The Government of Malawi has launched investigations into the growing cases of antiretroviral therapy (ART) resistance in the country, with over 400 cases already recorded since April 2024.
Speaking at a Dolutegravir (DTG) resistance meeting held in Lilongwe yesterday, Secretary for Health Samson Mndolo revealed that 418 resistance tests have been conducted so far, averaging 50 tests per month.
He said this follows the introduction of routine DTG resistance testing by the Ministry of Health (MoH) nearly a year ago.
“Drug resistance, particularly to Dolutegravir, is becoming [an issue of] serious concern in our fight against HIV. We are responding with improved surveillance, testing and access to third-line treatment.
“More than 404 patients are currently receiving third-line ART regimens—primarily based on Darunavir/ ritonavir—demonstrating the country’s commitment to safeguarding [the lives of] those living with HIV,” Mndolo said.
While Malawi has made strides in HIV management, having already exceeded the UNAids’ 95-95-95 targets ahead of the 2025 deadline, drug resistance now threatens to reverse those gains.
Between 2010 and 2024, ART prevented more than 574,000 deaths, and prevention of mother-to-child transmission averted over 131,000 new infections.
However, growing resistance could compromise the effectiveness of current treatment protocols.
Dream Lab Supervisor Davide Brambilla, whose organisation supports HIV programmes in Malawi, emphasised that drug resistance was not unique to Malawi.
He stressed the importance of testing people who are on ART to detect resistance early and ensure they remain on safe and effective medication.
