The pill exchange

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Science  15 Jun 2018:
Vol. 360, Issue 6394, pp. 1174
DOI: 10.1126/science.360.6394.1174

A network of what amount to underground pharmacists shares anti-HIV drugs.

In 2012, when Alexander Chebin was dying from AIDS, he met a Pentecostal bishop who persuaded him to seek care and start taking antiretrovirals (ARVs). Chebin, who had served time in prison for a heroin-related offense and did not believe that HIV causes AIDS, realized “it was time to change not only my mind, but my faith.” Now a pastor himself, Chebin is part of an informal network of activists in seven Russian cities who give other people with HIV hope through what they call a “reserve pharmacy.”

People who can't access ARVs, mainly because government clinics have run out, post their problems on social media sites that Chebin and other activists monitor. Some people use private chats on Facebook, but many others post to a public website called pereboi.ru that is run by Patients in Control, “a movement of people living with HIV and other socially significant diseases.” Chebin and other like-minded activists, or “consultants,” in turn distribute ARVs to people in need in their areas.

At his home, Chebin keeps a large stock of ARVs donated by people who have switched drugs or by relatives of people who have died. He also swaps ARVs through the informal network with activists such as Yulia Vereschagina, who lives in St. Petersburg and keeps her own large stash of medicine in a cabinet under her TV. Vereschagina, a consultant with pereboi.ru, says she filled 600 requests between March and November 2017, sending 140 packages to Chebin and suppliers in other cities.

Vereschagina got involved with the network in March 2017, when she had side effects from her own ARVs and her clinic said it could not take back the pills that she wanted to return. She says people ask for help not only because of drug shortages, but also because the official process of registering for treatment can take months and is sometimes impossible. “Until the situation with the medication improves, I'm often the only source,” she says. “There's always a shortage somewhere.”

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