Nadia Kist, Blood:Water’s Director of Africa Partnerships, recently attended the global AIDS conference where she learned that HIV and COVID-19 have an even greater overlap than previously expected.
For starters, the fact that so many people require immediate attention adds a large burden to health systems around the globe, many of which are not even equipped for their existing needs. Coronavirus has presented a situation none of us expected or know what to expect from, so we are still learning how it will impact greater issues that were already being faced.
On one hand, the history of finding new treatments and technologies to respond to HIV has provided a LOT of helpful insight into how to handle coronavirus (see how Dr. Birx has been a bridge between the two efforts). The global AIDS response has been hailed by health experts as the single most relevant experience to COVID response. From researchers to political figures, the work done on drug and vaccine trials, mass training, life with after-effects, and patient home care have helped to prepare the world for the work required to treat coronavirus. And a critical aspect of approaching both is that communities have to be at the center of all disease control efforts.
On the other hand, as it has here in America, wider political and social issues have been brought to the surface in the mad dash to figure out how to handle this immense pandemic. As with HIV, disparities in society are making the COVID disease burden higher among some groups than others. Vulnerable and marginalized communities are more susceptible even if they don’t have a health risk factor. Things like color and economic status impact income, access to healthcare, employment, and people per household; things that, when combined, create a higher risk for the spread of coronavirus.
Unfortunately, the UNAIDS 90-90-90 target is projected to not be met by the end of the year. The 90-90-90 target is an international goal to ensure that 90% of people have access to testing to know their HIV status, 90% of HIV-positive people have access to treatment, and 90% of people on treatment have attained viral suppression, meaning the virus cannot be detected in their blood. This would mean new infections are low enough for a global downward trend. However, even before COVID, we were not expected to meet those targets.
In addition, because of the pandemic, AIDS-related deaths are expected to be 500,000 higher than originally projected. At the end of 2019 we reached an incredible milestone of less than 770,000 deaths, due to a combination of treatment and technology working to increase prevention and decrease unnecessary deaths. Another unfortunate prediction is that if lockdowns continue for another six months, there is likely going to be a staggering reversal of 10 years worth of progress in reducing mother to child transmission of HIV.
On the bright side, all of our partners framed their proposals around those 90-90-90 targets, so they are already working with their national coordinating bodies on those tasks. For example, LCA has ensured that 90% of the population using one of their rain catchment systems has access to HIV testing and 90% of those that test positive have access to treatment (since their facility can test viral suppression). While PIH does not have a health facility, they bridge their clients with treatment facilities that can assist them. So while the situation may look dire, we take comfort in the fact that our partners are working tirelessly to try to curb these numbers for the families they serve.
Another issue prevalent in addressing both HIV and COVID-19 is a lack of inclusivity throughout the global community in addressing disparities for those most at-risk. It can be very difficult to get medication and preventative services to the areas and people that are most in need of them. Strikingly, girls between the ages of 15 and 19 are 4 times more likely to be infected with HIV than their male counterparts. This is, in part, due to social and economic disparities like intergenerational relationships and less access to school or protection, for example. Jimmy Katuma of COPRED, for one, says that as a father of all daughters, he won’t stand for realities like these.
Seeing as Blood:Water’s partners are already committed to addressing these disparities and providing necessary aid to all of those affected, we are confident that they will play a pivotal role in the global drive to end AIDS for all people everywhere. We are not so different as it seems, and we know that you are passionate about ending these disparities and providing opportunity for our brothers and sisters around the world. So, thank you for your support, and please join us in continuing to fight not only HIV/AIDS, lack of water, and now COVID-19, but the inequalities that have fueled these awful situations for far too long.