Learning from hiv for corona: living with the virus

The infectious diseases Covid and AIDS can hardly be compared. But the fight against Corona would be much harder if HIV had not existed.

A red ribbon as a symbol of solidarity with people infected with HIV Photo: Andrej Isakovic/afp

The world has learned something, at least a little bit: That is the good news for World AIDS Day on December 1. The HI virus has claimed countless victims in times when there would have been drugs to save them long ago. But at least: today, in the corona crisis, countries worldwide can fall back on a medical infrastructure that would not exist without HIV.

At the height of the AIDS epidemic, from 2004 to 2006, 1.7 million people worldwide died from the disease each year. In 2019, that number was still 690,000. Still too many – and yet it could be much worse. Today, 38 million people worldwide are living with the virus, more than 10 million more than in 2005.

Why are far fewer dying? Today, more than 25 million people are regularly treated with effective antiviral drugs. In 2009, there were only 6 million. They mostly lived in developed countries; in developing countries, many people could not afford the overpriced drugs.

Now, HIV and Corona cannot be compared in many ways: The modes of transmission are different, relatively few contracted HIV, but the virus was a death sentence for all who had it before drugs were developed. Sars-CoV-2, on the other hand, spreads at breakneck speed, but kills only in the fewest cases. Still, UN Aids now writes in a report, "There are key lessons to be learned from our decades-long fight against HIV."

The same fighters

A lot of people who saw during the HIV crisis in the noughties what suffering lack of global cooperation leads to are fighting Covid-19 today. One of them is Anthony Fauci, the head of pandemic control in the US. He made appeals for global distribution of HIV drugs at AIDS conferences in the noughties.

In Ethiopia or South Africa, the heads of national anti-AIDS programs are now also leading action against Covid-19; in many other developing countries, the situation is similar. The reason is simple: they have a complete infrastructure available in their countries that is normally used to distribute HIV drugs or other vaccines.

A gigantic market

There is a second point, which the former head of the Unitaid drug pool, Dutch lawyer Ellen ‘t Hoen, described in detail in the site: There is now a business model for humanity. In the HIV crisis, the pharmaceutical companies of the industrialized countries refused until the end of the noughties to allow their effective antiviral drugs to be produced cheaply for developing countries by generic manufacturers. India did this in part anyway, but was not allowed to export the drugs; in South Africa, countless people died because therapies were unaffordable. Unitaid buys drugs for HIV/AIDS, malaria and tuberculosis and has built up a network to distribute them worldwide.

Unitaid and ‘t Hoen negotiated for years on a legally secure global system in which pharmaceutical companies would have their vaccines and therapies produced under license in developing countries and sell them there at much lower prices than in industrialized countries. For the pharmaceutical companies, this meant above all: access to a gigantic market. This system has now been working relatively smoothly for a good decade – and is now leading, for example, to the British company AstraZeneca having its Covid vaccine for developing countries produced in India and exported from there.

But whether the industrialized countries will also distribute the first vaccine doses globally or initially keep them for themselves is another matter.

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