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Time to embrace access programmes for medicines: Lessons from the South African flucytosine access programme.

Shroufi, A; Govender, NP; Meintjes, G; Black, J; Nel, J; Moosa, M-YS; Menezes, C; Dawood, H; Wilson, D; Trivino Duran, L; et al. Shroufi, A; Govender, NP; Meintjes, G; Black, J; Nel, J; Moosa, M-YS; Menezes, C; Dawood, H; Wilson, D; Trivino Duran, L; Ajose, O; Murphy, RA; Harrison, T; Loyse, A; Ruffell, C; Van Cutsem, G (2020) Time to embrace access programmes for medicines: Lessons from the South African flucytosine access programme. Int J Infect Dis, 95. pp. 459-461. ISSN 1878-3511 https://doi.org/10.1016/j.ijid.2020.02.057
SGUL Authors: Harrison, Thomas Stephen

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Abstract

BACKGROUND: Cryptococcal Meningitis (CM) is estimated to cause 181,000 deaths annually; with the majority occurring in Sub Saharan Africa. Flucytosine is recommended by the World Health Organization as part of the treatment for CM. Widespread use of flucytosine could reduce mortality in hospital by as much as 40% compared to the standard of care, yet due to market failure quality assured flucytosine remains unregistered and largely inaccessible throughout Africa. METHODS: The recently established South African flucytosine clinical access programme is an attempt to address market failure which led to a lack of public-sector access to flucytosine for cryptococcal meningitis, by making the medicine freely available to tertiary hospitals in South Africa. RESULTS: Between November 2018 and September 2019, 327 CM patients received flucytosine through this programme, with efforts to support sustainable national scale up presently ongoing. We describe why this programme was needed, its catalytic potential, what is still required to ensure widespread access to flucytosine, and observation from this experience that may have wider relevance. CONCLUSIONS: The South African Flucytosine Access Programme illustrates how access programmes may be one part of the solution to addressing the vicious cycle of perceived low demand, limiting manufacturer interest in specific product markets.

Item Type: Article
Additional Information: © 2020 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. Under a Creative Commons license (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Keywords: AIDS, AIDS mortality, Access, Ahd, Flucytosine, HIV, South Africa, advanced HIV disease, cryptococcal meningitis, 0605 Microbiology, 1108 Medical Microbiology, Microbiology
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: Int J Infect Dis
ISSN: 1878-3511
Language: eng
Dates:
DateEvent
June 2020Published
29 February 2020Published Online
26 February 2020Accepted
Publisher License: Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0
Projects:
Project IDFunderFunder ID
UNSPECIFIEDDoctors Without BordersUNSPECIFIED
PubMed ID: 32126322
Go to PubMed abstract
URI: http://openaccess.sgul.ac.uk/id/eprint/111764
Publisher's version: https://doi.org/10.1016/j.ijid.2020.02.057

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