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Covid-19's adverse impact on HIV, TB and malaria programmes

The number of people treated for drug-resistant TB has dropped by 19%, with an even bigger drop of 37% registered for those on treatment for extensively drug-resistant TB in 2020, showing the catastrophic impact the Covid-19 pandemic has had on the fight against TB worldwide.
Source: ©The Global Fund. A march through Agogo town in Ghana to educate citizens on malaria
Source: ©The Global Fund. A march through Agogo town in Ghana to educate citizens on malaria
The number of HIV-positive TB patients on antiretroviral treatment as well as TB treatment dropped by 16%. The fight against Malaria has also been affected, but not as severely.

This is in countries where the Global Fund (the Fund) invests. A new report released this week by the Fund shows that while some progress was made, key programmatic results have declined for the first time in the history of the Fund.

Since its inception in 2002, the Global Fund partnership has saved 44 million lives. The number of deaths caused by AIDS, TB and malaria has decreased by 46% in countries where the Global Fund invests.

“To mark our 20th anniversary, we had hoped to focus this year’s Results Report on the extraordinary stories of courage and resilience that made possible the progress we have achieved against HIV, TB and malaria over the last two decades,” says Peter Sands, executive director of the Global Fund.

“But the 2020 numbers force a different focus. They confirm what we feared might happen when COVID-19 struck.”

Significant declines


The report highlights significant declines in HIV testing and prevention services for key and vulnerable populations who were already disproportionately affected. Compared with 2019, people reached with HIV prevention programmes and services declined by 11% while young people reached with prevention services declined by 12%.

Mothers receiving medicine to prevent transmitting HIV to their babies dropped by 4.5%. HIV testing dropped by 22%, holding back HIV treatment initiation in most countries.

Interventions to combat malaria appear to have been less badly affected by Covid-19 than the other two diseases. Thanks to adaptation measures and the diligence and innovation of community health workers, prevention activities remained stable or increased compared to 2019.

The number of mosquito nets distributed increased by 17%, structures covered by indoor residual spraying increased by 3%. In 2020, 11.5 million pregnant women received preventive therapy.

However, suspected cases of malaria tested fell by 4.3% and progress against the disease stalled.

Mitigating Covid-19’s impact


In 2020 the Global Fund disbursed 4.2bn to continue to fight against HIV, TB and malaria, and an additional 980m was approved to respond to Covid-19.These investments, along with fast action and funding from donors, governments, communities and health partners, has helped to mitigate the impact of Covid-19 on HIV, TB and malaria and achieve the progress made in the fight against the three diseases.

Key Results for 2020 in countries where the Global Fund invests include:
  • 21.9 million people received lifesaving antiretroviral therapy for HIV in 2020, an 8.8% increase compared to 2019 despite Covid-19.
  • 8.7 million people reached with HIV prevention services in 2020.
  • 4.7 million people treated for TB in 2020.
  • 194,000 children in contact with exposed to TB patients received preventative therapy in 2020.
  • 188 million mosquito nets distributed to protect families from malaria, a 17% increase compared to 2019 despite COVID-19.

As of August 2021, the Global Fund has approved a total of $3.3bn to more than 100 countries to adapt lifesaving HIV, TB and malaria programmes, provide critical tests, treatments and medical supplies, protect front-line health workers and urgently reinforce fragile systems for health.

“Despite the horrible toll Covid-19 has taken, the pandemic presents us with a chance to build a better, more equitable and healthier world,” says Sands.

“Together, we have changed the trajectory of HIV, TB and malaria and we are determined to continue to do so. If we continue to innovate and collaborate — at global, national and local levels– we can end HIV, TB and malaria, beat Covid-19 and build a much stronger foundation for pandemic preparedness and response.
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