CROI 2021: Urgency of global access to vaccines, the potential of mAbs and the lessons learned from HIV
The three opening lectures this year covered both HIV and COVID-19 from community and scientific perspectives.
In the first of these, leading global activists Fatima Hassan and Gregg Gonsalves opened CROI with a focus on global access to COVID-19 vaccines. This was in the Martin Delaney presentation (which is usually only included in a pre-conference workshop). This talk is now online for open access. 
The talk drew parallels with the early campaigns to ensure that broadened access to ART beyond high-income countries. Unless access to COVID-19 vaccines globally is developed, as well as within each country, relaxing lockdown will never safely extend to international travel. Current projections do not expect significant vaccine cover in south east Asia until the end of 2022 and in most African countries until 2023.
New variants will continue to develop spontaneously in populations where vaccine cover is limited and those with transmission advantages will spread globally. This included the divisions on equity of access to vaccines by race, where many high income countries (including the US) have lower rates of vaccine uptake by black and ethnic minority citizens and where global access in extremely limited in low and middle-income countries.
Although some vaccines (including Oxford/AZ) are already being manufactured by generic companies and widely distributed at a not-for-profit cost, the talk called on CROI to endorse the international People’s Vaccine campaign and to sign the WHO Vaccine Equity declaration (#VaccineEquity #endvaccineapartheid). [2, 3, 4]
In the two other talks in the opening session were also on COVID-19.
Pamela J Bjorkman from the California Institute of Technology talked about developing neutralising monoclonal antibodies against the spike protein of SARS-CoV-2. This has included using microscopy and X-ray crystallography to map and classify variants as part of a large programme to design a vaccine that would protect against both variants of SARS-CoV-2 and future coronaviruses.
The third talk, given by Anthony Fauci from the US NIAD, reviewed the connections between the HIV and COVID-19 epidemics. 
This included lessons that can be learned from responses to both infections that could accelerate new ways to prevent and treat COVID-19, including the considerable role that HIV scientists have played in COVID-19 research. This includes the programme of CROI 2021 where approximately half the oral oral presentations and 25% of the posters include COVID-19.
A working group of scientists, public health and legal experts, and community leaders from CROI draft a call for vaccine equity.
Please contribute to this initiative by signing this call and forwarding through your networks.
The weblink for all talks in the opening session, currently restricted to delegates, is:
- Gonsalves G and Hassan F. Vaccine nationalism is killing us: how inequities in research and access to sars-cov-2 vaccines will perpetuate the pandemic.The Martin Delaney Presentation. CROI 2021.
https://www.youtube.com/watch?v=2zYxBQHQbq8 (YouTube open access)
- The People’s Vaccine.
- WHO Vaccine Equity declaration.
- People’s Vaccine Day of Action. An online rally on 10 March at 13:30 Washington / 18:30 London / 19:30 Brussels / 21:30 Nairobi. Free registration.
- Bjorkman PJ. Neutralizing antibodies against coronaviruses. The Bernard Fields Lecture. CROI 2021.
- Fauci A. Lessons from the concurrent HIV/AIDS and covid-19 pandemics: a two-way street.
This article was first posted on 8 March 2021.