Well, to be more clear on the #what: These are strains resistant specifically to efavirenz and nevirapine. Both drugs are members of the same class of anti-ret

Well, to be more clear on the #what: These are strains resistant specifically to efavirenz and nevirapine. Both drugs are members of the same class of anti-retrovirals, NNRTIs, which aren't prescribed together, they are two alternatives of the same type of drug and are used in combination with other drug classes. None of the people have resistance to anti-retrovirals in general, they have resistance to a particular class which is no longer recommended in the US (as a first treatment) but is still a go-to in Africa. There are multiple other drug classes that can be put together for effective treatment. In the US, Efavirenz (brand name Sustiva) used to be one of the first-line recommendations, but has been replaced by other drugs with fewer side effects and higher barriers to resistance. Importantly, no currently recommended starting regimens contain a member of the NNRTI class. All 4 of the current US recommended regimens now contain an integrase inhibitor (Dolutegravir, Bictegravir, or Raltegravir) https://aidsinfo.nih.gov/guidelines/brief-html/1/adult-and-adolescent-arv/11/what-to-start https://aidsinfo.nih.gov/guidelines/brief-html/1/adult-and-a... The integrase inhibitors have exceptionally few side effects and are also very high barrier to resistance. Dolutegravir which is mentioned at the end of the article is especially good in this regard, to the point that it is the only drug currently used in an only 2 drug (vs 3 drug) combination therapy. The main thing that needs to happen is for these areas to transition off of these particular NNRTIs.