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The AIDS Crisis Offers Essential Lessons for Fighting COVID-19

AIDS

Dr. Rowena Johnston from amfAR outlines how the response to one epidemic could save lives in another.

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As we watch -- and experience -- the world's response to the novel coronavirus, it's useful to reflect on lessons learned from the response to the emerging threat of HIV and AIDS in the 1980s. Those were hard-won lessons, earned by doctors and researchers working with limited funds and by the heroic efforts of AIDS activists, too many of whom lost their lives.

Just as in those early days of HIV, there are no existing treatments for this new virus. Ambassador Deborah Birx, who is both the White House coronavirus response coordinator and U.S. global AIDS coordinator, has drawn parallels between early HIV and current coronavirus responses, highlighting that doctors are trying drugs that have already been approved for other uses.

Rigorous Testing Needed

This includes certain antiretrovirals used to treat HIV. But as Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, reminds us, it is important that all candidate drugs are tested rigorously in controlled clinical trials. Earlier this month, we learned that the anti-HIV drugs lopinavir/ritonavir were not effective in treating advanced COVID disease. As trials of these and other drugs continue in the setting of early and late-stage COVID disease, other researchers are turning their attention to the development of a vaccine against this new strain of coronavirus.

Many will be frustrated by the seemingly slow pace of trials of drugs and vaccine candidates. But in fact, these studies are moving relatively quickly, thanks to what we learned about conducting these kinds of studies in the context of HIV. And let us not forget that these clinical trials are critically important for protecting the public -- about 10 years ago we learned that a vaccine candidate for HIV actually resulted in more, not fewer, infections.

The speed with which scientists have been able to turn their attention to developing new treatments or a vaccine against the coronavirus is a direct legacy of knowledge gained and lessons learned in the course of fighting HIV. Many of the thousands of virologists and immunologists around the world cut their teeth on the most challenging and complex viral infection to date -- HIV. Their ability to pivot to this new challenge is a direct result of investments made in HIV research.

Stigma

Now is not the time to forget another lesson we learned from our response to HIV. Stigmatizing a group of people -- be they men who have sex with men or people of Asian descent -- is counterproductive to the fight against any virus. Everyone needs to feel safe enough to get tested and, if they test positive, to seek treatment and take measures to prevent the onward spread of the virus.

The best response will come from well-conducted scientific studies whose results and benefits are shared with everyone, and that inform and guide the most effective public health policies. While many stories about potential treatments are circulating, the scientific method exists because it provides us with the best answers. We can pay our respects to the millions of people we have lost to HIV by applying the lessons learned from that epidemic and following the best scientific and public health leads for this coronavirus.

Dr. Rowena Johnston is amfAR's vice president and director of research.

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