases, USA, said that we cannot forget HIV
just because we happen to be in the middle of Covid-19.
Decades of investment and science in HIV research, albeit as
yet unsuccessful in developing an HIV vaccine, has played a
major role in the development of highly successful Covid-19
vaccines in a very short period of time. But the fact that
we have a Covid-19 pandemic does not lessen the importance
and devastation associated with the HIV pandemic that has
resulted in substantial mortality and morbidity during the
last 40 years.

Dr Fauci said that in terms of
preparedness for future pandemics (which will be there) we
are better prepared in some respects, but in others we are
not. To deal with any emerging outbreak there is a public
health response and there is a scientific response. The
public health response for Covid-19 has been fragmented in
many countries. It was characterised by a disturbing degree
of divisiveness when there was a politicisation of how one
approaches an outbreak. When you are dealing with a
pandemic, the common enemy is the virus, and not the people
you may have disagreements with. A global pandemic requires
a global response in a synergistic way, and not just an
individual country response.

Fortunately, the
scientific response has been tremendous and resulted in the
rapid development of effective and safe vaccines, said Dr
Fauci. The challenge now is to get equitable distribution of
these vaccines throughout the world. The rich countries of
the world have a moral obligation to ensure that the low and
middle income countries are able to access these life saving
vaccines in real time.

Dr Fauci shared that an
important lesson learnt is to have a global system so that
life saving scientific interventions can be rapidly
distributed to people in real time without them having to
suffer unnecessarily.

Lessons learnt from HIV to
address inequalities in the Covid-19 response

Dr
Soumya Swaminathan, Chief Scientist at the World Health
Organization (WHO); former Director General of Indian
Council of Medical Research; former Secretary, Department of
Health Research, Ministry of Health and Family Welfare,
Government of India; and former head of National Institute
for Tuberculosis Research, said that the HIV response was
successful when affected communities were actively engaged.
When anti retroviral therapy (ART) was not available for
many people living with HIV in Africa, they rallied around
and fought for access to treatment. A record 27 million
people living with HIV are now on ART globally.
Unfortunately we are seeing a sort of repeat of the same
with inequity in the distribution of Covid-19
vaccines.

Dr Soumya Swaminathan said that it was the
community-led and community-based health delivery solutions
that worked in Covid-19 as well. Countries with strong
primary healthcare systems, where community health workers
play an important role, have better managed to keep the
pandemic under check. Role of political leadership is also
critical. Countries where there has been a strong scientific
evidence based data led response to the pandemic, where data
is collected, disseminated and used transparently to inform
the public- those are the countries that have done well in
managing the pandemic. We have to redouble efforts to scale
up infection control measures and vaccinations, and at the
same time not take the focus away from diseases like HIV and
TB that still kill millions every year.

Trust,
transparency and proper communication with the public are
extremely important in dealing with any public health
challenge, rightly said Dr Swaminathan. We saw stigma for
people affected with Covid-19 just as we saw it in those
affected by HIV or TB. In countries where people generally
have a higher trust in the government and in public health
authorities, there has been more public acceptance of
preventive social measures, and vaccination as well. Also,
the data that has been available in many countries is far
removed from the ground reality. This brings out the
importance of investing in data systems (especially for
mortality and cause of death statistics) to really
understand the burden of any disease.

But along with
having the scientific tools- whether for diagnostics,
treatment, or prevention (including vaccines), we also have
to focus on making them accessible to all and the private
sector plays an important role in delivering these tools,
said Dr Swaminathan.

Multilateral and inclusive
response to global health challenges

Jens Spahn,
Federal Minister of Health, Germany, said that HIV has
taught us that a multilateral response, that includes people
and affected communities, is the way to get through it, and
this applies to Covid-19 response as well. What we have
learnt from HIV is that universal health coverage is the
key. Primary healthcare makes a big difference in fighting
all these diseases. But we are yet not there. That is why
Germany, Ghana, and Norway have asked for a global action
plan for healthy lives.

It is one thing to have a drug
or a vaccine, but you still need to be able to deliver and
administer it in all countries. And for that you need a
working healthcare system. So, besides multilateral
cooperation on certain diseases, we also need strong primary
healthcare systems in every country, said Germany’s Health
Minister Jens Spahn. While the world coming together very
quickly to speed up the Covid-19 response is a humanitarian
help, it is in our own national interests to vaccinate the
world, because no one is safe until everyone is safe. That
should be the motto of our engagement. If we put our heads
together and really want to make a difference to science and
public health, we can. I accept that there is not yet
equitable access to Covid-19 vaccines, but it would be there
soon within months and not within years, he said.

