WHO has played a leading role in developing strategies for the surveillance and containment of antimicrobial resistance in bacterial and parasitic diseases. A global resistance monitoring programme is also needed for HIV. In the developed world, the reduction of HIV-related morbidity and mortality through use of antiretroviral agents has been accompanied by an increase in the prevalence of drug-resistant viruses. It has been proposed that WHO develop a detailed plan of action involving partnerships with existing antiretroviral resistance monitoring centres and networks. The plan will be based on the following priorities mapped out at a Consultation organized by WHO in collaboration with the International AIDS Society and the Istituto Superiore di Sanità, Italy.
• Identify sites currently involved in monitoring activities.
• Develop uniform criteria for the collection and reporting of HIV drug resistance.
• Develop and maintain a surveillance system to determine HIV drug resistance among previously untreated patients, and targeted ARV-experienced populations.
• Monitor simultaneously the subtype of circulating HIV strains by using protease and/or reverse transcriptase sequences.
• Determine trends in the prevalence of drug resistance in different geographical areas in relation to the introduction of ARV therapy.
• Establish linkages between surveillance sites and quality-controlled laboratories and promote technology transfer of drug resistance testing methodologies to sites in the developing world.
• Promote education about strategies to reduce the selection of antiretroviral resistance.
Implementation of this plan of action will be coordinated by a steering committee, with WHO acting as the secretariat, and will be developed in partnership with other international organizations. Initial steps will involve the collection of data, establishment of a common data base and development of a Website to disseminate results.
Reference: Weekly Epidemiological Record, 76: 195 - 196 (2001).