The authors were interested in the extent to which COVID-19 is disrupting services for HIV, tuberculosis and malaria in low- and middle-income countries and whether this is leading to additional loss of life over the next 5 years. They assumed a basic reproduction number of 3·0 and constructed four scenarios for possible responses to the COVID-19 pandemic: no action, mitigation for 6 months, suppression for 2 months or suppression for 1 year. The authors found that, in high-burden settings, deaths due to HIV, tuberculosis and malaria over 5 years could increase by up to 10%, 20% and 36%, respectively, compared with if there were no COVID-19 pandemic. The greatest impact on HIV was found to be due to interruption to antiretroviral therapy, which could occur during a period of high health system demand. For tuberculosis, the greatest impact would be from reductions in timely diagnosis and treatment of new cases during prolonged periods of COVID-19 suppression interventions. The greatest impact on malaria burden could be due to interrupting planned net campaigns. These disruptions could lead to a loss of life-years over 5 years that is of the same order of magnitude as the direct impact of COVID-19.
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