Reduced ARV Script Visits: Clinics Cuts Down on Trips with Six-Month Prescriptions
South Africa to Roll Out National 6MMD ARV Dispensing Model
South Africa is set to introduce a new antiretroviral (ARV) dispensing model, known as 6MMD, in August 2025, with the aim of expanding the model to provinces across the country [1][5]. This shift in healthcare delivery approach is expected to prioritize patient autonomy, alleviate pressure from clinics, and improve the efficiency of ARV distribution [1].
The 6MMD model allows stable HIV patients to collect a six-month supply of ARVs in just two clinic visits per year, significantly reducing clinic congestion and improving patients' quality of life [1][5]. Key components of the rollout plan include nationwide implementation, continued use and expansion of ARV clubs, and the implementation of a national patient recording system to track ARV dispensing across provinces [1].
However, challenges associated with implementing 6MMD across provinces include the lack of a national patient recording system, ensuring all clinics are equipped and resourced, maintaining adherence and monitoring of stable patients, and addressing possible logistical difficulties in medicine supply chain management with larger ARV quantities dispensed less frequently [1].
The benefits of the 6MMD model, as experienced in the Western Cape, include easing pressure on staff, improved retention in care, and providing more freedom to patients [1]. For instance, Neliswa Nkwali, a patient living with HIV for 25 years, has found the implementation of 6MMD in Western Cape clinics last year to be life-changing, as it has allowed her to plan her life more freely due to less time spent in clinic queues [1].
Policy experts urge faster action, suggesting that the implementation of 6MMD could help the health system cope with a high number of patients and lessen the impact of US funding cuts [1]. The expansion of 6MMD to other provinces may provide benefits similar to those experienced in the Western Cape, such as improved efficiency in ARV distribution and reduced pressure on clinics [1].
References: [1] "National rollout of 6MMD ARV dispensing model in South Africa: A new era for HIV care?". Health-e News. 2025. Available at: https://www.healthenews.co.za/news/national-rollout-6mmd-arv-dispensing-model-south-africa-new-era-hiv-care/ [5] "6MMD: The future of ARV dispensing in South Africa?". South African Medical Journal. 2025. Available at: https://www.samj.org.za/index.php/samj/article/view/10790
- In line with the 6MMD ARV dispensing model rollout, it would be beneficial to incorporate a comprehensive health-and-wellness program for patients that includes mental-health support, fitness-and-exercise opportunities, and education on managing chronic-diseases and medical-conditions to ensure holistic care.
- To optimize the 6MMD model's potential impact, it is crucial to invest in the development of a national patient recording system that accounts for patients' other medical-conditions and treatment plans.
- Given the significant decrease in clinic congestion due to the 6MMD program, health-and-wellness advocates should consider partnering with clinics to promote access to fitness-and-exercise facilities and mental-health services in order to address the whole spectrum of patients' needs.
