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dc.contributor.authorShroufi, A
dc.contributor.authorGovender, NP
dc.contributor.authorMeintjes, G
dc.contributor.authorBlack, J
dc.contributor.authorNel, J
dc.contributor.authorMoosa, MY
dc.contributor.authorMenezes, C
dc.contributor.authorDawood, H
dc.contributor.authorWilson, D
dc.contributor.authorTrivino Duran, L
dc.contributor.authorAjose, O
dc.contributor.authorMurphy, RA
dc.contributor.authorHarrison, T
dc.contributor.authorLoyse, A
dc.contributor.authorRuffell, C
dc.contributor.authorvan Cutsem, G
dc.date.accessioned2020-06-23T19:46:03Z
dc.date.available2020-06-23T19:46:03Z
dc.date.issued2020-02-29
dc.date.submitted2020-04-23
dc.identifier.pmid32126322
dc.identifier.doi10.1016/j.ijid.2020.02.057
dc.identifier.urihttp://hdl.handle.net/10144/619662
dc.description.abstractBACKGROUND: 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.en_US
dc.language.isoenen_US
dc.publisherElsevieren_US
dc.rightsWith thanks to Elsevier.en_US
dc.subjectAIDS
dc.subjectAIDS mortality
dc.subjectAccess
dc.subjectAhd
dc.subjectFlucytosine
dc.subjectHIV
dc.subjectSouth Africa
dc.subjectadvanced HIV disease
dc.subjectcryptococcal meningitis
dc.titleTime to embrace access programmes for medicines: Lessons from the South African flucytosine access programmeen_US
dc.typeArticle
dc.identifier.eissn1878-3511
dc.identifier.journalInternational Journal of Infectious Diseasesen_US
dc.source.journaltitleInternational journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
refterms.dateFOA2020-06-23T19:46:04Z
dc.source.countryCanada


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