Effects of COVID-19 on HIV services: the case of Malawi

Abstract

The coronavirus (COVID-19) pandemic is a global health emergency. It presents a significant threat for people living with HIV and AIDS and for the global response to HIV. Changes that countries have set in motion within the health systems and economies to adapt to the COVID-19 pandemic threaten to deprioritize the urgent, ongoing needs of people living with HIV and derail decades of hard-won progress in the response to HIV, TB and other diseases. Disruptions to supply chain systems for key HIV commodities, logistics and reporting systems have limited the ability for countries like Malawi to maintain or extend HIV-related services, as well as to set up adequate COVID-19 control measures. In such countries where there is high burden of HIV, it is a priority to ensure continuity of ART during the pandemic. HIV related deaths could increase substantially during the COVID-19 pandemic under reasonable worst-case assumptions about interruptions to HIV services. It is highly recommended for the COVID-19 response to be informed and grounded in rights-based and community-centred approaches. True progress will require addressing deep-seated structural inequalities to protect the most marginalized. There is a need to actively involve People Living with HIV (PLHIV) when making crucial decisions about their health during pandemics and that HIV-related policies need not be overlooked during the pandemic if the successes of the decades-long fight against HIV/AIDS have to be maintained.