Summary:
Antiretroviral drugs are increasingly being provided to patients living with
HIV in developing countries. Experience gained in Europe and North America has
shown that the use of these drugs dramatically reduced mortality but is also
associated with the emergence of drug resistant HIV. Surveillance of drug
resistant HIV in developing countries is therefore important, as the spread of a
resistant virus could seriously hamper the fight against the AIDS pandemic.
The EU Fifth Framework Programme (FP5)-funded Strategy To Control Spread of
HIV Drug Resistance, (SPREAD) network has gained a leading role in the area of
surveillance of HIV drug resistance. Within UNITE-MORE, SPREAD will closely
co-operate with the World Health Organisation (WHO) to support the establishment
of a uniform global network for HIV drug resistance surveillance.
The activities of UNITE-MORE can be divided into three main areas: (i)
supporting the selection, and training of national HIV drug resistance
surveillance teams in Eastern Europe, Africa, Asia and Latin-America, (ii)
supporting the development of common clinical laboratory standards for the
monitoring of HIV resistance (standard protocols, sample collection methods, and
standard data storage and analysis), and (iii) supporting the training and
operational activities of the country HIV drug resistance surveillance
teams.
UNITE-MORE will actively contribute to the further development, transfer and
take-up of the FP5-funded SPREAD clinical laboratory guidelines and systems at
the global level. Further, UNITE-MORE will contribute to the objectives of the
European Research Area (ERA) notably the opening up of ERA to third countries
(specifically poor-resource countries), increased networking at the global level
and raising the scientific and technological profile of Europe.
Background:
The use of antiretroviral therapy has dramatically reduced mortality in
patients living with HIV in countries with access to antiretroviral drugs. But
only a limited proportion of HIV-infected patients in developing countries have
access to antiretrovirals. To address this emergency, the WHO established its ‘3
by 5 initiative’; getting 3 million people on treatment by 2005.
Unfortunately, the provision of antiretrovirals in Europe and North America
has resulted in the rapid emergence of drug resistant HIV, which frequently
limits the benefits of antiretroviral treatment. The spread of drug-resistant
populations of the virus in developing countries may render current ART less
effective in the longer term. In other words, if the further spread of HIV drug
resistance is not controlled, the fight against the AIDS pandemic could be
seriously hampered.
Confronting the global emergency caused by HIV therefore necessitates a
global uniform effort in HIV resistance surveillance with common clinical
laboratory standards, leading to comparable global data on the prevalence,
transmission and trends of HIV drug resistance.
Aim:
UNITE-MORE aims to support the establishment of a uniform global network for
HIV drug resistance surveillance, including standardised laboratory procedures
and quality assurance programmes. The network could provide governments,
scientists and policy-makers with relevant and comparable global data on the
prevalence, transmission and trends of HIV drug resistance. UNITE-MORE will
contribute to the objectives of the European Research Area (ERA), notably the
opening up of ERA to third countries (specifically poor-resource countries),
increased networking at the global level and raising the scientific and
technological profile of Europe.
Expected results:
UNITE-MORE will support the establishment of a uniform global network for HIV
drug resistance surveillance. This will include standardised laboratory
procedures and quality assurance programmes. UNITE-MORE will act as a key force
in global efforts on HIV drug resistance surveillance using existing European
activities under SPREAD, and WHO Global HIV Drug Resistance programme within the
‘3 by 5 initiative’ as a strong and solid basis. The actions proposed by
UNITE-MORE will have a strategic impact on national HIV resistance surveillance
teams across the globe.
In addition, by setting up country level networks, UNITE-MORE will contribute
to the dissemination of knowledge across countries in four continents.
Potential applications:
After its establishment, the surveillance network could provide governments,
scientists and policy-makers with relevant and comparable global data on the
prevalence, transmission and trends of HIV drug resistance. Further, the
established network could provide a resource for addressing important questions
of HIV drug resistance patterns and spread related to HIV genetic diversity.
Coordinator:
Charles AB Boucher
University Medical Center Utrecht
Department of Virology G04-614
Heidelberglaan 100, 3584 CX Utrecht
The Netherlands
Tel: + 31 30 250 6526
Fax: + 31 30 250 5426
E-mail: c.boucher@azu.nl
