Professor Sharon Lewin, director, Doherty Institute for Immunity and Infection, Melbourne, Australia has been working relentlessly to find a cure for HIV.

She talks to Gunjan Sharma about drug resistance, the challenges doctors face because of that and the ways to combat it.
 
Why do you think Antibiotic resistance is becoming a major concern across the world?

One of the major reasons for antibiotic resistance is the overuse of antibiotics both in animals and humans. Yes, World Health Organisation has declared antibiotic resistance as the biggest global challenge. India has the highest rate of antibiotic resistance.

Hospitals across the world report newer drug resistance bacteria that  circulate from hospital to hospital and country to country. 
  
What needs to be done to prevent the overuse of antibiotics?

We need to bring agriculture experts, veterinary physicians, doctors, ecologists, and psychologists together to understand why there is such an overuse of antibiotics. We need to bring in regulations based on a detailed understanding of the issue. 

What we immediately need to do is stop sale of antibiotics as an over-the-counter medicine. In India, antibiotics are widely available as an OTC drug and the government should  take an immediate action.

Sometimes doctors prescribe antibiotics even when they are not sure about the type of infection.

One needs a lot of training to detect viral and bacterial infections clinically. It is difficult to follow a strict protocol all the time in medical science.

But there are times when doctors prescribe antibiotics to meet the expectations of the patients. There are patients who feel satisfied only after their doctors give them an antibiotics prescription. In such situations, we need to educate the communities about the importance of antibiotics being used judiciously.
 
You have done enormous work in HIV, do we see drug resistance in HIV patients?

About 10 to 20 per cent of HIV patients have drug-resistance. These patients require a life-long treatment and if they stop it midway because  of any reason-- if they cannot afford it or they don't have access to the medicines--the chances of them developing the resistance are high. 

Resistance in HIV, malaria, tuberculosis is worrisome. All these are deadly infections.
 
Do scientists face any problem while developing a vaccine against a disease if the bug is resistant?

Usually not. A vaccine works by developing immunity against the pathogen. In fact, vaccines can help us fight drug resistance. 
 
Is there an alternative... 

Yes. Another approach is to develop the body's immune system. We are already doing it in some cancers through immunotherapy. 

Medicine poisons the disease-causing pathogen. In cases such as HIV, where the virus hides inside the body, medicine cannot cure the person of the infection. However, in such cases, developing body’s immunity against the virus may help kill the virus in hiding. 
 
Where does India stand as far as the treatment for HIV is concerned?

India has third largest population of people with HIV. Only 50 per cent of them have access to treatment. There is no access to second line treatment for those who do not respond to the first line of treatment. 
 
If we want to control the spread of HIV, we have to give pre- exposure prophylaxis treatment to people who are at high risk of contracting HIV.
 
What is the next big advancement in HIV that you are looking at?

In the next decade or so, we should be having new injectable drugs for HIV patients. The patients would need to take one injection once in two- three months instead of daily oral pills.