Jens
Spahn rightly underlined that there is no vaccine against
hate or fear that we have seen manifesting during these
pandemics. The demonstrations against Covid-19 control
measures- the fears and blunt aggression in people’s eyes-
reminds us that liberal democracy is about having a good
sober debate which presumes that the other person might be
right too. I do hope that we leave behind us all the hatred,
false information and the nationalist view that many had,
and learn from the good that happened- having a vaccine in a
very short a time within a pandemic
situation.

Personal experience as a Covid survivor as
well as a black woman living with HIV

Yvette Raphael,
Executive Director of APHA (Advocates for Prevention of
HIV), South Africa, shared her experience of not only living
with HIV as a black woman since last 20 years, but also as a
Covid-19 survivor. She said that “I carried 3 burdens- being
black, being a woman and being poor. My journey started when
I was diagnosed with HIV in the midst of HIV denialism and
lack of political will in South Africa at that time. My
involvement with HIV struggle started due to my experiencing
stigma myself for being HIV positive. Never did I imagine
that I would be infected with HIV and also recover after
getting very sick from Covid-19 infection only a few days
ago. Never did I imagine I would be at the centre of
fighting for the rights of people living with HIV, fighting
for access to HIV treatment and also be in the forefront of
fighting for the research and development agenda.”

She
added that many countries and governments have spent
billions of dollars on Covid-19 response, while diverting
resources from HIV and TB – like TB is the poor cousin of
HIV and Covid-19 is the rich aunt. We did not act how we
should have acted! The biggest mistake was to not have
proactively engaged the HIV sector globally and make
community leaders part of the Covid-19 response. Leadership
is needed at all levels. Community action and information
must be available in real time for local responses and for
communities to be able to act, embrace the science, and
innovations while protecting human rights. Advocates and
scientists must speak through to power. Now is the time to
start planning for the next pandemic today, as it might be
there tomorrow, alerted Yvette.

“Most of us have lost
so many family members, friends, leaders globally to
Covid-19 (as well as to HIV). I see faces where scientists
see statistics. For us, our own lived experiences matter
more than mere data. Treat people not as numbers, but as
human beings so that HIV does not become a forgotten
pandemic” was Yvette’s important message to remember while
we shape global health responses.

Germany’s Angela
Merkel speaks at IAS 2021

It would be pertinent to
end this piece with some of the remarks made by Angela
Merkel, the Federal Chancellor of Germany, (and a scientist
herself) during her welcome address at #IAS2021. “The
Covid-19 pandemic is not the first event to teach us that
infectious diseases know no borders. AIDS has sadly been
proof of this for decades. Infectious diseases confront us
with global challenges. So the fight against these diseases
is only conceivable in the form of worldwide cooperation.
During the Covid-19 pandemic we have seen how international
cooperation has enabled multiple effective vaccines to be
developed in record time. However, we have also witnessed
how in the shadow of the pandemic, the achievements made in
the fight against HIV have slipped from our grasp. AIDS must
not be allowed to fade into the background due to Covid-19.
In fact the international community must redouble its
efforts to reach the global SDGs relating to HIV, because
the ongoing fight against AIDS too can succeed through
global cooperation. Germany stands ready in its capacity as
a hub for science and research to partner with others so
that together we can continue to make progress in the fight
against AIDS and other infectious diseases.”

And as
the US President Joe Biden told Dr Fauci, no matter what, we
must follow the science. We may not be right all the time
but if we are not, we are going to correct it and we are
going to go in the right direction. That is going to be a
pathway to ending this terrible pandemic.

Shobha
Shukla – CNS

(Shobha Shukla is the award-winning
founding Managing Editor and Executive Director of CNS
(Citizen News Service) and is a feminist, health and
development justice advocate. She is a former senior Physics
faculty of prestigious Loreto Convent College and current
Coordinator of Asia Pacific Regional Media Alliance for
Health and Development (APCAT Media). Follow her on Twitter
@shobha1shukla or read her writings here
www.bit.ly/ShobhaShukla)


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