File Picture: John Cairns/ University of Oxford via AP)
File Picture: John Cairns/ University of Oxford via AP)

Treatment for other killer diseases lags behind in SA due to focus on Covid-19

By Bongani Nkosi Time of article published Jul 21, 2020

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South Africa faces the unintended consequences of lagging behind in the treatment of other killer diseases and quadrupling mortality as a result of channelling most of its healthcare resources to the Covid-19 pandemic.

This is the warning by two health experts, Shabir Madhi and Karen Hofman, from Wits University’s Faculty of Health Sciences and Medical Research Council. Their article has been published by the prestigious South African Medical Journal.

“Until we have a vaccine or a cure, Covid-19 may be among us for a while. Finite resources cannot be diverted solely to the pandemic,” they wrote.

“Careful priority-setting, taking into consideration the costs and benefits of basic health interventions and services, is critical to the success and sustainability of public health gains of the past decades, while simultaneously addressing the Covid-19 pandemic.”

Not only have resources been shifted to focus on the virus, the nationwide lockdown has caused a decrease in demand and the supply of health services, Madhi and Hofman said.

“On the supply side, human resources’ shift to Covid-19 has resulted in limited services for diagnosis, treatment and prevention of other health issues.

“On the demand side, the public has avoided health facilities and has been affected by transport restrictions,” they said.

They cite as an example the statistics from the National Institute for Communicable Diseases showing a 48% decline in testing for TB, as well as a 33% reduction in newly diagnosed positive cases over a five-week period compared with the six-week period before the level 5 lockdown.

There have also been reports of people living with HIV failing to collect their antiretrovirals (ARVs) during the lockdown.

Madhi and Hofman said an interruption to supply of ARVs over a six-month period to all the country’s HIV patients on treatment would double mortality in a year.

“This amounts to an excess of between 83800 and 140900 adult HIV deaths should such a high level of disruption occur,” they wrote.

“Disruption to maternal and child health (MNCH) services could have a similarly devastating impact.

“A 9-18% reduction on MNCH coverage over a 6-month period would lead to an additional 2160 child deaths at a minimum in SA, despite children being at extremely low risk of severe Covid-19 illness.

“Of all MNCH services, sustaining routine childhood immunisation is particularly important.

“Measles in particular is a highly contagious disease that mostly affects children aged under 5 years.”

Madhi and Hofman urged decision-makers to change tactics and ensure equity in the distribution of health expenditure.

“Efficient and equitable allocation of resources is therefore critical, now more than ever.

“Unless we prioritise interventions that are cost-effective and address the major challenges from both the demand side and the supply side, SA will experience increased mortality and morbidity from diseases that have been sidelined in favour of Covid-19.

“This outcome will obliterate hard-won improvements in life expectancy over the past decade, thwarting any chance of SA reaching its 2030 Sustainable Development Goals.”


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