Decades of Progress Against the World’s Deadliest Diseases Could be Lost to the COVID-19 Pandemic

By the bioMérieux Connection Editors

COVID-19 has upended lives all over the world, and especially in the United States, where we face the largest numbers of confirmed cases and deaths globally. So, it is understandable that Americans are chiefly focused on COVID-19, wanting to know when we will find an effective treatment, what progress is being made on developing a vaccine, and other issues. The scientific and medical communities are working at an unprecedented pace to solve these problems.

Yet there is another threat that Americans may rarely think about, but that keeps many healthcare professionals up at night. Three well-established infectious diseases—Tuberculosis, malaria, and HIV—are poised to kill millions worldwide, with decades of healthcare progress that could be lost due to disruptions caused by COVID-19. Even under normal circumstances, the toll these three diseases exact worldwide is staggering.

1.5 Million Lives

Tuberculosis (TB) is a respiratory illness and the leading cause of infectious disease deaths on the planet, with 1.5 million people losing their lives each year. TB, which is caused by Mycobacterium tuberculosis (Mtb), is so pernicious because it is capable of surviving in the body for long periods without causing disease. As many as 1 in 3 people worldwide have this type of infection, known as latent TB. Tuberculosis thrives in densely populated cities and can be transmitted through the air by a person with active disease. Latent TB can be detected with a simple skin prick test—if a person tests positive, the doctor can prescribe antibiotic treatment before the patient becomes symptomatic or contagious. However, major challenges in treatment can arise if a patient’s TB infection is resistant to antibiotics, which has become increasingly common in recent years.

Despite the challenges, global TB numbers dipped to their lowest recorded levels in 2018, the most recent year for which there is complete data. It has taken decades of concerted effort and resources to bring the number of TB cases down, and COVID-19 threatens to scuttle that progress. Disruptions to shipping and supplies of critical antibiotics mean that some countries may run out of treatment options for TB. Potentially even more concerning is that the number of TB cases being diagnosed has dropped drastically—not because the cases aren’t there, but because people aren’t being tested. The problem is largely twofold: people are hesitant or unable to visit the doctor because of COVID-19, and resources are being redirected to COVID-19.

What this means is that people with latent infections are going without treatment, opening up the opportunity for the infection to turn into active disease and spread to other people. In countries like India and Russia, which already deal with high TB burdens, this type of silent spread could prove disastrous. An estimate from the Stop TB Partnership projected that disruptions due to COVID-19 could result in up to 6.3 million additional cases of TB and up to 1.4 million additional deaths between 2020 and 2025.

1.2 Million Lives

COVID-19 has also disrupted progress against two other major killers—HIV and malaria. According to The Global Fund to Fight AIDS, tuberculosis, and malaria, around 80% of HIV and malaria programs have reported disruptions to their services. And, 1 in 4 people living with HIV have reported issues with medication access. The World Health Organization stated recently that a 6-month disruption to retroviral therapy—the type of medication used to treat HIV—could lead to more than 500,000 additional deaths from illnesses related to HIV infection. The outlook for malaria could be even more formidable—the WHO’s model for a worst-case scenario showed that malaria deaths could double to 770,000 per year. Together, these two diseases could take more than 1.2 million lives.

Critical Resources Needed

In many countries, hospitals and clinics were already operating under severe resource constraints prior to COVID-19, and the pandemic has only exacerbated the problem. For healthcare facilities to deal effectively with both COVID-19 and the burdens of HIV, TB, and malaria, significant funds are needed. The Global Fund estimates that a minimum of $28.5 billion will be required to mitigate the damage caused by COVID-19. If countries can’t come up with the necessary resources to address these combined infectious disease burdens, then we may feel the global public health and economic consequences for years to come.

Opinions expressed in this article are not necessarily those of bioMérieux, Inc.

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