Will global health learn from COVID-19 collateral damage?

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Mothers wash their hands at a maternal and child health center in Mogadishu, Somalia. Photo by: Mukhtar Nuur / UN Photo / UNSOM Somalia

The number of COVID-19 deaths is updated constantly, but that’s not the case for the second-largest killer among infectious diseases.

COVID-19 killed an estimated 1.8 million people in 2020, but the number of deaths due to tuberculosis won’t be available until October 2021, said Peter Sands, executive director at the Global Fund to Fight AIDS, Tuberculosis and Malaria. He estimated that 1.5 million people died of tuberculosis in 2020 but said the infectious disease does not get “the kind of money and attention” COVID-19 does.

The COVID-19 pandemic led to a decline in diagnosis and treatment of tuberculosis by as much as 25%-30% in some high-burden countries, Sands said, adding that there have been similarly devastating impacts on HIV/AIDS and malaria.

“I think the collateral damage in most really low-income countries is going to be greater than the direct impact of COVID,” he said in a session at The Davos Agenda, virtual meetings hosted by the World Economic Forum this week. “You’re going to see relatively low mortality from COVID itself and relatively high mortality from these non-COVID consequences.”

After the pandemic: How will COVID-19 transform global health and development?

We asked 21 leaders and big thinkers to share their insights and predictions for how the COVID-19 crisis might transform the fields of global health and development. Here is what they said.

Disruptions to health services caused by COVID-19 have reversed progress on a range of other global health priorities, including reducing maternal mortality and preventing death from noncommunicable disease. Sands, along with other experts on a panel Tuesday, spoke with a sense of urgency, saying the longer these disruptions continue, the greater the collateral damage will be.

At the same time, they noted the opportunity for the global health community to leverage the lessons it has learned over the past year as it emerges from the pandemic.

Reduction in access to health services is disproportionately impacting the most vulnerable, as demonstrated by lung cancer, said Michelle Mitchell, chief executive officer at Cancer Research UK.

“Cancer affects us all, but for lung cancer, there’s a socioeconomic dimension to it,” Mitchell said. “Smoking is a big driver, and some of our poorest communities will be hit hard.”

Early diagnosis is critical for lung cancer. But over the past year, fewer people have come forward with symptoms, and screenings have been postponed. More people will die because of these delays in treatment, Mitchell said.

She suggested participants reference a new report from the World Economic Forum and the Lung Ambition Alliance, which shares lessons from Europe on addressing the short-term impact of COVID-19 on lung cancer care.

But COVID-19 could present an opportunity to break down health care silos, according to Charles Gore, executive director at the Medicines Patent Pool.

“The collateral damage in most really low-income countries is going to be greater than the direct impact of COVID.”

— Peter Sands, executive director, Global Fund to Fight AIDS, Tuberculosis and Malaria

“What are the collateral benefits of COVID in terms of how we do things?” he said. “We’re able to do things much faster, we’re able to concentrate resources where we want to, we’re able to actually do things differently — using tech, for example.”

Conversations with leading pharmaceutical companies are happening at a far earlier stage than they used to, Gore wrote in a follow-up email to Devex. This could accelerate the timeline for new patented drugs to become available in low- and middle-income countries, he said.

COVID-19 is having a catastrophic impact on mental health, with rates of anxiety, depression, and other forms of psychological distress on the rise globally. But the pandemic has also led to more attention for mental health, which currently receives less than 1% of global health funding, said Elisha London, founder and CEO at United for Global Mental Health.

She discussed how one collateral benefit of COVID-19 could be integrating mental health into other health services.

“The question will be now whether this interest turns into investment,” she told Devex via email. “Mental health must be prioritised not as a cost, but as an investment essential to recovery.”

Michelle Williams, dean of the faculty at Harvard University’s school of public health, said she hopes COVID-19 will serve as a wake-up call about how “weak global public health infrastructure can bring us all to our knees.”

Now is the time to recognize the value of public health and invest accordingly, she said.

About the author

  • Catherine Cheney

    Catherine Cheney is a Senior Reporter for Devex. She covers the West Coast of the U.S., focusing on the role of technology, innovation, and philanthropy in achieving the Sustainable Development Goals. And she frequently represents Devex as a speaker and moderator. Prior to joining Devex, Catherine earned her bachelor’s and master’s degrees from Yale University, worked as a web producer for POLITICO and reporter for World Politics Review, and helped to launch NationSwell. Catherine has reported domestically and internationally for outlets including The Atlantic and the Washington Post. Catherine also works for the Solutions Journalism Network, a non profit that trains and connects reporters to cover responses to problems.