UN agencies have agreed to develop a joint work plan on antiretroviral (ART) adherence after the WHO in South Africa presented the current status and challenges of ART adherence to UN agencies. This followed a request by the UN Resident Coordinator on how UN agencies could contribute to improving adherence rates.

ART adherence is particularly important in South Africa which has the largest treatment program in the world and is rapidly expanding ART to over 3 million people and introducing new policies for earlier treatment initiation.

Medication adherence is a persistent problem with multiple causes affecting an estimated 50-75% of patients globally who do not use medication as prescribed.  ART adherence is estimated to range from 49% to 100% globally. The costs of non-adherence are high, leading to higher morbidity and mortality outcomes, drug resistance, more expensive second line regimes, higher rates of hospitalization, and the risk of transmission of communicable diseases.

The National Department of Health recognized the problem early and, since 2013, put into place policies and programs to address health systems factors and some therapy, condition and patient-related factors.

However, gaps and opportunities for support from UN exist, including adapting service delivery systems to the needs of specific groups such as youth friendly services, as well as addressing most of the socioeconomic factors, including community support. 

UN partners agreed that a UN joint work plan would provide insight into the right balance of effort in prevention and treatment, for example, and identify what the UN partners could do in other sectors to support the NDOH. See the attached presentation for more information.