Far greater investment in global pandemic response is required to ensure that core public health initiatives, like AIDS prevention and treatment aren’t thrown off course by future pandemics, while roll-out of a cheap and accessible “People’s Vaccine” would help get other core public health programmes quickly back on track, UNAIDS has said.

In a message at the launch of the annual World AIDS Day report, Prevailing against pandemics by putting people at the centre, UNAIDS Executive Director Winnie Byanyima also called on the global pharma industry to unlock the secrets to their COVID-19 vaccine technologies to produce a cheap and accessible “People’s Vaccine”.

“Even today, more than 12 million people are still waiting to get on HIV treatment and 1.7 million people became infected with HIV in 2019 because they could not access essential services, said the UNAIDS head in her message. “That is why UNAIDS has been a leading advocate for a People’s Vaccine against the coronavirus. Global problems need global solidarity.

“As the first COVID-19 vaccine candidates have proven effective and safe, there is hope that more will follow, but there are serious threats to ensuring equitable access,” she said. “We are calling on companies to openly share their technology and know-how and to wave their intellectual property rights so that the world can produce the successful vaccines at the huge scale and speed required to protect everyone and so that we can get the global economy back on track.”

Byanyima’s comments followed upon her open letter to the The Financial Times, and published Thursday, which said that media coverage of fast-moving vaccine research has too often ignored “the fundamental problem of the failure of pharmaceutical firms to openly share their technologyand knowhow, and waive their intellectual property rights.

“The Pfizer/BioNtech and Moderna vaccines have received millions in public money, from the US and EU to develop these vaccines,” Byanyima added in her letter, referring to the two companies most likely to win regulatory approval in the next few weeks for the first vaccines against COVID to show efficacy, but which rely upon expensive mRNA technologies that are out of the price range of low- and middle-income countries.

“These vaccines are not private property to be sold for a profit, but public property to be mass produced for the global common good. We would urge all corporations to join the World Health Organization’s Covid technology access pool (C-TAP) and for their rich country backers to insist that they do so, given the huge public subsidy they have received. Only this will enable every vaccine producer in the world to manufacture on the huge scale required to protect everyone, and get our global economy back on track. We cannot let this be a profit vaccine; it must be a peoples’ vaccine,” Byanyima wrote in the FT letter.

Weak Health Systems Left World Unprepared For COVID

The UNAIDS report notes how insufficient investment and action on HIV and other pandemics left the world exposed to COVID-19. State UNAIDS: “Had health systems and social safety nets been even stronger, the world would have been better positioned to slow the spread of COVID-19 and withstand its impact. COVID-19 has shown that investments in health save lives but also provide a foundation for strong economies. Health and HIV programmes must be fully funded, both in times of plenty and in times of economic crisis.”

“The collective failure to invest sufficiently in comprehensive, rights-based, people-centred HIV responses has come at a terrible price,” Byanyima also said. “Implementing just the most politically palatable programmes will not turn the tide against COVID-19 or end AIDS. To get the global response back on track will require putting people first and tackling the inequalities on which epidemics thrive.”

There are bright spots nonetheless, the UNAIDS report notes: “The leadership, infrastructure and lessons of the HIV response are being leveraged to fight COVID-19. The HIV response has helped to ensure the continuity of services in the face of extraordinary challenges. The response by communities against COVID-19 has shown what can be achieved by working together.

But the Organization warned that countries risk repeating the “mistakes” of the early days of HIV response – when millions of people in Africa died as a result of being unable to access expensive new antiretroviral drug treatments that were being rolled out in developed countries:

“The world must learn from the mistakes of the HIV response, when millions in developing countries died waiting for treatment. Even today, more than 12 million people still do not have access to HIV treatment and 1.7 million people became infected with HIV in 2019 because they did not have access to essential HIV services,” said the statement.

“Everyone has a right to health, which is why UNAIDS has been a leading advocate for a People’s Vaccine against COVID-19. Promising COVID-19 vaccines are emerging, but we must ensure that they are not the privilege of the rich. Therefore, UNAIDS and partners are calling on pharmaceutical companies to openly share their technology and know-how and to wave their intellectual property rights so that the world can produce successful vaccines at the huge scale and speed required to protect everyone.”

When asked at a press conference on Thursday about how young people will be considered in this startegy, she flagged that the risks posing young people today are different to those experienced by young people at the start of the AIDS crisis.

“The HIV pandemic is in its second – even third – generation, and the attitudes toward the disease each geneeration keep changing,” she said, citing that Uganda’s younger generation as viewing the disease as “just a chronic illness, like diabetes or hypertension”.

“They have no sense that it kills. They think you just live with it because they never saw the deaths,” she added. “I saw the deaths.” Young people today, in countries with a high number of cases are made more vulnerable by this lack of education, she said.

Countries Falling Way Behind – New 2025 Targets for Getting Back on Track

Modelling of the pandemic’s long-term impact on the HIV response shows that there could be up to 293,000 additional new HIV infections and up to 148,000 additional AIDS-related deaths between by 2022, the new UNAIDS report finds.In its latest report UNAIDS outlined a series of new targets for reducing HIV infections by 2025  – aimed at  getting progress that was admittedly already “off track before the COVID-19 pandemic hit” – back on the rails.

New HIV/AIDS treatment targets set out in the report aim at achieving a 95% coverage for each sub-group of people living with and at increased risk of HIV. By taking a person-centred approach and focusing on the hotspots, countries will be better placed to control their epidemics.

The targets  also focus on a high coverage of HIV and reproductive and sexual health services together with the removal of punitive laws and policies and on reducing stigma and discrimination. They focus on people most at risk and marginalized— including young women and girls, adolescents, sex workers, transgender people, people who inject drugs and gay men and other men who have sex with men.

And the 2025 targets also include the promotion of more ambitious anti-discrimination laws and policies – so that less than 10% of countries have punitive laws and policies vis a vis people living with HIV; less than 10% of people living with and affected by HIV experience stigma and discrimination; and less than 10% experience gender inequality and violence.

Although some countries in sub-Saharan Africa, such as Botswana and Eswatini, have achieved or even exceeded the targets set for 2020, many more countries are falling way behind, the Organization also noted, stating that nonetheless. “The high-performing countries have created a path for others to follow.”

Image Credits: UNAIDS.