Aids-related deaths could more than double by 2030 to 10 million after US cuts

The World Health Organisation has raised serious concerns that HIV medication shortages sparked by cuts to USAID will increase resistance to crucial treatment, The Independent can reveal.

- REBECCA THOMAS BEL TREW

Leading epidemiologists have raised fears that shortages could reduce the effectiveness of the most commonly used HIV drug, dolutegravir (DTG), which is used by around 27 million people. This could leave patients without an alternative treatment.

Professor Andrew Phillips, at University College London, has created a model predicting resistance in HIV patients to DTG. He warns the number of people currently resistant to the drug could “easily at least double in six months” if people take less than one pill per day due to supply fears.

“If resistance starts to grow, this is a substantial problem for long-term HIV control in lower- and middle-income countries,” Prof Phillips said. “If there is a new reality for another year that people are taking less than 70 per cent of their doses, then it would start to feel like a real concern for building up resistance.”

A World Health Organisation spokesperson told this publication it “remains very concerned that we will not have a suitable replacement option for dolutegravir that is as easy to take, with low side effects, delivered at low cost, and safe for all, including children and pregnant women”.

“We should be doing all that we can to protect this first-line treatment and to ensure that the worst-case scenario of increased drug resistance projected by this UCL modelling exercise does not occur,” they added.

Because DTG-based treatment is intended to be taken daily, “intermittent use of DTG-based anti-retroviral treatment due to drug shortages is likely to lead to increased drug resistance, and we worry about this scenario”.

The warning comes after