HIV and Covid-19: A tale of two pandemics

The two most challenging pandemics of the last 40 years provide valuable epidemiological lessons as the world prepares for the next pandemics. The relationship between cause and effect or intervention and effect have been challenging to unravel in the two pandemics, though the challenges have differed. This presentation will focus on the causes and interventions for the high HIV risk in young women as well as on the effects of variants in Covid-19. 
 
In the HIV pandemic, about 70% of all new infections occur in Africa, where the highest incidence rates are in young girls. Identifying the behavioural and biological factors driving the risk of HIV in young women has taken decades. In parallel, research and development of cause-agnostic interventions to slow down infections in young women continued apace leading to the discovery that antiretrovirals prevent sexual HIV transmission. But the adherence challenges in implementing this intervention as a prevention strategy has complicated the assessment of their effectiveness and spurred development of long-acting formulations.
 
The research experience and capacity developed for the HIV response in Africa, were key to responding to the Covid-19 pandemic, particularly in developing the understanding as each new variant of concern drove each new wave. Interventions that were variant-agnostic became increasingly important.
 
The key lessons from both pandemics include the importance of taking heed of warning signs, the timeous scientific evidence to facilitate informed decision-making and the central importance of global solidarity and humanity’s mutual interdependence.
 

Salim S. Abdool Karim is a clinical infectious diseases epidemiologist widely acknowledged for his scientific contributions and leadership in AIDS and Covid-19.

He is the Director of CAPRISA (Centre for the AIDS Programme of Research in South Africa) and Professor of Global Health in Epidemiology at Columbia University. He is an Adjunct Professor at Cornell and Harvard Universities, Pro Vice-Chancellor at the University of KwaZulu-Natal and Special Advisor on pandemics to the WHO Director-General.

He is Vice-President of the International Science Council. He is a member of the WHO Science Council. He serves on the Boards of the New England Journal of Medicine, Lancet HIV and Lancet Global Health. He is a Member of the US National Academy of Medicine and Fellow of the Royal Society.

London School of Hygiene & Tropical Medicine