A system where pharmacists are allowed to initiate and administer anti-retroviral therapy – Schedule 4 medication – to patients over the counter oversimplifies comprehensive HIV management and ignores the complexities that go with managing a patient infected with HIV.  

Stressing this point in a strongly worded statement issued today, the Independent Practitioner Association Foundation (IPAF)*, representing more than 5000 family practitioners, has given notice that it will be objecting to the proposed amendments by the South African Pharmacy Council to the Pharmacy Act, 53 of 1974, namely:  

i. Board Notice 17 of 2021 – Pharmacists who provide Pharmacist-Initiated Management of  Antiretroviral Therapy (PIMART) services in South Africa (Board Notice 17); and  

ii. Board Notice 71 of 2021 – Rules Relating to Good Pharmacy Practice (Board Notice 71) 

The statement continues:

“IPAF appreciates the initiative to improve patients’ access to and response time between HIV treatment and time of diagnosis, however the dictates of patient care must prevail and IPAF cannot support a system that can compromise patient care and safety.

“A comprehensive patient history, detailed physical examination, accurate diagnosis, appropriate investigations (pathology and radiology) and correct treatment of patients infected with HIV, requires qualified clinical expertise, to ensure that the patient is appropriately and safely managed, as opposed to dishing out ARV medication on a positive HIV test. 

“The emphasis is on treating the patient holistically and not just the HIV disease. If patients are not optimally managed according to best practice with appropriate clinical experience, then the safety, comorbidity and death rates will inevitably increase. 

“We strongly disagree that pharmacists are better placed to provide therapeutic guidance to women of all ages on matters of contraception, fertility, pregnancy, menopause, abortion services and sexual and gender-based violence.  

“There are several factors associated with the above proposed amendments that the IPAF finds deeply concerning for the safety and well-being of patients and in particular the quality of healthcare that patients will receive under these new proposed amendments to the Pharmacy Act.  

“General practitioners,” IPAF concludes, “have a duty of care to the public to ensure patient safety, best outcomes and that the quality of care is not compromised. It is our opinion that these changes seek to drastically reduce the standards of care already achieved rather than improve them.”

*IPAF is a national network of family practitioners comprising members of SPNet, ASAIPA, NHC (National Health Care) and SAMCC (KZNDHC, GMCC and CPC/Qualicare).

SOURCE: Dr Unben Pillay, CEO, IPAF