World Aids Day: More than half-a-million could die due to Covid-19 disruptions

• Decades of response
• Tonnes of challenges
• Stark reality that HIV is still with us

World Aids Day: More than half-a-million could die due to Covid-19 disruptions

• Decades of response
• Tonnes of challenges
• Stark reality that HIV is still with us

By Vivian Mugarisi
It was in 2004 and she vividly remembers the last day she saw her mother.
She had lost weight and Sandra struggled to recognise her when she visited St Theresa’s Hospital in Chirumanzu where her mother was admitted.
A once strong woman just lay there waiting to die and there was nothing anyone could do. She is one of thousands who died of AIDS because treatment then, was not readily available.

Ten years later in August, her father breathed his last. When she held him the day he collapsed and was waiting for the ambulance to ferry him to Parirenyatwa Group of Hospitals, she knew it was only a matter of days, if not hours.

Four days after being admitted, her father was also to be transferred to the same hospital that had housed her mother during her last days in 2004.
While Sandra’s parents both died of HIV-related complications, their stories were different because unlike her mother, her father died because of self-stigma and failure to accept his status.

Information around HIV/Aids had filtered through communities, and even babies understood that HIV was not a death sentence. But a well-spoken and educated man could not comprehend being HIV positive.
The country is still dealing with stigma and discrimination, with some, like her father, defaulting only because they did not want their neighbours to know they were on anti-retroviral treatment (ART).

“With so much appreciation of health issues, particularly HIV, I had always wondered if the outcome would have been different had I engaged him on time on the need to religiously take his medication,” Sandra told Nhau, a few days before the country marked World AIDS Day.

“Talking about the subject to him was taboo, and people from my community struggled with having conversations around HIV. But I knew better, I had dedicated my career towards unpacking health issues but I guess I always thought that my father was smart enough to make better decisions.”

Covid-19 effect
Six years after his death, the globe is now grappling with the coronavirus pandemic, which has derailed progress towards the attainment of an Aids-free generation by 2030.

While time may be there to scale-up responses, Zimbabwe in particular has missed the 90-90-90 2020 target. The target sought to ensure that at least 90 percent of all people living with HIV know their status and 90 percent of all people with diagnosed HIV infection will receive sustained antiretroviral therapy.

The target also sought to ensure that by 2020, 90 percent of all people receiving antiretroviral therapy would have viral suppression.
The lockdown instituted to control the spread of Covid-19, saw many fail to access HIV services, with some forced to default due to the challenges that ensued.

Movement restrictions saw many missing their appointments, with Government moving in to give medication for more than three months as was the norm.

Furthermore, due to logistical nightmares, countries like Zimbabwe were and still is face a lot of challenges in bringing in medications, with Government mooting the idea of starting to give patients three months’ supply of medicines instead of six months, until more supplies come into the country.

UNAIDS reports that a six-month complete disruption in HIV treatment could cause more than half-a-million additional deaths in Sub-Saharan Africa, Zimbabwe included, over the next year, bringing the region back to 2008 HIV mortality levels.

However, the Covid-19 pandemic also offers countries an opportunity to address gaps that were left unattended during the HIV programming. This includes, but not limited to, investment in primary healthcare to ensure that people can access services at the lowest level possible.

World Health Organisation National Professional Officer for HIV Dr Simbarashe Mabaya said the Covid-19 pandemic exposed the need for countries to ensure that all services including HIV, are accessible at the lowest level of care, close to the communities.

“Covid-19 gives us a unique opportunity to reimagine how to provide HIV services going forward. Now with the Covid-19 response we really need to decongest our facilities to ensure that we take service into communities,” said Dr Mabaya.

He also notes that while notable progress has been made towards Zimbabwe’s response to HIV, men, among other key populations, still struggle to access HIV services. This has been attributed mainly due to poor health seeking behaviour and adherence to medication amongst men.
In her remarks to mark World ADS Day, WHO Regional Director for Africa Dr Matshidiso Moeti said: “To sustain and accelerate the gains made, I urge governments and partners to come together, with the same level of urgency and leadership demonstrated in response to Covid-19, to increase domestic funding and strengthen health systems.

“There must be global solidarity and shared responsibility among all stakeholders to ensure integrated, people-centred, quality care and an uninterrupted supply of essential commodities for HIV services.”
This year’s AIDS Day is running under the theme, global solidarity, shared responsibility. Nhau/Indaba