Addressing the impact of the COVID-19 pandemic on the AIDS response and building back better for pandemic preparedness

At the UNAIDS High Level Meeting, Co-Chair The Rt Hon. Helen Clark gave the following statement on behalf of the Co-Chairs.

1. Your excellencies, distinguished delegates, it is a privilege to address you in my capacity as Co-Chair of the Independent Panel for Pandemic Preparedness and Response, and also as a long time-supporter of the fight against HIV.

2. While COVID-19 is killing many thousands of people every day, HIV/AIDS also continues to take a large toll of lives around the world, as we have heard throughout this High-Level Meeting. At 690,000 AIDS-related deaths a year, that is 1890 deaths a day. The battle against HIV is far from won, and it must retain high visibility and global attention.

3. With respect to the COVID-19 pandemic, our Panel concluded that it was a preventable disaster. Despite many warnings of the need for pandemic preparedness, many countries had paid little heed to them and were not able to respond effectively when COVID-19 emerged as a major threat.

4. It is clear that we need a strong international movement focusing generically on reducing risks and addressing underlying factors which drive pandemics – inequalities are prominent among those factors. The COVID-19 pandemic has exacerbated pre-existing inequalities. HIV continues to thrive in the most marginalised and vulnerable populations.

5. While urgent investments must be made in pandemic preparedness now, the current pandemic must also be tackled decisively. Just as equity and rights are at the core of effective HIV responses, so they must be with COVID-19.

6. Yet the same old battles are having to be fought – the battles for a TRIPS waiver and for equitable access to diagnostics and therapeutics – and in this case to vaccines too. I salute UNAIDS Executive Director Winnie Byanyima for her tremendous leadership on these issues which draws on the lessons learned in fighting HIV.

7. Sadly, the two-tier rollout of COVID-19 vaccines now reminds us of the previous two-tier rollout of antiretrovirals for people living with HIV – both cases have amounted to a denial of the right to health. This is intolerable anywhere, anytime, and it must be overcome.

8. We look to the G7 meeting this week to act decisively and to lead on making more of the existing COVID-19 vaccine stock secured by high-income countries available for redistribution via COVAX to low- and middle-income countries. Our Panel called for a billion doses to be redistributed by September, and another one billion by mid next year. As high-income countries have ordered in excess of four billion doses for 1.16 billion people, even at two doses per person they have plenty to spare.

9. The COVID-19 response has benefitted from investments that were originally made to tackle HIV. Platforms for vaccines and diagnostics were repurposed. Laboratory capacities which had been developed were utilised, as were community-based care models supporting HIV testing.

10. But we have also seen the need for those living with HIV to be protected during a crisis like this pandemic. Evidence from intensive care units in Sub-Saharan Africa, for example, shows that HIV is associated with almost double the odds of dying from COVID-19. Effective pandemic response must protect all those with pre-existing conditions, including by ensuring continued access to essential medication.

11. With COVID-19 and HIV, we can’t limit our response narrowly to the health sector. COVID-19 has had a disproportionate social and economic impact on women and girls, including through increased gender-based violence. As well, investments in social protection must be seen as essential investments in pandemic preparedness, and tackling discrimination and marginalisation are key to disrupting transmission.

12. Unlike COVID-19, HIV was able to be recognised as a threat to peace and security by the UN Security Council. It was elevated in the UN system to the level of Heads of State and Government at the 2001 General Assembly Special Session. Our Panel is calling for such a high-level special session on pandemic preparedness and response this year to give political momentum to the reforms needed in the international system. In making this and other recommendations, we can be inspired by what the movement to fight HIV has achieved and apply lessons learned from that experience.

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