COVID-19 and syndemic challenges in 'Battling the Big Three': HIV, TB and malaria

Area of Science:

• Global Health
• Infectious Diseases
• Public Health Policy

Background:

• The COVID-19 pandemic presents significant indirect threats to healthcare systems globally.
• Sub-Saharan Africa faces a heightened risk due to existing health challenges and resource limitations.
• The pandemic's disruption extends beyond direct viral impact, affecting management of other critical diseases.

Purpose of the Study:

• To analyze the collateral impact of the COVID-19 pandemic on malaria, tuberculosis (TB), and HIV in sub-Saharan Africa.
• To synthesize current evidence on how COVID-19 disruptions affect the control and treatment of these "big three" diseases.
• To highlight the potential for increased disease incidence and mortality due to pandemic-related indirect effects.

Main Methods:

• Review of existing literature and epidemiological data from sub-Saharan Africa.
• Analysis of reports on healthcare system disruptions caused by COVID-19.
• Assessment of the impact on disease surveillance, diagnosis, and treatment services for malaria, TB, and HIV.

Main Results:

• Evidence suggests disruptions in malaria prevention programs and treatment access.
• Tuberculosis case detection and treatment initiation have been negatively impacted.
• HIV services, including antiretroviral therapy adherence and new diagnoses, face significant challenges.
• Potential for resurgence or increased burden of these diseases is evident across the region.

Conclusions:

• The indirect effects of COVID-19 pose a substantial threat to progress made against malaria, TB, and HIV in sub-Saharan Africa.
• Urgent, targeted interventions are needed to mitigate these collateral impacts and protect essential health services.
• Strengthening health systems to withstand future pandemics while managing endemic diseases is crucial.