Monday, 24 July 2017
WHO Urges Action against HIV Drug Resistance Threat
...Calls on the global community for continued vigilance and responsiveness
The World Health Organisation (WHO) has alerted countries to the increasing trend of resistance to HIV drugs detailed in a report based on national surveys conducted in several countries.
The Organisation warns that this growing threat could undermine global progress in treating and preventing HIV infection if early and effective action is not taken.
According to the WHO HIV drug resistance report 2017 in six of the 11 countries surveyed in Africa, Asia and Latin America, over 10% of people starting antiretroviral therapy had a strain of HIV that was resistant to some of the most widely used HIV medicines. Once the threshold of 10% has been reached, WHO recommends those countries to urgently review their HIV treatment programmes.
HIV drug resistance report 2017
“Antimicrobial drug resistance is a growing challenge to global health and sustainable development,” WHO Director-General, Dr Tedros Adhanom Ghebreyesus, said. “We need to proactively address the rising levels of resistance to HIV drugs if we are to achieve the global target of ending AIDS by 2030.”
He explained that HIV drug resistance develops when people do not adhere to a prescribed treatment plan, often because they do not have consistent access to quality HIV treatment and care.
The DG added that individuals with HIV drug resistance would start to fail therapy and “may also transmit drug-resistant viruses to others. The level of HIV in their blood will increase, unless they change to a different treatment regimen, which could be more expensive – and, in many countries, still harder to obtain”.
The report also shows that of the 36.7 million people living with HIV worldwide, 19.5 million people were accessing antiretroviral therapy last year. Ghebreyesus disclosed that the majority of these people were doing well, with treatment proving highly effective in suppressing the HIV virus but lamented that a growing number are experiencing the consequences of drug resistance.
WHO is, therefore, issuing new guidelines to help countries address HIV drug resistance. These recommend that countries monitor the quality of their treatment programmes and take action as soon as treatment failure is detected.
Meanwhile, the Director of WHO’s HIV Department and Global Hepatitis Programme, Dr Gottfried Hirnschall, said: “We need to ensure that people who start treatment can stay on effective treatment, to prevent the emergence of HIV drug resistance. When levels of HIV drug resistance become high, we recommend that countries shift to an alternative first-line therapy for those who are starting treatment.”
He expressed that increasing HIV drug resistance trends could lead to more infections and deaths. Mathematical modelling shows an additional 135 000 deaths and 105 000 new infections could follow in the next five years if no action is taken, and HIV treatment costs could increase by an additional US$ 650 million during this time.
Tackling HIV drug resistance, according to Hirnschall, will require the active involvement of a broad range of partners. A new five-year Global Action Plan calls on all countries and partners to join efforts to prevent, monitor and respond to HIV drug resistance and to protect the ongoing progress towards the Sustainable Development Goal of ending the AIDS epidemic by 2030.
In addition, WHO has developed new tools to help countries monitor HIV drug resistance, improve the quality of treatment programmes and transition to new HIV treatments, if needed.
The WHO HIV drug resistance report 2017 was co-authored by the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the Centers for Disease Control and Prevention, USA.
“This new report shows a worrying picture of increasing levels of HIV drug resistance and, if unchecked, it will be a major risk to program impact,” Interim Executive Director of Global Fund, Dr Marijke Wijnroks, said.
He continued: “We strongly recommend implementing WHO recommendations for early warning indicators and HIV drug resistance surveys in every national plan for antiretroviral therapy, and to consider funding them through Global Fund grants or reprogramming.”
Now, Director of CDC’s Division of Global HIV and Tuberculosis, US Centers for Disease Control and Prevention, Dr. Shannon Hader added: “The new report pulls together key HIV drug resistance survey findings from across the globe that, taken together with other national-level data, confirm we must be forward-thinking in our efforts to combat resistance: scaling up viral load testing, improving the quality of treatment programs, and transitioning to new drugs like dolutegravir.“
Therefore, Hader stated that overall high rates of viral suppression across three recent national Population-based HIV Impact Assessments showed that present first-line regimens remain largely effective. However, he maintained that special attention to populations at risk for higher resistance, such as pediatrics, adolescents, pregnant women and key populations, will be critical to target more urgent interventions. “We call on the global community for continued vigilance and responsiveness.”