USAID provides antiretrovirals (ART) to most of the Southern African population that need them. Through the provision of free antiretrovirals, HIV patients who are adhering to their daily regimen are able to live full lives and plan for the future.
Previously, in most of Southern Africa, patients had to attend the clinic to collect their ARVs every single month. Unfortunately, clinics were heavily over-burdened leading to long waiting times and short consultations. Many patients could simply not afford the time required each month to collect their ART and simply defaulted on their regime. Others lost days of work, preventing them from earning an income and affecting their quality of life.
To address this challenge, multi-month dispensing has been introduced by Right to Care in clinics in Lesotho and other areas in Southern Africa. This model has resulted in improved adherence, and a better quality of life for patients. Stable patients can now gain access to their medication in three-month batches, reducing the time they spend at the clinic and increasing the amount of time they spend with their healthcare practitioner when they do attend the appointment.
Lebo, a farmer in Lesotho, describes her experience of the old system of single month dispensing: “In 2014 I began taking the antiretrovirals (ART) supplied by USAID. After milking the cow and feeding the farm animals, I’d do my best to leave the house by 7 AM and walk two hours to St. Joseph Hospital in Roma. If I wasn’t there by 9:00, the wait would be even longer because the clients were many. Five hours of sitting and then a brief visit with the nurse, collection of the ART and then I’d walk the two hours home again so I could do evening chores. I was lucky to be home by 4:00. Every month! That’s why I couldn’t sleep the night before clinic visits.”
Fortunately, multi-month dispensing has transformed her HIV treatment experience: “Now because of multi-month dispensing, I only have to visit the clinic once every three months. This cuts the waiting time from five hours to one, and it has the added benefit of giving the nurses more time to spend with each patient – to find out what’s really going on and how to best treat any complications.” Ultimately, for Lebo, this means that rather than clinic visits consuming twelve full days each year, she can now spend just four half days at the clinic. This allows her to work on her farm and earn an income, whilst remaining adherent to her ART.
This simple, yet hugely effective, model of multi-month dispensing has now been replicated for thousands of people across Southern African thanks to USAID and Right to Care.