Day: August 26, 2026

Categories : Healthcare Politics and Regulations HIVTags :

Some Pharmacists Can Now Apply for Permits to Provide HIV Prevention Pills Without a Doctor’s Script

On By ModernMedia
Specially trained pharmacists will be allowed to dispense HIV treatment and prevention medicines without a doctor’s script. (Photo: Unsplash)

By Catherine Tomlinson for Spotlight

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.

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.”

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.

This article was first published by Spotlight – health journalism in the public interest. Sign up to the Spotlight newsletter.

Categories : Obstetrics & GynaecologyTags :

The Silent Epidemic in Maternal Health: Why More Pregnant Women Need Hepatitis B Screening

On By ModernMedia
Photo by ManuelTheLensman on Unsplash
  • Hepatitis B remains one of the world’s most underdiagnosed infections.[1]
  • Untreated hepatitis B can remain silent for years while increasing the risk of severe liver disease and preventable infant infection.[1,2]
  • Integrated point-of-care testing during antenatal care visits presents an important opportunity to identify undiagnosed infections and support measures aimed at reducing transmission to newborns.[2,3] 

A pregnant woman attending her first antenatal care (ANC) appointment will often be screened for conditions that could affect her health and the health of her unborn child, including HIV and syphilis, but not always for hepatitis B virus (HBV) infection. This is not because hepatitis B is rare; in fact, quite the opposite. Millions of people worldwide are living with chronic hepatitis B infection, yet many remain unaware of their infection because the disease can progress silently for years without symptoms.[1] As a result, infection is often diagnosed only after serious liver complications develop.[1]

Late diagnosis increases healthcare costs, may limit treatment options and contributes to preventable illness and death.[1] For pregnant women, delayed diagnosis creates an additional risk of vertically transmitting the virus to their babies during childbirth.[2] That missed opportunity is why hepatitis B needs to be seen not only as a liver disease, but as a maternal and child health priority. For healthcare companies such as Abbott, there is an opportunity to help health systems make every ANC touchpoint work harder by bringing reliable, rapid and integrated testing closer to the point of care.

The central question is no longer whether hepatitis B can be detected, prevented or managed. It can. The question is whether health systems are using routine moments of care, especially pregnancy, to find the infection early enough to enable interventions that can improve outcomes for mothers, infants and families.

  • Hepatitis B is often silent, but its consequences are not.[1]
  • ANC offers a critical window to prevent mother-to-child transmission through timely immunoprophylaxis.[2,3]
  • Integrated testing can help expand access while reducing practical barriers for patients and frontline healthcare workers.[3]
  • Africa has the tools to change the trajectory; now systems must scale them.[1,3]

The cost of not knowing

Hepatitis B remains one of the world’s most significant infectious diseases despite being preventable and treatable. According to the World Health Organization’s (WHO) Global Hepatitis Report 2026, an estimated 240 million people were living with chronic hepatitis B in 2024, and the WHO African Region accounted for 68% of new hepatitis B virus infections globally.[1]

Behind these numbers are people who may be asymptomatic for years while the virus quietly damages the liver. When hepatitis B is not detected, the first sign of illness may be cirrhosis, liver cancer or liver failure.[1] For families, delayed diagnosis may contribute to repeated clinic visits, rising treatment costs, lost income and the emotional burden of managing a condition that could have been identified much earlier.

“Hepatitis B challenges health systems because it is often invisible until the consequences are severe,” says Dr Evans Mathebula, Senior Medical Affairs Manager at Abbott’s rapid diagnostics business in Africa. “If we wait for symptoms, we have waited too long. The priority should be to make hepatitis B screening routine, accessible and connected to care, particularly at moments when people are already engaging with the health system.”

This is especially important in maternal care. Pregnancy represents one of the most important opportunities to identify previously undiagnosed hepatitis B infection. For many women, ANC is among the few periods of regular engagement with the healthcare system.[2] This visit already serves as an important screening and health education opportunity and can facilitate preventive interventions. Many African countries have made important progress in preventing mother-to-child transmission of HIV. That progress shows what is possible when testing, treatment, policy and community trust are aligned. Hepatitis B now needs the same systems discipline, because the antenatal care clinic may be one of the few reliable points of contact between a pregnant woman and the health system.

This approach aligns with the WHO’s triple elimination initiative, which encourages countries to eliminate mother-to-child transmission of HIV, syphilis and hepatitis B together, rather than through fragmented disease-specific programmes.[3] It recognises a simple reality: healthcare systems across Africa continue to face constraints, workforce pressures and laboratory challenges. In this context, adding new screening priorities must be practical and sustainable. Additionally, pregnant women should not have to navigate three separate pathways when one integrated screening moment can support identification of multiple risks and enable timely care during a single encounter.[3]

An integrated antenatal panel that screens for HIV, syphilis and hepatitis B from a single finger-prick is one example of how health systems can simplify access while maintaining a comprehensive standard of care.[3] For mothers, it can help reduce the risk of missed results and clarify next steps. For healthcare workers, it can support faster decision-making at the point of care when linked to appropriate follow-up pathways. For newborns, timely identification of maternal hepatitis B can support measures that reduce the risk of exposure and enable timely preventive action.

