The number of people vaccinated in the US alone is five times those immunised in the entirety of Africa. This uneven distribution of life-saving interventions is reminiscent of what was seen 25 years ago with access to HIV treatment. But just addressing this inequity is not enough, local health systems must also be strengthened to support the delivery and uptake of these medications or vaccines. Forty years ago, the world recorded the first known cases of Aids. Today, that pandemic holds essential lessons for the latest disease outbreak - and in particular, the quest for an equitable - and effective - global Covid-19 vaccine roll-out.