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JOHANNESBURG - A group of renowned HIV and TB scientists, public health officials and physicians will meet at the University of Botswana in Gaborone, this coming Monday and Tuesday (7th & 8th of November) to discuss the growing problem of HIV and TB drug resistance in southern Africa.

At this meeting new information will also be presented regarding HIV & TB drug resistance diagnostic tests which will soon become available for impoverished population in southern Africa. The Workshop will host local HIV and TB physicians from across Botswana, South Africa and neighbouring countries, who will be trained on the optimum management of HIV and TB treatment failures, given the treatment resources available. Overall, 225 local and international participants are expected to attend.

While resistance to antiretroviral (ARV) medication has not become a threat to regional treatment programmes yet, as sure a night follows day, the continued expansion of antiretroviral therapy will be followed by an increase in HIV antiretroviral drug resistance over time. Nearly every major infectious disease has developed resistance to drugs commonly used for treatment. Drug resistance in tuberculosis is a well-described and longstanding problem. With the recent increases in multiple TB drug resistance and the outbreak of extremely-drug resistant tuberculosis, clinicians and public health officials need to be on heightened alert for the possibility of drug resistance, seek training in the management of drug-resistant cases and increase efforts to monitor and control its transmission.

At present, Botswana has placed 171,065 adults and children on ARVs, which accounts to nearly 10% of its population. South Africa has now over 1.2 million patients on ARVs. While much care, financial resources and great effort has been generated to ensure the expansion of these programmes, the same level of attention has not given to the management of patients failing ARV and TB treatment with resistance strains. One reason for this is that drug resistance testing is expensive, time consuming and dependent on high-level technology (such as genetics, biotechnology and bioinformatics). However, this situation is now changing.

The good news is that recent advances in technologies and effective collaboration between the Botswana Ministry of Health and partnerships with South African academic organizations, government and biotechnology companies allow resistance genotype tests to be reduced in price from approximately ZAR 3,300 per test to less than ZAR 1,000 per test. However, even at the higher of these prices it is known resistance testing is cost-neutral to ARV programmes as its saves unnecessary switches to more complex and costly ARV treatment regimens by providing valuable information to the physician/nurse to better manage patients failing on ARVs. Discounted resistance test capacity will soon be available at national scale in Botswana and South Africa.

Experts from academia, industry and government institutions in the region have collaborated in the development of the discounted HIV resistance test under the leadership of SATuRN. 'SATuRN is an exciting academic and government collaboration that provides access to resistance interpretation to clinicians at primary health care facilities and allows comprehensive surveillance of the levels of resistance in the region', said Dr. Tulio de Oliveira, one of the organizers of the meeting, who is from the Africa Centre for Health and Population Studies, University of KwaZulu-Natal (UKZN), a rural HIV & TB treatment and research centre in South Africa.

Although drug resistance is a growing concern, effective partnerships between researchers, clinicians, and public health officials can ensure that resistance levels are accurately traced and managed. Dr. Tendani Gaolathe, speaking on behalf of the Botswana Ministry of Health explained, 'Information and training on HIV and TB resistance is urgently needed to guide treatment options and to ensure that southern Africa's HIV & TB treatment programmes are highly effective and financially sustainable'. Dr. Madisa Mine, director of the HIV Reference Laboratory, added, 'Developing the capacity of laboratory scientists to meet the future challenges that long-term ARV use pose will go far to safe-guard the gains made in Botswana's fight against HIV and TB.'

In addition, the workshop will also launch an open access book on HIV / TB drug resistance and clinical management that will be available free of charge. The 6th Southern Africa HIV/TB Drug Resistance and Treatment Monitoring Workshop is sponsored by the Botswana Ministry of Health in collaboration with the Africa Centre for Health and Population Studies, The South African Medical Research Council (MRC),The Southern African Treatment and Resistance Network (SATuRN) in collaboration with Life Technologies, the European Commission (EC), the Canadian International Development Agency (IDRC), the Wellcome Trust and the US PEPFAR/CDC. For more information, http://www.bioafrica.net/saturn/

Interested in training and capacity building? Please visit our annual SATuRN workshop webpage:

7th South African HIV & TB Drug Resistance and Treatment Monitoring Workshop, Cape Town International Conference Centre, 28 to 29 November 2012, Cape Town, South Africa.

News date: 2011-11-04

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