The year 2021 is a sad anniversary for the AIDS pandemic. The disease was first described 40 years ago and has since cost an estimated 36 million lives. The HIV virus was identified three years later, in 1984, and the first clinical study of a vaccine began in 1987. But the search for a vaccine against HIV is difficult. There is hardly any virus - with the possible exception of Sars-CoV2 - as well researched as HIV. Indeed, the global response to Covid-19 has benefited greatly from the achievements of HIV research: be it the rapid development of a PCR test, the development of drugs such as mononuclear antibodies, or the monitoring of virus variant formation.
Despite all the successes, we must not forget that AIDS is almost always fatal without treatment. We must also not overlook the fact that global targets have not been achieved and that HIV is a health crisis for many countries. In 2020, 37.7 million people were living with HIV, of whom 10.2 million received no life-saving treatment. In 2020 there were 1.5 million new HIV infections, all of which would have been preventable, and 680,000 AIDS-related deaths. They too would have been avoidable if they had been treated in time.
Such numbers are simply unacceptable and also testify to a lack of political will, progressive fatigue and political ignorance in combating one of the most devastating pandemics of modern times.
They are based on inequalities - in terms of power, status, rights and participation.
It is inequalities that kill.
To end AIDS, we need to end inequalities.
Science depends on political will
The Covid-19 pandemic has exacerbated many of the inequalities and also had a negative impact on the HIV pandemic.
Despite the joint efforts of UN-AIDS and its partners, many programs were interrupted or not implemented, HIV infections remained undetected, and life-saving drugs were not distributed.
The Covid-19 pandemic has also shown us what can be possible in the fight against HIV if the political will is there. For Covid-19, we had eight approved vaccines and more than 30 vaccine candidates in phase III in a very short space of time. Since the discovery of HIV, however, only eight vaccine trials have made it into the crucial phase III.
Covid-19 has shown that science moves at the speed of political will. We need to accelerate HIV research by investing in innovation in treatment, prevention, care, and most importantly, vaccines as global public goods. We need to use science to reduce inequalities, not to increase them. New long-acting antiretroviral drugs are currently being researched and developed that will facilitate the treatment and prevention of HIV and will hopefully soon be approved for use. These drugs must be made available first to the people most affected by HIV in the countries most affected by HIV, rather than years after people in rich countries have access.
We have the means and the means
In a pandemic, we are all interdependent.
While we have good Covid-19 vaccination rates in many rich countries, less than one percent of the population of low-income countries is vaccinated and many of these countries are in the middle of a third or fourth wave with soaring deaths.
Only when we have reduced the viral load in all countries can all countries in the world feel really safe that we will not be thrown back in the fight against Sars-CoV2.
The same goes for HIV.
While we are on the way to ending one pandemic, the other has been going on for 40 years.
It is time to end this one too.
We have the means and the means, but the political will and financial resources are lacking to halt the pandemic and end it by 2030.
It takes courageous leadership and a concerted effort.
Germany is also asked to continue to lead by example.
The Ugandan engineer Winnie Byanyima is the director of UN AIDS, the German doctor Hendrik Streeck is the director of the Institute for Virology at the Medical Faculty of the University of Bonn. He is the host of the eleventh International AIDS Conference on HIV Research, which begins on Sunday in Berlin.
The Ugandan engineer Winnie Byanyima is the director of UN AIDS, the German doctor Hendrik Streeck is the director of the Institute for Virology at the Medical Faculty of the University of Bonn.
He is the host of the eleventh International AIDS Conference on HIV Research, which begins on Sunday in Berlin.