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COVID-19 as an AIDS response stall severely affected access to HIV drugs

According to a new WHO survey conducted ahead of the International AIDS Society's biennial conference, seventy-three countries have warned that they are at risk of stock-out of antiretroviral (ARV) drugs as a result of the COVID-19 epidemic. Twenty-four countries reported severely low stock of ARVs or disruptions in the supply of these life-saving drugs.

The survey follows a modeling exercise
It was convened in May by WHO and UNAIDS which estimated that a six-month disruption in entry into ARVs could double AIDS-related deaths in Sub-Saharan Africa in 2020 alone.

In 2019, an estimated 8.3 million people were benefiting from ARVs in 24 countries that are now facing supply shortages. It represents one-third (33%) of all people receiving HIV treatment globally. While there is no cure for HIV, ARVs can control the virus and prevent further sexual transmission to other people.

Suppliers' failure to deliver ARVs on time and the closure of land and air transport services, along with limited access to health services within countries as a result of the epidemic, were among the reasons cited for the survey disruptions.

; The findings of this survey are said to be in-depth. “Countries and their development partners must make all efforts to ensure that those who need HIV treatment continue to access it. We cannot allow the COVID-19 pandemic to be a difficult victory in the global response to this disease.

Stagnant progress

According to data released today from UNAIDS and WHO, new HIV infections dropped by 39% between 2000 and 2019. HIV-related deaths dropped by 51% in the same period, and the use of antiretroviral therapy saved some 15 million lives.

However, Progressards is blocking global targets. In the past two years, the annual number of new HIV infections has been 1.7 million and there has been a slight reduction in HIV-related deaths, from 730 000 in 2018 to 690 000 in 2019. Despite the steady progress in treatment scaling treatment – with more than 25 million people needing ARVs in 2019 – the key 2020 global targets will be missed.

HIV prevention and testing services are not reaching the groups they most need. Proven prevention and testing will be important to reinforce better targeting of services
Global response to HIV.

WHO Guidance and Country Action

COVID-19 increases risk status. The WHO has recently developed guidance for countries to safely maintain access to essential health services during epidemics
All people affected or affected by HIV. This guidance encourages countries to "limit disruptions in access to HIV treatment through multi-month delivery," a policy under which drugs are prescribed for a longer period of time – up to six months. To date, 129 countries have adopted this policy.

Countries are reducing the impact of divestment to maintain logistics and challenges by maintaining flights and supply chains, engaging communities in the delivery of HIV drugs, and working with manufacturers.

New opportunities for HIV treatment in young children

At the IAS conference, WHO will highlight how global advances in reducing HIV-related deaths can advance support and services for epidemic-affected populations, including young children. In 2019, there were an estimated 95 000 HIV-related deaths and 150 000 new infections in children. Only half (53%) of the children in need of antiretroviral therapy were receiving it. The lack of optimal medications with appropriate pediatric formulations is a long-standing barrier to improving health outcomes for children living with HIV.

Last month, the WHO welcomed a decision by the US Food and Drug Administration, which approved the new 5mg formulation of doglegrivir (DTG) for infants over 4 weeks of age and children weighing more than 3 kg. This decision will ensure that all children have rapid access to an optimal drug, which to date is only available to adults, adolescents and older children. WHO is committed to fast-tracking the prequalification of DTG as a generic drug so that it can be used by countries as soon as possible to save their lives.

With the cooperation of several partners, we are likely to see generic versions of dolgravir for children by 2021, which will drastically reduce the cost of this drug, ”Dr. HIV Doherty, Director of Global HIV, Hepatitis Department and STI Program at WHO. "This will give us another new tool to reach children living with HIV and keep them alive and healthy."

Battling opportunistic infections

Many HIV-related deaths result from infections that take advantage of a person's weakened immune system. These include bacterial infections, such as tuberculosis, viral infections.
Hepatitis and COVID-19, including parasitic infections such as toxoplasmosis and fungal infections, histoplasmosis.

Today, WHO is issuing new guidelines for the diagnosis and management of histoplasmosis in people living with HIV. Histoplasmosis is highly prevalent in the WHO region
America, where 15 600 new cases and 4500 deaths occur every year among people living with HIV. Many of these deaths can be prevented through timely diagnosis and treatment of the disease.

In recent years, the development of highly sensitive clinical trials has allowed rapid and accurate confirmation of histoplasmosis and initiation of treatment. However, innovative diagnoses and optimal treatments for the disease are not yet widely available in resource-limited settings.

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