On-Site Packaging of ARV Dosed for the Prevention of Transmission of HIV from Mother to Child



  • Duke University,
  • Duke Global Health Institute


  • Elizabeth Glaser Pediatric Aids Foundation

End Date:

  • Ongoing

On-Site Packaging of ARV Dosed for the Prevention of Transmission of HIV from Mother to Child

There may be as many as 2.1 million children worldwide infected with HIV; and the number continues to grow. The United Nations estimates that more than 1,900 children are being infected every day. Over the past 15 years, several options have become available for treating children and preventing the transmission of HIV from mother to child, including zidovudine (AZT), didanosine (ddl) and nevirapine (NVP). A single dose of nevirapine, for example, delivered within 24 hours of birth has been shown to dramatically reduce the chances that the child will contract HIV from the mother (Guay, 1999). To aid in the treatment and prevention of HIV in resource limited settings, an improved method of packaging single use doses of nevirapine has been developed that allows a foilized pouch to be heat sealed by a pharmacist on-site, using only boiling water. There is no syringe. After birth, the mother rips open the foil pouch (like tearing open a take-out ketchup container from McDonalds) and squeezes the drug into the infant's mouth. Preliminary data shows that this packaging dramatically extends the life of the drug. This study has two objectives: 1. gather data on the chemical stability of nevirapine packaged in heat sealed (boiling water), foilized pouches and 2. design and test the acceptability for mothers of directly squeezing liquid (water in this case) from a foilized pouch into their newborn's mouth. Ideally, single doses could be distributed to health huts and stored for months, allowing nevirapine to be used to prevent mother-to-child transmission of HIV far into the rural health care delivery system.

Last updated on January 10, 2018