Global public health campaigners marked World AIDS Day on Wednesday by delivering a stark warning to humanity: “History is repeating itself with Covid.”

More than a year and a half into the coronavirus pandemic, billions of people in poor nations remain without access to lifesaving vaccines as rich countries hoard doses and profit-seeking pharmaceutical companies monopolize key technology—a situation that, according to experts and activists, bears a striking resemblance to the early stages of the AIDS crisis, which began in the early 1980s and continues to exact a staggering toll in the present.

“We don’t have time. End inequalities. End AIDS. End pandemics.”

“In Africa alone, it’s estimated up to 12 million people died needlessly in the time it took to make HIV treatment universally available,” the People’s Vaccine Alliance, an international coalition of humanitarian groups, said Wednesday. “We cannot allow it to happen again with Covid-19.”

“We will not,” the alliance added. “Break the monopolies. Share the know-how. Deliver a people’s vaccine.”

To call attention to the “striking parallels” between the coronavirus pandemic and the HIV/AIDS crisis—which is currently classified as a global epidemic by the World Health Organization—the vaccine equity coalition published a video Wednesday narrated by UNAIDS executive director Winnie Byanyima and Prince Harry, Duke of Sussex, whose mother has been credited with helping to dismantle stigma surrounding HIV/AIDS.

“The world is fighting a killer virus—and not for the first time,” Byanyima says in the video. “Both have caused millions of deaths, and in both cases scientific breakthroughs have meant that—for many—life could begin again.”

“But not for all,” Prince Harry adds. “This is a story about how corporate greed and political failure have prolonged both pandemics—and what we can do to stop it.”

Prince Harry goes on to recount that “in the early 2000s, a wave of activism helped break drug company monopolies, giving millions of people access to generic medicines at a fraction of the price.”

“By ending vaccine monopolies and sharing technology,” he continues, “companies in the developing world can start producing Covid vaccines too.”

Historian Paul Adler noted in a Washington Post op-ed earlier this year that in 1997, the new democratic government of South Africa—a nation badly impacted by HIV/AIDS— “passed a law aimed at ensuring wide distribution of medicines” through tactics such as “compulsory licensing that challenged the predominance of intellectual property rights.”

“In response, a group of 41 drug companies, along with pharmaceutical industry lobbies, sued the South African government. Several global North governments also blasted the law. Both the companies and governments accused South Africa’s law of violating TRIPS,” Adler wrote, referring to the Trade-Related Aspects of Intellectual Property Rights agreement that campaigners today view as a major obstacle to equal distribution of coronavirus vaccines.

Adler continued:

The actions of governments such as the United States and the pharmaceutical industry provoked immediate global outrage. Social movements and advocacy groups across the world mobilized. In South Africa, the Treatment Action Campaign brought together people living with HIV, unions, faith groups and nonprofits to mount protests and file lawsuits defending the law. In the United States, activists disrupted public events featuring Vice President Al Gore (then campaigning for the Democratic presidential nomination), accusing the Clinton administration of engaging in a “morally reprehensible” defense of profits over people.

The campaign worked. Rich country governments ceased their diplomatic and economic pressure. Within a few years, pharmaceutical companies withdrew their legal challenges. Some even agreed to voluntary price reductions. In the years following, prices of antiretrovirals dropped substantially and, most critically, more people gained access to these medicines. However, internationally, the TRIPS framework remained.

In October 2020, South Africa and India introduced a proposal at the World Trade Organization that would temporarily waive the TRIPS agreement for coronavirus vaccines and therapeutics, arguing that the intellectual property regime was constraining global production and denying shots to developing nations.

But the proposal has been stuck in largely fruitless negotiations for more than a year as the pharmaceutical industry and rich countries—including the European Union, the United Kingdom, and Switzerland—continue to object and lobby against its enactment.

With vaccines and technology concentrated in wealthy nations, only 6% of people in low-income countries have been at least partially inoculated against Covid-19. Just 25% of African healthcare workers have been fully vaccinated, according to the WHO.

Byanyima emphasized in a statement Wednesday that the world’s ongoing battles against the coronavirus and HIV/AIDS—for which there is not yet a vaccine—are interlinked. “Without the inequality-fighting approach we need to end AIDS,” she argued, “the world would also struggle to end the Covid-19 pandemic and would remain unprepared for the pandemics of the future.”

“Progress in AIDS, which was already off track, is now under even greater strain as the Covid-19 crisis continues to rage, disrupting HIV prevention and treatment services, schooling, violence prevention programs, and more,” noted Byanyima, whose agency warned earlier this week that the world could see 7.7 million additional AIDS-related deaths over the next decade if global leaders don’t act.

“Through fighting the AIDS pandemic, we have learned a lot about what we need more of for AIDS and for all pandemics,” she said. “We need policies to ensure fair and affordable access to science. Every new technology should reach each and everyone who needs it without delay… Every minute that passes, we are losing a precious life to AIDS. We don’t have time. End inequalities. End AIDS. End pandemics.”