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HIV and SARS-CoV-2: the interplay of two wicked problems

Anneleen Kiekens, George Msema Bwire, Catherine Decouttere, Michael R Jordan, Ally Mangara, Idda H Mosha, Tobias Rinke de Wit, Raphael Zozimus Sangeda, Omary Swalehe, Nico Vandaele, Japhet Killewo, Anne-Mieke Vandamme

Summary box

  • The AIDS and COVID-19 pandemics are intersecting at multiple levels.

  • Both pandemics have previously been described as wicked problems and can be studied as complex adaptive systems.

  • We recently designed a qualitative model of all known factors influencing HIV drug resistance (HIVDR) in sub-Saharan Africa and analysed its complexity as a complex adaptive system. Our detailed systems map featured three main feedback loops driving HIVDR.

  • Visualising both pandemics in one systems map confirms the urgency to address both simultaneously in order to mitigate a prolongation of the current COVID-19 pandemic and a rise in drug-resistant HIV.

  • Also at local level, a visualisation of the effects of the COVID-19 pandemic and response measures on the HIVDR system is valuable in gaining an understanding of its system-wide impact when rapid public health action is needed.

Read the full report.