The unknown struggle against COVID-19 consequences in WHO listed African Region

Photo source @ONEcampaign

A disruption to trade routes caused by COVID-19 has resulted in essential treatments for HIV, Tuberculosis and Malaria from reaching those who need it most. The consequences will be far reaching as new infection rates for the three diseases could rise with children being amongst the most vulnerable groups.

HIV

HIV, an abbreviation for human immunodeficiency virus, makes people vulnerable to other infections or diseases as the virus attacks the cells in the body that help it fight off infection. The most common ways to get HIV is either through unprotected sex with someone with HIV or by haring a needle with someone who has HIV. It is not curable but it is preventable and treatable through a combination of drugs that slow down the progression of the virus.

The WHO states that currently 38 million people are living with HIV/AIDS with a total of 690,000 deaths worldwide from related illnesses in 2019. Through studies the WHO has identified WHO African regions as the worst effected with 3.7% of adults living with HIV, contributing more than two-thirds of people living with HIV around the world.

Tuberculosis

Tuberculosis, known as TB, is an infectious disease caused by bacteria which affects the lungs. It can be spread from when someone with TB spreads TB germs through coughing, sneezing or spitting. A person without TB only has to inhale some of the infected germs to become infected with TB. Active TB can be treated and cured with the use of antibacterial medications for 6-12 months. It is also possible for people to carry latent TB meaning they carry the infected bacteria but do not suffer from the illness and cannot transmit the disease

The 2019 Global Tuberculosis Report completed by the WHO found that in 2018 alone that an estimated 10 million people fell ill with TB with a total of 1.5 million people having died. TB is not geographically isolated and is found in every part of the world but the worst affected areas have been South-East Asian and African regions; contributing to 44% and 24% of new cases respectively.

Malaria

Malaria is a life-threatening disease transmitted to people through parasite-infected, female Anopheles mosquitos. It is both preventable and curable and is treated through prescription drugs that kill the parasite but the medication used is dependent on the type of parasite and severity of the illness.

The WHO found that in 2018 there were 228 million cases of malaria worldwide with African regions being disproportionately impacted with 93% of all malaria cases and 94% of total malaria deaths being attributed to the region. Children under the age of 5 are the most vulnerable group as they accounted for 67% of all malaria deaths worldwide.

The Bigger Picture

Upon analysis of the worst affected areas, a common theme can be noticed in which the African Region as listed by the WHO is among the worst, if not the worst, impacted areas globally for TB, Malaria and HIV.

Moreover, all three diseases can be prevented and treated which results in the saving millions of lives. However, COVID-19 has disrupted trade routes and forced nations into lockdown. Apoorva Mandavilli quotes research that found that: 85% of HIV programs, 78% of TB programs and 73% of Malaria programs all reported a disruption to service delivery; threatening to reverse the hard work committed by organisations such as Medicins Sans Frontieres and the UN.

To put into context the severity of the disruptions, an estimated 16.4 million people out of 25.7 million people living with HIV in sub-Saharan Africa were taking medication therapy in 2018. If the staggering statistics were not enough new HIV infections in children in sub-Saharan Africa declined by 43% from 2010 to 2018 however all the efforts may be reversed as mother-to-child transmissions could increase by 104% in Uganda alone.

If we consider the relationship all the diseases have with one another we can begin to understand how much of the population are at risk. Those with HIV are 16-27 times more likely to be at risk of developing TB than those who do not have HIV. The risk of increased new HIV infections in children is also especially concerning when considering that children under the age of 5 are the most vulnerable to Malaria.

Due to HIV weakening the immune system's ability to fight against new infections and diseases, it could make more people susceptible to both TB and Malaria; creating a greater overlap in diseases and resulting in more deaths.

Conclusion

We are all aware of the direct consequences of COVID-19 but considering the facts above enables us to consider the indirect consequences. A domino knock on effect has occurred in which disrupted trade routes has led to a lack of provision of medical services. This will not only increase rates of new HIV infections but also lead to increased vulnerability to both TB and Malaria. Diseases that can be prevented and treated are having devastating effects at the cost of millions of lives but is the world listening?

Key Legal Notes

• Right to health

Article 25 UN Declaration of Human Rights: Right to Health

“The right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services”

See also: WHO Constitution 1946; OHCHR Right to Health Fact Sheet No. 31

• Right to life

Article 3 Universal Declaration of Human Rights

“Everyone has the right to life, liberty and security of person.”

Article 5 African Charter on the Rights and Welfare of the Child

“Every child has an inherent right to life. This right shall be protected by law.”

See also: Article 6 International Covenant on Civil and Political Rights; Article 4 Charter on Human and Peoples’ Rights – there are also region-specific Declarations and Conventions in Europe and America.

• 2030 Sustainable Development Goals

Goal 3: Good Health and Well-Being

Goal 10: Reduced Inequalities

Tying it all together!

Although it is no one’s fault that COVID-19 has had such devastating effects it does highlight how vastly different the situation is for the developed and developing world. It can be argued that the idea that human rights is universal and fundamental to every person is still very Western-centric and has yet to really be implemented in the vast majority of countries.

On a more positive note, the pandemic has highlighted the hard work of medical personnel around the world and none more so than those who have been working against not only COVID-19 but HIV, Tuberculosis and Malaria.

International responses continue to be limited due to the COVID-19 restrictions but we can hope that in a post COVID era more might be done to support communities who bare the burden of not one virus or disease but multiple.