HIV-Positive People in Cameroon Face Resistance to Second-Line Antiretrovirals

While countries worldwide are scaling up their antiretroviral treatment programs, more people living with HIV/AIDS are expected to develop resistance to their drug regimens and lack access to more expensive alternative therapies, IRIN/PlusNews reports. According to IRIN/PlusNews, although the number of people who have developed resistance to second-line antiretrovirals remains small, "the challenge is trying to keep these numbers down." Many HIV/AIDS experts say that the main cause of drug resistance is poor adherence to treatment regimens.

In Cameroon, IRIN/PlusNews reports that the case of Marie Gisele Tientcheu, an HIV-positive advocate who developed resistance to second-line antiretrovirals and could not access treatment in the country, "has thrown the spotlight" on the problem. Although there are no official statistics on resistance rates in Cameroon, a 2007 study on patients receiving care at a hospital in the capital of Yaounde found that 4.4% of patients were developing resistance after one year of treatment. However, Charles Kouafang, head of the hospital's AIDS unit, said the rate of resistance had fallen from 2002, when a similar study showed that 16.2% of patients developed resistance after only eight months of treatment. Kouafang said that the 2002 data reflected the high cost of antiretrovirals and that the situation improved after the government introduced no-cost treatment in 2007. However, he said "the fact that cases of resistance still occur is a public health concern." According to IRIN/PlusNews, approximately 55,000 HIV-positive Cameroonians receive antiretroviral treatment, and GTZ -- with participation from Cameroon's Ministry of Health and National AIDS Commission -- in August established an awareness campaign encouraging patients to adhere to their drug regimens.

Caroline Kenkem, deputy executive secretary of the Cameroon Network of People Living With HIV, said that given the issue of drug resistance among HIV-positive people living in the country, it is "imperative" that third-line antiretrovirals be distributed. However, Alain Fogue, president of the Cameroon Movement for Advocacy and Access to Treatment, said that it is unlikely to happen. Fogue said, "I don't think the authorities are planning to provide third-line" antiretroviral in Cameroon, adding, "I don't even know if they are aware of this situation, because managing the second-line protocol is hard enough." According to IRIN/PlusNews, organizations of HIV-positive people in Cameroon have launched an appeal to the government to address the issue. Fogue said, "We feel there is no real policy on medication or on providing care and support for patients. It feels like we're trying to get our voices heard, despite many years of fighting and demonstrations for political action" (IRIN/PlusNews, 11/5).