Virtual CROI 2021: Disparate impacts of two pandemics highlight systemic and leadership failures across four decades

As the AIDS epidemic emerged and spread in 1981, its swift and steep death toll raising urgent needs for answers and action, it was met at first with silence, a speaker at today's virtual CROI noted.

President Reagan did not acknowledge the pandemic or say the word AIDS until 1987, while other officials spoke of the deadly disease with disdain.

When responses to HIV finally began to take hold, new illnesses among White Americans began to decline. At the same time, incidence among Black Americans began to climb.

Four decades later, the response to, and impacts of COVID-19, has been "strikingly parallel," to those that continue in the HIV pandemic, Dr. James E.K. Hildreth of Meharry Medical College in Nashville said. His plenary talk "Disparities in Health: From HIV to COVID-19 and Beyond examined common factors behind the disparate impacts of the two pandemics.

"Our president knowingly made false statements about the gravity of a true national and international public health crisis," Dr. Hildreth said, speaking of former President Trump.

And, the heightened risk of severe and fatal disease COVID-19 poses to people with health issues that include metabolic and cardiovascular disorders, contributed to the toll of the virus among populations with limited access to health care, as well as other social determinants of health, including lack of economic, employment, housing and education opportunities.

The differences those factors have made stark, with COVID-19 case fatality rates of Black people 10 times those of White people in Michigan, and five times that of White people in Louisiana, Dr. Hildreth showed.

"It's not an exaggeration to say COVID-19 has been devastating for people of color," he added.

Responses targeting the population as a whole increased disparities, he added. Meeting Individual and community needs is one immediate step toward equity, he said. "Take a more focused approach, next time."

The passage of time between the start of the HIV public health crisis and and that caused by COVID-highlights systemic, long-standing and wide disparities in  health access, he noted.

"Closing the health gap is going to require a coordinated effort across a range of organizations, businesses and agencies."