Table 1. Summary of indirect impact of COVID-19 and the recommended mitigation strategies to minimize its impact on HIV, TB, malaria, and MCH programs.

Disease control program	Impact from COVID-19	Mitigation strategies
HIV	Increase in HIV incidence and attrition, drug resistance, and deaths due to disruptions in access to prevention, treatment, and monitoring services as well as structural factors impacting treatment adherence	• Adapting and scaling up differentiated service delivery including multimonth ARV dispensing • Integrating HIV testing into COVID-19 community-based testing • Promote and prioritize self-testing to high-risk or vulnerable groups such as partners of people living with HIV and pregnant women • Adopting digital/virtual health service delivery platforms to support treatment initiation, psychosocial support, and adherence • Promoting home-based care for patients with advanced disease • Supporting community-based, home-based, and pharmacy-based distribution of prevention tools, self-test kits, ARVs as well as blood draws for viral load, and early infant diagnosis testing • Adopting digital platforms for surveillance and monitoring such as monitoring stock levels for timely distribution of commodities
TB	Increase in TB incidence, drug resistance, and deaths	• >1 month dispensing of anti-TB drugs for treatment and prevention • Adapting community-based model of care including delivering treatment and adherence such as direct observed treatment supported by family members or self-administered therapy coupled with increased literacy • Integrating TB diagnosis in COVID-19 testing strategies • Adopting virtual digital health technologies for patient care and support including VOT
Malaria	Increase in incidence and deaths	• Community-based testing, treatment, surveillance, and distribution of preventive measures including seasonal malaria chemotherapy • Innovative distribution channels of prevention campaigns like use of motorcycles for door-to-door distribution of ITNs so as to ensure physical distancing and minimize mass gatherings common with the convention mass campaigns • Providing frontline healthcare workers including those involved in IRS with COVID-19 prevention equipment and prioritizing them for COVID-19 vaccination • Continuing prevention campaigns including chemoprevention services, ITN distribution, and IRS while ensuring COVID-19 infection, prevention, and control measures
MCH	Increase in deaths and disability	• Using community outreach platforms for antenatal and postnatal care and immunization services • Leveraging any hospital visits for mother and child to provide other essential services like nutrition support and immunization for children and antenatal and postnatal care for mothers • Ensuring continuity of MCH services while strengthening infection, prevention, and control measures • Intensive catch-up campaigns • Spacing out maternal and child visits to avoid overcrowding in hospitals • Strengthening data systems to facilitate identification of children missing immunization schedules who can be prioritized during catch-up campaigns • Use of digital technologies for counseling, health promotion, and screening for danger signs • Targeted outreach services for both antenatal and postnatal care

ARV, antiretroviral; COVID-19, Coronavirus Disease 2019; IRS, indoor residual spraying; ITN, insecticide-treated net; MCH, maternal and child health; TB, tuberculosis; VOT, video-observed therapy.