/ 2 December 2021

South Africa Aids gains in danger as it grapples with Covid-19

Alexandra Residents Get Screened And Tested For Covid 19 On Freedom Day In South Africa
Scientists have developed medicine that can control HIV in our bodies, turning it into a manageable, chronic disease. But inequality frequently prevents the drugs from reaching the people who need them most. (Photo by Dino Lloyd/Gallo Images via Getty Images)

Because of Covid-19, South Africa has seen a reversal of some of the gains it had made in the fight against HIV/Aids and tuberculosis (TB), but one expert believes some of the resources used to grapple with the current global pandemic can also be utilised for HIV programmes.

South Africa has the biggest HIV epidemic in the world, with 7.5-million people living with the virus in 2019. HIV prevalence is high among the general population at 19%.

United Nations Aids agency UNAids set countries a 90-90-90 target for 2020, by which time 90% of people should know their status, 90% should be on treatment and 90% of all people receiving antiretroviral therapy should have viral suppression. As of June this year, South Africa was sitting at 93-76-89 for the total population.

The South African National Aids Council says the Covid-19 pandemic has led to disruptions in testing and treatment services for HIV. The National Income Dynamics Study Coronavirus Rapid Mobile Survey found that there was a reduction in how many people used primary healthcare facilities during the pandemic, especially in HIV testing, across almost all districts in the country.

For facilities supported by global social healthcare group BroadReach, there was a drop of up to 55% among patients coming to facilities when the government first imposed a national lockdown in response to the Covid-19 crisis in March 2020. As of November this year, the number sat at 70% of pre-pandemic levels.

But while Covid-19 affected the delivery as well as access to health services, it also brought new opportunities, says BroadReach public health expert Dr Ernest Darkoh.

“Covid-19 is forcing us to do remarkable things and with the vaccine roll-out currently taking place, it gives us an opportunity to get to the majority of the population,” said Darkoh.

“Covid-19 has also allowed healthcare workers to see patients online. The dispensing of HIV medication has been made easy and has proven to be a better model to manage treatment. We need to capitalise on the gains made in the Covid-19 management and if we don’t use the experience from Covid-19, we will not be ready for another pandemic.”

According to Darkoh, as a country with the single largest population of people living with HIV, South Africa has over the years made strides in ensuring that they are able to access treatment.

For the country to be able to prevent new infections, 30 percent of which are among adolescent girls and young women between the ages 15 to 24, there needs to be a focus in addressing intergenerational sex, sexual and reproductive health rights and services as well as addressing the economic and social determinants that make this population vulnerable to contracting HIV, Darkoh said.

“So many of the interventions like the vaginal ring, condoms and pre-exposure prophylaxis rely on how comfortable people are with sex,” he said.

“It makes it harder for people to use them when they are uncomfortable to have the conversation about sex because we have this conservative approach towards sex, which needs to be changed.”