Feb. 24, 2007 (Bloomberg) -- The World Health Organization will use funds from the Bill and Melinda Gates Foundation and other sources to step up its efforts to watch for the emergence of drug-beating HIV strains in the developing world.
The WHO is rolling out guidelines that will help countries prevent drug-resistant HIV strains from developing and quickly identify them when they occur, said Donald Sutherland, a team leader for the Geneva-based agency's HIV resistance program. A five-year $15.2 million grant from the Gates Foundation and 1 million euros from the Spanish government will help, he said.
Health officials are trying to preserve for as long as possible the effectiveness of cheap, safe drugs that are used to treat HIV in the developing world, Sutherland said. Preventing the spread of resistant viruses is an essential part of expanding treatment programs in Asia and Africa, he said.
``Globally we want to expand treatment to millions of people,'' he said today in an interview at a Los Angeles conference on drug resistance organized by the WHO. ``If we can support people who take these medications successfully, we will get as much out of the first-line drugs as we possibly can.''
The money from the Gates Foundation and Spain will help countries with small health budgets that are already struggling to provide HIV drugs to patients, protecting the effectiveness of therapies such as zidovudine, a generic drug.
New Figures Coming
The WHO will publish new figures in about a month showing that HIV treatment has expanded internationally, said Charles Gilks, the agency's HIV treatment coordinator.
Using WHO's recommended surveillance techniques, health officials in Tanzania, Russia and Thailand have surveyed newly infected people for drug resistance, officials said today. None reported finding drug-beating strains, indicating that transmission of resistance probably occurs in no more than five percent of cases in the city where the testing occurred.
Still, the eventual appearance of drug-resistant forms of the human immunodeficiency virus that leads to AIDS is inevitable, officials said today.
``Zero is great and we want it to continue to be zero,'' said Scott Hammer, a Columbia University infectious disease specialist who advises WHO on HIV resistance. ``When it gets to be 1 percent and 2 percent consistently, though, that's going to be a warning bell.''
Conference
Scientists are also gathering in Los Angeles for the 14th Conference on Retroviruses and Opportunistic Infections. That conference will review new approaches for treating the human immunodeficiency virus that infects about 40 million people worldwide and can lead to AIDS.
The WHO held its meeting today to announce the new funding and discuss its plans to fight drug resistance, which occurs because of the virus's extraordinary ability to mutate around hurdles placed in the way of infection.
As many as one in five of the 40,000 people who catch the virus annually in the U.S. are infected with a strain that is already resistant to at least one drug.
HIV only becomes resistant to drugs when it is forced to by prolonged treatment. Resistance rates remain low in many developing countries because they have only recently gained access to treatment through WHO programs, or international efforts such as one U.S. President George W. Bush established to bring treatment to 2 million people internationally by 2009.
`Absence of Attention'
As international HIV treatment has expanded ``there started to be an absence of attention and resources for resistance monitoring,'' said Nick Hellman, director of the Gates Foundation's HIV/AIDS program, at the conference. Drug resistance threatens to ``compromise the economic viability of the scale-up effort.''
The Gates Foundation has contributed to research on the development of an HIV vaccine and other means of preventing the disease from spreading.
Patients who become infected with resistant strains must be switched to new medications that are often more expensive and toxic than those they're taking. Pfizer Inc., Merck & Co., Johnson & Johnson's Tibotec unit are among companies expected to present new data in Los Angeles this week to treat new strains of the virus that can overcome existing drugs.
While testing for resistant strains may be beyond the means of individual developing countries, the WHO is also encouraging international health officials to watch for conditions that might lead to resistance.
For instance, the agency is asking HIV treatment clinics to collect data on how many patients switch therapy within their first year of treatment, lose touch with their doctors, share their drugs because of inability to afford them individually, or have their supply of drugs interrupted for any reason.
About 20 developing countries have begun collecting data to help fight resistance, and at least 10 more are expected to begin similar programs using the WHO guidelines this year, Sutherland said.
``It's a rapidly expanding map,'' he said.
To contact the reporter on this story: John Lauerman in Boston at jlauerman@bloomberg.net .
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