In Uganda, clients were travelling long distances to overcrowded facilities with long queues to collect their ART. The AIDS Support Organization (TASO), a local non- governmental organization (NGO), initially responded by instituting home delivery of ART. However, as client numbers grew, home delivery of ART became unfeasible. TASO then set up a number of community drug distribution points (CDDPs). Eligible clients were referred to the CDDP closest to their home for both ART refills and clinical consultations. The CDDP is an out-of-facility individual model.
As of 2015, 70% of TASO clients (about 50,000) received their ART within this model, with 69% retained after five years. Loss to follow-up was reported as 16.5% in facility-based treatment as compared to 4.28% in the CDDP model. Among CDDP clients, viral load suppression (<1,000 copies/mL) was 93% (median time on ART: 7.0 years).
Other examples similar to the CDDPs include the PODI community pharmacy within the Democratic Republic of the Congo, various external pick-up point options in South Africa ranging from community pick up points to private pharmacies and lockers, community pick-up points in Zambia, private pharmacies in Nigeria and Uganda and community-based ART sites in Namibia.
6 months on ART, viral load of less than 1000 (virally suppressed)
Pre-packed ART (2-3 months) Adherence counselling
2-3 monthly visits
Community points closer to clients’ homes
Primary care clinics providing ART