The Supreme Court of Appeal has dismissed an appeal by a group of private doctors seeking to overturn a decision allowing trained pharmacists to prescribe and manage HIV medication.

In a judgment delivered electronically on 9 October 2025, the court found that the South African Pharmacy Council (SAPC) acted lawfully and rationally when it approved the Pharmacist-Initiated Management of Antiretroviral Therapy (PIMART) programme.

The appeal was brought by the Independent Practitioners Association Foundation (IPA), a non-profit representing private medical doctors, which argued that the SAPC’s decision to expand pharmacists’ scope of practice to include initiating HIV treatment was procedurally unfair and irrational.

However, the court rejected these arguments, ruling that the SAPC had followed due process when it published the proposal for public comment in 2021.

Justice Makgoka, writing for a unanimous bench, said the consultation period was sufficient and that the decision complied with the Pharmacy Act and Promotion of Administrative Justice Act.

The court also found that PIMART, which enables accredited pharmacists to prescribe pre-exposure prophylaxis (PrEP), post-exposure prophylaxis (PEP) and first-line HIV treatment, is a rational and necessary intervention to improve access to healthcare.

“PIMART is an essential intervention in the fight against HIV/AIDS,” Justice Makgoka said, noting that it helps fulfil the state’s constitutional obligation to expand access to healthcare under section 27(2) of the Constitution.

The appeal was dismissed with costs, effectively clearing the way for more pharmacists to provide HIV prevention and treatment services across South Africa.

Reacting to the ruling, the Independent Community Pharmacy Association (ICPA) welcomed the outcome, describing it as a victory not just for pharmacists, but for healthcare in South Africa.

“This judgment recognises that hundreds of thousands of people remain undiagnosed and untreated for HIV. It allows for a collaborative effort between medical practitioners, nurses and now pharmacists in the fight against HIV/AIDS.”

The ICPA congratulated the SAPC for “having the fortitude to defend the initiative for the betterment of the South African public” and urged all healthcare professionals to work together to expand access to treatment.

“Patient care will surely be improved as the healthcare professions unite in the fight against HIV/AIDS.”