Three pandemics, zero vaccines: NB AIDS workers take distressing calls from southern Africa
COVID closes schools to students already orphaned by HIV
As executive director of AIDS Moncton, Debby Warren travelled to the country then known as Swaziland to work with children who had lost their parents to HIV/AIDS.
Sixteen years later, she's hearing from friends on the ground who fear COVID-19 will be a worse pandemic.
"They're telling me they're scared," said Warren, who maintains contact with community leaders in the region of Manzini.
A high school that she visited in 2005 has been closed for most of the past year.
The principal, Bheki Zwane, says he has no way to check on the welfare of his students.
They have no access to the internet or phones, he said, and many relied on the school for their main, maybe only, meal of the day.
"A lot of these children are coming from child-headed homes," said Zwane. "They don't have a mother. They don't have a father."
Of the 860 students enrolled at Zombodze National High School, 500 are classified as orphans or vulnerable because they lack the basic needs for survival.
"And we don't even know how they're coping," he said.
HIV positive patients at risk
In 2018, the king of Swaziland renamed the country Eswatini.
Today, it has the highest rate of HIV infection in the world. Nearly a third of the adult population is HIV positive.
"We thought we would never see a pandemic that would square with HIV," said Thandi Nhlengethwa, executive director of the AIDS Information and Support Centre.
"Then COVID was on our doorstep."
In the past few months, COVID has been linked to the deaths of two Eswatini cabinet ministers, the country's Anglican bishop and its 52-year-old prime minister.
Nhlengethwa says patients can live with HIV for many years but COVID seems to be killing her compatriots quickly.
"With COVID, you're dead in the space of maybe 14 days," she said.
Now she's worried to what extent healthcare resources will be diverted to managing this newest threat.
"We can't have a patient default on HIV treatment. That is suicide," she said.
Dr. Bernhard Kerschberger says there's been a lot of pressure to put more resources into the COVID response.
As project manager with Médecins Sans Frontières in Eswatini, Kerschberger has been occupied with HIV and the country's high burden of tuberculosis.
In 2011, the government declared TB a national emergency.
"We can see it's very difficult now for the health system to actually cope with this triple pandemic -- HIV, TB and corona," said Kerschberger.
Still, he's optimistic that COVID vaccine will start arriving later this month through the COVAX initiative.
It was created in part so wealthier countries could help drive vaccine development with the expectation that lower income countries would later benefit.
Canada is a participant, having invested $440 million, half of which paid to secure vaccine for Canadians. The other half will help buy doses for the 92 countries that do need help.
"In Africa, almost no countries have received the vaccine so far," said Kershberger. "And I think it's a bit sad to see because at the beginning of the pandemic, there was a lot of talk about a global approach, about solidarity ... but at the moment, I don't think we see a lot of solidarity."
In an interview from Mbabane, the country's executive capital, on Tuesday, Kerschberger said he expected Eswatini would be getting the AstraZeneca vaccine.
A few hours later, Reuters reported that Eswatini was rejecting that vaccine.
The decision was made after a trial showed it gave minimal protection against mild-to-moderate COVID-19 caused
by the dominant variant in South Africa.