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UN agency issues drug resistance alert

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The World Health Organisation (WHO) has issued a warning over 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.

In a report, HIV drug resistance report 2017, the WHO says that in 6 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 urgently review their HIV treatment programmes.

“Antimicrobial drug resistance is a growing challenge to global health and sustainable development,” said WHO Director-General, Dr Tedros Adhanom Ghebreyesus. “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.”

Of the 36.7 million people living with HIV worldwide, 19.5 million people were accessing antiretroviral therapy in 2016. The majority of these people are doing well, with treatment proving highly effective in suppressing the HIV virus. But a growing number are experiencing the consequences of drug resistance.

The rising trend entails the ability of HIV to mutate and reproduce itself in the presence of antiretroviral drugs professionally known as HIV drug resistance (HIVDR).

The consequences of HIVDR include treatment failure and further spread of drug resistant HIV. This can compromise the effectiveness of the limited therapeutic options to reach the last 90 target (of achieving viral suppression) and further reduce HIV incidence, mortality and morbidity.

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.

Currently, WHO is developing a new five-year global action plan for 2017-2021 to support a coordinated international effort to prevent, monitor and respond to the emergence of HIV drug resistance, and to strengthen country efforts to achieve the global HIV targets.

We need to ensure that people who start treatment can stay on effective treatment, to prevent the emergence of HIV drug resistance,” said Dr Gottfried Hirnschall, Director of WHO’s HIV Department and Global Hepatitis Programme. “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.”

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