Thank you very much for your kind words and for the question.
COVID-19 has impacted the programs in many ways. First of all on the offer side, health workers and community health workers were completely overwhelmed and under stress by the COVID-19 pandemic. Some of them were sick—we've lost many health workers—and/or couldn't access the health facility and/or could not cope with the level of demand.
That applies obviously to frontline health workers, but also labs were completely overwhelmed. That means that health workers or the labs that were usually used to fight tuberculosis, malaria or HIV were busy dealing with COVID-19 and could not cope with everything at the same time.
The other aspect is more on the demand side. For example, you had a lot of people who had a fever, let's say, in Burkina Faso. Having fever, they understood that they shouldn't go out from their houses and that they should not go to the health centre because it could be COVID and therefore they could contaminate others. There are contradictory instructions. For TB, similarly, if you cough you should immediately get tested and get treated, but if you cough and you have COVID you should stay home. It was very difficult for people to actually know what to do. Also lockdown orders prevented people from getting access to treatment or prevention services.
We've seen indicators go backwards very significantly in HIV testing, which was very badly affected. TB testing and treatment were very badly affected as well. Malaria resisted a bit more because programs and actors on the ground managed to adapt, for example, the way they distributed mosquito nets. They went door-to-door and therefore such programs were more resilient to COVID-19, but TB and HIV were very badly affected because of those different factors.