SAPC: Pharmacists Can Apply for HIV Prevention PIMART Permits in South Africa

• South African pharmacists can now apply for temporary permits to dispense HIV prevention medications like PrEP and PEP without a doctor's prescription.
• The South African Pharmacy Council announced the permitting process on August 13, ten months after a Supreme Court of Appeal ruling cleared the way for PIMART implementation.
• These temporary permits, valid for 24 months, also allow for HIV testing services but do not yet include HIV treatment.
• Only pharmacists who have completed the South African HIV Clinicians Society's previous PIMART training course are currently eligible to apply.
• The Department of Health aims to process permit applications within 90 days, with the SAPC recording process taking up to 14 days.

This development introduces a new regulatory framework for pharmacists to dispense HIV prevention medication in South Africa, requiring legal and compliance teams to advise healthcare clients on navigating the permit application process, verifying training requirements, and understanding the scope of services under the temporary PIMART permits.

South African pharmacists are now able to apply for permits that authorize them to dispense critical HIV prevention medications, including pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), without requiring a doctor's prescription. This significant development was communicated to pharmacists through an e-Note issued by the South African Pharmacy Council (SAPC) on August 13.

This announcement arrives ten months after a pivotal Supreme Court of Appeal ruling effectively removed legal obstacles to the implementation of pharmacist-initiated management of antiretroviral treatment (PIMART) across the country. The current permits are temporary, valid for a period of 24 months, and specifically allow for the provision of PEP, PrEP, and HIV testing services. Notably, these initial permits do not yet extend to the dispensing of HIV treatment services.

The concept of PIMART, which represents a form of task-shifting within the healthcare sector, was initially proposed by the SAPC to the Department of Health in 2018. This proposal was a direct response to the department's request for pharmacists to assume a more substantial role in the nation's ongoing efforts to combat HIV. While reports in 2021 indicated an imminent launch of PIMART services, the program's rollout was subsequently halted by a legal challenge initiated by a group of general practitioners.

It took another four years for the legal landscape to clear, with the Supreme Court of Appeal delivering a ruling in October 2025 that finally paved the way for the SAPC to proceed with PIMART. Following this judicial decision, Vincent Tlala, CEO and Registrar of the SAPC, had previously informed media that a memo inviting pharmacists to apply for PIMART permits would be issued in November 2025. However, this invitation ultimately materialized in August 2026, marking the official commencement of the application process.

PIMART is designed to enable pharmacists to deliver certain limited HIV services that have traditionally been the exclusive domain of doctors and nurses. The overarching goal of the PIMART program is to authorize specially trained pharmacists, holding a specific permit from the Director-General of Health, to provide first-line antiretroviral treatment to individuals with uncomplicated HIV, all without the need for a doctor's prescription. Furthermore, these authorized pharmacists will be permitted to dispense HIV prevention medications, such as PrEP and PEP, independently. PrEP is a preventative measure taken before potential exposure to HIV to avert infection, while PEP is administered shortly after a possible HIV exposure to prevent the virus from taking hold. This development introduces a new regulatory framework for pharmacists to dispense HIV prevention medication in South Africa, requiring legal and compliance teams to advise healthcare clients on navigating the permit application process, verifying training requirements, and understanding the scope of services under the temporary PIMART permits.

Eligibility for these limited-scope, temporary PIMART permits is currently restricted to pharmacists who have already completed the specific PIMART training course offered by the South African HIV Clinicians Society (SAHCS). Pharmacists who have not undertaken this particular course will need to await the accreditation and launch of a new training program before they can apply to provide PIMART services.

The process for obtaining these permits involves multiple stages. According to Vincent Tlala, the Director-General's office typically processes permit applications within a maximum of 90 days. Following approval by the Department of Health, the subsequent recording process with the South African Pharmacy Council can take between 72 working hours and 14 days, contingent on the completeness and accuracy of the submitted application. It is imperative that applicants have successfully completed the SAHCS continuous professional development (CPD) PIMART course to be considered for a permit.

This development introduces a new regulatory framework for pharmacists to dispense HIV prevention medication in South Africa, requiring legal and compliance teams to advise healthcare clients on navigating the permit application process, verifying training requirements, and understanding the scope of services under the temporary PIMART permits. Lawyers should also assess potential shifts in liability and competition within the healthcare sector due to this task-shifting.

Source: Original reporting via Spotlight