A recent WHO survey conducted prior to the International AIDS Society’s biannual conference revealed, seventy-three countries warned they are at risk of stock-outs of antiretroviral drugs as a result of the COVID-19 pandemic. Twenty-four countries stated having either a critically low stock on ARVs or disruptions in the supply of these life-saving medicines.
8.3 million individuals were predicted to benefit from Antiretroviral drugs (ARV) in the 24 countries now experiencing shortages. This represents 33% of all people taking HIV treatment in the world. Currently, there is no cure for HIV, ARVs can control the virus thereby, preventing further sexual transmission to other people.
A modelling exercise set up by WHO and UNAIDS in May predicted that a six-month interruption in access to ARVs may possibly lead to doubling in AIDS-related deaths in sub-saharan African in 2020 alone.
The inability of suppliers to convey ARVs on time due to the shut-down on land and air transport service combined with the limited access to health services within countries as a result of the pandemic, were some of the reasons cited for disruption in the access to drugs in the survey.
The WHO Director General, Dr. Tedros Ghebreyesus said “the findings of the 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”.
UNAIDS and WHO data made public 6 July 2020 revealed, new HIV infection reduced by 39% between 2000 and 2019. HIV related deaths fell by 51% over the same time period, and about 51 million lives were saved through the use of antiretroviral treatment. Regardless of the progress, if more than 25 million individuals in need of ARVs are denied access due to shortage, crucial 2020 goals might not be near achievable.
HIV prevention and testing are reported not getting to the targeted groups, improved access to the service have proven to be vital in reviving the global response to HIV.
WHO Guidance and Country Action
The recently developed guidance for countries on continuing access to health care in a safe manner during the pandemic, as well as people living with HIV, encourages countries to limit access disruption to HIV treatment through “multi-month dispensing”, a policy whereby drugs are prescribed for a longer periods of time –up to six months. To date, 129 countries have adopted this policy.
Maintaining flights and delivery, involving communities in the delivery of HIV drugs and collaborating with manufacturers to overcome logistics challenges, are some of the ways countries are reducing the impact of the disruption in drug supply.
Implications of Disruption in Drug Supply
ARVs assist in controlling the virus thereby, preventing its multiplication. COVID-19 is known to manifest severe complications in individuals with underlying disease, as well as people living with HIV who are also immuno-compromised. Failure to adhere by prescribed medication due to drug supply being disrupted, could further weaken the immune system thus increasing their susceptibility to life-threatening complication from COVID-19 and other opportunistic diseases.