In a groundbreaking decision that promises to reshape South Africa’s fight against HIV and AIDS, the Pretoria High Court has given the green light to the Pharmacist-Initiated Management of Antiretroviral Therapy (PIMART).
This move, hailed by the South African Pharmacy Council (SAPC) – the nation's pharmacy profession regulator – is set to significantly expand access to life-saving treatments.
South Africa has the largest number of people living with HIV worldwide.
The SAPC said the High Court's affirmation, "confirmed our long-held view that PIMART is a competently designed and necessary intervention to bolster South Africa's fight against HIV and AIDS."
This after an association representing a small number of medical practitioners sought to stop the implementation of PIMART.
The council said the introduction of PIMART is expected to alleviate the strain on an already overburdened healthcare system.
It offers a more immediate route to improved quality of life and longevity for those diagnosed with HIV and AIDS.
"The programme ensures that patients diagnosed can now be initiated into treatment more swiftly within the multidisciplinary health care team, which now proudly counts pharmacists among its ranks," the SAPC said in a statement..
This initiative aligns seamlessly with the nation's ambitious goals and the UNAIDS 95-95-95 strategy.
The strategy aims for 95% of Persons Living with HIV and Aids (PLWA) to be aware of their status, 95% of these individuals to be on treatment, and 95% of those on treatment to achieve viral suppression.
With PIMART in action, these targets seem more achievable than ever, the association believes.
Pharmacy giant, Dis-Chem welcomed the court ruling that, in addition to HIV medication, allows pharmacists to prescribe medicine to tuberculosis patients.
“We applaud any move which will expand access to HIV services. This decision ties into our healthcare ambitions and focus to provide integrated primary healthcare to a greater number of consumers, aimed at increasing access, reducing cost, and delivering better health outcomes for more South Africans. HIV and TB place significant burdens on the broader healthcare system so moves to improve access and availability of first line antiretrovirals and TB-preventative medicine is critical to improving the health outcomes of people living with HIV,” Tanya Ponter, executive manager at Dis-Chem said.
“Primary healthcare is gaining widespread recognition as being the “front door” of the healthcare system, and pharmacies are ideally positioned as a fundamental entry point to first line treatment protocols and the wider healthcare ecosystem,” she says.
Ponter says Dis-Chem already has more than 400-PIMART trained pharmacists and nursing practitioners who will fully abide by the expanded scope of practice and competency standards published by the SAPC, and applications for the necessary Section 22 (15A) permits will now be made to the Department of Health so that the service can be offered to customers.
This means that from today, , pharmacists will stand shoulder to shoulder with other primary health care practitioners, playing a pivotal role in the provision of first-line antiretroviral treatment, as well as crucial HIV testing and prevention services.
The essence of PIMART is collaboration. It seeks to foster a cohesive approach with other healthcare professionals, including nurses and doctors, to provide HIV care that aligns with national treatment guidelines.
This is all with the overarching goal of enhancing the quality of life for PLWA and curbing the escalating HIV infection rate.
This initiative also resonates with President Cyril Ramaphosa's 2018 pledge to bring two million more HIV-positive individuals under treatment in the foreseeable future.
Understanding PIMART
At its core, PIMART is a pharmacist-led initiative that empowers pharmacists to join the frontline in combating the surge of HIV infections in South Africa.
It addresses the pressing issue of treatment adherence among PLWA and aims to reduce the alarming number of preventable HIV-related fatalities. With the backing of Section 22A(15) of the Medicines and Related Substances Act, 101 of 1965, trained pharmacists can now administer primary treatment or, in intricate cases, direct patients to specialists for advanced care.
Beyond the immediate health benefits, the programme could also provide some relief to the nation's stretched health budget, which dedicates nearly half its funds to HIV. By curbing new infections, ensuring treatment adherence, and streamlining the referral process, medical observers say that PIMART could be the game-changer in treating South Africa’s sick.
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