Zimbabwe’s significant progress in HIV treatment is under threat from emerging resistance to dolutegravir (DTG), a key life-saving drug used in Antiretroviral Therapy (ART).
Over 1.2 million people in Zimbabwe are currently on ART, representing around 90% of those living with HIV.
However, the rising cases of resistance to DTG pose a serious threat to Zimbabwe’s progress in managing HIV, putting at risk the country’s hard-won gains in treatment and prevention.
In an interview with an <a href="https://www.263chat.com/zimbabwe-faces-new-challenge-in-hiv-treatment-as-resistance-to-dolutegravir-dtgemerges/">online publication</a>, Dr Cleophas Chimbetete, Director of Training and Research at Newlands Clinic, said that there is an urgent need to discuss future treatment options after the third-line ART regimen, in light of increasing resistance.
He said Zimbabwe’s HIV treatment guidelines are based on recommendations from the World Health Organization (WHO), which continues to inform the country’s approach to managing HIV care. Said Chimbetete:
<blockquote>
These guidelines recommend that individuals testing HIV-positive start a combination of three medicines, known as first-line ART.
If the virus becomes resistant to these medicines, patients are switched to second-line ART, and subsequently to third-line ART if necessary.
We’re beginning to see resistance to Dolutegravir… previously, the need for guidance on what to do after third-line treatment failure wasn’t there, but now we need to start having that conversation.
</blockquote>
Dr. Chimbetete stressed the need for research on DTG resistance, updated national guidelines for post-third-line treatment failure, ongoing healthcare worker training, and improved patient adherence.
As a member of the Zimbabwe HIV Clinicians Society, he is actively addressing these issues.
The Society, alongside healthcare professionals and stakeholders, recognizes the urgency of action to meet Zimbabwe’s commitment to the UNAIDS 95-95-95 targets: 95% of HIV-positive individuals knowing their status, 95% on treatment, and 95% achieving viral suppression.
More: <a href="https://www.pindula.co.zw/">Pindula News</a>

Pindula News

Zimbabwe has made good progress in treating HIV with many people on medicine. But some people are becoming resistant to a key drug, making treatment harder. Doctors are worried and want to find new ways to help. They follow advice from the World Health Organization. Doctors say more research is needed, and they are working hard to help patients stay healthy. Everyone is working together to reach targets for HIV care. The goal is for 95% of HIV-positive people to know their status, be on treatment, and have the virus under control.

Zimbabwe's HIV Treatment Progress Threatened By Resistance To ARVs

Poultry farmers have been warned against using antiretroviral drugs (ARVs) and steroids to fast-track the growth of chickens.
The veterinary extension supervisor for Odzi, Inspectorate Cathrine Sakupwanya, told <a href="https://www.herald.co.zw/poultry-farmers-warned-against-feeding-chickens-arvs/">The Herald</a> that some farmers were still using ARVs and steroids to boost production despite efforts to convince them to abandon the practice. She said:
<blockquote>
There are farmers who are using ARVs, and corticosteroids so that the chickens develop faster with big muscles.
Unfortunately, unsuspecting buyers prefer the ‘huge chickens’ as compared to those that have been nurtured in the correct way and have a standard weight.
</blockquote>
The abuse of drugs in poultry farming is causing anti-microbial resistance (AMR) which is affecting the health of humans, plants, and animals.
AMR occurs when germs that cause disease or infection in humans and animals, change and become resistant to antimicrobial medicines used for treatment.

Poultry Farmers Warned Against Feeding Chickens ARVs, Steroids

Zimbabwe is among the few countries in Africa that will try flavored Anti Retroviral drugs on kids, New Zimbabwe reports.
According to the publication, Aid agencies have said Zimbabwe has been selected to be among the 5 countries that will try the strawberry flavored first generic pediatric version of the ARVs that will be administered even on babies.
This also means there will be no need for people to crush the pills for them to be administered on children. Official statistics say about half the children living with HIV are not on medication because the pill is bitter and it is difficult to administer to children.
Other counties like Kenya, Malawi, Nigeria, and Benini will also try the flavored ARV drug which costs $120 per year instead of the current $500 per year
More: <a href="https://www.newzimbabwe.com/zimbabwe-to-roll-out-flavoured-hiv-drug-for-children/">New Zimbabwe </a>

