Pan-African Studies to Evaluate Resistance


To monitor HIV drug resistance in adults in sub-Saharan Africa.


The World Health Organization (WHO) recommends that antiretroviral treatment (ART) follows a public health approach in resource-poor settings like Africa: this strategy allows for the rapid scale-up of access to treatment for HIV positive persons and indeed has been successful over the past years. However, this approach provides less attention to individualized patient management and laboratory monitoring, in particular testing for HIV viral load in the blood, which raises the concern that HIV drug resistance (HIVDR) could emerge more easily.


The PharmAccess African Studies to Evaluate Resistance (PASER) was established in 2006 as a multi-country capacity building and research program in the sub-Saharan African region, for the assessment and prevention of HIVDR. Between 2006 and 2012, PASER and its sister network TASER in Asia (TREAT Asia Asian Studies to Evaluate Resistance), were part of the LAASER program; a partnership of the Amsterdam Institute for Global Health and Development, PharmAccess, Stichting Aids Fonds, TREAT Asia, and the International Civil Society Support. Since January 2013 PASER is managed through AIGHD.


The observational PASER program was articulated around the WHO HIV drug resistance (HIVDR) prevention strategy. It involved surveillance and monitoring of various cohorts of HIV patients initiating ART in 13 public and private clinical sites, from six countries: Kenya, Nigeria, South Africa, Uganda, Zambia and Zimbabwe.


Second phase PASER

Since 2012, AIGHD Foundation continues the PASER studies in five of the six original participating countries with support from several donors: AIDS Fonds (Zimbabwe), Heineken Africa Foundation (Nigeria), NWO-WOTRO and the Jura Foundation (Uganda) and the Embassy of the Kingdom of the Netherlands regional HIV/AIDS program (Zambia, South Africa and Zimbabwe). The objectives of this second phase of the PASER program are:


  • To continue observational cohorts creating unique longer-term follow-up data on acquired HIVDR in adults in Africa;
  • To contribute to and align with the developing WHO HIVDR strategy as propagated by HIVResNet;
  • To forge strategic and operational alliances with like-minded organisations in HIVDR, in particular SATuRN
  • To contribute to advocacy “keep HIVDR on the map in Africa” and inform policy makers for evidence-based decision making; and
  • To accommodate complementary (operational) research in the area of HIVDR, for example in the areas of modeling consequences of HIVDR, immune activation as a driver for HIVDR or affordable HIVDR tests for Africa.

Over the past several years the PASER program on African adults has been supplemented with similar studies on pediatric ART and HIVDR: children from Uganda and Nigeria are involved in the Monitoring Antiretroviral Resistance in Children (MARCH) study, contributing to the international network on HIV drug resistance in Africa.


AIGHD Research Lead

Prof T.F. Rinke de Wit

PhD students: Drs Sonia Boender and Drs Stefanie Kroeze


PharmAccess Foundation
Department of Virology at the University Medical Centre Utrecht
Department of Molecular Medicine and Haematology of the University of the Witwatersrand
Advanced Biological Laboratories (ABL)
Joint Clinical Research Centre (JCRC)
Lagos University Teaching Hospital (LUTH)
Institute of Human Virology – Nigeria
Newlands Clinic – Zimbabwe
Muelmed Hospital/Practise of Dr Botes – South Africa
Lusaka Trust Hospital – Zambia
Coptic Hope Center – Zambia


Ministry of Foreign Affairs of the Netherlands (NWO-WOTRO)
African partnership for capacity development and clinical interventions against poverty-related diseases (NACCAPII): ART-A phase I, ART-A phase II
Stichting AIDS Fonds: Project Leerstoel
De Grote Onderneming
Heineken Africa Foundation
Jura Foundation
Embassy of the Kingdom of the Netherlands in Pretoria Regional HIV/AIDS Program


South Africa