Expanding public access to chronic medication in South Africa through community-based pick-up points: A decade of scaling the central chronic medicines dispensing and distribution programme
1
National Department of Health, Pretoria, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A1795
ABSTRACT
INTRODUCTION:
The Central Chronic Medicine Dispensing and Distribution (CCMDD) programme in South Africa was designed to reduce facility congestion by offering stable chronic patients convenient, de-linked access to medicines. A decade into implementation, the programme has scaled significantly, evolving from an adherence club support mechanism into a primary vehicle for integrated, decentralised health service delivery.
METHODS:
This analysis draws on Quarter 3 2025/26 performance data across all provinces (excluding the Western Cape). Key operational indicators analyzed included active enrolments, pick-up point utilization trends, and medicine supply intervals. We specifically reviewed the distribution of public versus private pick-up points, the uptake of Tenofovir/Lamivudine/Dolutegravir (TLD) for antiretroviral therapy, the transition to 3-month medicine dispensing, and emerging operational challenges regarding youth enrolment and medicine availability.
RESULTS:
As of Quarter 3, over 3.7 million patients were actively receiving medication through the programme, with 61% utilizing private-sector external pick-up points, demonstrating a successful public-private operational partnership. The transition to TLD has reached 99.7% coverage among eligible patients, and 79% of participants now benefit from 3-month supply intervals, generating significant system efficiencies. Despite these successes, the data reveals critical gaps: adolescent enrolment remains disproportionately low (36,394 patients aged 5–19), and persistent medicine stockouts in specific districts continue to hamper reliability.
CONCLUSIONS:
After a decade of scale-up, the programme has achieved significant system efficiencies, particularly through the use of private-sector networks and multi-month dispensing. However, the low uptake among adolescents suggests that the current model may not yet be youth-friendly. Future operational investments must focus on resolving supply chain instability and adapting the service model to better serve younger populations.
The Central Chronic Medicine Dispensing and Distribution (CCMDD) programme in South Africa was designed to reduce facility congestion by offering stable chronic patients convenient, de-linked access to medicines. A decade into implementation, the programme has scaled significantly, evolving from an adherence club support mechanism into a primary vehicle for integrated, decentralised health service delivery.
METHODS:
This analysis draws on Quarter 3 2025/26 performance data across all provinces (excluding the Western Cape). Key operational indicators analyzed included active enrolments, pick-up point utilization trends, and medicine supply intervals. We specifically reviewed the distribution of public versus private pick-up points, the uptake of Tenofovir/Lamivudine/Dolutegravir (TLD) for antiretroviral therapy, the transition to 3-month medicine dispensing, and emerging operational challenges regarding youth enrolment and medicine availability.
RESULTS:
As of Quarter 3, over 3.7 million patients were actively receiving medication through the programme, with 61% utilizing private-sector external pick-up points, demonstrating a successful public-private operational partnership. The transition to TLD has reached 99.7% coverage among eligible patients, and 79% of participants now benefit from 3-month supply intervals, generating significant system efficiencies. Despite these successes, the data reveals critical gaps: adolescent enrolment remains disproportionately low (36,394 patients aged 5–19), and persistent medicine stockouts in specific districts continue to hamper reliability.
CONCLUSIONS:
After a decade of scale-up, the programme has achieved significant system efficiencies, particularly through the use of private-sector networks and multi-month dispensing. However, the low uptake among adolescents suggests that the current model may not yet be youth-friendly. Future operational investments must focus on resolving supply chain instability and adapting the service model to better serve younger populations.
| eISSN: | 2654-1459 |
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