Debating access to HIV treatment 

The Wits Pharmacy Student Council (WPSC) and the Sefako Makgatho Health Science University (SMU) explored the pros and cons of PIMART in South Africa.

Pharmacists from both Wits University and SMU debated the issue of HIV treatment relating to the Pharmacist-Initiated Management of Antiretroviral Therapy implementation at the Wits Education Campus on Friday, July 28.  

The Wits team argued in favour of the treatment, while SMU argued against it.  

PIMART appeared in the Government Gazette for implementation in August 2021. This type of therapy would allow pharmacists to administer HIV medication without a script or medical consultation from a general practitioner. 

The Independent Practitioner Association (IPA) has taken PIMART to court claiming that pharmacists are not qualified enough to supply ARVs, which formed the foundation of the debate. The IPA represents all primary healthcare practitioners in independent private practice

Former South African Medical Association chairperson, Dr. Angelique said the move would allow for “unfair competition”, as pharmacists would “compete with general practitioners whilst not having the necessary qualifications.”

A pharmacy student from the SMU team, Covenant Ngomana, argued that PIMART is needed to address the “high volume of HIV-related deaths in South Africa” due to lack of treatment. Statistics show that 94.2% of South Africans know their HIV status but only 75% seek treatment.  

Wits pharmacy student, Maria Phalane, disagreed, she said pharmacists mainly work in the private sector with only “27% of South Africans in private healthcare, leaving 73% [of the majority] uncatered for.” 

Dr. Maria Eksteen, a professional in pharmacy education, told Wits Vuvuzela that “PIMART has a valuable place in the South African healthcare context,” and added that pharmacists are the “most accessible healthcare professionals, [changing] the game in terms of accessibility to treatment for employed and uninsured patients.”  

Eksteen adds that PIMART is definitely “part of many solutions to Africa’s high HIV infection rates,” with an estimated 13.2% of South Africans living with HIV in 2022.  

It is unclear at this point whether PIMART will be fully implemented in South Africa, but the debate was meant to help “raise awareness and promote a discussion around PIMART,” said WPSC member, Lethokuhle Ndaba.  

Although the IPA and some practitioners are against PIMART, the debate highlighted how it could help increase the treatment rates of HIV positive patients throughout South Africa. 

FEATURED IMAGE: Students watching and discussing the PIMART Debate at Wits’ Education Campus in Parktown. Photo: Georgia Cartwright

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Pharmacy students show they care 

Wits fourth-year students administered free healthcare assessments to the public on campus. 

Pharmacy students put the adage ‘prevention is better than cure’ to the test on May 18. 2023, when various tests were made available to staff and students at Solomon Mahlangu House at Wits University.  

Fourth-year pharmacy student Caitlynn Pillay checking the blood pressure measurements of her patient, mechanical engineering student, Xolani Radebe. Photo: Georgia Cartwright

The Screening and Testing Programme by Pharmacy Students (STEPPS) puts students in the driving seat for the first time. A battery of tests were on offer, including but not limited to blood pressure, blood glucose, HIV and Body Mass Index (BMI).  

Dr. Ane Orchard who organized the event and observed the students’ said the aim of the program was to show people that pharmacists can also conduct healthcare assessments. Orchard said screening helps in “identifying risk factors” so patients can be proactive with their health.  

Orchard went on to explain how, like working professionals in healthcare, each pharmacy student had to sign a confidentiality agreement which serves to protect patients’ personal information. The pharmacy students also ensure that tests such as HIV tests are kept hidden from public view when they are being conducted and that only the patient receives the results. 

If a patient tests positive for HIV after two confirmed tests, they are referred to the Wits Campus Health & Wellness Centre or the Counselling and Careers Development Unit (CCDU). “A further test is then conducted, and the patient may choose which recommended treatment plan they would like to follow,” said Orchard. 

Master of pharmacy in clinical pharmacy student, Ebenezer Maimele, told Wits Vuvuzela that, “It is nice to put [the] clinical skills we have learnt over the years into practice and to interact with people who need our help.” 

Although some pharmacy students were nervous at first, this changed as the day progressed. Makhosazana Zindela, described the experience as “fulfilling,” as she finally put her training to the test.  

