New WHO framework aims to tackle rising resistance to HIV, STI, and hepatitis treatments

News brief
Topics
Antimicrobial Stewardship
HIV/AIDS
Hepatitis
Sexually Transmitted Infections
Boxes of HIV medications
USAID / Wikimedia Commons

The World Health Organization (WHO) yesterday released a roadmap to address rising resistance to treatments for HIV, hepatitis B and C, and sexually transmitted infections (STIs).

Building on the WHO's Global Action Plan on Antimicrobial Resistance, the integrated drug resistance action framework proposes a unified global approach to prevent the emergence and spread of drug resistance and reduce its impact through a people-centered approach. The document outlines strategic priorities and concrete actions across five key domains: prevention and response; monitoring and surveillance; research and innovation; laboratory capacity; and governance.

Current treatments for HIV, STIs, and hepatitis B and C face varying degrees of resistance. Among HIV patients with unsuppressed viral load, resistance to dolutegravir-based antiretroviral therapy has been reported in some low- and middle-income countries, with resistance rates ranging from 5% to 20%. Resistance to first-line treatments for Neisseria gonorrhoeae—one of the four most common STIs globally—have substantially increased over the past decade, leaving some gonorrhea patients with limited treatment options. 

And while WHO-recommended treatments for hepatitis B and C remain highly effective, there are concerns about emerging resistance amid expanded treatment access.

Rising resistance could undo decades of progress

WHO officials say drug resistance could lead to rising rates of new infections and treatment failure, increase preventable morbidity and mortality, undo decades of progress in HIV, hepatitis, and STI control, and undermine global elimination goals.

“This framework is a call to action for countries, communities and partners to unite around a shared agenda,” Tereza Kasaeva, MD, PhD, director of WHO’s Department for HIV, Tuberculosis, Hepatitis and Sexually Transmitted Infections, said in a news release. “Together, we can preserve the effectiveness of life-saving antimicrobial drugs and accelerate progress toward ending these epidemics.”

Estimate: US city-level COVID indoor vaccine mandates had uneven, marginal effects

News brief
Topics
COVID-19
Vaccine mandate sandwich board
Paul McKinnon / iStock

An analysis published in Contemporary Economic Policy suggests that COVID-19 indoor vaccine mandates in major US cities didn't increase weekly vaccination rates or reduce infections and deaths in adults or children, despite their success in countries such as Canada and France.

The authors, led by a Clemson University researcher, estimated the effect of mandates in nine major US cities on first-dose COVID-19 vaccine uptake, cases, and deaths. The included cities—New York City, San Francisco, New Orleans, Seattle, Los Angeles, Philadelphia, Boston, Chicago, and Washington DC—issued indoor vaccine requirements in 2021 and 2022.

“Governments implemented a wide range of policies during the COVID-19 pandemic to encourage vaccination and reduce disease spread, including public information campaigns, monetary incentives, and various forms of vaccine mandates,” they wrote. “Among the most restrictive and controversial of these were indoor vaccine mandates, which required proof of vaccination to enter public indoor venues such as restaurants, bars, gyms, and theaters.”

City-level mandates easy to skirt

While vaccine mandates appeared to be effective in some cities, no consistent pattern of significant effects was identified. “Even when point estimates appear sizeable… the confidence intervals are wide and include both meaningful increases and decreases,” the authors wrote.

Our findings don’t suggest that mandates can’t work—only that their effectiveness depends on timing, context, and how easily people can sidestep local restrictions.

Elijah Neilson, PhD

They said that city-level mandates—unlike those at country and state levels, which are difficult to avoid—may have had limited effects because unvaccinated people can skirt restrictions by traveling to nearby jurisdictions.

“The contrast with international findings suggests localized mandates may be less effective in settings with high baseline coverage, mobility across jurisdictions, and vaccine hesitancy,” as in the United States, the researchers wrote.

In a Wiley news release, corresponding author Elijah Neilson, PhD, of Southern Utah University, said, “By the time most cities introduced indoor vaccine mandates, vaccination rates were already high, and many unvaccinated individuals were deeply hesitant or resistant, leaving limited room for further gains.”

“Our findings don’t suggest that mandates can’t work—only that their effectiveness depends on timing, context, and how easily people can sidestep local restrictions,” he added.

Ethiopia’s Marburg death toll rises to 5

News brief
Topics
Marburg
Viral Hemorrhagic Fever
marburg
James Joel/ Flickr cc

At least five people are dead in a Marburg virus outbreak with 10 confirmed cases in Ethiopia. The country reported its first Marburg outbreak last week.

According to media reports, there may be an additional three deaths not yet lab confirmed associated with this outbreak. Marburg, a filovirus, is related to Ebola but has no vaccine or treatment. Outbreaks often have high fatality rates, and the virus is typically transmitted to people from fruit bats. 

Late last week the World Health Organization (WHO) said the source of the outbreak has not yet been identified

“Ethiopia is facing concurrent emergencies and multiple disease outbreaks, including of cholera, measles, dengue, which results in stretched health capacity,” the WHO said. 

This week's top reads

  1. First ever human case of H5N5 avian flu confirmed in Washington state

    Previous human detections in the US have involved the H5N1 strain.

    Stephanie Soucheray

  2. After unprecedented autism-vaccine messaging change, scientists, advocates say CDC no longer trustworthy

    Doctors, public health advocates, and the autism community expressed anger and sorrow over the CDC's reversal of its messaging on vaccines and autism.

    Liz Szabo
    Laine Bergeson
    CDC headquarters sign

  3. Ethiopia faces its first Marburg outbreak, which has proved deadly

    Nine cases have been confirmed and 17 are suspected.

    Stephanie Soucheray
    marburg virus

  4. CDC: 31 infants now sickened with botulism in formula-related outbreak

    All 31 patients have required hospitalization.

    Stephanie Soucheray

  5. Experimental mRNA flu vaccine is more effective than conventional flu shot, but causes more side effects

    In a phase 3 trial, participants who received the shot were 29% less likely to be diagnosed with flu than those who received a conventional flu shot.

    Liz Szabo
    Young woman receiving a flu shot from female doctor

  6. While no one was watching: Tenuous status of CDC prion unit, risk of CWD to people worry scientists

    If the Prion and Public Health Office is shuttered, human CWD cases could go unnoticed, and it will be too late to mitigate the consequences, experts say.

    Mary Van Beusekom
    CWD zone deer disposal site

  7. Washington state officials confirm H5N5 avian flu patient has died from infection

    All previous human avian flu infections had been caused by H5N1 and were relatively mild.

    Stephanie Soucheray
    backyard birds

  8. New test promises faster, more accurate Lyme disease diagnosis, researchers say

    The test had 91% sensitivity in detecting Borrelia burgdorferi.

    Laine Bergeson
    Tick

  9. Utah, South Carolina confirm more measles as CDC call suggests US elimination status in jeopardy

    Today the South Carolina Department of Health reported 5 new cases in Spartanburg County.

    Stephanie Soucheray
    measles boy

  10. CDC outlines new initiatives such as expanded hepatitis B screening with potential vaccine policy impacts

    The list offers the clearest view yet of the Trump administration's plans for the agency under HHS Secretary Robert F. Kennedy Jr. 

    Laine Bergeson
    pregnant woman and doctor

Our underwriters

Grant support for ASP provided by

Unrestricted financial support provided by

Become an Underwriter