The AIDS fight is rattling. Forgotten viruses like measles and polio are on their way back. Scientists, aid organisations and health agencies are increasingly warning that the global fight against coronavirus must not lead to a revival of other infectious diseases.
For example, on the basis of research in 27 countries, the AIDS Fund reports today that three quarters of HIV testing programmes and more than half of HIV treatment programmes have been “seriously” disrupted by coronapandemic.
Stocks of HIV inhibitors are running out, and new deliveries are slowed down, as the production of cheap drugs in India and China has been stationary for months. Lockdowns make people more difficult access to medication, which causes them to stop treatment. At the risk of the virus mutating and standard drugs will stop working.
There is also less testing for the virus in countries; HIV test buildings have been transformed into coronallocations. AIDSFund director Mark Vermeulen said in the CCEit Radio 1 News since March that the two pandemics would eventually touch each other. “That fear is coming true now.”
The situation is most acute in Africa, says Vermeulen, where two thirds of the 38 million HIV patients live. The fight against the coronavirus has virtually eliminated HIV care in African countries. But the containment of other infectious diseases that have been struggling in recent decades is also faltering in developing countries, says Professor of Tropical Medicine Martin Grobusch, affiliated with the AMC.
“ This involves, for example, acute infectious diseases such as malaria or tuberculosis, which require emergency treatment,” says Grobusch. “All available resources now go to covid prevention and treatment. In addition, people are in lockdown, which gives them less opportunities to make money and less often come to the hospital to get treatment on time. So it is something that strengthens overall health in Africa.”
Early this month, UNICEF and the World Health Organization (WHO) said in a distress call that hundreds of millions were needed to prevent new epidemics of infectious diseases such as measles and polio. “Because we cannot allow the fight against one deadly disease to mean land loss in the fight against other diseases,” said UNICEF director Henriette Fore.
According to the WHO, the coronapandemic disrupted a total of 91 vaccination programmes in at least 53 countries. Marion Koopmans, Head of the Virology Department of the Erasmus MC, recognises the global vaccination problem. “Because of the coronacrisis there is much to do to postponed care. Of course, vaccination is also part of that. And we know about measles and polio: the fewer children you vaccinate, the greater the risk of outbreaks. You dont see that right away, but that makes it no less worrying.”
Last year, the WHO had the highest number of measles infestations in over two decades, and in 2021 and 2022 it only fears more outbreaks with the extremely contagious virus due to the pandemic.
The same concerns exist around polio, which was virtually eradicated worldwide before the start of the coronapandemic. As a result of a decrease in vaccination rates, resulting in immunity holes in the population, the number of new cases could increase again from a few tens to 200,000 a year within ten years, the WHO states.
Virologist Koopmans does say that there are other positive effects: on the basis of recent research, measures against the coronavirus appear to be inadvertently effective against other diseases. “For example, there is less flu,” she says.
According to LUMC epidemiologist Frits Rosendaal, it does not alter the fact that developing countries in the pandemic are especially more vulnerable to outbreaks caused by other viruses, in addition to the coronavirus. It is also because in these countries the risk of contracting an infectious disease is higher and people have to leave the door, regardless of the risk of infection. “Because in many African countries there is no safety net,” says Rosendaal.
In South Africa, people are also reluctant to get tested because of the taboo that rests on a coronavirus infection, as shown in the video below from July:
How then to control other infectious diseases and at the same time fight the coronavirus? Professor of Tropical Medicine Grobusch does not have the answer ready. He speaks of a dilemma, in which each country has to find a balance between fighting coronavirus and other infectious diseases. “For we must prevent the indirect effects of the pandemic from becoming worse than the pandemic itself.”