Table 1.
Country‐specific COVID‐19 adaptations to MMD policy [14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32]
| COVID‐19 adaptation category | |||
|---|---|---|---|
| Country | Pre‐COVID‐19 MMD policy/practice | Increased dispensing intervals | Expanded eligibility details |
| Burundi | 3MMD for clinically stable a , c | No |
3MMD for clinically stable and unstable clients, children and PBFW on first‐line regimen; 2MMD for clients on second‐ or third‐line regimen |
| Cote d'Ivoire | 3‐6MMD for clinically stable b , c | No | 3MMD for new ART initiators and clinically unstable clients |
| Democratic Republic of the Congo (DRC) | 3MMD for clinically stable a | 6MMD |
3MMD for new clients who have been on ART for 3 months; 6MMD for clients on ART for > 3 months |
| Dominican Republic | No policy | 6MMD |
6MMD for clinically stable clients; 3MMD for clinically unstable clients |
| Eswatini | 3MMD for clinically stable a , c | 6MMD |
3MMD for virally suppressed children > 2 years; 3MMD for all clients on first‐line TLD; 3MMD for stable, virally suppressed clients on second‐line DTG‐based regimens; 6MMD for all clients on first‐line TLE; 3MMD for eligible, new ART initiators |
| Ethiopia | 3‐6MMD for clinically stable b | No | 3MMD for PBFW, paediatrics, new ART initiators, clients on second‐ and third‐line ART and clinically unstable clients not needing readmission |
| Kenya | 3MMD for clinically stable a , c | No | Up to 3MMD for all PLHIV regardless of age and viral load status (does not include PBFW and new‐ART initiators) |
| Lesotho | 3MMD for clinically stable a , c | 6MMD | 3–6MMD for all eligible clients including stable children > 2 years, adolescents and PBFW |
| Malawi | 3‐6MMD for clinically stable a | 6MMD |
6MMD for clients > 20 kg, new ART initiators (on ART for 3 months) and suppressed VL in the last 6 months is not required; 3MMD for PBFW |
| Mozambique | 3MMD for clinically stable a , c | No | 3MMD for new ART initiators (on ART for 3 months), children > 2 years and PBFW |
| Uganda | 3MMD for clinically stable a , d | No | No age limits for 3MMD (this does not include clients on second‐ or third‐ line ART, new ART initiators, virally non‐suppressed clients, lactating mothers with babies < 6 months and the very sick) |
| Zambia | 3‐6MMD for clinically stable a , c | 6MMD |
3MMD for children 2–10 years; 6MMD for adolescents 10–19 years; 3–6MMD for clients with comorbid conditions; 3MMD for clients failing treatment and receiving enhanced adherence counselling; All health facilities providing ART must ensure recipients of care in contact with the facility receive 6MMD |
| Zimbabwe | 3MMD for clinically stable a | 6MMD | 6MMD for priority groups: PLHIV > 50 years, clients with comorbidities and adolescents |
| Haiti | 3‐6MMD for clinically stable a , d | No policy change, but guidance issued to intensify scale‐up of MMD | |
| South Sudan | 3‐6MMD for clinically stable a | No policy change, but guidance issued to intensify scale‐up of MMD | |
| Tanzania | 3‐6MMD for clinically stable a | No policy change, but guidance issued to intensify scale‐up of MMD | |
| Angola | 3MMD for clinically stable a , c | Unknown/official documentation not located | |
| Cameroon | 3‐6MMD for clinically stable a | Unknown/official documentation not located | |
| Nigeria | 3‐6MMD for clinically stable a , c | Unknown/official documentation not located | |
| Rwanda | 3MMD for clinically stable a , d | Unknown/official documentation not located | |
| Vietnam | 3MMD for clinically stable c | Unknown/official documentation not located | |
Minimum age and/or weight requirements.
Pregnant and/or breastfeeding women not included.
Age requirements not specified.
First‐ or second‐line ART only.
ART, antiretroviral therapy; DTG, dolutegravir; MMD, multi‐month dispensing; PBFW, pregnant/breastfeeding women; PLHIV, people living with HIV; TLD, tenofovir lamivudine dolutegravir; TLE, tenofovir lamivudine efavirenz; VL, viral load; 3MMD, 3‐month multi‐month dispensing; 6MMD, 6‐month multi‐month dispensing.