Successful Public/Private Donation Programs: A Review of the Diflucan Partnership Program in South Africa

Abstract

A review of the partnership between Pfizer Inc. and the South African Ministry of Health to distribute free Diflucan (fluconazole) in the Diflucan Partnership Program (DPP) demonstrates that product donations may be a useful response to AIDS if they are coupled with efforts to build means of drug distribution and enhance professional healthcare capacity to treat patients. Equally important is the creation of a new set of productive working relationships between stakeholders who came to the project with different backgrounds and perspectives, as well as a frankly disparate set of objectives. A decision tree illustrates how these relationships were built into the DPP. This review concludes with a few lessons learned in providing medicines not only to South Africa, but also to the 77 other African countries now participating in the DPP. As the search for new treatments and vaccines continues, increasing access to existing medicines through targeted donations--including training and infrastructure support--is the most practical way for the health community to address the problem of ill health among the poor. In addition to a detailed analysis of the DPP, there is also a discussion of the benefits of a donation program that addresses the AIDS crises on a global scale. This review may serve as a blueprint for establishing programs that are successful in fighting AIDS and improving the lives of millions of people.

In vitro activity of inexpensive topical alternatives against Candida spp. isolated from the oral cavity of HIV-infected patients

“…Tel. : +1 216 844 8580; fax: +1 216 844 1076. countries [4]. Although this is encouraging news, the introduction of FLZ for the treatment of OC in African patients brings its own challenges, namely the possibility of resistance development as well as the selection of non-albicans Candida spp.…”

Clinical and Therapeutic Aspects of Cryptococcal Meningitis in West Africa

“…Fluconazole causes fewer, less severe side effects, including skin rashes and liver enzyme abnormalities. Even with the use of fluconazole alone, problems with access to expert medical care and the management of complications of AIDS still exist in this region (Mwaba, 2001;Wertheimer, 2004). In most countries of West Africa fluconazole monotherapy was used.…”

Trends in Antifungal Drug Susceptibility of Cryptococcus neoformans Isolates Obtained through Population-Based Surveillance in South Africa in 2002-2003 and 2007-2008

“…Although the fungicidal combination of amphotericin B and flucytosine is recommended for induction treatment (33), flucytosine is not available in countries with a high incidence of cryptococcosis (8), and the use of amphotericin B deoxycholate is limited by toxicity and the need for clinical and laboratory monitoring (8). Since 2000, fluconazole has been widely available in South Africa through the Diflucan Partnership Program for treatment of cryptococcal meningitis and esophageal candidiasis (41). Due to ease of administration and low toxicity, in sub-Saharan Africa fluconazole is often first-line treatment for cryptococcal meningitis, despite its fungistatic activity.…”