It has been revealed that no less than 2.3
million Nigerians living with the Human
Immunodeficiency Virus are not on any form of
treatment even as health experts have raised
alarm over the growing incidence of resistance
to Anti-retroviral drugs in the country.
Vanguard reports that a professor of
Haematology and Transfusion Medicine at the
College of Medicine, University of Lagos,
Professor Suleiman Akanmu, while disclosing
this yesterday in Lagos, said only 900,000
persons living with HIV in the country are
currently on a treatment programme as against
the estimated total number of 3.2 million
persons nationwide.

Akanmu, who is also the Chairman, National
Task Team on Antiretroviral therapy (ART) in
Nigeria, spoke during a joint stakeholders’
Summit with the theme: “Drug Resistance
Monitoring, Early Infant Diagnosis and Viral
Load” organised by World Health Organisation,
WHO, blamed the development on inability to
carry out routine viral load test, as well as
unavailability of second and third line drugs to
treat HIV.

“Many of our patients that are on first line
drugs are failing and they are supposed to be
put on second line drugs which is not available
now. Also we are not detecting failure on time,
if you have about 900,000 Nigerians on first line
drugs, we do not know how many of them have
failed the first line regimen because we do not
routinely carry out viral load test to show that
while on drugs, the virus is still detectable in
them.

“If we have facilities in Nigeria where people
can easily do viral load test, then we would be
able to detect first line failure and be talking
about putting them on second line regimen,” he
argued.
Äkanmu, however, called for more research and
support for laboratories in the country to
effectively carry out viral load test and when
detected there should be enough drugs to put
them on second line regimen.
“Research is key, in other parts of the world,
before you put a patient on ART, they normally
do drug resistance testing to know what type of
drug the individual is sensitive to before
applying the drugs, but that is not feasible in
our situation.

“If we are going to prevent viral resistance from
evolving, then we must ensure that the virus
does not replicate, because the resistance is
coming from the ability of the virus to replicate,
so we must administer drugs that do not allow
the virus to replicate itself”.
At the forum, the WHO country representative,
Dr Wondimagegnehu Alemu expressed the
global health body commitment to produce
guidelines that will help countries to improve
surveillance of drug resistance as well as
monitor and detect it in a public health setting.
Alemu who was represented by the WHO vocal
point for HIV/AIDs, TB, Malaria, Dr Rex
Mpazanje said that drug resistance are
inevitable but the important thing for countries
was to minimize the impact of that resistance to
the programme outcome.

“The challenge in Nigeria is that there have
been load of works done in drug resistance but
to large extent these have not been properly
coordinated at national level. We have several
initiative been done but there is no opportunity
to disseminate it to everybody, so we are using
this meeting to bring together expertise to
disseminate what they have doing in term of
drug resistance. Presently Nigeria is doing well
as they always follow the WHO guideline on
which drugs to use.”