South Africa’s 21-day coronavirus lockdown presents an unusual challenge for a nation with the world’s highest burden of HIV.  In order to remain healthy, those on antiretrovirals need to venture out of their homes for their lifesaving medication — a move that puts them at greater risk of contracting the highly infectious coronavirus.Therefore, some health care advocates are seeking broader use of an existing workaround in the form of automatic pharmaceutical dispensaries, much like ATMs, where patients can get their pills without making human contact.
 
Already, South African hospitals are busy preparing for a coming storm of coronavirus cases, which officials expect to peak in September.  
 
But as they stare down this pandemic, they’re also dealing with at least 7.7 million HIV patients, already supported by one of the world’s largest free government-sponsored antiretroviral programs.
 
So how, in this age of lockdowns and strict social distancing, can these vulnerable patients stay safe from a new viral threat?
 
Enter the pharmacy ATM.  
 
South African non-profit Right to Care rolled out the innovative program in 2018 to give patients with chronic illnesses a quick virtual consultation with a pharmacist, followed by dispensation of their medication — all in under three minutes. In normal times, the program saves patients the inconvenience of waiting in long lines at government clinics.
 
But during this new pandemic, it could save lives, says pharmacist Taffy Chinamhora.  
 
“The interaction between the patient and health care professional is minimized, is very minimal; it’s more or less virtual from the patient point of view, because it’s via an audiovisual link. So interaction, so the spread of the virus is limited because there is no person-to-person interaction because we’re using audiovisual link, we’re using an ATM pharmacy to dispense medication to patients,” Chinamhora said.The program’s managing director, Fanie Hendriksz, says it could also lift a burden off the nation’s hospitals. Patients can get two months of medication at a time.
 
“In a time like this it’s important that we decant our chronic, stable patients from our overburdened facilities to make way for the side effects of the pandemic,” Hendriksz said.
 
The program has five locations in South Africa, most of them in high-density urban areas in Johannesburg and the city of Bloemfontein. Most are inside shopping malls, which, under South Africa’s strict lockdown conditions that only allow essential trips outside of the home, also minimizes the number of trips patients have to make. Hendriksz says there has already been a spike in the usage of these locations.
 
“We’ve seen a rapid increase in patient numbers at our ATM pharmacies. One of the main reasons for this is just remember that these ATM pharmacies are situated in community shopping centers. So, in a period of lockdown, patients can easily align the collection of their medication with their monthly or weekly shopping. And also, the ATM pharmacy is open seven days a week, and already we are open 80 hours a month more than the public health care facilities,” Hendriksz said.
 
The program is busy collecting data on how many new patients have entered the program. But, they say, every single patient they can help contributes to the larger fight against the coronavirus pandemic.
 

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