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Disruptions in HIV-Related Services due to COVID-19 Response Could Result in Hundreds of Thousands of Extra Deaths from HIV

KAMPALA, Uganda– A modelling group convened by the World Health Organization and UNAIDS has estimated that if efforts are not made to mitigate and overcome interruptions in health services and supplies during the COVID-19 pandemic, a six-month disruption of antiretroviral therapy could lead to more than 500,000 more deaths from AIDS-related illnesses.

This research brought together five teams of experts using different mathematical models to analyze the effects of various possible disruptions to HIV testing, prevention and treatment services caused by COVID-19, with each model looking at the potential impact of treatment disruptions of three months or six months on AIDS mortality and HIV incidence in sub-Saharan Africa. Estimates show that excess AIDS-related deaths in one year ranged from 471,000 to 673,000, making it inevitable that the world will miss the global 2020 target of fewer than 500,000 AIDS-related deaths worldwide.

“We must read this as a wake-up call to countries to identify ways to sustain all vital health services. For HIV, some countries are already taking important steps, for example ensuring that people can collect bulk packs of treatment, and other essential commodities, including self-testing kits, from drop-off points, which relieves pressure on health services and the health workforce. We must also ensure that global supplies of tests and treatments continue to flow to the countries that need them,” said Dr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization.

UGANET champions existing rights of persons living with HIV, which now more than ever, are likely to be overlooked and easily sacrificed as services are simply becoming overwhelmed due to competing needs to support the COVID-19 response.

UNAIDS estimates show that 1.4 million people are living with HIV in Uganda. Women are disproportionally affected: of the 1 300 000 adults living with HIV, 770 000 (59.23%) were women. New HIV infections among young women aged 15–24 years were more than double those among young men: 14 000 new infections among young women, compared to 5000 among young men.

Significant strides have been made in an effort to combat AIDS. UNAIDS stats show that there has been a 58% decrease in AIDS-related deaths in the last ten years and a notable reduction in new infections in Uganda, thanks to the efforts of the government, civil society organizations and the community.

UGANET holds that access to HIV-related health services is a critical enabler in influencing the success of health and HIV interventions intended to prevent further spread and also mitigate the adverse social impact and suffering caused by HIV and other health conditions.

Since 2010, new HIV infections among children in sub-Saharan Africa have declined by 43% owing to the high coverage of HIV services for mothers and their children in the region. The disruption of these services by COVID-19 for six months could reverse gains made in preventing mother-to-child transmission of HIV with new child HIV infections rising drastically by 104% in Uganda.

 “The COVID-19 pandemic must not be an excuse to divert investment from HIV,” said Winnie Byanyima, Executive Director of UNAIDS. “There is a risk that the hard-earned gains of the AIDS response will be sacrificed to the fight against COVID-19, but the right to health means that no one disease should be fought at the expense of the other.”

Other significant effects of the COVID-19 pandemic on the AIDS response in sub-Saharan Africa that could lead to additional mortality include reduced quality clinical care owing to health facilities becoming overstretched and a suspension of viral load testing, reduced adherence to counselling and drug regimen switches. The extent to which a disruption to prevention services including suspension of voluntary medical male circumcision, interruption of condom availability, and suspension of HIV testing, and how this would impact HIV incidence in the region was considered.

UGANET therefore calls for urgent efforts to ensure the continuity of HIV prevention and treatment services in order to avert excess HIV-related deaths and to prevent increases in HIV incidence during the COVID-19 pandemic. We have made significant progress in the fight against HIV. We cannot afford to lose the momentum.

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