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Increasing access to treatment by redistributing medication and decreasing waste
Presented by Tobey Busch, United States.
T. Busch, J. Valencia
AID FOR AIDS International, New York, United States
Issues: Currently there are over 38 million people living with HIV and AIDS around the world. Despite recent scale-up efforts, only a small percentage of these individuals are receiving antiretroviral (ARV) medication. In a time of such scarcity, inefficient procurement and distribution systems in developing countries results in wasted mediation that expires before use.
Description: Based on its trademark “recycling” (medication redistribution) methodology, AID FOR AIDS has redistributed thousands of bottles of ARVs that would have otherwise expired before use. After conducting inventories, governmental organizations in Cambodia and several countries in Africa notified AFA of surplus medication. National AIDS Programs (NAP) in Latin America and the Caribbean were then notified of the available medication and encouraged to request any antiretroviral treatment in need in their country. Medication was promptly shipped to the recipient country and, once distributed, program directors completed a short demographic surveillance questionnaire to ensure proper use of treatment.
In total, 17,980 bottles of 8 different ARV medications were available for AFA to redistribute. Of these, AFA was able to send 6,769 (approximately 38%) bottles to four different countries in Latin America. Medication was used to provide continuum treatment to 449 people: 259 pediatric patients (second-line medication), 201 adult patients. Eleven naïve patients were initiated on treatment.
Lessons learned: AFA has shown that international aid organizations and governments can work together to ensure valuable resources are not wasted and are distributed to those in need. We hope to expand this program and involve all developing countries in the “recycling” process.
Next steps: Regulations of some NAPs prevent acceptance of medication with less than 1 year until expiration. To date, donating governments absorbed the costs of shipment for the medication; however these expenses may pose an obstacle for some programs. There was considerable lag in reporting from governments due to weak surveillance systems.
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