COVID pandemic has affected our life, has deepened the existing inequalities and worsened the situation of vulnerable people. HIV infected and affected people were facing problems related to poor access to health services, education, stigma, discrimination and violation of their rights before the pandemic, too. The 2020 global reports of UNAIDS enumerate increased risks for this category of people, such as weakened health systems that also result in poor access to testing, treatment, rising level of poverty, violation of rights and marginalization. Even being subject to antiretroviral treatment, which ensures good state of health, these are somehow vulnerable in the face of COVID because the burden of chronic diseases and co-morbidities such as tuberculosis, hepatitis among these people, is high. HIV infected people who do not know about their status, and in the Republic of Moldova over 30% of people who are estimated to live with HIV are in this situation, have a weak immunity.
The socio-economic situation of people in this group was already worrisome long before COVID pandemic. The People Living with HIV Stigma Index study carried out in 2018 shows that about 36% or every 3rd person living with HIV is not employed; women being more affected or every second woman has no job. Situation monitoring during COVID shows that social situation of these people living with HIV, as of other citizens of the country, has worsened.
The Republic of Moldova managed to stabilise HIV-related epidemiology indicators by 2019. This is maintained at the level of epidemic concentrated in high risk of infection groups. Although far from reaching its goals, the Republic of Moldova has aligned to the newest WHO recommendations on diagnostics, treatment and infection prevention measures. COVID, as in many other countries of the world, puts these results at risk.
From the quarantine onset, the mobilization of all partners, begining with the Ministry of Health, Labour and Social Protection, Dermatology and Communicable Diseases Hospital, IMSP IFP “Chiril Draganiuc”, National Public Health Agency, UCIMP and UN Family and over 20 non-governmental organisations, has allowed to adjust and provide for uninterrupted and safe prevention and treatment services. In the Republic of Moldova as well as in its Eastern region, the antiretroviral treatment is provided in only 6 medical institutions in civil sector and in penitentiaries. Thus, about 900 patients from remote villages and districts have received home-based treatment provided by the NGOs in the field successfully involved in this process. These also provided counselling on COVID, protection measures and material support packages for the most vulnerable. About 125 citizens of the RM living with HIV were helped to receive ARV treatment in the host state where they got stranded during the quarantine. Most of them were in Western Europe and Russian Federation. Around 100 patients received pre-exposure prophylaxy treatment and thousands of people from the high risk of infection group continued to receive HIV prevention services.
Globally and in the Republic of Moldova, with the mobilization of all efforts, the treatment enrollment rate has decreased by about 30%, while the treatment abandonment rate has increased by 30% by mid 2020. These indicators represent a serious concern. UNAIDS advises that future country development strategies put an emphasis on health, ensure investment necessary to strengthen health system, eliminate stigma and discrimination, develop person-centered services and base their pandemic response on protecting human rights and gender equality.
Svetlana Plamadeala, Country Manager UNAIDS Moldova
Disclaimer: This editorial is developed in the context of the Human Rights Awareness Campaign “Recover Better Together: Human Rights for All” launched by UN Moldova under the guidance of the UN Human Rights Office Moldova.