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.
Key resources:
- DDD tools landing page
- Key Considerations in Planning for Sustaining the Decentralized Drug Distribution Approach for HIV Programs
- Training Curriculum for Staff Involved in Decentralized Drug Distribution (DDD) of Antiretroviral Therapy (ART) in the Private Sector
- DDD Final Activity Report: December 2019 – May 2022
- Decentralized Drug Distribution Mobile Application: Overview and Technical Architecture Guide
- Virtual Learning Collaborative on Decentralized Drug Distribution: Recordings and Presentations
- Modifying Models for Decentralized Distribution of ART through the Private Sector to Address Disruptions Related to COVID-19
- EpiC Botswana Launches e-Lockers to Promote Access to ART
- Private Clinics in Malawi Help Decongest Public Health Facilities during the COVID-19 Pandemic
- Liberia Begins to Ease Burden on Health System by Dispensing ART in Community Pharmacies
- Distribution of antiretroviral Therapy through Private Pharmacies and Postal Courier Services During COVID‐19 in Botswana: Acceptability and Reach of Two Out‐Of‐Facility Individual Differentiated Service Delivery Models
- How Home Delivery of Antiretroviral Drugs Ensured Uninterrupted HIV Treatment During COVID-19: Experiences from Indonesia, Laos, Nepal, and Nigeria
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.