Covid-19: the epidemic risks undermining the fight against AIDS

The health consequences of the pandemic are manifold. The number of AIDS-related deaths has continued to drop last year and access to treatment is improving, but the Covid-19 is likely to undermine this progress in the coming months, warned UNAIDS in its Monday. Annual Report.

In 2019, 690,000 people worldwide died of AIDS-related illnesses, compared to 770,000 people in 2018. This is between two and three times less than at the peak of the epidemic in 2004 (1.7 million deaths ).

Likewise, the proportion of people living with HIV who have access to antiretroviral therapy continues to increase year after year.

Two-thirds of HIV-positive people worldwide (25.4 million out of 38) are now undergoing these treatments, which will prevent them from transmitting the AIDS virus if taken correctly. This is the highest proportion ever, and it is about ten times more than in the mid-2000s.

Dangerous care interruptions

But the Covid-19 epidemic risks provoking a step backwards, fears the UN agency dedicated to the fight against AIDS.

"According to estimates from recent modeling, a total interruption of antiretroviral therapy for six months could lead to more than 500,000 additional deaths from AIDS-related opportunistic diseases (such as tuberculosis) in sub-Saharan Africa in 2020-2021," according to the UNAIDS, which had already drawn attention to these estimates in May, with the World Health Organization (WHO).

"At a time when the spread of the new coronavirus is threatening to overwhelm the capacity of the health system, while confinement reduces displacement and puts the economy under stress, people living with HIV and those most exposed to the risk of it contract suffer the interruption of health and HIV services, "the text continues.

Higher cost of treatments

"This interruption could prevent the global response to HIV from reaching its commitments for 2020," warns UNAIDS.

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This objective is summarized by the formula 90-90-90: that 90% of people living with HIV know their status, that 90% of them are on treatment, and that among these, 90% have an undetectable viral load . In 2019, these proportions were 81%, 82% and 88% respectively, with regional disparities.

In addition, UNAIDS is alarmed by the potential consequences of confinement and border closings on "the production and distribution of medicines".

"It is estimated that the final cost of antiretroviral therapy produced in India (where most of the generic drugs are produced, editor's note) could be 10% to 25% higher than their normal price," the report said.

New infections around the world

"Like the HIV epidemic before it, the Covid-19 pandemic highlights the fragility of our world, including persistent economic and social inequalities and woefully inadequate public health investments," wrote the secretary. General of the United Nations, Antonio Guterres.

In 2019, some 1.7 million new AIDS virus infections occurred worldwide, a decrease of 23% since 2010.

"This is largely explained by a substantial decrease of 38% in eastern and southern Africa, but at the same time, HIV infections have increased by 72% in eastern Europe and Central Asia, 22% in the Middle East and in the north of Africa and 21% in Latin America ", underlines the executive director of the UNAIDS, the Ugandan Winnie Byanyima.

"We will not reach our 2020 targets, reducing the number of AIDS-related deaths and the number of new infections to less than 500,000," she said.

The UNAIDS report is published when the International AIDS Conference, which was organized this year via distance and via video, opened on Monday because of the Covid-19 epidemic.