Some pharmacists can now apply for permits to provide HIV prevention pills without a doctor’s script
Specially trained pharmacists will soon be allowed to dispense HIV treatment and prevention medicines without a doctor’s script. (Photo: Shutterstock)Ten months after an enabling court judgment, some pharmacists in South Africa can finally start applying for permits that allows them to dispense HIV prevention pills without a script from a doctor.
Specially trained pharmacists can now begin applying for permits to dispense antiretroviral medicines for HIV prevention without a doctor’s prescription. The long-awaited permitting process was announced to pharmacists in a South African Pharmacy Council (SAPC) e-Note on 13 August.
The announcement came 10 months after the Supreme Court of Appeal cleared the way for the implementation of pharmacist-initiated management of antiretroviral treatment (PIMART) in South Africa.
What is PIMART?
PIMART is a form of task-shifting that allows pharmacists to provide some limited HIV services that are currently only provided by doctors and nurses.
It is intended that, under the PIMART programme, pharmacists that have completed a dedicated training programme and have received a special permit from the Director-General of Health will be authorised to provide first-line antiretroviral treatment to people with uncomplicated HIV without a doctor’s script.
They will also be allowed to dispense HIV prevention medicines without a doctor’s script – this includes both pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP). PrEP is taken prior to sex to prevent potential infection while PEP is taken shortly after a possible HIV exposure to prevent infection.
PIMART’s long road to implementation
The SAPC first proposed PIMART to the health department in 2018. The proposal was in response to a request from the department for pharmacists to take on a larger role in the country’s HIV response.
In 2021, Spotlight reported the imminent launch of PIMART services in South Africa’s pharmacies, but then a court challenge against PIMART by a group of general practitioners blocked the programme’s implementation.
Four years later, in October 2025, a ruling by the Supreme Court of Appeal finally cleared the way for SAPC to launch PIMART. Following the court ruling, Vincent Tlala, CEO and Registrar of the SAPC, told media that the SAPC would issue a memo in November 2025 inviting pharmacists to apply for PIMART permits. But this would in fact only materialise in August 2026.
PREPARING FOR PIMART | With enabling permits for specially trained pharmacists to dispense antiretrovirals without a doctor’s script now seemingly on the horizon, Angela Tembo and Dr Deanne Johnston ask if enough planning has been done for this initiative.
www.spotlightnsp.co.za/2026/07/08/t…— Spotlight (@spotlightnsp.bsky.social) July 8, 2026 at 12:39 PM
The SAPC’s 13 August memo to pharmacists, said that certain pharmacists can now begin to apply for temporary PIMART permits to provide PEP, PrEP, and HIV testing services – but not yet HIV treatment services. The temporary permits will be valid for 24 months.
Also, only pharmacists that completed the South African HIV Clinicians Society’s (SAHCS) previous PIMART training course can apply for the limited-scope, temporary PIMART permits.
Pharmacists that have not completed this course will have to wait for a new training course to be accredited and launched before they can apply for permits to provide PIMART services.
How long will it take to get a permit?
Tlala told Spotlight that the granting of the limited-scope, temporary PIMART permits by the Director-General and their recording by the SAPC may take a few months.
“The Department of Health processes applications for permits within 90 days (maximum),” said Tlala, adding that “[t]he PIMART permit recording process with the South African Pharmacy Council then takes between 72 working hours and 14 days, depending on the completeness of the application.”
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The permits will only be granted to pharmacists who have already completed the Southern African HIV Clinicians Society’s (SAHCS) continuous professional development (CPD) PIMART course. Pharmacists that did not complete this course will need to wait for an updated PIMART course to become available before they can undertake the required training to be permitted.
Fiona Story, CEO of SAHCS, told Spotlight that nearly 800 pharmacists have completed the course.
Taken together, all of this suggests that toward the end of the year, a few hundred pharmacists in South Africa might be dispensing HIV prevention medicines without doctors’ scripts.
When will the updated training course be available?
Currently, there is no PIMART training course available for pharmacists, as the previous PIMART training course provided by SAHCS is on pause, while the updated course awaits accreditation. Based on dates provided by SAHCS, the updated course might only be available early next year.
However, once the updated course is available, it is anticipated that pharmacists that complete it will be able to apply for full-scope PIMART permits that allow them to dispense first-line antiretrovirals to people with uncomplicated HIV without a doctor’s script, in addition to PEP and PrEP.
“The CPD-accredited PIMART course is no longer available as it was reviewed and updated in line with the requirements for accreditation as a supplementary training course,” Story told Spotlight.
She said that the SAHCS is seeking accreditation of its updated PIMART training course from the SAPC. “SAHCS anticipates the PIMART supplementary training course accreditation process will conclude before the end of 2026,” said Story. She added: “SAHCS has prepared to launch the PIMART supplementary training course as soon as accreditation has been received.”
When will pharmacists be able to dispense HIV treatment without a doctor’s script?
The timeline for when pharmacists will be able to provide the full scope of services intended under PIMART, including HIV treatment for uncomplicated cases, remains unclear. Before this can happen, the SAPC must accredit the SAHCS’ updated supplementary training course and the SAHCS must launch this course.
After this, the permits granted to pharmacists by the Director-General will need to be expanded to include the provision of first-line antiretroviral therapy for treatment of uncomplicated HIV.
In the meantime, the around 800 pharmacists who completed the SAHCS’s previous PIMART training course can now start applying for permits to provide PrEP, PEP, and HIV testing services.
Help us track the rollout of PIMART services in pharmacies
Are you an independent pharmacist planning to apply for a limited-scope PIMART permit to provide antiretroviral medicines for HIV prevention in your pharmacy?
If so, we would be keen to learn about your experience of implementing PIMART services as the rollout begins in the coming months.
If you are willing to share your experiences of applying for a permit and implementing PIMART services in your pharmacy, please contact Spotlight at PIMART@spotlightnsp.co.za.
