Unlike malaria and tuberculosis, HIV/AIDS was identified only 40 years ago, and still we’ve seen the same trend. After the infection emerged in the early 1980s, it went from a condition thought to affect only gay men in the global North to a global pandemic that, yes, mostly affects the global South today. In 2020, nearly 38 million people globally were living with HIV, and 680,000 people died from AIDS-related illnesses, with two-thirds of both cases and deaths in Africa. When effective antiretroviral drugs first became available in the early 1990s, they were expensive and mainly accessible to people in high-income countries. For these lifesaving tools to reach the global South took incredible activism and years of effort, and millions of people (mostly Africans) died as a result of this inaction. Even today, we do not have a vaccine against AIDS.

Despite the continued toll of these “big three” infectious diseases, they are rarely spoken of as pandemics. “By epidemic we actually mean a pandemic that no longer kills people in rich countries,” wrote Peter Sands, the CEO of the Global Fund, an international group that combats these diseases. “By endemic we actually mean a disease the world could get rid of but hasn’t. HIV/AIDS, TB and malaria are pandemics that have been beaten in rich countries. Allowing them to persist elsewhere is a policy choice and a budgetary decision.”

With the coronavirus, the global South is being left behind once again.