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Ending Aids while learning from Covid

This year’s World Aids Day celebrations, coming as the world works to push back the Covid-19 pandemic, have given the scientific and public policy community an opportunity to consider lessons learnt during the latest medical and scientific struggle faced globally. 

As of the end of 2020, an estimated 27.5 million People Living with HIV worldwide were taking ART — two-thirds of the universal treatment target set by UNAIDS.  This has led to significant contributions in the failures that have prevented the world from achieving its global targets despite the progress achieved.

Covid-19 has further exacerbated the situation, with growing inequalities and disparities in access to HIV treatment owing to the disruption in service provision. This has been occasioned by structural and social challenges that continue to impede people from receiving safe and effective HIV prevention tools.

However, despite the adverse impact that Covid has had on HIV treatment, there are a number of lessons that can be borrowed from the Covid vaccines such as provision of a new path forward for HIV vaccine discovery by providing applications for new vaccine platforms, such as mRNA, and novel strategies for rapidly identifying vaccine targets. For instance, using these learnings, there are increasing developments being made in broadly neutralizing antibodies (bNAbs) for long- acting HIV prevention. This suggests it may be possible to achieve a HIV vaccine with a high level of efficacy—an almost inconceivable scientific possibility several years ago. 

Further to this, scientists have made significant progress in the anti-retroviral field as well with development of Long-acting ART (cabotegravir) which if achieved would replace daily oral medications, which has been the cornerstone of both HIV treatment and prevention for decades. Long-acting antiretroviral medication via injection will also soon be considered for regulatory approval as pre-exposure prophylaxis.

These, and other lessons, may be used to reduce the Aids burden across the burden and concerns that despite the considerable progress that has been made since the first World Aids Day in 1998, far too many people continue to acquire HIV and die from its related illnesses. 

In 2020, an estimated 680,000 people globally died from HIV-related causes, and roughly 1.5 million people became newly infected with HIV, according to the World Health Organization (WHO). 

Similar to 1988, the rallying call for this year’s World AIDS Day was to end the HIV/AIDS pandemic but at the same time to deal with the inequalities that have dragged the fight back.

As the concurrent battles against the HIV/AIDS and COVID-19 pandemics continue, the critical work needed is to optimize strategies for improving the health of those with HIV, prevent new cases, and achieve a durable end to HIV/AIDS. 

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