The COVID-19 pandemic has disrupted public health systems and health service delivery for HIV, tuberculosis, and malaria in Africa and Asia, threatening to reverse the progress made to date against those diseases, a report from the Global Fund to Fight AIDS, Tuberculosis and Malaria finds.
Based on information from health facilities in thirty-two low- and middle-income countries — twenty-four countries in Africa, seven countries in Asia, and Ukraine — between April and September, the report, The impact of COVID-19 on HIV, TB and malaria services and systems for health: a snapshot from 502 health facilities across Africa and Asia (18 pages, PDF), found that, compared with the same period in 2019, outpatient consultations declined significantly due to patients fearing infection by the virus or being unable to access health facilities as a result of lockdown and stay-at-home orders and/or disruptions to public transportation.
According to the report, HIV testing and referrals for those in need of further diagnosis and treatment, including pregnant women, were down 41 percent and 37 percent. Referrals for TB patients and drug-sensitive TB diagnosis and screening services fell 59 percent and 44 percent overall — 70 percent/52 percent in Asia and 29 percent/28 percent in Africa. Malaria diagnoses fell 31 percent overall, with diagnoses and treatment services down 56 percent and 59 percent in Asia, while in Africa, where 94 percent of global malaria cases and deaths occur, diagnoses and services were down 17 percent and 15 percent. In addition, prenatal care visits declined 43 percent across Africa and Asia.
The report also found that only 45 percent of health facilities in Africa had enough personal protective equipment (PPE), including masks, disinfectant, gloves and hand sanitizer, while only 11 percent and 8 percent could conduct COVID-19 antigen rapid diagnostic tests and polymerase chain reaction (PCR) tests.
"This snapshot underscores the scale of the challenge," said Global Fund executive director Peter Sands. "HIV prevention has been knocked backwards. With the dramatic drop in case management for malaria, we face a real risk for a spike in mortality. Much of the progress we've made to close the gap on finding 'missing' people with TB has been reversed. The stark truth is that we will see more incremental deaths from HIV, TB, and malaria in 2021 as a consequence of the disruption caused by COVID-19 in 2020."
(Photo credit: Global Fund/Atul Loke/Panos)