A robotic machine that dispenses antiretroviral (ARV) drugs to patients infected by HIV was unveiled yesterday in Durban during the ongoing 2016 International Aids Conference.
The R1.2 million robotic machine was developed at the Right to Care, a non-governmental organisation that supports and delivers prevention, care and treatment services for HIV and associated diseases.
The pilot project is at the Helen Joseph Hospital in Johannesburg, and is a prototype of what its South African developers believe could be a game-changer in the fight to contain the AIDS pandemic in the country and beyond.
The machine was developed with robotics from Germany which teamed up with local expertise on software.
SA has the highest number of HIV-positive people in the world, estimated to be about 6.4 million in 2012. However, the Department of Health says 3.3 million South Africans are not on ARVs although they should be.
Between 2000 and 2005, more than 330 000 people died of AIDS, many because they did not have access to ARVs. At the height of the pandemic, life-saving ARVs were available, but only via very expensive, private treatment, or for a lucky few, if they fell within the catchment areas of non-state, privately-funded pilot programmes.
The government was ordered by the Constitutional Court to provide ARV-nevirapine (which stops HIV from multiplying) in 2002. But it only began a slow rollout two years later, in 2004. By then, the virus had emerged as one of the biggest threats to post-apartheid reconstruction and development.
Today, antiretroviral therapy has transformed HIV infection from a progressive, typically fatal infection to a chronic disease that can persist for many decades. A typical young adult who acquires HIV is expected to be on therapy for up to 50 years, according to a recent article in the Lancet medical journal.
The new robotic machine drastically reduces the time spent in queues by patients waiting to receive their monthly dose of life-saving ARVs and TB medication.
Fanie Hendriksz, MD of Right To Care's ePharmacy project, says the pilot would begin immediately afterwards, with four units going into Alexandra township.
"We hope to have reached six sites this year," says Hendriksz. "The sites will come with their own power source and have a link via a Web cam to a centre where there will be a pharmacist on call if needed - but generally it will be patients scanning in smartcard IDs and accessing their three months' prescription, forgoing the need to come all the way into a hospital or a clinic and wait for hours to access their medication."
To prevent any problems with stigma, the machines won't be identified as HIV-related because other medication will also be available for patients with chronic conditions such as diabetes or TB.
Right to Care says the shortage of pharmaceutical personnel has had a significant impact on the delivery of pharmaceutical services and the ability to provide continuous availability of medicines in the public sector.
The NGO notes that scaling up access to ARV therapy from the current level of two million patients to the required 3.5 million patients requires a step-change in medicine supply-chain management. Innovative strategies are needed to maximise the availability of medicines.
It adds that robotic pharmacy automation technology is an innovative approach to addressing these challenges. It can optimise and improve supply-chain efficiencies, optimise the use of pharmacy personnel, and make medicines available in a controlled secure environment at reduced cost. All this can be done while maintaining patient convenience and safety.
Moreover, Right to Care points out, automation can ease overcrowding at high volume facilities, reduce waiting times for patients, and this improves patient adherence to medication and retention in care. Wider economic benefits are also achieved through minimising time off from work for employed patients.
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