Even as the COVID-19 pandemic demanded global attention, malaria, tuberculosis (TB) and HIV remained the leading causes of death in Africa.
New evidence is emerging to show how the pandemic has prevented the delivery of health services and slowed years of progress made in the battle against other diseases.
“The COVID-19 pandemic has brought hidden, dangerous knock-on effects for health in Africa,” Dr. Matshidiso Moeti, the World Health Organization’s regional director for Africa, said during a November 2020 news conference. “With health resources focused heavily on COVID-19, as well as fear and restrictions on people’s daily lives, vulnerable populations face a rising risk of falling through the cracks.”
A report by Global Fund to Fight AIDS, Tuberculosis and Malaria provides data that shows Moeti’s fear was well-founded: Africa has had sharp declines in referrals and treatment for malaria, TB and HIV.
For example, the report noted a 60% decline in diagnoses of drug-sensitive TB and an 80% decline in TB treatment referrals in 2020 compared to 2019. It also found that HIV testing dropped by 41%, and malaria diagnoses dropped by 17% compared to the previous year.
“The pandemic is creating a perfect storm of economic, health and social crises and threatens to reverse the extraordinary gains made by the Global Fund partnership in the fight against HIV, tuberculosis and malaria and in building resilient and sustainable systems for health,” the report’s authors wrote.
The report found that children under 5 years old are particularly at risk, noting a 23% drop in medical consultations for this age group. “If mothers and children’s access to essential health services is reduced, mortality among children under 5 could be expected to rise,” the authors wrote.
Medical services declined because of fear, mistrust and uncertainty over contracting COVID-19 at health care facilities. There were also disruptions in public transportation, lockdowns or stay-at-home orders, delayed care-seeking and changes in public recommendations on seeking medical care for mild illnesses, according to the study.
Around the continent, governments also grappled with a shortage of basic nonmedical supplies and equipment, such as masks, personal protective equipment and oxygen-delivery systems, as well as an inadequate number of beds in intensive care units and a lack of rapid diagnostic testing.
John Nkengasong, director of the Africa Centres for Disease Control and Prevention (Africa CDC), addressed vulnerabilities in African health systems in a January 2021 essay for U.S. research group the Brookings Institution.
To strengthen African health systems and prepare for future disease outbreaks — including a predicted fourth wave of COVID-19 — Nkengasong suggested greater communication between the Africa CDC and national public health institutions, private sector support to boost local production of medicines and increase diagnostic capacity, and investment in public health workforce programs.
“A sufficiently large, well-prepared health workforce is key to any of the activities mentioned above,” Nkengasong wrote. “But the gaps are significant. For example, Africa requires 25,000 frontline epidemiologists and has about 5,000.”
Analysts at the Actuarial Society of South Africa (ACCA) predicted that a fourth wave of COVID-19 infections will hit the country in December. COVID-19 has hit South Africa harder than any other African nation.
The severity of the potential fourth wave will most likely depend on whether the country is successful in building immunity in the majority of the adult population, Adam Lowe, a member of the ACCA Covid-19 Working Group, told South African news website BusinessTech.