‘Hamisa (not real name) is a teenage girl currently living with HIV in Malawi. She is on free ARVs government program. A few months ago during the spike of Covid-19 cases she had problems in accessing her drugs, as thelocal clinic workers frequently claimed stock outs and also unwilling to meet various patients regularly. She cannot afford the ARV drugs that are being sold by black market dealers within the village as they are very expensive. At the same time, there is a male health worker (also living with HIV) who appears to be friendly and promising a continuous supply of the free hospital drugs if she gives in to sex’.
Although the experiences learned from HIV pandemic can be applied to the COVID-19 situation, these are one of the many sad stories that may indicate some retrogression towards the advances that have been made so far. After getting the right information on the current procedures of getting the drugs during COVID-19 at local clinics, Hamisa was finally assisted by Senior Hospital Staff. However, such scenarios also indicate that the effective responses against HIV, TB and malaria are currently under threat due to COVID-19. The general concern now is that People living with HIV who are not on treatment areat a greater risk; as they may be more vulnerable to respiratory infections when their HIV is not clinically well managed. The issue of social distancing has meant some governments asking people to avoid other people and to stay inside doors in order to stop the spread of the virus. While this has been a good public health measure; the situation has also just increased stigma and discrimination, gender based and sexual violence/exploitation both at household and health facility level. The increased stigma and discrimination, within the social distance demands, has had effects on how People Living with HIV access treatment. In this year’s theme UNAIDS has observed that the defeat of AIDS as a public health threat depends on how the world responds to COVID-19.
In the face of COVID-19 access to treatment within the ‘global solidarity and shared responsibility theme’ should mean physical availability, accessibility and affordability of essential drugs in an environment where there is guaranteed social protection and notraces of stigma and discrimination. In this period, access to treatment should also mean access to accurate and consistent information, social protection, and HIV friendly health services. This means that there is a deliberate conducive policy environment that guarantees the efficiency and effectiveness of national prevention programs. For access to treatment to be a reality, indeed for young girls like Hamisa, it would mean there is political commitment for governments in building resilient and sustainable systems of health that guarantees universal health coverage even in the face of a new global pandemic. This year’s world AIDS theme should remind us that Access to treatment during COVID-19 is everyone’s responsibility.
ACB Policy and Advocacy Advisor