National HIV drug resistance working groups
Ministries of Health in coordination with National AIDS Councils should form national HIV drug resistance working groups, made up of ART programme planners, clinicians, epidemiologists, laboratorians, monitoring and evaluation specialists, community members, and partner organizations, to develop the strategy.
Formation of a national HIV drug resistance working group
WHO recommends that the Ministry of Health/National AIDS Council in each country establish an HIV drug resistance (HIVDR) working group to develop a country-specific HIVDR prevention, surveillance and monitoring plan, and make evidence-based recommendations for HIVDR prevention. The group generally includes epidemiologists, clinicians and laboratorians with expertise in HIV surveillance, HIV prevention, ART and related laboratory issues. Inclusion national and international research scientists performing HIVDR-related research in the country, to increase their awareness of and potential contribution to the strategy, is important.
Among the main tasks of the working group is the collection of indicators and implementation of surveys, and the collation of any additional HIVDR-related information from projects or research being performed in the country. The working group plans further evaluations to clarify issues raised by survey results and address other country-specific issues.
The WG is encouraged to develop terms of reference and to integrate HIVDR strategy into country specific plan, GF proposal, PEPFAR Country Operational Plan (COP) to support sustainability of drug resistance related activity.
The WG is also encouraged to develop an annual HIVDR report.
Example terms of reference:
- Implement the HIV Drug Resistance (HIVDR) Plan 2007-2009
- Revise and implement protocol for monitoring HIVDR in sentinel treatment sites
- Regularly perform HIVDR threshold surveys to evaluate transmitted resistance
- Collect and analyze HIVDR Early Warning Indicators
- Build capacity for genotyping to support HIV drug resistance surveillance and monitoring within the country including quality control
- Analyze and report on the situation with regard to HIVDR in the country
- Coordinate the country strategy with the WHO HIVResNet
- Ensure all activities follow international ethical standards
HIVDR Working Group Current Members, institutions, and external affiliates: example
- Ministry of Health (MOH) M & E representative
- Director of National AIDS Council
- MOH ART Director (Chair of HIVDR Working Group)
- HIV Laboratory Director
- Pediatric ART representative
- ART Monitoring representative
- CDC representative
- MOH ART planning representative
- MOH HIV surveillance representative
- University HIV Epidemiology representative
- PMTCT representative
- Others: Representatives from relevant NGOs operating in countries and universities performing HIVDR research
HIVDR status report as of February 2009
Terms of Reference for national HIVDR working groups, and HIVDR strategy were developed in the following 11 WHO focus countries - Burkina Faso, Cambodia, Ghana, India, Indonesia, Namibia, Rwanda, Senegal, Ukraine, Zambia, and Zimbabwe. This adds to the 11 countries from 2007.