More than countries have warned that they are at risk of stock-outs of antiretroviral (ARV) medicines as a result of the COVID-19 pandemic, according to a new WHO survey conducted ahead of the International AIDS Society’s biannual conference.

The survey follows a modelling exercise convened by WHO and UNAIDS in May which forecasted that a six-month disruption in access to ARVs could lead to a doubling in AIDS-related deaths in sub-Saharan Africa in 2020 alone.

In 2019, an estimated 8.3 million people were benefiting from ARVs in the 24 countries now experiencing supply shortages. This represents about one third (33%) of all people taking HIV treatment globally.  While there is no cure for HIV, ARVs can control the virus and prevent onward sexual transmission to other people.

A failure of suppliers to deliver ARVs on time and a shut-down of land and air transport services, coupled with limited access to health services within countries as a result of the pandemic, were among the causes cited for the disruptions in the survey.

The findings of this survey are deeply concerning,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Countries and their development partners must do all they can to ensure that people who need HIV treatment continue to access it. We cannot let the COVID-19 pandemic undo the hard-won gains in the global response to this disease.

According to data released today from UNAIDS and WHO, new HIV infections fell by 39% between 2000 and 2019. HIV-related deaths fell by 51% over the same time period, and some 15 million lives were saved through the use of antiretroviral therapy.

Over the last two years, the annual number of new HIV infections has plateaued at 1.7 million and there was only a modest reduction in HIV-related death, from 730 000 in 2018 to 690 000 in 2019.  Despite steady advances in scaling up treatment coverage – with more than 25 million people in need of ARVs receiving them in 2019 – key 2020 global targets will be missed.

HIV prevention and testing services are not reaching the groups that need them most. Improved targeting of proven prevention and testing services will be critical to reinvigorate the global response to HIV.

WHO recently developed guidance for countries on how to safely maintain access to essential health services during the pandemic, including for all people living with or affected by HIV. The guidance encourages countries to limit disruptions in access to HIV treatment through “multi-month dispensing,” a policy whereby medicines are prescribed for longer periods of time – up to six months. To date, 129 countries have adopted this policy.

Countries are also mitigating the impact of the disruptions by working to maintain flights and supply chains, engaging communities in the delivery of HIV medicines, and working with manufacturers to overcome logistics challenges.