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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