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.

Source: British Medical Journal