South Africans Await Go Ahead to Get ARVs Without Doctor's Script

In August 2021, the South African Pharmacy Council (SAPC) published legislation in the Government Gazette to enable pharmacists to prescribe and dispense antiretroviral medicines (ART) for the treatment and prevention of HIV. The initiative, known as Pharmacist-Initiated Management of ART, or PIMART, aims to address the low rates of uptake of ART prophylactic treatment in South Africa and close the gap between the numbers of people diagnosed with HIV and those initiated onto treatment, reports Catherine Tomlinson for Spotlight.

Yet, almost two years after the legislation was published, pharmacists remain unable to initiate ART in South Africa. This is because a legal challenge has been brought against the PIMART legislation and its introduction by the Independent Practitioners Association (IPA) Foundation.

PIMART aims to expand uptake of PrEP by allowing pharmacists to prescribe and dispense PrEP, which is taken as a daily tablet, without requiring that people first attend and pay for a doctor's visit and script or first have to visit a public sector clinic. PrEP is available free of charge in designated public sector healthcare facilities.

PrEP, which can be used on an ongoing basis for long-term protection or over an anticipated period of risky sexual behaviour, is highly effective in preventing HIV. Yet, use of PrEP in South Africa remains extremely low despite the ongoing high rates of new HIV infections in the country.