A new WHO study highlights the risk of antiretroviral shortages due to the COVID-19 pandemic. Sub-Saharan Africa could be particularly affected by the situation.
On the eve of the biannual conference of the International AIDS Society (ISA), 73 countries warned that they were at risk of running out of antiretroviral (ARV) drugs due to the COVID-19 pandemic. Some countries (24) reported extremely low stocks or disruptions in the supply of these vital medicines. The COVID-19 pandemic has severely disrupted the AIDS response and could continue to do so. Sub-Saharan Africa is particularly affected by the situation.
Sub-Saharan Africa
In 2018, an estimated 25.7 million people in sub-Saharan Africa were living with HIV, and 16.4 million (64%) were on antiretroviral treatment. These people are now at risk of having their treatment interrupted because antiretroviral services are closed or unable to provide antiretroviral treatment. The disruption to the supply chain is a consequence of the need to support the response to COVID-19. A six-month interruption in antiretroviral treatment could result in over 500,000 additional deaths from AIDS-related illnesses, including tuberculosis, in the period 2020-2021. This setback would bring the region's AIDS mortality rate back to 2008 levels. An interruption of even 20% would result in a further 110,000 deaths. Efforts must be made to mitigate the effects of the disruption on health services and the supply of health supplies.
"The COVID-19 pandemic must not be used as an excuse to divert investment from the fight against HIV. These hard-won gains against AIDS risk being sacrificed to the fight against COVID-19, but the right to health means that no disease should be fought at the expense of another." Winnie Byanyima, UNAIDS Executive Director
Impact on mother-to-child transmission
Coronavirus-related disruptions could also reverse the progress made in preventing mother-to-child transmission of HIV. Since 2010, new HIV infections among children in sub-Saharan Africa have fallen by 43%, from 250,000 in 2010 to 140,000 in 2018. If the problems continue for six months, this could lead to a considerable increase in new HIV infections in children, up to 37% in Mozambique, 78% in Malawi, 78% in Zimbabwe and 104% in Uganda.