COVID‐19: Learning from the HIV/AIDS pandemic response in Africa

Abstract

About 74.9 million persons were infected during the human immunodeficiency virus/acquired immunodeficiency syndrome HIV/AIDS global pandemic with nearly half of them succumbing to the disease. In 2018 alone, Africa recorded over 400,000 AIDS‐related deaths which is more than half of the global total. This reflects years of inequality in the global pandemic response. Also, the international response to AIDS in the early years was very slow, with a global programme only developed 6 years into the pandemic. Many African countries still lack pandemic preparedness plans to handle a global pandemic. Thus, this paper highlights the important lessons that can be learnt from the response to the AIDS pandemic and recommends how they can be applied during the coronavirus disease 2019 (COVID‐19) pandemic. Some of the important lessons include: HIV reversed the previous success recorded in health systems of developing countries; the antiretroviral drug development process was prolonged and required long term commitment; and primary healthcare was crucial in preventing and controlling the disease. These lessons can be utilised in the fight against COVID‐19 pandemic. It is recommended that: there should be solidarity among the nations of the world to fight COVID‐19; health authorities should be proactive in curbing misinformation; and interventions should prioritise human rights and focus on vulnerable communities. HIV treatment services should not be discontinued as it is still an ongoing pandemic. A balance needs to be achieved in combating both pandemics as discontinuation of HIV treatment during the coronavirus pandemic could result in more than 500,000 deaths.

Containing COVID-19 and the social costs on human rights in African countries

“…Govender and colleagues (2020) report that various sexual and reproductive health services in South Africa were suspended because of the prioritisation of COVID-19 treatment, leaving women also with unmet needs for contraceptives, health screening and related exams, and other key services. Gender-based violence is pervasive and reportedly increased during the pandemic (Renzaho, 2020 ; Sekalala, 2020 ; Olufadewa et al, 2021 ); lockdowns and curfews limited women’s capacity to seek help to escape family violence or to report on sexual assault. In West Africa, many women who live in poverty lack sufficient education to be familiar with the law and human rights; even if they report violence, “courts are likely to underestimate the degree of harm faced by women” (Sekalala, 2020 , p. 14) and minimise women’s suffering.…”

“…In West Africa, many women who live in poverty lack sufficient education to be familiar with the law and human rights; even if they report violence, “courts are likely to underestimate the degree of harm faced by women” (Sekalala, 2020 , p. 14) and minimise women’s suffering. Few policy measures exist that address women’s vulnerability, and those that exist have been identified as inadequate (Akech, 2020 ; Amadasun, 2020 ; Govender et al, 2020 ; Ntlama and Chitsamatanga, 2020 ; Renzaho, 2020 ; Sekalala, 2020 ; Chiwona-Karltun et al, 2021 ; Olufadewa et al, 2021 ).…”

“…These four vulnerable groups were most frequently addressed in the literature, and described in greatest detail. In general, the populations disadvantaged by or excluded from COVID-19 policies in Africa to mid 2021 included: Women (Akech, 2020 ; Govender et al, 2020 ; Ntlama and Chitsamatanga, 2020 ; Renzaho, 2020 ; Sekalala, 2020 ; Chiwona-Karltun et al, 2021 ; Olufadewa et al, 2021 ) Children (Akech, 2020 ; Amadasun, 2020 ; Dube, 2020 ; McQuoid-Mason, 2020 ; Ntlama and Chitsamatanga, 2020 ; Adebisi et al, 2021 ; Boretti, 2021 ) Youth (Amadasun, 2020 ; Govender et al, 2020 ; Renzaho, 2020 ) Migrants, including refugees, asylum-seekers, documented and documented immigrants, persons who migrate from rural to urban environments, internally displaced persons, and trafficked survivors (Bukuluki et al, 2020 ; Mukumbang et al, 2020 ; Oladimeji et al, 2020 ; Somse and Eba, 2020 ; Chiwona-Karltun et al, 2021 ) Inmates (Botes and Thaldar, 2020 ; Iversen et al, 2020 ; Muntingh, 2020 ; Oladimeji et al, 2020 ), people in closed settings (Iversen et al, 2020 ), and prison staff (Van Hout, 2020 ) Persons with medical co-morbidities, including chronic pulmonary disease, cardiovascular disease, cerebrovascular disease, diabetes and compromised immunity (Govender et al, 2020 ; Iversen et al, 2020 ; Adebisi et al, 2021 ; Olufadewa et al, 2021 ) Populations living in extreme poverty, such as those living in informal settlements (Botes and Thaldar, 2020 ; Odunitan-Wayas et al, 2020 ; Sehoole, 2020 ) Persons living with disabilities (Botes and Thaldar, 2020 ; Adebisi et al, 2021 ), including learners living with severe disabilities (Moodley et al, 2020 ) Professional (Sekalala, …”

“…The latter includes birth attendants, community volunteers, traditional healers, and female healthcare providers. Homeless populations (Botes and Thaldar, 2020 ; Oladimeji et al, 2020 ) Sex workers (Iversen et al, 2020 ; Adebisi et al, 2021 ) People who use drugs, especially those who inject drugs (Iversen et al, 2020 ; Adebisi et al, 2021 ) Elderly people (Botes and Thaldar, 2020 ; Olufadewa et al, 2021 ) Sexual minorities, including men who have sex with men and transgender populations (Iversen et al, 2020 ) Individuals in conflict regions (Olufadewa et al, 2021 ). …”

“…Women (Akech, 2020 ; Govender et al, 2020 ; Ntlama and Chitsamatanga, 2020 ; Renzaho, 2020 ; Sekalala, 2020 ; Chiwona-Karltun et al, 2021 ; Olufadewa et al, 2021 )…”