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Covid-19 derailed the response against tuberculosis and HIV and slowed progress against malaria in 2020 compared to 2019, according to the annual results report of the Global Fund (The Global Fund).
For the first time in its 20-year history, the largest multilateral funder against these ailments has registered serious setbacks in the countries with few resources in which it invests.
Above all, in the area of tuberculosis testing and treatment and HIV diagnosis and prevention.
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"The numbers are stark confirmation of our omens when COVID-19 started," says the organization's chief executive, Peter Sands. “Covid-19 is the worst obstacle in the fight against HIV, TB and malaria that we have encountered since the creation of the Global Fund, exacerbating non-existent inequalities, diverting critical resources, stopping or reducing access to treatment and prevention. and increasing the risk among vulnerable people ”.
According to the document, the number of people who received tuberculosis treatments fell by one million compared to 2019. The treatment of drug-resistant cases fell by 19%, and that of ultra-resistant cases, by 37%.
The impact, which the organization calls catastrophic, could be multiplied taking into account that each patient can infect about 15 individuals per year.
Until the outbreak of COVID-19, tuberculosis was the world's deadliest infectious disease, with 1.4 million victims in 2019, and it remains the leading cause of death among people with HIV.
A patient receives her tuberculosis treatment at her home in Dhaka, Bangladesh.The Global Fund / Yousuf Tushar
As for HIV, diagnostic tests fell 22% and prevention programs reached 11% fewer people.
"After so many years of hard-earned progress, it would be a tragedy to see a new spike in HIV infections," says Peter Sands, executive director of the Global Fund, 40 years after the first cases of this virus were detected. .
In the world, there are still 4.1 million people who do not know they are living with HIV and another 6.1 million who know they are infected but do not receive treatment.
The response against malaria was the most resilient, although evidence of suspected cases fell 4.3% and progress against the disease came to a standstill.
After so many years of hard-earned progress, it would be a tragedy to see a new spike in HIV infections
Peter Sands, Executive Director of the Global Fund
The report offers various explanations.
In many countries, the virus overwhelmed health systems, lockdowns disrupted service provision and supply chains, and many existing resources were used to fight the new pandemic.
Then there is the fear of people to go to health centers for fear of catching Covid-19 or of being stigmatized if they present with symptoms such as cough and fever that could well be cases of malaria or tuberculosis.
Speaking to El País, the head of External Relations and Communication of the Global Fund, Françoise Vanni, explained: “The results are serious because the three epidemics are fearsome adversaries: if we relax prevention, cases increase, and then they can increase. the deaths, returning us to a vicious circle that derails the progress made to date. "
Due to her experience with Ebola, Pauline, 58, and her colleagues were able to adapt more quickly to the challenges that arose when COVID-19 reached the Democratic Republic of the Congo.
Healing people brings him joy, but his struggle is not easy: “Managing patients is still very difficult.
We are also facing a shortage of protective equipment and medicines. ”The Global Fund / Pamela Tulizo
Some positive changes
Regardless, the COVID-19 pandemic has led to some major improvements in the response against all three diseases - improvements that Vanni says need to be consolidated and deployed on a large scale. For example, more people are now receiving HIV and TB medications for various months, so that they no longer have to travel to the health center each week and it is easier for them to follow the prescribed treatment. In addition, digital and messaging tools are being deployed in different countries to monitor TB treatments and to strengthen HIV prevention. Efforts are also being made to diagnose, in a single visit, HIV, TB and covid-19.
In Nigeria, for example, the strategy of HIV testing people who come for covid-19 tests has found cases that otherwise would have escaped diagnosis.
In the case of malaria, the programs have gone from distributing mosquito nets in town squares and neighborhoods to doing it door-to-door, reaching a record number of people.
Thanks to adaptation measures like this one, 17% more mosquito nets were distributed last year.
Twenty years of the Global Fund
The Global Fund, created in 2002 at the height of the HIV / AIDS pandemic, has saved an estimated 44 million lives and reduced deaths caused by the three diseases by 46% (the aforementioned, plus tuberculosis and malaria, the three major pandemics prior to covid-19) in the countries in which it invests. Globally, it provides 77% of international funding for tuberculosis programs, 56% for malaria and 25% for HIV. By August this year, it had approved a total of $ 3.3 billion to support national responses to COVID-19 and tailor programs against HIV, malaria and tuberculosis in more than a hundred countries. According to its annual report, continuing to strengthen health systems and mitigate the impacts of the coronavirus will be essential to achieve three objectives:recover lost ground in the fight against the three diseases, face covid-19 and prepare for the pandemics of the future.
Covid-19 has also benefited from investments made in recent decades in other diseases and in health systems as a whole.
"It was expected, but now it has been proven," says Vanni.
Refers to the many countries that have responded to the COVID-19 pandemic using the same laboratories, disease surveillance systems, community networks, trained health workers, and supply chains that were created to fight HIV, TB, and disease. malaria.
In Nigeria, for example, the strategy of testing people for covid-19 testing for HIV has found cases that otherwise would have escaped diagnosis
The organization views the immediate future with concern, but also with confidence - both with regard to Covid-19 and the rebound of the response against the three epidemics.
"What gives us hope is that we know what works, but if we do not invest now, the new variants of covid-19 will win the race," Vanni warns.
"The world has not yet understood the scale of the crisis and the magnitude of the resources needed to face it and avoid worse health, social and economic impacts."
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