BACKGROUND: Lesotho is an HIV-burdened country with over 340,000 people affected and about 220,000 currently enrolled for ART. The integration of ART services into primary healthcare facilities has left healthcare workers in these facilities overburdened with high volumes of clients. The covid pandemic exacerbated this burden, with many healthcare workers off ill and clients reluctant to collect medication from facilities for fear of contracting the virus. One of the strategies implemented by Right ePharmacy, supported by Right to Care (NPC), USAID and the Ministry of Health, included the external packaging of chronic repeat medicines via a Centralized Dispensing Unit (CDU) and dispatching of these medicine parcels to alternative pick-up points (PuPs) outside of facilities. PuPs can include alternative counters at facilities, private pharmacies, and Collect & Go Smart Lockers. Successfully launched by Right ePharmacy in Maseru, the total BonoloMeds solution was rolled out from concept to implementation in just 60 days, and its early success provides evidence that a healthcare gap has been filled in the small mountain nation.
DESCRIPTION: Through this program, a CDU model (BonoloMeds) was established in Maseru, Lesotho, with a network of 21 PuPs. BonoloMeds serves 8 health facilities, allowing the decanting of HIV and other chronic clients to the program. This means clients only return to their facilities every 6-12 months for clinical evaluation and re-scripting, alleviating the client burden on these facilities.
LESSONS LEARNED: Since its inception, BonoloMeds enrolled more than 10,000 clients with rapid uptake for HIV patients. Alternative PuPs allow clients to collect medication outside of clinic queues quickly. Previously, manual systems in primary health clinics often resulted in stock-outs and clients not always receiving their medication on time.
CONCLUSIONS: The CDU as a differentiated model of medicine delivery has proved effective in increasing ease of access, adherence, and retention of treatment, particularly during COVID-19. Client and commodity tracking has improved due to integrated Warehouse Management Systems and Electronic Medical Records systems with a centralized data repository allowing faster and more efficient programme decisions. This is key to reducing the impact of COVID-19 and other potential pandemics.

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