GABARONE - For the first time, Botswana is hosting the Africa HIV/TB Drug Resistance and Clinical Management workshop. The two-day workshop started yesterday at the University of Botswana (UB). Scientists, public health officials and physicians from across the world are attending the event to discuss the growing problem of HIV and TB drug resistance in Southern Africa.
The European Union, CDC, University of Columbia, Stanford, Harvard, Rio de Janeiro, the University College of London, the London School of Hygiene and Tropical Medicine, Nelson Mandela School of Medicine and Stellenbosh are some of the institutions that have sent representations to the workshop.
When addressing delegates yesterday, director of the Department of HIV/AIDS Prevention and Care, Dr Refeletsoe Lobelonyane said that the workshop has come at a critical time, where ensuring the long term sustainability of Botswana's ARV treatment programmes is keeping the country awake as donor funds are drying up.
'With almost 180,000 patients on ART in Botswana and an estimated 150,000 in need of treatment in the coming years, sustainability depends not only on the prevention of new HIV infections but also on the prevention of the development and transmission of HIV and TB drug resistant strains which is an inevitable consequence of ARV treatment. We do have a challenge here,' she noted.
She said that to meet this challenge, scientists from around the world must collaborate to build the necessary capacity in every country to stay ahead of the growing threat of HIV and TB drug resistance. Lobelonyane said that the fact that Botswana has integrated HIV prevention and treatment into public health centres for over a decade, drug resistance has become a reality in Botswana. 'So having managed patients with ARV for a decade now, ARV drug resistance is not another theory to us but a reality and we hope by the end of this workshop, participants would be better equipped to detect and manage (the problem),' she said.
Meanwhile, spokesperson for the United States Embassy, Laona Segaetsho has said that while resistance to ARV medication has not become a threat to regional treatment programmes yet, the continued expansion of ARV therapy will be followed by an increase in ARV drug resistance over time. He said that nearly every major infectious disease has developed resistance to drugs commonly used for treatment. He added that drug resistance in TB is a well-known 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,' he said.
Segaetsho added that presently, Botswana has placed 171,065 adults and children on ARVs. This accounts for nearly 10 percent of the population. South Africa has now over 1.2 million patients on ARVs. Sagaetsho said that while much care, financial resources and great effort has been generated to ensure the expansion of the anti-HIV programmes, the same level of attention has not been 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,' he said. He asserted that the situation is however, changing.