Covid-19 blowing Africa's HIV fight off track — experts
If the disruptions to HIV programmes, which have largely been influenced by the global response to Covid-19 and protracted lockdowns, continue unabated for another six months, an additional half a million people living with HIV in Africa will die and mother-to-child transmission of HIV will be set back by a decade.
Speaking during the opening of the 23rd virtual International Aids Conference on Monday, UNAids executive director Winnie Byanyima said despite the progress made by many countries in their fight against HIV, too many people are still dying from HIV-related deaths.
In Africa, women remain at the greatest risk of contracting HIV with 59% of new infections affecting women and young girls.
“We know why. It is gender inequalities, gender-based violence, structural barriers that limit girls’ safety from HIV. They are not at school and are not safe at home. We can do more for women and girls in Africa and equalise opportunities for them,” she said.
Byanyima said the onset of Covid-19 brought more negatives to work done on the continent to combat HIV, which had been “built over the years with passion and lives of the people living with HIV”.
She said the disruptions, which saw HIV infrastructure repurposed and those who worked within HIV services, such as technicians, community-led services and volunteers, being moved to work on Covid-19, were worrying.
“We were already off track in achieving our HIV goals, but now coronavirus is completely blowing us off track and that’s a concern.” Last year’s HIV deaths of 690,000 as opposed to the target of 500,000 deaths were indicative of this slow progress.
“We’ve modelled together to and put an alert out with the World Health Organisation to show that if these severe disruptions were to continue for another six months we would have 500,000 additional deaths in Sub-Saharan Africa and we can’t afford that. We could have a reversal of mother-to-child transmission taking us back to 10 years ago.
“So the message is keep both balls in the air ... keep the services going for both diseases,” she said.
Byanyima also warned that the continent could feel the pinch of the pandemic with funding by richer nations set to dwindle due to the negative effects that Covid-19 had on economies of richer nations.
Of the $26.2 billion needed to fight HIV/Aids in the continent, there was already a financing gap of $7.6bn. “Over the years we’ve seen our funding partners from Europe and the US faithfully standing in solidarity with the poorest countries and we salute that, but we are seeing real threat. With their economies hit hard by Covid-19, there is a real danger of losing ground on financing the countries that are in need
The conference, which is the largest conference on HIV in the world, attracting the brightest minds fighting HIV/Aids including scientists, doctors, activists and people living with HIV, is being held virtually this year, in the shadow of the Covid-19 pandemic.
More than 25,000 participants are expected in this conference, which is also exploring how the Covid-19 crisis is affecting health services for those living with HIV. Delegates from 175 countries are attending the conference, originally set to have taken place in Oakland and San Francisco, US.
“These are remarkable times — and defining times — for the global HIV movement and for the world,” International Aids Society president and chair of the conference Anton Pozniak said. “Every conversation we have now sits at the confluence of the Covid-19 pandemic and a new global reckoning with systemic racism.”
“We don’t yet know the extent of increased risk that Covid-19 poses for people living with HIV, but we do know that social distancing efforts and government lockdowns have disrupted HIV prevention and treatment efforts — and put vital HIV research on hold.” WHO director-general Dr Tedros Adhanom Ghebreyesus shared findings of a new WHO survey showing significant disruptions in access to HIV treatment because of the Covid-19 pandemic. The survey showed that due to protracted lockdowns 73 countries were at risk of stock-outs of ARVs, and that HIV medicines had been “significantly curtailed as a result of the pandemic”.
“The findings of this survey are deeply concerning. Countries and their development partners must do all they can to ensure that people who need HIV treatment continue to access it. We cannot let the Covid-19 pandemic undo the hard-won gains in the global response to this disease.” Erik Lamontagne, a senior economist at UNAids, also shared the findings of survey done in 138 countries including SA, which showed that Covid-19 had a devastating impact on the 13,562 lesbian, gay, bisexual, transgender and intersex (LGBTI) community worldwide.
Nearly half the survey participants faced economic difficulty, with many unable to meet their basic needs, skipping meals or reducing meal sizes.
Nearly half of those who were working expected to lose their employment in the wake of the pandemic, and 13% had already lost their jobs.
About 26% of participants living with HIV reported that they had experienced interrupted or restricted access to refills of antiretroviral treatment.
Lamontagne said the crisis has pushed 1% of respondents to start engaging in sex work. Among this group, the pandemic has reduced their ability to negotiate safer sex practices, thus potentially increasing their risk for acquiring HIV.
Respondents also reported reduced access to safe injection equipment and opioid substitution therapy.
Lamontagne noted that these findings demonstrate some of the reasons that Covid-19 “threatens to undo global progress towards HIV prevention and treatment goals”.