Up to 1, 35,000 deaths and 1,05,000 HIV infections will surface across the globe in the next five years if drug resistance to anti-retroviral therapy (ART) drugs is not tackled effectively, estimates the World Health Organisation (WHO) in the 2017 WHO HIV Drug Resistance report.

India has the world’s third largest number of persons living with HIV, an estimated 21 lakh, according to the UNAIDS 2017 report. Of these, over twelve lakh HIV-infected persons are registered on the rolls of the government, according to the National AIDS Control Organisation (NACO) figures.  Up to nine lakh patients have yet not been picked up under the National AIDS Control Programme (NACP).

While it is estimated that there are many more patients who may be resistant to HIV drugs in India, it has yet not undertaken an HIV drug resistance (HIVDR) survey, according to recommendations by WHO, the report points out.

Of the over twelve lakh registered patients,  9, 97, 869 patients are on ART medication. When first line of drugs stops working, patients become drug-resistant and progress to second line of advanced treatment. Up to 15, 500 patients are on second-line drugs. A measly 125 patients are registered with NACO to receive the last resort, third line drugs. When third line drugs stop working, with no further treatment available, an HIV patient succumbs to the deadly virus. According to UNAIDS 2017 report India figures, it is estimated that 62,000 persons died of HIV/AIDS in the country last year.

While many countries have submitted their HIVDR data to WHO between 2014 – 17, India dragged it’s feet and submitted no data. It is further categorised to be in stage of “planning,” to collect HIVDR data, while many countries have completed already completed the exercise.

The report shows that in six of the 11 countries surveyed in Africa, Asia and Latin America, over 10 per cent of people starting antiretroviral therapy had a strain of HIV that was resistant to some of the most widely used HIV medicines. Once the threshold of 1 per cent has been reached, WHO recommends those countries to urgently review their HIV treatment programmes.

Gottfried Hirnschall, director of the WHO’s HIV and hepatitis programme said, “We need to ensure that people who start treatment can stay on effective treatment, to prevent the emergence of HIV drug resistance.”