The COVID-19 pandemic is causing disruptions to prevention and treatment services for HIV, tuberculosis (TB) and malaria that could drive a surge in deaths from those diseases in low- and middle-income nations.

The number of these excess deaths could be as great as that of people who die directly of COVID-19 over the next five years, according to a new modeling study published in The Lancet Global Health.

Alexandra Hogan, PhD, of the Medical Research Council Center for Global Infectious Disease Analysis, and her colleagues projected that in low- and middle-income nations, where the impact of HIV, TB and malaria is most severe, COVID-19–related disruptions to prevention and treatment services could increase the annual death rate by as much as 10% for HIV, 20% for TB and 36% for malaria over the next five years.

The researchers stressed that a considerably mitigation of these impacts of the COVID-19 pandemic is still possible if the most critical services for each disease are prioritized.

The Joint United Nations Programme on HIV/AIDS (UNAIDS) recently projected that if sub-Saharan Africa sees a six-month disruption in the delivery of antiretroviral (ARV) treatment to 20% of people living with HIV in the region, this could lead to an extra 110,000 deaths from AIDS-related complications by the end of 2021. If all people with HIV in the region saw a six-month disruption in access to ARVs, this would lead to a projected 560,000 extra deaths by the end of next year—a doubling of the preexisting death rate in the region.

UNAIDS and the World Health Organization have also raised the alarm about the risk of shortages of seven major generic ARVs in 73 nations, including the vitally important tenofovir disoproxil fumarate. 

Peter Sands, the executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, wrote in an essay published along with the new modeling study that biweekly surveys of more than 100 countries in which the fund invests have noted disruptions in the services of 85% of the HIV programs, 78% of the TB programs and 73% of the malaria programs. There has been high or very high disruption in a respective 18%, 17% and 19% of these programs.

To read a press release about the study, click here.

To read the study, click here.