Sunday Times 17 May 2020

Transport restrictions and fear of coronavirus infection are among the reasons for a big drop in HIV/Aids and TB patients collecting medication.

Researchers warn that missing treatments could lead to people developing resistance to medications and set back treatment campaigns by years.

The health department has increased delivery points, said spokesperson Popo Maja.

“We have implemented centralised chronic-disease dispensing and delivery. With the move to level 4, we are likely to see more patients able to visit health facilities.”

Surveys by the health-care organisation Right to Care and the Africa Health Research Institute (AHRI) show declines of about 50% in medication collection during lockdown.

Among the 125,000 households we survey, we contacted 213 weekly to assess Covid-19’s impact. Five weeks after the lockdown, the number dropped to around 30%

Africa Health Research Institute director professor Willem Hanekom

Thula Mkhize of the HIV nongovernmental organisation Good Stories said that in the past two months about 30 people have asked for help because of their Covid-19 fears.

Right to Care CEO professor Ian Sanne said only between 30% and 50% of patients are collecting medication during the lockdown. “Usually, of the 380,000 patients we survey at our Mpumalanga and Free State project sites, over 90% keep their appointments.”

Sanne said they were concerned about SA’s 7.2-million HIV-positive people, “2-million of whom are undiagnosed”.

He said the lockdown could lead to people becoming resistant to HIV medication, and in the long term developing complications. One of the main reasons patients miss appointments is that they are afraid of being exposed to Covid-19, he said.

“We need to carefully reopen certain portions of the health-care system, where the correct Covid-19 screening and protection takes place, so routine health services can continue.”

AHRI director professor Willem Hanekom said its research in KwaZulu-Natal, which includes a survey on people accessing chronic medicines for HIV, TB and other diseases, showed that two weeks after the lockdown began, nearly 50% reported they could not access their medication.

“Among the 14,000 households we survey, we contacted 213 weekly to assess Covid-19’s impact. Five weeks after the lockdown, the number dropped to around 30%.”

He said the lack of access to chronic medication will push back advances made in HIV and TB care.

Maja confirmed the decline in HIV-positive people honouring appointments, but said the drop in pick-ups from state medical facilities is about 8%.

“Since we started measures to reduce the amount of contact HIV-positive clients have with health facilities, an additional 67,832 patients have enrolled to collect medication outside of health facilities.”

Pharmacies and technology researchers are looking for better access options, from online orders to smart lockers.

Right ePharmacy, with the Council for Scientific & Industrial Research, has launched the Collect & Go locker system in 69 sites in Mpumalanga, the Free State and Gauteng. The lockers are designed to alert health-care workers when people have not collected their medication.

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