A report recently released by Mo Ibrahim hints that focus on Covid-19 may paralyse efforts to contain other lethal diseases in Africa.
“Concerningly, while malaria, tuberculosis (TB) and HIV/AIDS are still amongst the main causes of death in Africa, the current refocusing of already limited resources on Covid-19 could lead to over a million excess deaths. According to the World Health Organsations (WHO), 14 African countries experienced a more than 50 percent decline in services, ranging from the provision of skilled birth attendants to the treatment of malaria cases in May-July 2020,” states the report.
It highlights that Sub-Saharan Africa accounts for 94 percent of global malaria deaths, with Burkina Faso, DR Congo, Mozambique, Niger, Nigeria and Tanzania alone representing up to half of global deaths in 2019. Fear of visiting clinics, lockdown restrictions and disruptions in the supply chain of essential malaria commodities have delayed malaria prevention campaigns as well as treatment. According to the WHO, these disruptions to current anti-malaria efforts, if not addressed, could result in deaths from malaria being more than from COVID-19 in sub-Saharan Africa.
“With an increasing number of studies on the effect of coinfections of COVID-19 and malaria, the precise nature of the interaction is still unclear. Several studies have indicated a possible role of pre-existing immunity or cross-immunity between the diseases. On the other hand, malaria as well as tuberculosis prevalence appear as significant factors negatively associated with COVID-19 mortality. There are also concerns with regards to the false-positives of rapid COVID-19 diagnostic tests in proven malaria cases.”
As for Tuberculosis (TB) the report observes that it may have gone back to its 2012 levels. It states: “Sub-Saharan Africa accounts for 25 percent of the 1.4 million deaths globally resulting from tuberculosis. Just as with malaria, the pandemic has adversely affected the tracking of TB cases as well as supply chains and budgets used for the fight against TB, resulting in millions of missed diagnoses. The WHO models suggest that a decrease in global notifications by 25-50 percent for just three months could lead to up to 400,000 additional deaths from TB, equivalent to the mortality for 2012.”
As with malaria, there is still conflicting information on the response of TB infected patients to COVID-19. While the previously mentioned study showed negative association with COVID-19 mortality, a population cohort study from South Africa found the risk of death from COVID-19 increased almost three-folds for patients with current or previous tuberculosis and two-fold for people living with HIV. Additionally, there was evidence that COVID-19 pneumonia may speed up tuberculosis progression.
HIV/AIDS has also been graphed. The report highlights that; “Of the 38 million people living with HIV worldwide, almost 26 million live on the African continent and 60 percent of the global deaths in 2019 were from sub-Saharan Africa. Just as with malaria and TB, there have been significant disruptions to the treatment and prevention campaigns as a result of the COVID-19 pandemic. A joint model by UNAIDS and the WHO estimated that a six-month disruption on antiretroviral therapy may result in an additional 500,000 deaths in sub-Saharan Africa. According to UNAIDS, this could take the region back to 2008 levels with almost one million AIDS-related deaths.”
In MIF’s latest survey with 100 members of its Now Generation Network (NGN), almost two-thirds of respondents -65.7 percent- listed COVID-19 as their biggest health concern. Around 40 percent also consider malaria a major concern while there are also worries about non-communicable diseases like cancer -32.3 percent and diabetes -29.3 percent.
