HIV-Sweden in the media - new article on HIV and preparedness in Altinget

Hiv-Sweden's article "If war comes, do we have a plan for HIV?" was published on April 15 in Altinget. The article can be read on Altinget.se here. The authors of the article are Emanuel Karlström, strategist at Hiv-Sverige and Erik Malmstig, freelance journalist.

If war comes, do we have a plan for HIV?

"How can Sweden manage HIV care during a major crisis, how can we manage access to medicines during a trade blockade, and how can a disinformation campaign about HIV be handled? Erik Malmstig, freelance writer and Emanuel Karlström, strategist Hiv-Sverige.

In 1962, Herman Kahn wrote "Thinking about the unthinkable doesn't necessarily mean thinking about the unlikely."

Kahn puts his finger on how unthinkable future scenarios mean neither low nor unlikely chance of occurrence.

"A telling example is that last year the government cut back on HIV work in favor of supporting public sporting events."

In today's uncertain world, with wars in our neighborhood, the tightening of global aid, and global trade wars, the likelihood that rational plans cannot be implemented as we intended increases. So we must dare to imagine what we hope never happens. And plan for it.

In 2024, Sweden became the first country in the world to achieve UNAIDS' ambitious targets for HIV testing and treatment. The flip side of this success story is that HIV risks being seen as a challenge society has already solved. This is what is known as the curse of good prevention: when a treatment is successful, people forget how bad things once were. There is then a risk that the focus will shift to other areas, as is now likely to happen with HIV in Sweden.

A telling example is that last year the government cut back on HIV work in favor of supporting public sporting events.

How would HIV care fare in war or crisis?

In our report we highlight lessons learned from Ukraine, which today has the largest spread of HIV in Europe. War is such an existential threat that people living with HIV risk forgetting to take their medication or being forced to flee their homes without it. In addition, it appears that the stigma surrounding HIV has an even greater impact in war than in peacetime. This affects willingness to get tested, especially among young people.

How would HIV care fare if Sweden were at war? As far as we can see, this question has never been tested, and no preparedness exercises involving HIV have ever been carried out. Who takes responsibility for ensuring that HIV is seriously on the table when preparedness is discussed and planned for?

We also see other threats. Research shows that times of crisis like today provide good conditions for spreading disinformation. At the same time, the LVU campaign has shown how vulnerable our country is to influence operations. What if the next target is people living with HIV? What narrative would then be spun?

Is HIV taken seriously in preparedness work?

It is likely that inspiration would be drawn from myths already spread in the Western world. Myths that have been spread in one of the most listened to podcasts in Sweden: The Joe Rogan Experience. A regular guest on the podcast is Professor Peter Duesberg, who has argued since the 1980s that HIV does not cause AIDS. Instead, Duesberg believes that AIDS is caused by drug abuse and promiscuity. Antiviral drugs should be completely avoided. How does this affect young people's views on HIV today?

At the same time, the shortage of medicines in Sweden is greater than it has been for a long time. As HIV drugs are mainly manufactured by two companies, Gilead Sciences and ViiV Healthcare, this makes supply particularly vulnerable to disruption. How can we secure the supply of antivirals when US drug research is under threat and we are facing a global trade war? 

Our report does not provide all the answers. Rather, it shows that the questions need to be asked. We must dare to think the unthinkable to prevent it from happening. What is the government and responsible authorities doing to ensure that HIV is taken seriously in preparedness work?"