Health
HIV Drug Resistance: Minister Harps On Surveillance
The Minister of Health, Prof. Isaac Adewole, last Monday, said surveillance and early identification of HIV drug resistance which necessitated prompt intervention, is required to prevent its effect.
Adewole made this known at a Joint Stakeholders Summit on Drug Resistance Monitoring, early Infant Diagnosis and Viral Load held in Lagos,organised by the National HIV/AIDS Control Programme (NASCP), recently.
Adewole, who was represented by the National Coordinator, National AIDs STIs Control Programme, Dr Sunday Aboje said that since the inception of the national HIV response in Nigeria, the programme had witnessed significant improvement orchestrated by the commitment of the various stakeholders.
“More people are getting to know their status and accessing HIV treatment and care; as a result, HIV related deaths are being averted.
“However, there is still pragmatic challenge such as therapy adherence and retention in care with attending issues such as HIV drug resistance, be it pre-ART or acquired among the different population groups.
“Studies have shown that the surveillance and early identification of these issues which necessitates prompt intervention is required to prevent the untold effect of HIV drug resistance, “he said.
The minister said there were still challenges in the management of HIV despite the commitment of government and donor partners to achieving global targets.
According to him, only about 8.9 per cent of infants born to HIV positive women were being tested.
“This is due to difficulty with tracking babies of HIV positive mothers delivered outside public facilities.
“Also, poor Dried Blood Spots (testing of infant blood samples) and viral load testing sample logistic systems.
“And weak mentorship and supportive supervision at the health facility levels among others, “ Adewole said.
The minister said that a well-coordinated programme involving all major implementers in the country would help solve the challenges.
He said, “Also, surmounting these challenges would require improving the implementation of the programme that will ultimately serve as good practice for other countries.”
Also speaking, a Consultant Haematologist, Prof. Sulaiman Akanmu said that regular monitoring of drug resistance mutations in form of studies carried out by institutions would help inform policies.
“The studies about drug resistance is key and any institution offering anti-retroviral therapy must expect that resistance will naturally evolve.
“We must anticipate it and put measures in place to ensure that we are able to contain it.
“Why the research is key is the fact that, unlike elsewhere, before you put a patient to anti-retroviral therapy, drug resistance testing is done to know what type of drugs the individual is sensitive to before applying the drug.
“That is not feasible in our situation; we really need to give it a public approach system in the sense that we will have to find out what is the common form of resistance that occurs in our patients.
“We use the report of the resistance testing study to inform policy on what we should consider as first line drug, second line drug and how we should manage what we call third line regimen.
“That is the reason why you must be able to do drug resistance testing,” he said.
Also, a Senior Virologist, Institute of Human Virology, Nigeria, Dr Nicaise Ndembi, said there was the need to design surveys where studies in a large scale can provide evidence-driven interventions.
Ndembi however said that the country lacked data that showed the problem of transmitted resistance.
“Basically, the concept is that if you have more exposure to anti-retroviral therapy, the virus will select resistant mutations.
“Thus, the reason why we should worry as a nation is that as we have more people being placed on treatment, we have more resistance, “
“ We need more research studies to be able to know the magnitude of the problem, “ he said.
In her remarks, a Consultant in Public Health, Prof. Phyllis Kanki, identified high cost of laboratory test, lack of patience to treatment by the patients as some challenges facing HIV treatment in the country.
“All the laboratory tests have a certain cost, that is one of the challenges and the other challenge is even though the therapy works pretty well it is still life long.
“So you have to have patience and the healthcare system be ready to support a patient for many years.
“And patients may have issues with taking the drugs, they may want to stop which can be a problem for them, “she said.
Two United States scientists who unraveled the human micro RNA have won the Nobel Prize in Physiology or Medicine 2024.
Victor Ambros and Gary Ruvkun won the coveted prize for their work on microRNA as their discoveries help explain how complex life emerged on earth and how the human body is made up of a wide variety of different tissues.
MicroRNAs influence how genes – the instructions for life – are controlled inside organisms, including humans.
Every cell in the human body contains the same raw genetic information, locked in our DNA.
However, despite starting with the identical genetic information, the cells of the human body are wildly different in form and function.
The electrical impulses of nerve cells are distinct from the rhythmic beating of heart cells. The metabolic powerhouse that is a liver cell is distinct to a kidney cell, which filters urea out of the blood.
The light-sensing abilities of cells in the retina are different in skillset to white blood cells that produce antibodies to fight infection.
So much variety can arise from the same starting material because of gene expression.
