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The COVID-19 pandemic has turned the clock back years in the fight against other diseases. It has halted research, trials, and other efforts to ease the public health burden.
A regimen for Parkinson’s disease, for example, was due to begin clinical trials this year. But this was postponed due to the pandemic.
Researchers have warned that if COVID-19 stops the distribution of long-lasting insecticide nets, malaria cases could increase by 206 million and malaria deaths by 379,000 in sub-Saharan Africa. Scientists predicted that HIV-related deaths could increase by 10%, tuberculosis by up to 20%, and malaria by 36% over the next five years.
Read more: Why malaria treatment shouldn’t take a backseat to COVID-19
Among the health conditions that could have faced a setback is leishmaniasis, a parasitic disease associated with poverty problems such as malnutrition and poor housing. It is transmitted by a sand fly that breeds in unsanitary conditions, such as open sewers and unmanaged waste, that may have been neglected during the pandemic.
Leishmaniasis ranks high among neglected tropical diseases. About a seventh of the world’s population is at risk of contracting it. The disease is a major public health problem in various parts of the world, including Africa. It can lead to devastating lifestyle changes, disability, social stigma, low work productivity, and death.
We believe that COVID-19 could potentially have reversed the fight against leishmaniasis in at least a decade.
Treatment and control of interruptions
COVID-19 has put great pressure on the capacity and infrastructure of health systems. The pandemic has created a great demand for hospital admissions, intensive care and medical personnel. Even hospitals and pharmacies have been limited in the services they can provide under some lockdown restrictions.
Treatment of patients with leishmaniasis requires medical personnel trained to inject drugs. People with leishmaniasis need access to health facilities for daily drug treatment. If this is not available, patients must be hospitalized for long periods to facilitate treatment.
During the pandemic, this would not be possible if all hospital beds were prioritized for COVID-19 patients.
Read more: Leishmaniasis needs more attention: it causes skin lesions and can kill
Prevention and control of leishmaniasis involves disease surveillance, vector control with insecticide sprays, and the provision of insecticide-treated nets to households in endemic areas. These activities have been hampered by limited allocation of funds or restriction of movement to prevent the spread of COVID-19.
The transport of researchers and doctors to the worst affected areas, many of them remote, has also been affected by the closures. Measures of physical distancing mean that researchers and clinicians are unable to conduct questionnaire-like data collection. As a result, they cannot establish infection rates or identify potential foci of disease.
Diverted resources
Scientists have been quick to develop drugs, diagnostic kits, vaccines, and protection kits for COVID-19. To facilitate this, most governments have redirected funds for the management of other infectious diseases towards anti-COVID-19 efforts. Neglected tropical diseases like leishmaniasis already receive only about 0.6% of WHO’s health development research budget. Redirecting more funds could mean that the leishmaniasis targets are lost.
The suspension of several research projects around the world could have resulted in various deadlines being missed, resulting in a probable loss of research funding. For example, South Africa has seen research budget cuts required by the impact of COVID-19.
Co-infection
There is another concern: South America is one of the epicenters of the coronavirus disease and all the countries of that continent have cases of leishmaniasis, except Chile and Uruguay. To prevent any of the infections, a person needs a robust immune system. But the Leishmania parasite and SARS CoV2 target the same cells needed to fight invading pathogens. Therefore, some people are likely to become infected with both diseases, and co-infection could complicate and exacerbate both conditions.
Collectively, COVID-19 cannot remain isolated. Many parts of the world are affected by multiple devastating diseases. These diseases should not be overlooked in the quest to control the new pandemic.
Raphael Taiwo Aruleba is currently a PhD in the Department of Molecular and Cell Biology at the University of Cape Town. It receives funds from the PhD Scholarship from the UCT Faculty of Sciences and from the Poliomyelitis Research Foundation for doctoral students.
Bernard Ong’ondo Osero is an Arturo Falaschi PhD Fellow at the Faculty of Medicine, Department of Pathology, University of Cape Town. The doctoral program is supported by the International Center for Genetic Engineering and Biotechnology (ICGEB).
Dr Ramona Hurdayal is a Professor in the Department of Cellular and Molecular Biology at the University of Cape Town School of Sciences and is Y1 rated by the National Research Foundation. It receives funding from the University of Cape Town, the National Research Foundation and the Poliomyelitis Research Foundation.
By Raphael Taiwo Aruleba, PhD Candidate, University of Cape Town and
Bernard Ong’ondo Osero, Arturo Falaschi PhD Fellow of the ICGEB, University of Cape Town and
Dr Ramona Hurdayal, Professor and Team Leader: Leishmaniasis Research Group, University of Cape Town
