South Africa could miss its HIV, TB and STI treatment and prevention goals, thanks to the Covid-19 pandemic, health experts warn. The five-year strategy to reduce infection and deaths, among other goals, may be upended by the responses to the global pandemic, speakers at the South African National Aids Council say.

 The council held a webinar on Tuesday to share its progress on the  national strategic plan on HIV, TB and STIs. The strategy, implemented from 2017 to 2022, has eight goals that cover the medical and social response to the existing pandemics of HIV and TB. This year…

Accessing ARVs a challenge

The lockdown has impacted what is the largest national antiretroviral (ARVs) treatment programme in the world, said Sibongile Tshabalala, national chairperson of the Treatment Action Campaign (TAC).

“Non-adherence is an issue that affects almost every person living with HIV because if you go to the facility, you’re given one-month treatment so it means every month, if you are working, you have to ask for a day off, go and collect your treatment,” she says.

Tshabalala says that many people are living with just one week’s supply of medication, while others who went home in rural areas for the initial 21-day lockdown period are now unable to access their treatment under the extended lockdown. Even those who travel shorter distances are impacted, unable to afford public transport due to disrupted income, she adds.

Challenges could be an opportunity for innovation

These challenges have encouraged officials to find new solutions to ARV distribution, says Dr Zukiswa Pinini, chief director of HIV/Aids and STIs at Ministry of Health. Working with provinces, the national office is developing catch-up plans and moving collection centres.

Patients can also sign up for programmes such as Central Chronic Medicines Dispensing and Distribution (CCMD), which allows patients to collect medication at private pharmacies closer to their homes, at the government’s expense.

Covid-19 brings lessons for other illnesses

The pandemic has also shown that public engagement on a virus is possible, breaking barriers that the health sector has struggled to overcome for years, says Dr Zameer Brey, who leads the TB programme at the Bill and Melinda Gates Foundation. The wearing of masks, for example, and the accountability that has this has fostered represents a shift in public response, says Brey.

“People who wore masks was stigmatised for wearing them. We are now in this space where there’s a stigma against not wearing a mask, and that’s actually a really big shift. We should figure out a way to grab that and continue using it as a preventative measure,” he says.

The digital screening process developed to trace Covid-19 can also be adapted to the response to HIV and TB, says Brey. The accessible mobile phone-based system was created in South Africa and has helped to trace two million people during the pandemic in a more sensitive manner than the previous screening methods used for TB.  – Health-e News