Rules for prescribing and dispensing of ARVs

Clinical description

ARVs for treatment of HIV (ART)

• Only MOH-certified clinical ART providers are authorized to prescribe ART: Medical Doctors;

Clinical officers; Clinical technicians; Medical Assistants; Registered Nurses; Nurse/Midwife Technicians.

• Only health workers and qualified pharmacy personnel are allowed to dispense ARVs.
• ARVs may be dispensed at MOH-certified static ART clinics and in outreach locations. Outreach

clinics must be staffed by certified ART providers. ARVs must not be distributed outside of these settings.

• Only the patient or his individual registered guardian/treatment supporter are allowed to collect

ARVs.

Prescribing and dispensing ARVs 73 ARVs for PEP

• PEP needs to be started as soon as possible after high-risk exposure. Such events are often

managed under challenging circumstances (e.g., rape, accidents).

• Non-health professionals (e.g., police officers) are allowed to dispense the initial dose of PEP

without prior confirmation of HIV negative status under the following circumstances:

o Received PEP training by a MOH certified ART provider.

o Under regular supervision by ART clinic staff o District pharmacy in charge is responsible for supplying and accounting for ARVs given to e.g., Victim Support Units and must provide active support with ARV stock management.

Emergency dispensing to patients from another PMTCT/ART site

• In an emergency, patients are allowed to collect one month of ARVs from any ART clinic in Malawi

under the following conditions:

o The patient must show an ART identity card or the health passport with ARV dispensing information.

o If in doubt about a patient’s authenticity, confirm by calling the site where the patient is registered.

o Document emergency ARV dispensing in the patient’s health passport.

o ARV dispensed to patients registered at another site must be recorded in an improvised Emergency ARV Dispensing Register. Document date, original ARV registration number, original facility name, patient name and contact details, ARV name and quantity dispensed, reason for emergency dispensation and staff name.

o Instruct patient to return to their ART clinic of registration as soon as possible to ensure the patient is not recorded as lost to follow-up.