Imperial College London

Dr Alexandra Hogan

Faculty of MedicineSchool of Public Health

Imperial College Research Fellow



+44 (0)20 7594 3946a.hogan Website




Norfolk PlaceSt Mary's Campus






BibTex format

author = {Hogan, A and Jewell, B and Sherrard-Smith, E and Watson, O and Whittaker, C and Hamlet, A and Smith, J and Winskill, P and Verity, R and Baguelin, M and Lees, J and Whittles, L and Ainslie, K and Bhatt, S and Boonyasiri, A and Brazeau, N and Cattarino, L and Cooper, L and Coupland, H and Cuomo-Dannenburg, G and Dighe, A and Djaafara, A and Donnelly, C and Eaton, J and van, Elsland S and Fitzjohn, R and Fu, H and Gaythorpe, K and Green, W and Haw, D and Hayes, S and Hinsley, W and Imai, N and Laydon, D and Mangal, T and Mellan, T and Mishra, S and Parag, K and Thompson, H and Unwin, H and Vollmer, M and Walters, C and Wang, H and Ferguson, N and Okell, L and Churcher, T and Arinaminpathy, N and Ghani, A and Walker, P and Hallett, T},
doi = {10.1016/S2214-109X(20)30288-6},
journal = {The Lancet Global Health},
pages = {e1132--e1141},
title = {Potential impact of the COVID-19 pandemic on HIV, TB and malaria in low- and middle-income countries: a modelling study},
url = {},
volume = {8},
year = {2020}

RIS format (EndNote, RefMan)

AB - Background: COVID-19 has the potential to cause substantial disruptions to health services, including by cases overburdening the health system or response measures limiting usual programmatic activities. We aimed to quantify the extent to which disruptions in services for human immunodeficiency virus (HIV), tuberculosis (TB) and malaria in low- and middle-income countries with high burdens of those disease could lead to additional loss of life. Methods: We constructed plausible scenarios for the disruptions that could be incurred during the COVID-19 pandemic and used established transmission models for each disease to estimate the additional impact on health that could be caused in selected settings.Findings: In high burden settings, HIV-, TB- and malaria-related deaths over five years may increase by up to 10%, 20% and 36%, respectively, compared to if there were no COVID-19 pandemic. We estimate the greatest impact on HIV to be from interruption to antiretroviral therapy, which may occur during a period of high health system demand. For TB, we estimate the greatest impact is from reductions in timely diagnosis and treatment of new cases, which may result from any prolonged period of COVID-19 suppression interventions. We estimate that the greatest impact on malaria burden could come from interruption of planned net campaigns. These disruptions could lead to loss of life-years over five years that is of the same order of magnitude as the direct impact from COVID-19 in places with a high burden of malaria and large HIV/TB epidemics.Interpretation: Maintaining the most critical prevention activities and healthcare services for HIV, TB and malaria could significantly reduce the overall impact of the COVID-19 pandemic.Funding: Bill & Melinda Gates Foundation, The Wellcome Trust, DFID, MRC
AU - Hogan,A
AU - Jewell,B
AU - Sherrard-Smith,E
AU - Watson,O
AU - Whittaker,C
AU - Hamlet,A
AU - Smith,J
AU - Winskill,P
AU - Verity,R
AU - Baguelin,M
AU - Lees,J
AU - Whittles,L
AU - Ainslie,K
AU - Bhatt,S
AU - Boonyasiri,A
AU - Brazeau,N
AU - Cattarino,L
AU - Cooper,L
AU - Coupland,H
AU - Cuomo-Dannenburg,G
AU - Dighe,A
AU - Djaafara,A
AU - Donnelly,C
AU - Eaton,J
AU - van,Elsland S
AU - Fitzjohn,R
AU - Fu,H
AU - Gaythorpe,K
AU - Green,W
AU - Haw,D
AU - Hayes,S
AU - Hinsley,W
AU - Imai,N
AU - Laydon,D
AU - Mangal,T
AU - Mellan,T
AU - Mishra,S
AU - Parag,K
AU - Thompson,H
AU - Unwin,H
AU - Vollmer,M
AU - Walters,C
AU - Wang,H
AU - Ferguson,N
AU - Okell,L
AU - Churcher,T
AU - Arinaminpathy,N
AU - Ghani,A
AU - Walker,P
AU - Hallett,T
DO - 10.1016/S2214-109X(20)30288-6
EP - 1141
PY - 2020///
SN - 2214-109X
SP - 1132
TI - Potential impact of the COVID-19 pandemic on HIV, TB and malaria in low- and middle-income countries: a modelling study
T2 - The Lancet Global Health
UR -
UR -
VL - 8
ER -