Zim To Try Flavored ARVs For Children

ARV shortages have hit Zimbabwe which might affect people living with HIV on the second regimen of the antiretroviral therapy as they might have to change one of their drugs after it was announced that there was a shortage of the drug, The Chronicle reports.
This was revealed in a statement  by the information ministry’s acting permanent secretary Dr Gibson Mhlanga who said:
<blockquote>This circular serve to notify you that we are experiencing a national shortage of Atazanavir/ritonavir due to reduced global production and delayed shipments from suppliers as a result of the global Covid-19 lockdown restrictions.
The ministry and its partners are working tirelessly to address this shortage. In the meantime, the ministry advices that patients on Atazanavir/ritonavir be given up to one month of supplies until the situation improves.</blockquote>
In the same statement, Dr Mhlanga gave a temporary solution to the problem if it persists and it cant be addressed on time and said:
<blockquote>If Atazanavir/ritonavir 300mg/100mg is no longer available, in consultation with the district pharmacy manager, it will be temporarily substituted with DTG 50mg until it is available. Please note the Lopinavir/ritonavir is not a viable substitute for Atazanavir/ritonavir as there are no sufficient quantities in the country to cover the gap</blockquote>
More: <a href="https://www.chronicle.co.zw/second-regimen-arv-shortage-hits-zimbabwe/">The Chronicle</a>

ARV Shortage Hits Zimbabwe

Five people died in Bulawayo in the period leading to the 2019 festive season after they reportedly discontinued talking Antiretroviral medications at their prophets’ orders.
<a href="https://www.pindula.co.zw/National_Aids_Council" rel="noopener noreferrer" target="_blank">National Aids Council</a> Bulawayo Provincial Manager, Sinatra Nyathi urged people not to discontinue their medications for whatever reasons. She said:
<blockquote>Remember, when someone is on ART, the ARVs are responsible for suppressing the viral load to levels where we don’t want it to be detectable in their bloodstream.
So if you don’t take your drugs, you are actually giving the virus the change to multiply and most of the time when the person’s virus has multiplied to those levels, most of them they will not make it.
That is why we have got a challenge to say people are going to the prophets and faith-based organisations and say prophet so and so prayed for me and I threw away the drugs.</blockquote>
Nyathi said that there is nothing wrong with prayer but encouraged patients to take their drugs until they are advised otherwise by the doctors who initiated them and not prophets or anyone.
There are concerns that withdrawal from taking ART will give birth to an even worse health situation such as HIV drug resistance among other health complications.
<h4>More: <a href="https://healthtimes.co.zw/2020/02/10/five-die-in-byo-as-prophets-order-them-to-stop-taking-arvs/" rel="noopener noreferrer" target="_blank">Health Times</a></h4>

5 People Die After Throwing Away ARVs On Prophets' Orders

<a href="https://www.pindula.co.zw/Mvurwi" rel="noopener noreferrer" target="_blank">Mvurwi</a> District Hospital administrator Florence Makombe was hauled before a disciplinary committee after she attempted to steal antiretroviral (ARV) drugs from the hospital.
This was confirmed by <a href="https://www.pindula.co.zw/Concession" rel="noopener noreferrer" target="_blank">Concession</a> district medical officer Rachel Sosera who revealed that investigations are ongoing. She said:
<blockquote>We conducted our first investigations at district level last week and I am not at liberty to divulge much as that will jeopardise the investigations.
I can safely say investigations are underway from district level it will go to the provincial level so it is still on-going.</blockquote>
ARV drugs are in short supply in the country due to foreign currency constraints.
Reports suggest that private dealers are selling ARVs at $500 per bottle.
<h4>More: <a href="https://www.newsday.co.zw/2019/11/mvurwi-hospital-official-up-for-arv-drugs-theft/" rel="noopener noreferrer" target="_blank">NewsDay</a></h4>

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