The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #74208

Malcolm Bryant, MB MS, MPH¹, Peter Mugyenyi², and Christine Whalen¹. (1) Strengthening Health Services, Management Sciences for Health, 165 Allandale Rd, Boston, MA 02130, 617-524-7799, mbryant@msh.org, (2) JCRC, NA, Kampala, Uganda

Antiretroviral agents (ARVs) have been shown to be effective in reducing viral load and in restoring immune system functioning. The experience in the United States and Europe, however, has shown that HIV is capable of developing resistance to ARVs extremely rapidly. Studies have shown that in the US -- where it is often assumed that there is ready access to high quality services and that clients are well educated about the needs to take drugs correctly -- treatment failure rates can be as high as 40– 60 percent, with resistance rates rising significantly. As many as 12% of all new infections have resistance to at least one ARV.

In Africa, the lack of infrastructure, lower literacy rates, poverty, and the overwhelming scale of the epidemic, lead to real concerns that the current availability and use of ARVs in Africa will lead to rapid development of resistance, and ultimately the inability to provide treatment to millions of infected people.

Widespread resistance is not inevitable, but in order to prevent it, immediate action by donors, governments, health care practitioners, patients and communities is required. This paper discusses how this action can be directed to: ·Minimize irrational prescribing practices ·Reduce non-adherence with treatment regimes ·Eliminate the interruption of supply of drugs due to health system infrastructure failures ·Decrease barriers to access by the individual such as affordability or geographic access.

Learning Objectives:

• NA

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.