The US scientists were the first to discover microRNAs and how they exerted control on how genes are expressed differently in different tissues.
The medicine and physiology prize winners are selected by the Nobel Assembly of Sweden’s Karolinska Institute.
They said: “Their groundbreaking discovery revealed a completely new principle of gene regulation that turned out to be essential for multicellular organisms, including humans.
“It is now known that the human genome codes for over 1,000 microRNAs.”
The World Health Organisation (WHO) has begun acting to curb effects of antibiotic pollution.
The new guidance on wastewater and solid waste management for antibiotic manufacturing sheds light on this important but neglected challenge ahead of the United Nations General Assembly (UNGA) High-Level Meeting on antimicrobial resistance (AMR) taking place on 26 September 2024.
The emergence and spread of AMR caused by antibiotic pollution could undermine the effectiveness of antibiotics globally, including the medicines produced at the manufacturing sites responsible for the pollution.
Despite high antibiotic pollution levels being widely documented, the issue is largely unregulated and quality assurance criteria typically do not address environmental emissions. In addition, once distributed, there is a lack of information provided to consumers on how to dispose of antibiotics when they are not used, for example, when they expire or when a course is finished but there is still antibiotic left over.
“Pharmaceutical waste from antibiotic manufacturing can facilitate the emergence of new drug-resistant bacteria, which can spread globally and threaten our health. Controlling pollution from antibiotic production contributes to keeping these life-saving medicines effective for everyone,” said Dr Yukiko Nakatani, WHO Assistant Director-General for AMR ad interim.
Globally, there is a lack of accessible information on the environmental damage caused by manufacturing of medicines.
“The guidance provides an independent and impartial scientific basis for regulators, procurers, inspectors, and industry themselves to include robust antibiotic pollution control in their standards,” said Dr Maria Neira, Director, Department of Environment, Climate Change and Health, WHO. “Critically, the strong focus on transparency will equip buyers, investors and the general public to make decisions that account for manufacturers’ efforts to control antibiotic pollution.”
In a concerted effort to curb brain drain, the Kebbi State Government has harmonised medical doctors’ salaries to be at par with their colleagues in the federal government’s tertiary health facilities.
Kebbi State Commissioner for Health, Musa Inusa-Isma’il, disclosed this at the handing over of ambulances to the state-owned health facilities at the Ministry of Health in Birnin Kebbi yesterday.
Inusa Isma’il, according to a statement by Ahmed Idris, the Chief Press Secretary to the governor, said the essence of the harmonisation was to retain the existing medical doctors and attract more to the services of the state.
According to him, the doctors across the state had already started enjoying the new salaries from August 2024.
He said the release of the vehicles was in fulfilment of Governor Nasir Idris’ promise to uplift health care services in the state.
“His Excellency said I should inform you, the beneficiaries of this gesture, that the vehicle should be strictly used for the intended purpose. It should not be used for anything else.
“If there is no referral case, each of the vehicles must be parked at the hospital by 6 pm. The governor said you should warn your drivers against reckless driving as well as violating the instructions.
“We should also do everything possible to reciprocate the gesture by working according to the terms and conditions attached,” he advised.
The benefiting health facilities included Sir Yahaya Memorial Hospital, Birnin Kebbi; State Teaching Hospital, Kalgo; General Hospital, Argungu; General Hospital, Yauri; General Hospital, Zuru; and General Hospital, Bunza.
In his speech, the permanent secretary of the ministry, Dr Shehu Koko, recalled that the ambulances were handed over to the ministry last Friday by the governor for the onward handover to the benefiting hospitals.
He observed that the ambulances would go a long way in improving the referral system in the state, adding that delays in reaching the secondary and tertiary facilities would be eliminated.
The permanent secretary attributed the high rate of maternal mortality in the country to delays in getting to the health facilities for proper medical care.
“We believe with the provision of these ambulances, part of the gaps we have in our referral system will be addressed, whereby patients who require secondary healthcare could be easily transported to secondary and tertiary health centres, where they can get such help,” he said.
In a goodwill message, Commissioner for Information and Culture Alhaji Yakubu Ahmed expressed gratitude to the governor for the support he has given to the ministry to excel.
While advising the beneficiaries to use the vehicles judiciously, the commissioner advised that services and maintenance of the vehicles must be prompt to derive the maximum benefits from the vehicles.
The commissioner also highlighted some achievements recorded by the government in the last year, including beautification of the state capital, completion of a multimillion-naira ultramodern state secretariat, road construction, construction and renovation of classrooms and upgrading of some health facilities, among others.