The decentralized drug distribution (DDD) approach for HIV expands access to antiretroviral therapy (ART), pre-exposure prophylaxis (PrEP), and HIV self-test kits by enabling clients to access relevant commodities at convenient community locations, including private sector pickup points, community pharmacies, private clinics, self-service lockers and kiosks, and even home delivery. DDD not only makes it possible for clients to access HIV commodities where they live or work but also reduces travel time and cost, reduces waiting time, and decongests public health facilities, contributing to reduced rates of interruption in treatment. The Meeting Targets and Maintaining Epidemic Control (EpiC) project funded by PEPFAR and USAID works with national governments to introduce and scale up differentiated service delivery models under the DDD approach, as well as to update policies and regulations that govern the delivery of HIV commodities outside of public health facilities to allow for DDD. EpiC has provided DDD support in 24 countries, and program evaluations have shown improvements in clinical outcomes among clients who enrolled in the DDD model. For example, in Cameroon, clients receiving ART refills at health facilities offering DDD had higher treatment continuity at 3 months (100% vs. 93%) and 24 months (90% vs. 79%) compared to those who received ARV refills at comparable health facilities not offering DDD. 

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This blog is part of a series highlighting EpiC’s technical approaches, key results, tools, and strategies that have driven positive change in HIV outcomes.