The COVID-19 outbreak is rightly shining a light on international and national responses to health emergencies—exposing gaps in our systems, showing our strengths and drawing on the valuable experience of responding to other health threats, such as HIV. At UNAIDS, we know that people living with HIV will have some anxiety and questions about the emergence of the virus that causes COVID-19. One of the most important lessons to be drawn from the response to the HIV epidemic is to listen and learn from the people most affected. UNAIDS continues to do so.
It’s important to underline that there is currently no strong evidence that people living with HIV are at an especially increased risk of contracting COVID-19 or, that if they do contract it, they will experience a worse outcome. As in the general population, older people living with HIV or people living with HIV with heart or lung problems may be at a higher risk of getting the virus and of suffering more serious symptoms. As for the general population, people living with HIV should take all recommended preventive measures to minimize exposure and prevent infection. As COVID-19 continues to spread around the world, it will be important for ongoing research in settings with a high prevalence of HIV in the general population to shed more light on the biological and immunological interactions between HIV and the new coronavirus.
But legitimate measures to contain the virus may have unintended adverse effects on people living with HIV. When the COVID-19 outbreak began in China, UNAIDS conducted a survey of people living with HIV to listen to their needs. A follow-up study has shown that some people living with HIV are beginning to experience challenges in receiving medicine refills. This is leading to some anxiety. In response, UNAIDS has been working with networks of people living with HIV and government officials to support special deliveries of medicines to designated pick-up points. A hotline has been established in China so that people living with HIV can continue to express their concerns while the outbreak persists. With our partners, we will also be closely monitoring developments in global supply chains to ensure that essential medical supplies continue to reach the people who need them and that disruptions to the manufacture of active pharmaceutical ingredients are kept to a minimum.
UNAIDS calls upon countries preparing their COVID-19 responses to ensure that people living with HIV have reliable access to their treatment medications. It’s now urgent that countries fully implement current HIV treatment guidelines from the World Health Organization for multimonth dispensing, ensuring that most people living with HIV are given three months or more of their medications. This will help to alleviate the burden on health facilities should COVID-19 arrive and allow people to maintain their treatment regimens uninterrupted without having to risk increased exposure to COVID-19 when retrieving their medicines.
A primary lesson from the AIDS response is that stigma and discrimination is not only wrong but counterproductive, both for an individual’s own health and for public health outcomes in general. That’s why UNAIDS has been supporting campaigns to reduce stigma and discrimination faced by people affected by COVID-19. We have never beaten a health threat through stigma and discrimination and our response to COVID-19 must be guided by lessons learned through the response to HIV. This includes listening to people affected by the outbreak and establishing trust and communication between people affected and health authorities, even before the disease burden rises.
Our biggest gains against HIV have come in countries that have reduced stigma and discrimination, encouraging people to test for the virus and to seek treatment if necessary. Using communication channels recommended by public health experts, let’s listen to people affected by COVID-19 and apply their lived experience so that we can strengthen our response to the virus.
The deaths caused by the COVID-19 outbreak are tragic and my thoughts go out to their families and loved ones. But if we are smart, the international community and individual countries will use this experience to further strengthen monitoring systems and make adequate investments in health infrastructure, both at the global and national levels. UNAIDS urges governments and health officials across the world not to delay in implementing public education programmes for all their citizens about the practical measures that should be taken to curtail the transmission and spread of the virus at the local level.
A people-centred approach is critical. Everyone must have the right to health—it’s our best defence against global epidemics.
Winnie Byanyima, UNAIDS Executive Director