UGANDA: Striving to provide first-, second- and third-line ARVs

Another reason why prevention education is so important.

Second-line drugs often cost up to four times more than first-line drugs. Photo: Kate Holt/IRIN

[www.irinnews.org]

KAMPALA, 1 December 2010 (PlusNews) –  Life-prolonging antiretroviral (ARV) medication is reaching more HIV-positive Ugandans than ever before, but health workers are concerned about how they will deal with the inevitable rise in drug resistance.

An estimated 400 accredited facilities are providing about 218,000 Ugandans with ARVs, and more than 300,000 have enrolled on HIV treatment, but many patients have died and some have simply abandoned treatment.

Although studies show that ARV adherence is generally high, frequent drug stock-outs as a result of funding shortages and supply-chain  problems as well as food insecurity mean that patients have experienced interruptions in their treatment regimens, predisposing them to resistance.

“The … drug resistance problem is in evolution and we need to be prepared to handle it,” said Dr Ivan Mambule Kiggundu, study coordinator of the Europe-Africa Research Network for Evaluation of Second-line Therapy (EARNEST) trial which is trying to determine the best option for resource-limited settings at the Infectious Disease Institute (IDI), part of the Mulago Hospital Complex in the capital, Kampala.

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