HIV antivirals, based in part on protease inhibitors, ended up being THE game changer in the fight against AIDS, even in the absence of a vaccine.
The situations are not exactly parallel. The antivirals needed to suppress HIV in the blood in order to prevent passing on the virus need to be taken for life. Clearly, a vaccine would be preferable for many reasons, and the search for one goes on.
I think there are lessons to be learned, though.
One is that “nut cases" abound and will never be silent. Despite the stunning (practically 100%) effectiveness of HIV antivirals, a loud fringe has never stopped saying they don’t work, often based on a long debunked claim that HIV does not cause AIDS.
Another problem is the exaggeration of side effects. While HIV antivirals have been linked to bone loss and kidney malfunction, the link is tenuous and causation is not certain. In any event, people who are HIV positive and begin taking antivirals soon after infection have been observed to enjoy slightly better health than the general public, possibly because of quarterly blood tests they need to take to qualify for their treatment, which often catch problems not related to HIV, at a stage early enough to be more easily treated than generally.
The third problem is expense. While these antivirals can be manufactured at very little expense, the major pharmaceutical companies that produce them have kept the prices very high, far beyond the ability of an ordinary person to pay. In most of Europe and North America, this isn’t a problem people feel, because insurance companies or governments typically pay. But the struggle to get treatment to people in the developing world has been extraordinarily challenging. The Bill Gates Foundation (I know, boo hiss, but still ...) has done some good work negotiating lower prices in Africa and helping with distribution, and the HIV pandemic as a result in Africa has started to level off, finally. But in general, high prices for a very cheap-to-manufacture class of drugs remain a serious obstacle to treatment.
It will be interesting to see if the greater prevalence of novel coronavirus infection will inspire more moral and ethical behavior from pharmaceuticals.
