What Does HIV And Coronavirus Have In Common – Whether or not the coronavirus turns into a major U.S. health threat, it’s only a matter of time before a new virus emerges that requires a rapid government-led effort to fight its spread via diagnostic, treatment, and prevention efforts. It’s time to acknowledge the greatest challenge will not be scientific — rather, it will be to prevent politics from thwarting an effective response.
The federal government’s politicized approach to HIV, the most devastating virus in modern times, provides a case study on the impact of politics going viral. Thirty-nine years after AIDS, the related infection, was first recognized in 1981, HIV still infects roughly 40,000 Americans annually.
And even as roughly 2 million Americans have become infected and almost 700,000 have died, an estimated 14% of those infected remain unaware. Almost 1% of federal tax receipts go to care for, treat, and assist HIV-infected people.
The failure to eradicate HIV traces directly to politics. The best way to prevent the spread of a viral infection is well established: early detection and response. Yet politics prevented screening from the earliest days of the epidemic.
In 1983, the Centers for Disease Control and Prevention dropped its plan to screen blood donors after blood banks objected to the cost and activists complained it posed serious civil rights issues.
A later review by the Institute of Medicine bluntly noted, “There was little potential political reward, and some political cost, associated with taking a leadership position in AIDS prevention, especially one that attracted political opposition from vocal and powerful groups.”
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After an HIV test was developed in 1985, AIDS activists strenuously opposed its widespread use. They feared discrimination and marginalization, advocating for condoms instead.
And so, despite their known high-failure rate, condoms became the government’s main prevention message — not knowledge from testing before having sex with someone with a fatal, incurable disease.
The dangerous notion that condoms make sex “safe” from HIV transmission became accepted wisdom. Similarly, contact tracing, standard for diseases such as tuberculosis, was only recommended for HIV (despite its 10-year asymptomatic incubation period) due to political opposition, not scientific reasoning.
In 1987, a company I founded applied for Food and Drug Administration approval of the world’s first home HIV test. Since HIV was spread sexually, there was strong demand for a home test. In fact, one-third of people said they’d only test using a home test.
People wanted to be able to test themselves and potential partners in the privacy of their homes, without being judged based on the result. But the FDA banned consideration of any home HIV test after both AIDS activists and organizations with a financial interest in providing lab HIV tests opposed their use.
It took the FDA until 2012 to drop its ban on home HIV tests, despite a compelling public need and data clearly showing safety and efficacy. Sadly, countries around the world had followed the FDA’s lead, believing it was based on science, not politics. Millions of people became unnecessarily infected and died as a result.
In 2014, a senior CDC official admitted that the CDC had “consistently opposed working on sound, rapid HIV test approaches” and that opposition had been based on CDC fears that home tests would compete with CDC’s network of brick-and-mortar clinics.
A recent sign at a China airport read, “If you come from Wuhan City with symptoms such as cough or fever, please contact the quarantine officer.” The reality is some people who have symptoms may fear coming forward.
This is especially likely in China, with the Chinese government deliberately making a big show of literally barricading some people infected with the coronavirus inside their homes.
Those who are infected may fear being marginalized. The same is true in America. The lesson of the AIDS epidemic is a warning of the tragic unnecessary loss of human life that can happen when government chooses politics over science.
Whether it is the coronavirus or a future outbreak, it will be the job of government to play a central role in ensuring that science, not politics, guides prevention efforts.
