By Pranav Tadikonda, C'24
The past eleven months have been some of the most unprecedented in recent human history, as the pandemic has caused millions of lost jobs, health crises, and deaths. A global cascade of events has affected the lives of billions, leaving many unemployed, sick, and/or detached from society. As the world’s health care leaders brainstorm necessary short-term and long-term solutions to the pandemic, progress in combating other health crises is being halted, even pushed back, such as in the case of HIV/AIDS, Tuberculosis, and Malaria.
In October 2020, I was fortunate enough to attend the annual North American conference of the Universities Allied for Essential Medicines, hosted virtually here at the University of Pennsylvania. During the conference, Ms. Linda Mafu gave a Keynote speech about how the progress in fighting both AIDS and Tuberculosis has gone at least 5-10 years back due to the emergence of COVID-19. In fact, such a setback can be rooted in the deeper hole of health disparities and health care gaps that African countries experience.
"... the progress in fighting both AIDS and Tuberculosis has gone at least 5-10 years back due to the emergence of COVID-19. In fact, such a setback can be rooted in the deeper hole of health disparities and health care gaps that African countries experience."
Why African countries? A study by the National Academies of Sciences, Engineering, and Medicine (published in NIH National Library of Medicine) shows how sub-Saharan African countries continue to face the greatest burden of HIV/AIDS, Malaria, and TB. This geographical population continues to be vulnerable as attention has shifted to combating the COVID-19 pandemic.
The emergent need to find a vaccine and deliver it to high-risk populations was quickly met in late 2020 and early 2021. As I write, people are getting vaccinated. This is an astounding accomplishment by Moderna, Pfizer, Johnson & Johnson, among many others.
As medical history is being made, there is a beacon of hope that things may return to normalcy sooner rather than later; however, there are still fundamental challenges for those suffering from HIV/AIDS, malaria, and tuberculosis (TB). Services for these infectious diseases, of which African people are most directly affected, have taken second, third, or even less priority. A study by The Global Fight accounts for lower services for HIV, TB, and Malaria since June 1, with HIV services being at the top of the three.
But that’s just the beginning of the story. Imperial College London estimates that “in high burden settings, HIV, TB and malaria related deaths over 5 years may increase by up to 10%, 20% and 36%, respectively, compared to if there were no COVID-19 epidemic.” The Global Fund saved 38 million lives since 2002, with over 6 million of them being solely from 2019. However, such progress has been halted since the pandemic by the increasing shortage of resources to continue working towards eradicating these infectious diseases. Particularly, testing volume has plummeted, with 50% less HIV testing and a significant drop in reporting of TB cases. This can be attributed to the lack of resources and awareness as opposed to a decrease in cases of TB contracted. COVID-19 has caused a shift in focus away from fighting AIDS, TB, and Malaria. Millions of lives are being lost due to COVID, so such immediacy and funding is essential. However, the reversal of progress of fighting other infectious diseases highlights a fundamental flaw in the health care system.
With Africa being the most affected part of the world, such a statistic is disappointing, yet also extremely alarming. If attention to fighting AIDS, TB, and Malaria continues to be pushed back and overlooked, Africa could enter a potential death spiral, fueling a greater mortality rate and further perpetuating the significant global health obstacles several low-income African countries deal with. Not only that, Partners in Health has recently reported a possibility of Ebola cases.
The color-coded world map below shows heavy funding for central African countries for fighting AIDS, TB, and Malaria, a necessary economic step to aid these developing nations. It will be important to understand how research and development is impacted over the next five years for these infectious diseases in relation to the development of the COVID-19 pandemic, in order to identify how to best meet the needs of each of these diseases.
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