There are many parallels between Covid-19 and HIV/Aids. There are both highly infectious novel viruses which reached pandemic proportions very quickly, and, at this point, there is no vaccine against either of them. But what happens when the two viruses collide? Unlike all the other regions where coronavirus is playing out, Africa is the only arena where HIV/Aids and tuberculosis (TB) are so prevalent.
Winnie Byanyima, executive director, UNAIDS. Source: UNAIDS
“HIV and TB gives us a certain amount of capital in dealing with Covid-19, but there are also risks, such as closing down some of the HIV and TB resources” said Mark Heywood, editor of Maverick Citizen and founding members of the Treatment Action Campaign (TAC) in a webinar entitled The Dual Epidemics: Looking at the overlapping and interweaving of HIV and Covid-19
Although he didn’t have the exact figures at hand, Heywood said there are about 100,000 TB deaths every year because people can’t access healthcare.
“We think that people on anti-retrovirals (ARVs) will be protected from Covid-19 to the same extent as people without HIV. But we’re worried about the two-million people in South Africa not on ARVs,” he said.
“That’s why there needs to be a drive for HIV testing and getting people onto treatment. Covid-19 could do us a favour for getting people onto ARVs,” he said.
In addition, the infrastructure the country has built for HIV can be redeployed for Covid-19. This includes being able to repurpose the Gene Xpert machines brought into the country to test for HIV and TB to scale up Covid-19 testing.
Heywood was joined in conversation by Winnie Byanyima, executive director of the Joint United Nations Programme on HIV and Aids (UNAIDS).
“Pandemics are not just a health issue. It’s about societies and the structures there. It’s about communities and science and politics. It’s about rights. All this we know from HIV. We need a multisectoral approach with communities at the centre.
"We must use everything we’ve learned and built in the AIDS response to fight Covid-19. At the same time, we cannot lose the gains we’ve made in the fight against AIDS," she said.
UNAIDS is watching that drug manufacturers are not switching priorities away from HIV, and that lockdown measures don’t get in the way of access to ARVs. “We are watching where the money for a second epidemic is coming from, and that is it being taken away for HIV. We are supporting those fighting coronavirus, but we must hold the ground on HIV.”
She said more research needs to be done to determine the risk of Covid-19 to people living with HIV, but the evidence so far showed people with chest problems and chronic conditions such as diabetes had worse outcomes from Covid-19.
“From this we can extrapolate that if your viral load is down the outcome will be worse. My advice to people who are living with HIV and aren’t on treatment , is to get on treatment.
“Testing is critical. Governments should continue advocating for HIV testing, and make sure the supply chains for HIV aren’t interrupted,” she said.
Byanyima is a fierce advocate of women.