From being a killer in the shadows, to having its own international day and UN programme, HIV's emergence into a global reality can offer many lessons in how to respond to COVID-19, the head of the International Aids Society told AFP Thursday.
Kevin Osborne, who has lived with HIV for nearly half his life, says that beating the pandemic requires a drastic upscaling in testing, private sector funding for research, and a new approach to life as normal.
Q: What is the main thing HIV can teach us about COVID-19?
A: Something we learned belatedly with the HIV response was the need for political commitment. It's important because it shows the urgency across sectors. The COVID-19 response can't just be a health response, you need community engagement, clear communication. Everybody has to play a role across the spectrum.
Most of the impact is going to be felt at a community level. So how we engage and inform them is crucial, otherwise things like lockdowns and quarantines aren't going to work.
And we have to protect the most vulnerable. The early days of HIV and who was becoming infected — young gay men — these were populations that people saw as somehow not worthy of help. Communities had to fight for their lives and drive political commitment.
Fast forward, who would have ever thought we'd now have a specialised UN unit for this disease? How do we make sure vulnerable communities who are more at risk (of COVID-19) because social distancing is difficult are looked after?
HIV showed the fault lines in society about how we deal with the most vulnerable people. COVID-19 is different but it's also showing the fault lines in societies, where we have fragile health systems and how they are going to respond.
'Testing is key'
Q: Is there any cause for optimism?
A: Unlike HIV, this virus was named and known very early on. But there's still a lot we don't know and we need to work on how to deal with these ambiguities in our daily lives.
The best way we can respond to COVID is understanding what we are dealing with. Testing is therefore key. Testing is the entry point to a world of possibilities.
In the early days of HIV the question was: what can we do for people? But now that treatment is available, testing is vital. The whole premise of the HIV response is based on people knowing their status. Test, test, test.
Not only to understand what we're dealing with but it also allows people to take more ownership of what they can do. If key health workers aren't tested but have to stay home, it defeats the point.
But if you test everyone now, then you get them back to work. Testing is so key for many reasons, and we learned that from HIV.
Q: How do we tackle COVID-19 once the emergency stage is over?
A: COVID-19 is a game changer in many ways. Besides the response at a human level, it's also affecting the architecture of society. To go back to business as usual would be foolhardy.
HIV has shown that even though we can see huge gains in terms of treatments, it's not over until it's over — we need to sustain the effort until everyone who needs care can access it. HIV was an emergency response that couldn't be wished away.
Q: Aside from disease prevention, what can we learn from COVID-19?
A: I've lived with HIV for half my life. What does COVID-19 mean in terms of people's sense of vulnerability, in terms of health care, in terms of food security, social interaction, work?
As we see this shock play out, everything has been thrown into sharp relief. We're realising that the economy we all subsist upon depends on each of us being able to get up and do our thing.
If we take this lesson for granted, the history books will write the tale of what could have been.