Introducing the LPV/r Pellet Toolkit

Despite widespread advances in HIV treatment, survival outcomes for babies and infants lag behind those of adults. Without access to antiretroviral therapy, 50% of babies with HIV die before the age of two, and only 20% survive to the age of five.

Lopinavir/ritonavir (LPV/r) syrup is widely perceived to have a bitter taste, resulting in substantial struggles for parents and caregivers who must administer it to children. LPV/r pellets are a more palatable, easier-to-administer formulation of this medication, which the World Health Organization recommends as the first-line treatment for children 3 months and older who weigh at least 5 kilograms, and who are able to swallow the pellets with liquid or soft foods. With an estimated 150,000 new HIV infections among children under age 10 globally in 2019, thousands of children stand to benefit from this medication

LPV/r pellets are well-received by health care workers and parents and caregivers, in part because of their delivery: the pellets come in capsules that are opened and sprinkled into breast milk or foods like yogurt and porridge, making them easier for children to swallow. Their palatability can lead to higher adherence, resulting in lower viral loads and young children who are staying healthier longer.

As countries adopt and scale-up the LPV/r pellet formulation, assistance is required to incorporate them into the regular supply chain of HIV medications. Clinicians also need skills to prescribe, administer, and monitor children on LPV/r pellets, and to educate parents and caregivers about their administration. 

To meet this need, we are excited to share the LPV/r Pellet Toolkit with our global partners. The toolkit is a set of online resources that provide important information and practical advice on introducing LPV/r pellets at all levels of the health system. They are intended for use by a variety of stakeholders, including the following:

• Ministries of health: These resources inform rollout, planning, and management and include information on programmatic decisions and planning for initial product distribution, as well as interactive tools to help manage the supply chain. 
• Parents and caregivers: Educational tools on the importance of LPV/r pellets and information on how to give them to a baby, including a demonstration video, poster, and written instructions.

The materials are all adapted for use on laptops and mobile phones and are available to download so that people with limited internet connectivity can use them online or off.

We are hopeful that the LPV/r Pellet Toolkit will contribute to measurable advances in childhood survival globally. Please share it widely!