1. A South-South Collaborative Network for Monitoring and Surveillance of HIV Drug Resistance
The LAASER program
Raphael Hamers, MD
Program Manager, PharmAccess Foundation
On behalf of the LAASER partnership

2. ‘Building capacity on surveillance & monitoring of HIV drug resistance in Asia & Africa’
Grant € 10.2 million
(US$ 12.5 million)
SAC

3. Aids Fonds implementing partners
Not-for-profit NGO; Dedicated to scaling-up
access to HIV/AIDS care in sub-Saharan Africa,
promoting public-private partnerships
Therapeutics Research, Education, and AIDS Training in
Asia; Network of clinics and research institutions,
facilitated by The Foundation for Aids Research (amfAR)
To strengthen and coordinate the reponse of civil society in
the global fight against AIDS, in collaboration with national
governments, private sector and international institutions
International Civil
Society Support
In collaboration with: University MC Utrecht
University of Witwatersrand
Stanford University

4. Capacity building & Research
Support to a multi-country HIVDR monitoring program
Surveillance surveys in recently infected (transmitted HIVDR)
Quality assurance network of laboratories
Training of medical and laboratory professionals
Support to policy makers on optimal ART program practices
International observational database

5. PASER network 15 countries 1 - 2 sites per country
clinical sites
3 reference laboratories
Mali
Senegal
Nigeria BF
Ethiopia
Benin
Kenya
Uganda
Rwanda
Rwanda
Tanzania
Zam
bia
PharmAccess activities
Angola
Zambia
Mozambique
Selected sites
Namibia
Zim
Planned/Potential sites
Reference laboratory
RSA

6. TASER network 10 countries 1 - 2 sites per country
clinical sites
10 reference laboratories
Selected sites
Planned/Potential sites

7. Monitoring: patients on HAART Prospective cohort study
Inclusion Criteria
Confirmed HIV+ test
≥18 years of age
Initiate 1st line HAART (criteria from clinic, based on CD4/AIDS-defining condition) or
Switching to 2nd line HAART due to treatment failure (after ≥6 months 1st line containing ≥3 ARVs)
Exclusion Criteria
HIV-2 infection

8. Monitoring: enrolment projections Africa
Yr 1
Yr 2
Yr 3
Yr 4
Yr 5
Total
participants
Number of countries 5 11 15
Participants enrolled/region
- Southern
- Eastern
- Western
250 -
750
300
500
200
1000
Total participants enrolled/yr
1350
400

9. Surveillance: transmitted HIVDR Cross-sectional surveys
Inclusion Criteria
ART naϊve; and
Newly diagnosed with a confirmed HIV+ test and ≥ 18 but <25 years of age; or
Confirmed HIV+ test with evidence of recent infection 
Exclusion Criteria
Known previous AIDS-defining illness
HIV-2 infection

10. Lab logistics Africa: tracking protocol
HARDCOPY+DIGITAL lab log form checked on all levels
Facilitated through web-based HAART MONITORING SYSTEM (HMS)
Clinic
Specimen
Collection
Master
Clinic
Storage -80C
Ref Lab
Viral load +
Sequencing
INFO ON TUBE:
PRELABELLED BARCODE
PATIENT CODE
DATE AND TIME BLOOD DRAW
PharmAccess
Data
management
Shipment on dry ice in batches

11. HAART Monitoring System
Pharmaccess patient data management system: simple & web-based

12. Achievements to date Clinical databases (HMS and TAHOD)
P/TASER clinical site selection
QA laboratory network (TAQAS)
Study protocols
Harmonization with WHO HIV ResNet
Launch TASER (July 2006) and PASER (October 2006)
Logistical challenges in Africa:
Tracking protocol
R&D project proposal: dried fluid spot technology
Start patient enrollment scheduled October 2006

13. Collaboration Eligible clinical and laboratory HIV sites
Eastern and Western Africa
Preferably from NGO and private sector
are kindly invited to contact PharmAccess Foundation

14. IAC: Round table meeting
Contacts
TreatAsia – TASER
IAC: Booth G438
Aids Fonds
IAC: Booth F422
PharmAccess – PASER
IAC: Booth G458
ICSS
IAC: Round table meeting
& Launch