HIV virus grows drug-resistant as funding for research stagnates

Over the past ten years, half of Africans infected with HIV were given the medicines they need. Millions of lives were saved. But the progress has a downside. The virus may mutate and become resistant, warn scientists.
“The fact that half of the Africans who are HIV-positive and are in need of medicines now have access to them is one of the greatest breakthroughs in medical history,” exclaims Tobias Rinke de Wit, a professor at the Amsterdam Institute for Global Health and Development, affiliated with the University of Amsterdam. “But this development comes with a downside. If you start combating a virus, it tends to mutate and find a way of becoming resistant to the drugs that are used.”
And this is already happening, says Rinke de Wit. “Some 5 percent of the Africans who are taking medicines against HIV are infected with a drug-resistant strain. This means that their treatment may be less effective. Our recent studies provide evidence that HIV resistance is really on the rise, particularly in East Africa.”
Six years and 10 million euros
A week ago, Rinke de Wit was in the Ugandan capital to attend a conference on HIV drug resistance. The Kampala meeting marked the end of a six-year research programme that was funded with 10 million euros from the Dutch government and the NGOs PharmAccess and Aids Fonds.
Raph Hamers, who is doing his PhD on the topic, was one of the programme’s lead researchers. “Over the past six years we monitored more than 3,000 patients in six African countries,” he says.
The programme foresaw training of 85 laboratory staff and over 100 clinicians. “Together we analyzed the data of these patients and found that for a percentage of them, the anti-retroviral therapy to battle the HIV virus does not work,” says Hamers. “The percentage is higher in countries like Uganda where people started taking medicines some years before the rest of the continent.”
Treatment
Rinke de Wit describes how patients’ treatment is classified. “For HIV, there are different lines of treatment that consist of drug combinations of at least three drugs. The standard treatment is called ‘first line’, which is the cheapest and most common in Africa,” he explains. “It costs some 250 US dollars [about 190 euros] to treat one person for one year. However, when patients become resistant, they have to switch to so-called ’second-line’ drugs, which are three to five times more expensive. Today, for many Africans who fail first-line therapy, there is hardly any second-line available.”
Funding uncertain
Rinke de Wit praises the Dutch government for being ”visionary”. The Netherlands started funding this research back in 2006. “It was only since 2004 that large-scale treatment in Africa had begun, and few people thought about the consequences of resistance that could arise,” he says.
“It is paradoxical that now in 2012, just when these programmes start to provide the evidence that HIV resistance is on the rise in Africa, the continuation of funding has become very uncertain,” says the professor. “We have a greatly successful programme which produces knowledge that can save many lives in the future – and now the funding stagnates. It would be a great loss and a great waste of investment by the Netherlands if this programme has to stop.”