Twenty-four countries reported having either a critically low stock of ARVs or disruptions in the supply of these life-saving medicines.

The survey follows a modelling exercise carried out 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 per cent) 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 from UNAIDS and WHO, new HIV infections fell by 39 per cent between 2000 and 2019. HIV-related deaths fell by 51 per cent over the same time period, and some 15 million lives were saved through the use of antiretroviral therapy.

However, progress towards global targets is stalling. 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.

From an international health insurance point of view, we know that many businesses have integrated employee assistance programmes that include medical aid and insurance offerings for employees living with HIV. We also know that there are a wealth of international private medical insurance policies available to expats, which include cover for assistance services and special benefits relating to HIV and AIDS. An insufficient supply of ARVs will have a direct impact on the health and wellbeing of these individuals and their families.

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