Editor’s Note: Jennifer Lotito is the president and chief operating officer of (RED). The views expressed in this commentary are her own. View more opinion on CNN.
Zambia’s local health clinics are usually bustling with the sounds of patients, nurses and doctors. But when Covid-19 hit, the noisy clinic corridors were rapidly replaced with an eerie silence.
“People are now afraid to go to health facilities,” said Yoram Siame, the head of Advocacy, Planning, and Development with the Churches Health Association of Zambia, the largest nongovernmental health provider in Zambia. “At the same time, how do they come to a health facility with an assurance that they are safe?”
The answer is we must fight two global health crises, AIDS and Covid-19, at once.
As we mark World AIDS Day on Wednesday, American life has been slowly returning to normal. But elsewhere, particularly in countries across sub-Saharan Africa – like South Africa, where scientists first discovered a new variant of the coronavirus called Omicron – the pandemic still poses a great threat. What’s more, in some sub-Saharan countries, like Botswana, vaccines are in short supply and fear is abundant. In order to defeat AIDS and Covid-19, our leaders must treat these twin crises like the global emergencies they are.
After nearly two years of tackling both AIDS and Covid-19 simultaneously, a sober truth has emerged: Persevering and catalyzing two decades of progress on AIDS will require stopping the spread of Covid-19 first. World leaders have coalesced behind the goal of vaccinating 70% of the world’s population by September 2022. But what’s needed now is more funding and resources from wealthy countries and the private sector to ensure doses are procured and administered to everyone, everywhere.
The pandemic is affecting communities worldwide, but the impact is particularly severe among the most vulnerable, including people living with HIV and other medical conditions. Sub-Saharan Africa is home to roughly two-thirds of people living with HIV, according to UNAIDS, but less than 5% of the population is fully vaccinated against Covid-19, leaving these individuals incredibly vulnerable to Covid-related morbidity and mortality.
Estimates from UNAIDS show that Covid-19 could cause up to 293,000 new HIV infections and 148,000 additional AIDS-related deaths from 2020 to 2022. And for the first time in the 20 years since its founding, The Global Fund to Fight AIDS, Tuberculosis and Malaria, an international global health organization that fights epidemics, saw a 22% decrease in HIV testing and an 11% decrease in reaching people with HIV prevention services in 2020 in countries in which the Global Fund invests.
Covid-19 has also put women and girls in the world’s poorest countries at greater risk of contracting HIV. In 2020, women and girls in sub-Saharan Africa accounted for 63% of all new HIV infections, up from 59% in 2019, according to UNAIDS. In many poor countries, like Eswatini (formerly known as Swaziland), which has one of the highest HIV adult prevalence rates in the world, the threat of Covid-19-induced poverty has put women and girls in extremely vulnerable situations in order to obtain necessities like food and money.
The good news is that the institutions and systems that were built to fight AIDS have been agile and responsive to the pandemic. For example, programs supported by the Global Fund have nimbly adapted to the challenges imposed by Covid-19 by dispensing multimonth courses of antiretroviral drugs so people require fewer trips to the doctor’s office. And organizations like the Coordinating Assembly of Non-Governmental Organizations, which hosts in-person HIV prevention sessions for adolescent girls and young women, have used Global Fund grants to move its sessions online.
The bad news is that while many of these health systems are currently holding the line, they are hanging by a thread and facing sustained headwinds from an inequitable and inadequate global pandemic response. Covid-19 vaccinations are reaching Africa at a faster rate than antiretroviral treatments did during the AIDS crisis in the early 2000s, but according to experts at the ONE Campaign, an organization that seeks to end poverty and preventable disease by 2023, at the current rate of progress, low-income countries may not reach Covid-19 vaccinations levels consistent with other high-income countries for another decade. This isn’t just morally repugnant, it’s prolonging the fight against other diseases like AIDS.
Fortunately, the next several months are ripe with opportunities for the world to help curb Covid-19 and put the AIDS fight back on track. In the first quarter of 2022, the United States will play host to a critical world leaders summit centered around fighting the pandemic. And earlier this month, the Biden administration announced that the Global Fund will hold its upcoming replenishment conference in the United States next year. By hosting the conference, the US is sending a clear signal about its commitment to ending the pandemic, but other wealthy countries and the private sector must step up to fight and commit more resources.
We all have a role to play in ending global health crises from AIDS to Covid-19, and now it’s easier for ordinary Americans to support stronger global health systems than ever before. Companies that are usually financial competitors are working together to enable their customers to use their rewards points to fight Covid-19 and save lives. Brands are teaming up to turn their products red – the color of emergency – to help raise awareness and commit money to fight AIDS and Covid-19. And the gaming industry is fundraising to provide life-saving relief where it is needed most.
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One of the biggest lessons of the AIDS crisis is that political leadership and global solidarity matter. Early in the AIDS fight, political leadership was glaringly absent, with many heads of state refusing for years to even acknowledge the existence of the deadly virus. It was only after the public at large and world leaders began to demand action that we slowly put HIV on the defense. While political leadership has been more visible on Covid-19, until world leaders and the private sector meet the demands of this crisis, more variants, like Omicron, will emerge and more lives will be needlessly lost.
Nearly four decades into the fight against AIDS, our challenge is ensuring that everyone who is HIV-positive has adequate access to treatment. That will not happen until everyone, everywhere has adequate access to Covid-19 vaccines.