South Africa: Some Pharmacists Can Now Apply for Permits to Provide HIV Prevention Pills Without a Doctor's Script

What the report says

South Africa’s pharmacy regulator has opened the door for a limited group of pharmacists to apply for permits to provide HIV prevention medicines without a doctor’s prescription, according to AllAfrica’s report based on Spotlight. The South African Pharmacy Council notified pharmacists on 13 August that applications could begin for temporary pharmacist-initiated management of antiretroviral treatment, known as PIMART.

The initial permits are narrowly scoped. They are limited to pharmacists who have already completed the South African HIV Clinicians Society’s earlier PIMART training and will allow them to offer HIV testing, pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP). The permits do not yet cover full HIV treatment for uncomplicated cases. The permits are expected to last 24 months, and the regulator said the approval and recording process could take weeks to months.

The development follows a Supreme Court of Appeal ruling in October 2025 that removed a legal obstacle to PIMART implementation. The programme had been proposed years earlier as a task-shifting measure to expand access to HIV services in pharmacies. Spotlight reported that around 800 pharmacists completed the earlier training, meaning only a subset can apply now while others wait for an updated accredited course.

The broader significance is that South Africa is beginning a phased rollout of pharmacy-based HIV prevention services. However, the report says the timing for full-scope PIMART, including treatment prescribing, remains uncertain until new training is accredited and expanded permits are issued.