PIMART Update: Court ruling in favour of PIMART appealed
The issuance of Section 22A(15) permits in relation to PIMART and the recording of PIMART supplementary training with Council remain on hold due to the IPAF’s appeal against the High Court’s ruling and the 22% of People Living With HIV and AIDS who are denied access to treatment by the unending litigation against PIMART remain condemned to a life without treatment.
PIMART Update: Court ruling in favour of PIMART appealed
On 14 August 2023, the North Gauteng High Court (Pretoria Division) ruled in favour of the implementation of Pharmacist-Initiated Management of Antiretroviral Therapy (PIMART). The high court confirmed that PIMART is a necessary and competently designed intervention programme to support South Africa’s efforts in providing access to patients diagnosed with HIV and Aids.
However, on 18 September 2023, leave to appeal to the Supreme Court of Appeal was granted to IPA Foundation (IPAF).
The current HIV/Aids situation and the expected contribution of PIMART
South Africa currently has 8,45 million people living with HIV and AIDS (PLWHA). Every year, at least 200 000 people are added to the HIV-positive population. While South Africa has made great strides in the provision of treatment with more than 5 million people on treatment, PIMART increases the country’s ability to reach more of the unreached and untested people. Currently, only 78% of people who know their HIV-positive status have access to treatment. Twenty-two percent (22%) are without any form of treatment, and are unreached by the current manpower. Further delays in the implementation of PIMART exacerbates the situations of these persons and increases the incidences of new infections tremendously.
What the leave to appeal means for PIMART?
The issuance of Section 22A(15) permits in relation to PIMART and the recording of PIMART supplementary training with Council remains on hold due to the IPAF’s appeal against the High Court’s ruling and the 22% of People Living With HIV and AIDS who are denied access to HIV and Aids treatment by the unending litigation against PIMART remain condemned to a life without treatment. These are the people who continue to be unreached and unreachable as the health care human resources and infrastructure available remain overstretched.
Council will continuously update the profession on further developments until the court case is concluded.
What is PIMART?
Pharmacist-Initiated Management of Antiretroviral Therapy (PIMART) is a type of pharmacist-initiated therapy which aims to allow pharmacists to join nurses and other clinicians in the fight against the rising HIV infections in South Africa. In addition, PIMART will help address the lack of adherence to treatment by persons living with HIV (PLWA), and the high number of avoidable HIV-related deaths by allowing these individuals an access to antiretroviral treatment through Section 22A(15) of the Medicines and Related Substances Act, 101 of 1965. Following a carefully designed supplementary training, PIMART allows these trained pharmacists to administer first-line treatment to patients or, in complex cases, refer patients to clinicians and/or specialists for the management of their conditions.
Programmes similar to PIMART have been successfully deployed in several countries the world over and can help South Africa attain its HIV management targets. The programme may also arrest and lower the ballooning HIV budget (which is nearly half the national health budget) by reducing the rate of new infections, increasing life expectancy among PLWA by ensuring adherence to treatment and viral suppression, and increasing the number of persons testing and referring complex cases along the referral pathways.