Prevention, monitoring and timely response to population levels of HIV drug resistance (HIVDR) are critical to achieving the WHO/UNAIDS 90–90–90 targets for 2020. HIVDR emerges when HIV replicates in the presence of ARV drugs. Drug resistance is caused by mutations in the genetic structure and affects the ability of ARVs to block its replication and is associated with poor clinical outcomes and reduced effectiveness of ART. If HIVDR becomes widespread, ARVs currently used to prevent and treat HIV infection may become ineffective.

In response to increasing levels of HIVDR, the WHO coordinated the development of The Global Action Plan (GAP) on HIVDR (2017-2022). The overall goal of the global action plan is to forge synergies that will prevent HIVDR from undermining national and global objectives, while providing the most effective treatment to all persons living with HIV. The plan emphasizes five strategic objectives (Prevention and response, Monitoring & surveillance, Research and innovation, Laboratory capacity and Governance and enabling mechanisms) as critical components that should be integrated into broader efforts to ensure a comprehensive, effective, and sustainable HIV response. It is essential that actions to monitor, prevent and respond to HIVDR are implemented at the clinical, programme and policy levels to address the many drivers of HIVDR. WHO also recommends that HIV treatment scale-up be accompanied by measures to monitor and improve the quality of ART delivery and surveillance of HIVDR. At the country level, the strategy endorses country ownership, HIVDR surveillance, leveraging of enablers, and timely dissemination and use of available HIVDR information.

The last HIVDR study was completed in 2007 and following discussions with a national team, it was agreed to implement new HIVDR surveillance approaches, based on WHO recommended methodology, which will inform and support the implementation of a national HIVDR prevention and control strategy in Belize, aligned with the strategic lines of the WHO HIVDR GAP. As part of HIVDR surveillance activities, a nationally representative survey to estimate pre-treatment and acquired HIVDR will be conducted by the Ministry of Health and Wellness of Belize with technical support from the Pan American Health Organization and with financial support from the national Global Fund Project.

To support the implementation of the national HIVDR survey, which is expected to commence in 2021, the Ministry of Health and Wellness Belize in collaboration with UNDP, the Principal Recipient of the Global Fund Project is seeking support of a consultant to develop a national HIVDR prevention and control strategy, including a protocol and plans for HIVDR surveillance to be implemented in 2021.