How COVID derails the fight against HIV, tuberculosis and malaria

The COVID-19 pandemic has had a “devastating” impact on the fight against other deadly infectious diseases, according to a report that compares 2019 and 2020 data on HIV, tuberculosis (TB) and malaria in more than 100 low and lower middle countries. -income countries.

The assessment was conducted by the Global Fund, an international organization that funds efforts to address these three health challenges.

“COVID-19 has been the most significant setback in the fight against HIV, tuberculosis and malaria, which we have encountered in the two decades since the creation of the Global Fund,” writes the executive director of the organization Peter Sands in an introduction to his Results report 2021.

As countries entered lockdown and resources diverted to tackle the pandemic, prevention, testing and treatment services for all three fell precipitously, although the impacts varied for each. In some countries, Sands says, “the spillover effects on HIV, tuberculosis and malaria could exceed the direct impact of COVID-19.”

Processing delays

For HIV, the number of people reached by prevention programs that provide condoms or clean needles and syringes, for example, has fallen by 11%. HIV testing has fallen by 22%, delaying treatment and contributing to continued transmission of the virus (see “Testing issues”).

Grace Ngulube, an HIV activist in Malawi, is particularly concerned for adolescent girls and young women, who account for six of the seven new HIV infections among 15-19 year olds in sub-Saharan Africa, according to the report. In some places, the rollout of COVID-19 vaccinations has also caused problems for HIV-related work. Due to misconceptions about their safety, many girls and young women are reluctant to seek medical attention for fear of being vaccinated, Ngulube says.

However, the number of people living with HIV who received antiretroviral drugs increased by 9%, in part because clinics in some countries began providing them with enough drugs to last for several months, in order to reduce the need for frequent visits.

Efforts to fight tuberculosis, the second leading cause of infectious disease death in the world after COVID-19, have been hit hard. Tuberculosis is also caused by an airborne pathogen, so it has lost ground because resources such as isolation rooms, diagnostic kits and medical specialists have been diverted to the pandemic, says Jamie Tonsing, senior adviser on tuberculosis at the Global Fund. In countries supported by the Global Fund, the number of people tested and treated for TB has fallen by 18%, or around one million people. For extensively drug-resistant tuberculosis, the drop was 37%, a particularly severe impact. Untreated cases will lead to increased transmission and even more TB deaths than the 1.4 million recorded in 2019.

“Stable” malaria

The outlook for malaria remains “somewhat stable” in Global Fund-supported countries, according to the report, without significant setbacks or gains. Although campaigns to distribute insecticide-treated bednets, currently the best malaria prevention tool, were delayed at the onset of the pandemic, countries quickly adapted, says Scott Filler, who heads the malaria control program. Global Fund malaria. When the countryside resumed, many countries switched from distributing mosquito nets in public spaces to delivering them door-to-door, to avoid overcrowding. This contributed to a 17% increase in the number of mosquito nets distributed. However, the number of people suspected of malaria who were tested decreased by 4.3%. “A lot of kids haven’t been tested when they should have been,” Filler said.

Despite this, progress against malaria has stalled “at unacceptable numbers,” says Pedro Alonso, who heads the Global Malaria Program at the World Health Organization. There are still over 400,000 deaths from malaria and 220,000 million cases per year.

Disease experts are concerned about the impact that waves of SARS-CoV-2 infections and the emergence of new variants will continue to have on efforts to fight these three diseases. “The crisis is far from over, especially with the Delta variant taking its toll,” Sands said. “We’re not really going to get back on track with HIV, TB and malaria until we get COVID-19 under control. “