Challenges in scaling up access to HIV treatment: early warning report
Global report on early warning indicators of HIV drug resistance
Global report on early warning indicators of HIV drug resistance
Earlier this year WHO issued a new report highlighting the challenges in scaling up access to HIV treatment. The report alerts countries to worryingly low levels of HIV treatment adherence and retention rates, as well as the need to ensure quality HIV services to achieve long-term impact.
The "Global report on early warning indicators of HIV drug resistance (HIVDR)”, released by WHO at the International AIDS Conference, is based on data from more than 12 000 clinics in 59 countries. Patients receiving antiretroviral therapy (ART) were monitored between 2004 and 2014.
The report documents existing gaps in the quality of ART services. While almost all patients (99%) were being prescribed WHO-recommended antiretroviral (ARV) drugs, many were also missing routine check-ups and disappearing from patient records.
On average, 20% of patients were missing from patient records within one year of treatment initiation, and some 73% of patients were not retained on treatment – both these indicators failed to comply with WHO targets. The report also shows that 36% of surveyed clinics experienced interruptions in the supply of their ARV drugs, resulting in drug stock-outs.
The report calls for a renewed global focus on HIVDR prevention, as countries further expand the number of people on ART under “treat all” policies.
Furthermore, subsequent research (see link below) published in the journal HIV Medicine demonstrates that early warning indicators are associated with, and highly predictive of, HIVDR using patient-level data.
An assessment of the relationship between the World Health Organization HIV drug resistance early warning indicators and HIV drug resistance acquisition
Research article by the British HIV Association - September 2016