HIV Aids

The Unequal COVID-19 Vaccine Rollout Divide: Turn Grief Into Rage


In the early days of the AIDS epidemic, the Ronald Reagan administration turned a blind eye to the suffering of people living with HIV (PLWH) in the United States. In fact, President Reagan first spoke about AIDS in 1985, four years after the first case of the disease was identified—and at a time when the epidemic was raging.

As we mark the one-year anniversary of the passing of the iconic activist, author, and co-founder of Gay Men’s Health Crisis (GMHC) and AIDS Coalition to Unleash Power (ACT UP), Larry Kramer, it makes sense to borrow his slogan at ACT UP calling out communities affected by HIV to “turn grief into rage.” And, too, we remember how Kramer turned his grief into rage in his 1988 open letter to Anthony Fauci, M.D., (who was then, as now, director of the National Institute of Allergy and Infectious Diseases) that appeared on the front page of the San Francisco Examiner. It worked—the U.S. government paid attention.

Similarly, I am calling on the U.S. HIV community to turn our COVID-19-related grief into rage and urge this country to break the global COVID-19 vaccine rollout divide. As I stated nearly a year ago, the COVID-19 pandemic is still very much a security and economic threat. And from all the reports we have been hearing in recent weeks, the COVID-19 pandemic is far from over as variants surge in other parts of the world with lower access to COVID-19 vaccines.

To illustrate, the U.S. and a few other developed countries have purchased the majority of all COVID-19 vaccines. While President Biden is confident that COVID-19 vaccines have proved effective in preventing COVID-19, serious illness, and hospitalization, and he continues to set ambitious vaccination targets for all U.S. adults, in other developed countries, the story is different. To give some perspective, just 0.3% of vaccine supply is going to low-income countries, as of May 14, 2021. South Africa, for example, one of the countries hardest hit by COVID-19 on the African continent, has reportedly vaccinated fewer than 2% of its population and will likely not reach herd immunity until February 2022.

Some other countries, known as “vaccine deserts” have not administered a single shot. If nothing is done to break the global COVID-19 vaccine rollout divide, many developing countries reportedly will not reach herd immunity until 2024. As a result of slow vaccination efforts and the surge of coronavirus variants, the COVID-19 pandemic continues to rage across the globe.

“Immoral and Unethical” Hoarding

Tedros Adhanom Ghebreyesus, M.D., director-general of the World Health Organization, warned the world back in August 2020 about “the threat of COVID-19 vaccine nationalism,” aka “my country first.” He added that it would be “immoral and unethical” to hoard vaccines and pull out of COVAX, a global initiative designed to speed up fair production of COVID-19 vaccines, the global COVID-19 vaccine rollout, and distribution and administration around the globe.

In his opening remarks at the World Health Assembly in May, Ghebreyesus reminded countries that have been able to vaccinate a large portion of their population to not be complacent, because, as he stated, the pandemic is not over “until and unless transmission is controlled in every last country.”

Meanwhile the Biden administration says that it is committed to controlling the COVID-19 pandemic at home and abroad. Back in February, during a meeting of G7, President Biden pledged $4 billion and authorized the immediate release of $2 billion toward global vaccination efforts. In April, the Biden administration helped start the 2021 COVAX investment opportunity, calling on world leaders and private businesses to invest in the global vaccination effort, and he authorized the deployment of emergency aid to India. I applaud the Biden administration’s efforts to speed up the global COVID-19 vaccination effort. However, as much as human lives are concerned, the United States and other wealthy countries’ aid is a drop in the sea. They can do more.

We Have Been Here Before With the HIV Treatment Divide

As all this is playing out, my memories and past trauma from earlier years of the AIDS crisis are coming back to me. While the U.S. and a handful of developed countries at the time had access to antiretroviral therapy (ART), AIDS was raging in other parts of the world. I witnessed the deaths of family members and neighbors—my community buried someone every day. By the time I was placed on ART after 2000, I had only a CD4 count of 12 and a viral load in the billions. I was waiting to die, and my fate was decided by the fact that I was born in a developing country.

Thus, I am addressing the HIV community, because we have been here before with the global HIV treatment divide. The global HIV community showed a tremendous amount of solidarity and turned “grief into rage.” Case in point: ACT UP activists in Washington, D.C. and New York held “die-in” demonstrations and protests in streets and churches, threw loved ones’ ashes on the lawn of the White House, and disrupted presidential campaigns and the CBS Evening News. The community came together to tirelessly advocate for the rights of PLWH and for the creation of the Health Global Access Project (Health GAP) for Africa and Asia to ensure universal access to lifesaving HIV medications.

As a result, today, tens of millions of PLWH across the globe can access HIV treatment regardless of their ability to pay. And we now know that undetectable equals untransmittable (U=U). Truly, taking HIV treatment properly leads to an HIV undetectable viral load, and PLWH with an undetectable viral load cannot sexually transmit HIV. Thus, currently, PLWH from Uganda, Vietnam, Brazil, the Netherlands, Turkey, Russia, and China, to name a few, are singing the wonders of U=U in their local languages.

Once again, people in the HIV community are the right people at the right time in our lifetime to “turn grief into rage” and urge the U.S. government to do more to break the global COVID-19 vaccine rollout divide.

For the HIV community, I urge you to get the COVID-19 vaccine and preach the good news of COVID-19 vaccines—convert your families and friends into vaccinated people to prevent new COVID-19 infections and block the spread of variants. Organize and call your senators and your representatives, urging them to do more to break the vaccine rollout divide, because, as World Health Organization Director-General Ghebreyesus declared: “We are not safe until everyone is safe.”

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