Lessons from the HIV response to the Covid-19 vaccine

Concerns about access to Covid-19 vaccines in Africa are reminiscent of those raised about the response to the HIV pandemic in the mid-1990s and early 2000s, when highly active antiretroviral therapy (ART) it was accessible in high-income countries but not on the African continent.

“The HIV pandemic taught us that drugs, by themselves, were not enough to achieve global control of the disease,” say in an article published in “The New England Journal of Medicine” researchers from the School of Health University of Pittsburgh Public (USA)

In their article, the researchers point out that the health infrastructure in different directions: «more medicines, promote adherence and the tracing, identify key populations at risk, overcome stigma that inhibits access to care, and develop community support for HIV prevention and treatment.

Another key need was to obtain solid data for effective HIV treatment in vulnerable populations, including children and pregnant women.

In addition to access to Covid-19 vaccines and therapies, the article assures that countries require “sufficient infrastructure to receive and administer these interventions, which can be a logistical challenge in rural and remote areas.

Local resources to address these requirements, especially for vaccines, they say, vary between urban and rural settings in the various African subregions. MRNA vaccines require a Cold chain continues for distribution, a much bigger challenge in Africa.

Local resources to address these requirements, especially for vaccines, they say, vary between urban and rural settings in the various African subregions.

For example, they comment: innovative solutions are needed for the storage and transportation.

Furthermore, “these mRNA vaccines are administered in two separate doses, of 3 to 4 weeks, which is a challenge to complete the entire series.

In this sense, they say, the Johnson and Johnson and AstraZeneca’s, offer advantages for its implementation in Africa, by not requiring ultra-cold storage and, in the case of the former, by being a single dose.

On the other hand, ‘given the limited supply of Covid-19 vaccines and the sudden increase in new cases and deaths in Africa, it will be crucial to vaccinate populations most at risk of infection and severe disease», They comment.

Other lessons learned from the HIV pandemic concern working on against denial, stigma and misinformation, and the lack of information on vaccines in pregnant women and children.

And they conclude. «As we have learned from the HIV pandemic, biomedical advances alone are insufficient to sustainably control a pandemic. Considerations related to health infrastructure, local epidemiology and responsiveness to concerns and local beliefs are critical to ending the Covid-19 pandemic, not only in Africa, but also globally.

Each country will have its own unique vaccine distribution challenges, which must be addressed with a careful planning, including leveraging computational prioritization models and implementation strategies, and applying implementation science methods to maximize local impact. Addressing these differences is essential if we want to control current and future pandemics.