The Access to Medicine Foundation has published a series of articles to address growing gaps in the treatment of malaria, HIV and TB across sub-Saharan Africa at a time when COVID-19 has dominated public health policy, leading to disastrous consequences for people living with these diseases, especially children.
Deaths from malaria in sub-Saharan Africa are predicted to double in 2020 due to disruptions to insecticide-treated net distribution because of COVID-19 lockdowns, according to the World Health Organisation. This “worst case scenario” would represent 769,000 malaria deaths, twice the number registered in 2018, and a mortality rate not seen since 2000.
New child HIV infections are also predicted to more than double in sub-Saharan Africa during to COVID-19 lockdown disruptions. Models by epidemiologists predict South Africa is likely to experience 55,000 excess HIV-related deaths from only three months of disrupted antiretroviral therapy drug distribution, and this number could rise to 84,000 if COVID-19 disruptions to regular healthcare services last 6 months.
Detection and treatment of TB has also fallen as Africa turns its attention to COVID-19. It has been predicted by a collaboration of researchers at John Hopkins University, Imperial College, Avenir Health and USAID that for each month taken to return to normal health service delivery, South Africa could register additional deaths from TB.
These dire predictions are the result of a breakdown in normal health service delivery due to social distancing and lockdown measures meant to prevent catastrophic losses from the COVID-19 pandemic. Measures implemented by different African countries to address this threat have included restrictions in travel and delivery of medicines and mosquito nets. The threat posed by malaria, TB and HIV gaining ground is especially great for children, who represent 23% of death cases.
“I have worked on tuberculosis for two decades, and I have never been more scared,” said Madhukar Pai, the Canada research chair in epidemiology and global health at McGill University in Montreal. “This pandemic is absolutely devastating for our quest to end the big three killers – Aids, TB and malaria,” Pai said. “If we were climbing a mountain before COVID-19, that mountain just became Mount Everest.”
The publication by the Access to Medicine Foundation comprises a series of articles stressing the urgent need for new treatments for HIV, malaria and TB that are suitable for children and has identified key areas of action that are needed to achieve this, including accelerating vaccine development and aligning treatment guidelines for children, as well as targeting pricing and accessibility issues.
Each article focuses on one of the three diseases and looks at a cross-section of the pharmaceutical companies active in HIV/Aids, malaria and TB, assessing the current level of paediatric R&D, and highlighting the gaps in child-friendly versions of existing medicines. It concludes that there is heavy reliance on a few pharmaceutical companies to develop the much-needed products, and that comparatively small markets for child-friendly medicines act as a disincentive for companies to step in or step up.
To show that action is possible, each article includes case studies of how pharmaceutical companies and other organizations are addressing key gaps in paediatric antiretrovirals, anti-malarials and anti-tuberculosis drugs (e.g., through pricing or licensing).
“After decades of investment, the last mile is in sight. To continue the fight against these diseases, while also battling COVID-19 and drug-resistance, children urgently need child-sized medicines. Yet they are waiting last in line for life-saving treatments. These timelines can be shortened with an ‘all hands-on deck’ response involving the pharmaceutical industry, regulators, governments, NGOs and civil society.”
Jayasree K Iyer
Executive director of the Access to Medicine Foundation
Issued by the Access to Medicine Foundation