access to HIV drugs with which COVID-19 has been seriously affected as a barn to fight AIDS

Seventy-three countries have warned that they are in danger of stockpiles of antiretroviral (ARV) drugs as a result of the COVID-19 pandemic, a new WHO study conducted ahead of a two-year conference of the International Society for AIDS has shown. Twenty-four countries reported having either critically low ARVs or disruptions in the supply of these life-saving drugs.

The research follows: exercise modeling
convened in May by WHO and UNAIDS, and predicted that a six-month break in access to ARVs could lead to a doubling of AIDS-related deaths in sub-Saharan Africa alone in 2020.

In 2019, an estimated 8.3 million people used ARVs in 24 countries that were short of supplies today. This represents approximately one third (33%) of all people who have been treated for HIV globally. Although there is no cure for HIV, ARVs can control the virus and prevent further sexual transmission to other people.

The failure of suppliers to deliver ARVs on time and the closure of land and air transport services, along with limited access to health services within countries as a result of the pandemic, were among the causes of the disruption in research.

The findings of this research are deeply troubling, “said Dr. Tedros Adhanom Ghebreyesus, Director-General of the WHO.” Countries and their development partners must do everything they can to ensure that people in need of HIV treatment continue to access it. We cannot allow the COVID-19 pandemic to undo the hard-earned gains in the global response to this disease.

Progress stopped

According to data released today by UNAIDS and the WHO, new HIV infections fell by 39% between 2000 and 2019. HIV deaths fell by 51% over the same period, and about 15 millions of lives have been saved using antiretroviral therapy.

However, progress towards global goals is stalled. In the last two years, the annual number of new HIV infections has reached 1.7 million, and there has been only a slight reduction in HIV-related deaths, from 730,000 in 2018 to 690,000 in 2019. Despite steady progress in increasing the volume of treatment – with more than 25 million people in need of ARV admission in 2019 – key global goals for 2020 will be missed.

HIV prevention and testing services do not reach the groups they need most. Improved targeting of proven prevention and testing services will be crucial to strengthening the global HIV response.

WHO guidelines and country actions

COVID-19 risks worsening the situation. WHO recently developed guidelines for countries on how to safely maintain access to basic health services during a pandemic, including all people living with or affected by HIV. These guidelines encourage countries to limit disruptions in access to HIV treatment through “multi-month dispensing,” a policy that prescribes drugs for extended periods of time – up to six months. To date, 129 countries have adopted this policy.

Countries also mitigate the impact of disruption by working to maintain flights and supply chains, engaging communities in the delivery of HIV drugs, and working with manufacturers to overcome logistical challenges.

New treatment options for HIV in young children

At the IAS conference, the WHO will highlight how global progress in reducing HIV-related deaths can be accelerated by increasing support and services for populations disproportionately affected by the epidemic, including young children. In 2019, 95,000 HIV-related deaths and 150,000 new infections among children were estimated. Only about half (53%) of children in need of antiretroviral therapy received it. The lack of optimal medications with appropriate pediatric formulations has long been an obstacle to improving health outcomes for children living with HIV.

Last month, the WHO welcomed the decision of the US Food and Drug Administration to approve a new 5 mg dolutegravir (DTG) for infants and children older than 4 weeks and weighing more than 3 kg. This decision will ensure that all children have quick access to the optimal drug that has been available only to adults, adolescents, and older children to date. The WHO is committed to rapidly monitoring the retraining of DTG as a generic drug so that countries can use it to save lives as soon as possible.

Through the collaboration of multiple partners, we are likely to see generic versions of dolutegravir for children by early 2021, enabling a rapid reduction in the cost of this drug, ”said Dr. Meg Doherty, director of the WHO’s Department of Global HIV, Hepatitis and STI Programs. provide another new tool to reach children living with HIV and keep them alive and healthy. “

Addressing opportunistic infections

Many HIV-related deaths are the result of infections used by an individual’s weakened immune system. These include bacterial infections, such as tuberculosis, viral infections such as hepatitis and COVID-19, parasitic infections such as toxoplasmosis, and fungal infections, including histoplasmosis.

Today, the WHO publishes new guidelines for the diagnosis and management of histoplasmosis among people living with HIV. Histoplasmosis is very widespread in the American region of the WHO, where as many as 15,600 new cases and 4,500 deaths are recorded annually among people living with HIV. Many of these deaths could have been prevented by timely diagnosis and treatment of the disease.

In recent years, the development of highly sensitive diagnostic tests has enabled rapid and accurate confirmation of histoplasmosis and early initiation of treatment. But innovative diagnostics and optimal treatments for this disease are not yet widely available in resource-limited environments.