Johannesburg – The South African Pharmacy Council (SAPC), which regulates the pharmacy profession in South Africa, has voiced its support for the Supreme Court of Appeal’s ruling on the legality, rationality, and necessity of the Pharmacist-Initiated Management of Antiretroviral Therapy (PIMART).
On Thursday, 9 October 2025, the Supreme Court dismissed an appeal from the IPA Foundation that sought to reverse a 2023 decision by the North Gauteng High Court, which declined their request to block the implementation of PIMART.
“This ruling reinforces our long-held belief that PIMART is an essential and well-structured intervention program critical to South Africa’s fight against HIV and AIDS,” the SAPC stated in a release shared with The Bulrushes on Monday, 13 October 2025.
South Africa has the highest number of people living with HIV worldwide and operates the largest HIV treatment program.
The SAPC explained that PIMART, offered solely by specially trained pharmacists, improves access to vital HIV prevention and treatment services.
The implementation of PIMART brings immediate advantages, such as enhanced quality of life and increased life expectancy for those living with HIV and AIDS.
“Additionally, it will boost efficiencies within the healthcare system, allowing HIV-positive individuals, whose conditions might have gone undetected until hospitalization for complications, to identify their status early and manage their viral loads through treatment from a multidisciplinary healthcare team, now including pharmacists,” the statement elaborated.
PIMART stands as a suitable intervention to strengthen ongoing HIV and AIDS treatment and prevention efforts.
The initiative aims to cater to a diverse range of underserved, under-tested, and hard-to-reach populations currently missing out on HIV prevention and treatment services.
“The national goal to ensure that 95% of persons living with HIV and AIDS (PLWA) know their status, 95% are receiving treatment, and 95% of those on treatment achieve viral suppression is more achievable with the rollout of PIMART,” according to SAPC.
Pharmacists trained in PIMART will administer HIV medications—including Post-Exposure Prophylaxis (PEP), Pre-Exposure Prophylaxis (PrEP), and first-line antiretrovirals (ARVs)—filling essential care gaps and supporting the country’s National Strategic Plan (NSP) 2023–2028 for HIV, Tuberculosis (TB), and Sexually Transmitted Infections (STIs).
In collaboration with stakeholders and the Department of Health, the South African Pharmacy Council will swiftly integrate PIMART-trained pharmacists into primary healthcare roles related to HIV and AIDS.
This includes providing first-line antiretroviral treatments and HIV testing and prevention services.
“While we are profoundly disappointed that PIMART has faced litigation, hindering the nation’s ability to treat untested, untreated, and hard-to-reach populations, we remain optimistic that PIMART’s implementation will improve access for South Africans who have struggled to receive life-saving treatment and prevention services for various reasons,” the SAPC remarked.
“Despite substantial progress—with over 5.9 million individuals on antiretroviral therapy—many still require HIV treatment.”
The latest Department of Health Annual Report indicates that at least 1.1 million individuals aware of their status are currently untreated.
Over the last five years since PIMART’s proposal, nearly one million new HIV infections have happened, as estimated by the Thembisa Model Version 4.8.
Furthermore, the Mid-year Population Estimates from Statistics South Africa suggest that approximately 395,000 HIV-related deaths have occurred between 2021, when PIMART first encountered legal challenges, and the present year.
“We believe that pharmacist participation in the fight against HIV/AIDS through PIMART could have lessened the disease’s negative impact on our country over the past five years,” stated the SAPC.
The PIMART program is aimed at promoting collaboration with other healthcare professionals (including nurses and doctors) in providing HIV care, focusing on improving access to prevention and treatment.
The program aligns with national treatment guidelines, aiming to elevate both life expectancy and quality of life for individuals living with HIV and AIDS while addressing escalating infection rates.
The SAPC highlighted that implementing PIMART would hasten the commitment made by President Cyril Ramaphosa during the 2025 State of the Nation Address to reach the 1.1 million untreated individuals living with HIV/AIDS by the end of the current financial year.
