“The clear pattern of increasing antiretroviral resistance in lower-income settings must be considered in the context of the worldwide HIV-control agenda,” especially because “the increasing rates of antiretroviral resistance in low-income settings represent a potential threat to the emerging treatment-as-prevention strategy,” Evan Wood and Julio Montaner of the BC Centre for Excellence in HIV/AIDS write in a Lancet Infectious Diseases opinion piece, adding, “Urgent action is needed.” They describe steps to help lower the threat of resistance, including deploying proven preventive strategies, “early and sustained” highly active antiretroviral therapy (HAART) to prevent vertical transmission, and programs to provide HAART to 15 million people worldwide by 2015.

“A decade ago, widespread implementation of HAART in resource-limited settings seemed impossible. However, this view was wrong, and more than five million individuals infected with HIV were receiving HAART in these regions by the end of 2010,” the authors write, concluding, “Now is the time to strengthen HAART roll-out initiatives to address the growing threat of antiretroviral resistance, a potential but manageable threat to the worldwide control of HIV/AIDS” (October 2011).