Last week was an exciting one for North Star’s Roadside Wellness Centres (RWCs) in the North-South corridor, as our pilot program to provide antiretroviral (ARV) treatment directly from RWCs was launched. Running at five sites across three countries, the pilot will assess the feasibility of providing an effective antiretroviral treatment (ART) service to a highly mobile population. This is a major boost to the service offering, as while all clients can currently receive HIV Counselling and Testing (HCT) at any RWC, ART has not yet been possible.
Funded by the Dutch Ministry of Foreign Affairs, the program was kicked off at Zimbabwe’s Chirundu South RWC under the mentorship of the Ministry of Health. Fellow pilot sites Beitbridge (Zimbabwe), City Deep (South Africa), Musina (South Africa) and Chirundu North (Zambia), will be launched in the next few weeks and months, depending on the respective Ministry of Health timelines and processes. After completing their mentorship period with the local Ministry of Health office, the RWCs will become a fully-fledged ARV provider. North Star will complete all reports and registers as required by the relevant health authorities in each country. North Star is being supported by its partners Wits RHI, PharmAccess and AIGHD in setting up, and monitoring and evaluating the project.
While all five sites will offer ARV refill services, both City Deep and Musina will also offer ARV initiation services, meaning that they have the capability to not only provide refills for clients who have already commenced ARV treatment, but also initiate newly diagnosed clients on ARV treatment, in line with national health protocols. In addition, all clients receiving ARVs at RWCs in this pilot will also be monitored and counselled for opportunistic infections, ARV side effects, drug interactions or other HIV-related complaints. If possible they will receive treatment for these at the RWC, but if this is not possible, they will be referred for treatment or care at the local referral facility.
During the pilot, factors including uptake, linkage to support services such as blood tests and counselling, patient follow-up, and retention in care will be considered. In addition to assessing the feasibility of the service, the optimum model for delivery of the service will also be explored – giving the pilot project two arms; provision of the service and the evaluation of this service. Through informed consent, clients will be given the opportunity to be included in or opt out of the evaluation study, which will assess the effectiveness of the ARV service in terms of improving HCT rates, linking patients to care, enhancing adherence to medication and retaining patients in HIV care in the longer term.
While the pilot stage will initially be at RWCs in the North-South Corridor, should the program be successful North Star plans to roll this out throughout all RWCs in the next few years.