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What the AIDS crisis can teach us about the COVID pandemic response

Volunteers stand after lighting candles in the shape of a red ribbon during an awareness event ahead of World AIDS Day in Kathmandu on Tuesday.
Prakash Mathema
AFP via Getty Images
Volunteers stand after lighting candles in the shape of a red ribbon during an awareness event ahead of World AIDS Day in Kathmandu on Tuesday.

Today is World AIDS Day, an annual opportunity to show support for people living with HIV and honor those who have died from AIDS-related illnesses.

It became the world's first-ever international day for global health when it was founded in 1988. And global health is a topic on the minds of many people today, as the coronavirus pandemic rages, a rapidly spreading new variant emerges and countries scramble to vaccinate their populations in the face of an inequitable vaccine rollout.

Plus, AIDS is by no means a pandemic of the past.

In fact, the Joint United Nations Programme on HIV/AIDS (UNAIDS) warned in a new report this week that if leaders don't do more to address inequalities, the world could see some 7.7 million AIDS-related deaths over the next decade — and could remain trapped in the COVID-19 crisis.

"Progress against the AIDS pandemic, which was already off track, is now under even greater strain as the COVID-19 crisis continues to rage, disrupting HIV prevention and treatment services, schooling, violence-prevention programmes and more," UNAIDS Executive Director Winnie Byanyima said in a statement. "We cannot be forced to choose between ending the AIDS pandemic today and preparing for the pandemics of tomorrow. The only successful approach will achieve both. As of now, we are not on track to achieve either."

The report notes that while some countries have made progress, new HIV infections are not falling fast enough globally to stop the pandemic.

The new infections (some 1.5 million in 2020) are also "following lines of inequality," UNAIDS says, pointing to the fact that gay men, sex workers and people who use drugs face a 25-to-35-times greater risk of acquiring HIV worldwide.

It adds that COVID-19 is "undercutting" the AIDS response in many places, with the pace of HIV testing declining and HIV prevention services — like harm reduction services for people who use drugs — facing disruption in many countries in 2020.

The Biden administration acknowledged that the COVID-19 pandemic has impacted "every aspect of the HIV/AIDS response, from prevention to treatment to research," and is marking this World AIDS Day by announcing several steps it will take to redouble the fight against HIV/AIDS at home and abroad.

Those steps include pledging to host the Global Fund to Fight AIDS, Tuberculosis, and Malaria Replenishment Conference next year and releasing a new national strategy for research, policy and planning through 2025. It aims to "aggressively reduce new HIV cases while increasing access to treatment and eliminating inequitable access to medical and support services" to end the U.S. HIV epidemic by 2030.

Public health experts say that by addressing root inequities, world leaders can not only end AIDS, but also overcome the COVID-19 crisis and be better prepared for any future pandemics.

So what lessons can we apply from AIDS to COVID?

Steven Thrasher, a professor at Northwestern University's Medill Journalism School, says the two diseases exploit similar societal weaknesses, like divides along the lines of race, class and power.

He spoke to NPR's Ari Shapiro last World AIDS Day about what that might mean for efforts to get vaccines and treatments to those who are the most vulnerable.

Thrasher found in his research that the majority of the roughly 33 million people who have died from AIDS over the last four decades actually died after 1996, when effective medication hit the market.

He expressed the same concern as many officials and public health experts: That the people who are most at risk of COVID-19 also have the least connection to institutions and financial resources to get the vaccines and treatments they need. The virus could take hold in these populations and worsen existing disparities, he added.

"Looking back at AIDS, it took seven years from the time antiretroviral therapy came to market before it started getting to every country in the world. And during that time, HIV continued to circulate and, thus, continued to climb," Thrasher said. "And so if we want to tamp down this virus, we need to have a transnational, international approach that's going to help the most vulnerable all over the Earth unless we all want to be just in our houses and not traveling for the next few decades."

For more on the similarities between the two pandemics, check out some of NPR's previous coverage:

  • History Repeats Itself: COVID-19 Vaccine Inequities Echo HIV Crisis
  • Skepticism Of Science In A Pandemic Isn't New. It Helped Fuel The AIDS Crisis
  • Strides Against HIV/AIDS In The U.S. Falter As Resources Diverted To Fight COVID-19
  • HIV activists have a history of outrageous energy. COVID protesters hope to match it
  • One Man Is Using His Experience With The HIV/AIDS Epidemic To Help With COVID-19
  • 'They Know What A Pandemic Is': HIV Survivors See Similarities To AIDS Epidemic

  • This story originally appeared on the Morning Edition live blog.

    Copyright 2021 NPR. To see more, visit https://www.npr.org.

    Rachel Treisman (she/her) is a writer and editor for the Morning Edition live blog, which she helped launch in early 2021.