For those who may not be aware, there is concern about the growing resistance to one of the key drugs used in the fight against HIV/AIDS. The drug is Tenofovir. Based on WHO recommendation, it replaced zidovudine as the preferred first line due to its better safety profile, comparable effectiveness, reduced cost and lower pill burden.

However, a recent study revealed a disturbing pattern of resistance to the drug especially in this part of the world - as high as 60%. This has the possibility of obliterating the modest gains made in the fight against AIDS over the past few years. Nigeria's prevalence decreased from a peak of 5.8% in 2001 to 4.1% in 2010. Its currently estimated at 3.4%. New infections (incidence rate) has also been on the decline from over 300,000 in 2005 to about 150,000 as of last year.

Much of the progress has been attributed to better awareness about HIV/AIDS; deployment at the federal, state and LG level, of a comprehensive response package (A,B,C,D)involving prevention, (know your status campaigns), PMTCT, etc; and of course the provision of effective ARVs. Indeed ARvs are believed to have averted about 71,000 deaths annually.

So how did the resistance come about? Well, many factors are to blame, but top on the list are adherence issues. ART require at least 95% adherence to function effectively. Anything less than that could predispose the client to resistance and thus therapy failure. The worse is, there is currently no equally effective first line alternative to tenofovir, unlike in developed countries. Those who fail are switched to second line which are more toxic and not as effective.

The foregoing is not to scare but to serve as a wakeup call. There has indeed been progress but the fight is still on. "Patients must be supported to adhere to therapy and to stay in care, and health systems must develop robust ways to monitor the effectiveness of their antiretroviral therapy programmes.”(USAID) Abstinence, being faithful and condom use (Yes, its effective, never mind what they say) and ART are pillars in the fight against AIDS. It must continue.

http://acsh.org/news/2016/02/11/undoing-35-years-of-progress-aids-meds-resistance-in-africa/
http://www.voanews.com/content/growing-resistance-first-line-aids-drug-worries-experts/3168778.html
http://www.unaids.org/en/resources/presscentre/featurestories/2016/february/20160208_Drug_resistance