#AIDS2020Virtual: Covid-1919 impacts 17.7 million people on ARVs
The World Health Organization and UNAIDS has warned that if efforts are not made to mitigate health services and supply interruptions during the COVID-19 pandemic,the disruption of antiretroviral therapy could cause 500 000 more deaths in sub-Saharan Africa in 2020–2021.
Speaking at the Virtual Aids conference World Health Organisation(WHO) Director of HIV, Hepatitis and STI programmes Meg Doherty, said that impact on of Covid19 onHIV services has been profound.
“From a survey that we have conducted among our Member States, we can see that now we have 73 countries that are reporting that they are at risk of stock–outs of antiretroviral medicines and that could affect an estimated 17.7 million people who are taking ARVs,” she said.
According to Doherty 24 of the 73 countries, report a critically low stock or major disruptions to supply.
Millions could be affected by critical ARV shortages
In some cases there is less than three months of antiretrovirals available that could affect an estimated 8.3 million people who are taking ARVs.
The main challenge is the supply chain according to Doherty. Suppliers are being impacted by land and air transport disruptions compounded by a limited access to health centres.
“To mitigate this impact on HIV treatment, the WHO has recommended a few interventions, one to prevent to use multimodal dispensing and differentiated services to ensure that people would have longer access to their ARVs when possible, but also to ensure that as the service delivery approaches are being developed,” she said.
Multi-month prescriptions recommended
The WHO has now recommended multi–month prescriptions are applied to other diseases and to other medications, such as those prescribed for hepatitis B and C.
“And certainly medicines that affect opiate substitution therapy as well as these are also critically important medicines that have been destructive during this period of time,” she added.
University of Cape Town School of Public Health and Family Medicine, associate Professor Dr Mary-Ann Davies presented findings from the Western Cape in South Africa.
It has experienced high levels of Covid-19 cases.
“What we were very concerned about in Southern Africa, and across Sub Saharan Africa, was that we might see extremely high mortality from Covid in people living with HIV,” she said.
Davies told the attendees of the Virtual conference that researchers were very concerned about the situation particularly in the Western Cape but they are able to access good information.
“We were fortunate in that we have quite good data on all our patients that attend public sector services, so that we could link together the data on all these patients with their COVID outcomes,” she added.
Risk has doubled for HIV patients in Western Cape
Davies said researchers found that there the risk of death has doubled for the 3.5 million HIV patients in the Western Cape who attend public sector health services regularly.
However there is a possible silver lining.
“Importantly, this is much less than the risk associated with other factors like older age or diabetes, but it did indicate that there was a significantly increased risk for people with HIV,” she said Davies.
But Davies stressed that South Africa will not experience massive excess mortality due to COVID, in people with HIV or with TB.
“And in fact, our results of a doubling of risk may even overestimate this risk if there is still some residual confounding because this is observational data and . it’s based on routine data sources which are not perfect,” she said.
According to Centre for the AIDS Program of Research in South Africa(CAPRISA) Director, Professor Salim Abdool Karim, the response to the Covid-19 pandemic demic in terms of restrictions of people’s movement, and lockdowns had a dramatic effect on healthcare services at a very broad level.
“In South Africa, it impacted access to TB testing and diagnosis. HIV viral loads went down by about 30 odd percent. As we’ve ease the lockdown, those are slowly now getting undone and we are now getting back to better access.” he said.
People avoid healthcare due to Covid-19 fears
According to Karim a South African survey revealed that 58% of people are hesitant to go to a healthcare service, because they worried they’re going to catch Covid-19.
“That’s something that is a major challenge as we grapple with these combined epidemics. But there’s little doubt that in countries like South Africa, and indeed in many countries in Africa, our substantial HIV epidemics have infrastructure that have placed us in a somewhat good position to respond to the Covid panpidemic,” he said.
Karim concluded by saying the world faces a long haul when it comes to a vaccine or cure which is likely to take many months, if not years.
“We’re going to need to change the way we tackle Covid and deal with it like the way we dealt with HIV.” – Health-e News