The Covid-19 pandemic has severely delayed the fight against other global plagues like HIV, tuberculosis and malaria, according to a sobering new report on Tuesday.
Before the pandemic, the world had made progress against these diseases. Overall, deaths from these diseases have fallen by about half since 2004.
“The advent of a fourth pandemic, at Covid, puts these hard-earned gains at risk,” said Mitchell Warren, executive director of AVAC, a non-profit organization promoting HIV treatment around the world.
The pandemic has inundated hospitals and disrupted supply chains for testing and treatment. In many poor countries, the coronavirus crisis has diverted limited public health resources from treating and preventing these diseases.
Far fewer people sought diagnosis or medication because they were afraid of being infected with the coronavirus in clinics. And some patients were refused treatment because their symptoms, such as a cough or fever, resembled those of Covid-19.
Unless global efforts to fight disease resume, “we will continue to play the role of the Whac-a-Mole emergency and global health response,” Warren said.
The report was compiled by the Global Fund, an advocacy group that funds campaigns against HIV, malaria and tuberculosis.
Before the arrival of the coronavirus, tuberculosis was the biggest killer of infectious diseases in the world, killing more than a million people each year. The pandemic has compounded the damage.
In 2020, around one million fewer people were tested and treated for tuberculosis, compared to 2019, a drop of around 18%, according to the new report.
The number of people treated for drug-resistant tuberculosis decreased by 19 percent and for extensively drug-resistant tuberculosis by 37 percent. Almost 500,000 people were diagnosed with drug-resistant tuberculosis in 2019.
“We have been hit very hard by tuberculosis,” said Peter Sands, Executive Director of the Global Fund. “I fear that will inevitably mean hundreds of thousands more deaths.”
India, which has the highest TB burden in the world, had resumed its rate of pre-Covid TB diagnoses at the end of 2020, but the epidemic last spring has likely reversed that progress, Mr. Sands.
A drop in TB diagnoses can have far-reaching consequences for a community. A person with untreated tuberculosis can transmit bacteria to 15 people each year.
Compared with 2019, the number of people in 2020 who requested an HIV test decreased by 22%, and the number of those who opted for HIV prevention services decreased by 12%. Male medical circumcision, believed to slow the spread of the virus, has fallen by 27%.
“Because there is no cure for HIV, each person infected has a long-term impact,” Sands said.
Malaria diagnoses have declined slightly, according to the report. Most countries have been able to adopt measures that have limited the impact on diagnosis and treatment.
Up to 115 million people have been pushed into extreme poverty as a result of Covid-19, further limiting their access to treatment and support. In some countries, school closures and closures have made it particularly difficult for adolescent girls and young women to access health services.
There were some glimmers of hope amid the grim news: The crisis forced health agencies and ministries in many poor countries to embrace innovations that could survive the pandemic. These include: distributing several months’ supplies of anti-tuberculosis and anti-HIV drugs to patients, as well as condoms, lubricants and needles; use digital tools to monitor TB treatment; and simultaneous testing for HIV, tuberculosis and Covid-19.
For example, in Nigeria, community health workers who tested people for Covid also looked for cases of HIV and tuberculosis. As a result, the country has become one of the few to experience an increase in HIV diagnoses compared to 2019.
In Ouagadougou, Burkina Faso, community health workers on motorcycles delivered insecticide-treated mosquito nets door-to-door, rather than distributing them from trucks to village squares. This approach allowed them to reach more households than before and helped reduce the number of malaria infections.
“It’s a little more expensive” to provide nets to individual households, said Sands, but “it was clearly an investment worth making”.
To minimize the impact of the pandemic, the Global Fund has spent about $ 1 billion more than its usual budget, Sands said. In March 2020, the organization released $ 500 million to help countries cope; by August 2021, it had raised $ 3.3 billion for use in 107 countries.
The funds have been used to strengthen health systems, provide tests, treatment and oxygen, and provide personal protective equipment for health care workers.
Donors have pledged an additional $ 6 billion for HIV and $ 2 billion for tuberculosis over the next three years, Sands said.