One patient, Xolani Radebe, said: “I trust the students because I understand that the only way to truly learn a skill is to practice it and these students are simply practicing being good pharmacists.” 

 Maimele explained that it is important to get regular checkups as a simple blood pressure test could reveal and prevent a future heart attack while other tests could prevent some serious health conditions later in life. 

There will be further free healthcare assessments as part of the STEPPS programme on July 6 at the Health Science campus, July 20 at the Education Campus, and August 3, 2023, on main campus for those interested.  

FEATURED IMAGE: Pharmacy student Thabiso Mdhlovu receiving a blood pressure measurement from classmate Sydney Mamogobo on May 18 in Solomon Mahlangu House at Wits University. Photo: Georgia Cartwright.

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Drugs for kids: “How to sell a disease”

Luc Hermann gave a seminar on how corporates dodge tax during day two of power reporting. Photo: Ray Mahlaka.

Luc Hermann speaks about the marketing strategies of Big Pharma in selling drugs to children.  Photo: Ray Mahlaka.

French journalist, Luc Hermann has made a career out of deconstructing “spin”.

Hermann, (@LucHermann) talked yesterday about how big pharmaceutical companies sell their drugs” at Power Reporting: The African Investigative Journalism Conference.

Hermann’s 90-minute CNN documentary: How to sell a disease investigates the multinational drug company, Pfizer, and how they managed to get doctors and reporters across the world to help them sell anti-depressant drugs to children.

Suicidal effects

His investigation started by looking into the case of a teenage boy in the US who committed suicide two days after taking the drug, Zoloft. Zoloft, which is an equivalent to the adult anti-depressant popularly known as Prozac, which is predominantly prescribed for the treatment of obsessive compulsive disorder (OCD).

In launching the drug, Pfizer released statistics which showed that up to 200 000 children in France could possibly suffer from undiagnosed OCD. The statistics had the effect of causing alarm among parents and doctors who worried that they may have overlooked the signs of the disorder.

Hermann says, “In the press, Zoloft can be prescribed to kids as early as six years old.”

Playing with statistics 

Pfizer’s statistics showed that one to two per cent of children are affected by OCD. Hermann says the disease makes basic functioning incredibly difficult for the sufferer. Children with OCD have difficulties to focus, have problems with anxiety and have obsessions with routines.

It makes it hard for them to learn and can make life very frustrating. These statistics allowed Pfizer to draw the conclusion that one child in every class in France could be affected by OCD.

The forced insider

The family of the boy who took his life after taking Zoloft took Pfizer to court. Their lawyer made contact with Dr David Healy, whom Hermann calls the “forced insider” in his documentary.

Healy was the key reviewer of data that found that Pfizer had noticed instances of suicidal tendencies by patients who took their anti-depressant drugs.

“If a child is diagnosed with OCD they will be hospitalised and treated under strict circumstances and then, yes, doctors will prescribe Zoloft or Prozac in order for kids to deal with their condition.

These decisions though are beyond the scope of the role of the general practitioner and if a prescription is issued at this point the patient should be carefully monited.

“Doctors will say that you have to monitor the patient for the first seven days of taking the drug, but no-one told the family of the boy this,” says Hermann.

Journalists get taken-in

Hermann’s investigations revealed that Pfizer targeted journalists and major media outlets who they invited to events and press related trips that were “quite appealing”.

The company fed information to reporters about the prevalence of the disease and the benefits of their drugs.

The Prime Time News (PTF1) channel in France aired a programme where they discussed how this disease affected children. “This programme was aired to about eight million people in France,” Hermann says.

None of the 25 journalists ever revealed that they were taken on an all expenses paid trip to Istanbul by Pfizer.

Hermann warns journalists that they should always be aware of how they are influenced and also of possible links between reporters and major companies.

Free-for-all drugs

Hermann ended his talk off by saying that six million children in the United States take these kinds of drugs, mostly Ritalin, for attention deficit disorder (ADD) and then Zoloft and Prozac. “What is most shocking is that some cases the schools have the power to prescribe these drugs, not only doctors.”

“These pharmaceutical companies have no idea how it affects children in the long run.” Hermann stresses that he wishes he did more to confront journalists who published articles endorsing the use of these drugs and who were effectively “spun” by Pfizers public relations team.