SCA rules against bid to halt pharmacist-led therapy
The SCA supported the Pimad initiative to enhance HIV treatment access to patients when it turned down an appeal by a group of doctors who had objected to this as they felt this was stepping on their domain.
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IN a major victory towards increased access to HIV and Aids treatment and prevention medicines, the Supreme Court of Appeal (SCA) has turned down an application by an association representing a small group of doctors seeking to stop the implementation of Pharmacist-Initiated Management of Antiretroviral Therapy (Pimart).
The regulator of the pharmacy profession, the South African Pharmacy Council (SACP), through Pimart, aimed to improve access to healthcare for HIV first-line treatment, given the inadequacies of previous initiatives.
However the Independent Practitioners Association Foundation (IPA), in 2023 turned to the Gauteng High Court, Pretoria, to stop the implementation of Pimart.
The court ruled against them in finding that Pimart was a necessary and competently designed intervention programme to support South Africa’s efforts in providing access to patients diagnosed with HIV and Aids.
It recognised that Pimart increases access to much-needed HIV prevention and treatment care, with an immediate benefit of improved quality of life and increased life expectancy for more persons living with HIV and Aids.
Unhappy with this finding, the IPA Foundation turned to the SCA to appeal it. The SACP maintained that Pimart improves efficiencies in the congested health-care system. Diagnosed patients have the opportunity to be initiated sooner within the multidisciplinary health-care team, which includes pharmacists. Pimart would help reach a large number of underserved, undertested and hard-to-reach populations, who are currently without access to HIV prevention and treatment services, the pharmacy authority said.
The IPA Foundation, however, objected to this initiative and argued that it encroached on the domain of medical practitioners and was not in tune with legislation. It also argued that it should have been consulted before this initiative was adopted.
Judge Tati Makgoka, who wrote the SCA judgment, however said contrary to the IPA’s contentions, Pimart was indeed an essential intervention in the fight against HIV/Aids.
“Its introduction constitutes a rational legislative and practical measure within the competence of the SAPC as an organ of the State in enhancing access to healthcare for HIV treatment, in fulfilment of the State’s obligation under the Constitution,” he said.
The Pimart initiative allows accredited pharmacists to administer first-line therapy for the treatment and management of HIV/Aids. Its implementation required amendments to the Pharmacy Act to expand the scope of practice for specifically qualified pharmacists providing these services. Such pharmacists would be able to, among others, conduct consultations with HIV patients at a pharmacy or at an approved healthcare setting.
Cape Times