“The most powerful public health interventions are those that fit naturally into the realities of existing care,” adds Mathebula. “The easier it is for healthcare workers to identify hepatitis B during a single antenatal visit, through the use of an integrated panel, the sooner patients can be considered for appropriate follow-up care. We are not only improving diagnosis; we are giving clinicians the information they need to support mothers, help reduce the risk of infant infection and strengthen confidence in the health system.”

A hopeful path to elimination

For too long, hepatitis B has remained overshadowed by other infectious diseases despite its scale and impact. The tools needed to prevent transmission, diagnose infection and support long-term management already exist.[1] What remains is the challenge of finding the millions of people who are living with this virus without knowing it, starting with those accessing maternal and primary healthcare.

To move from awareness to action, policymakers and healthcare leaders should prioritise routine hepatitis B screening in antenatal care, support point-of-care testing in decentralised settings, strengthen linkage to treatment and ensure newborns receive timely protection.[1,3] These are practical steps that can turn a silent infection into a manageable health issue and help prevent transmission to the next generation.

Eliminating hepatitis B as a public health threat will require more than technology alone. It will require political will, domestic investment, continued education to increase awareness, trusted community engagement and health systems designed around people’s real lives. But the path is clear: if one antenatal care visit can identify risk, enable timely care and support measures that help reduce a child’s risk of infection, then it is one of the most powerful opportunities public health has to change two lives at once.

References: 

[1] World Health Organization. (2026). Global hepatitis report 2026. Geneva: World Health Organization.

[2] Afolabi, I. B., Phillips, J. C., El-Chaar, D., Bainbridge, S. A., & Phillips, K. P. (2026). Preventing vertical transmission of hepatitis B in sub-Saharan Africa: protocol for a systematic review and meta-analysis on vaccination uptake and determinants among pregnant women. BMJ Open, 16(1), e113229. https://doi.org/10.1136/bmjopen-2025-113229

[3] World Health Organization & United Nations Children’s Fund. (2025). Country guidance for planning triple elimination of mother-to-child transmission of HIV, syphilis and hepatitis B virus programmes. Geneva: World Health Organization.

Categories : Respiratory DiseasesTags :

Indoor Airflow in Tuberculosis Spread Has Been Underestimated

On By ModernMedia

Researchers explore how a key factor can mitigate or promote tuberculosis transmission.

Tuberculosis bacteria. Credit: CDC

Tuberculosis (TB) is a leading cause of infectious disease deaths, claiming over 1 million lives every year. It spreads through the air when an infected person coughs, sneezes, or exhales, and drug-resistant strains and asymptomatic spreading are growing concerns. Curbing TB transmission is an urgent public health challenge, yet scientists still don’t understand how airflow and other environmental factors influence that spread.

One problem is that studies of infectious disease transmission have focused mainly on population-level assessments or individual immune responses. But understanding how airflow and mixing influence transmission in indoor spaces requires expertise in fluid physics and computational modelling.

An interdisciplinary team including researchers at MIT and the University of Texas Southwestern Medical Center has now combined animal transmission experiments with quantitative particle tracking and flow modelling to understand how some lab-based environments can promote the spread of respiratory infectious diseases such as TB, while others mitigate that spread.

A key factor in predicting infectious transmission was not just the total ventilation rate but, more importantly, the local pattern of airflow driven by the design – such as air leakage, inflow and outflow locations, and forces created by an infected individual.

“The local airflow patterns turn out to be pivotal,” says Lydia Bourouiba, the Japan Steel Industry Chair Professor at MIT and faculty lead of the Fluid Dynamics of Disease Transmission Laboratory, part of the Fluids and Health Network within the Institute for Medical Engineering and Science (IMES). “Our team’s findings provide some of the clearest evidence I’m aware of showing the importance of accounting for [airflow] inhomogeneity and its effects when designing for airflow detailed patterns. This insight is critical when building or retrofitting an indoor space to mitigate airborne transmission, or when designing an airborne transmission study.”

The research is an important step toward connecting laboratory infectious disease studies with how people spread such diseases in the real world. The team hopes their insights can extend beyond their model system and show the importance of flow physics in building designs to prevent the spread of airborne diseases indoors.

“Despite recent pandemics and epidemics, there is still resistance to incorporating airflow in routine infectious disease prevention tools,” Bourouiba says. “Infrastructure could be retrofitted at relatively low cost, but the paucity and difficulty of gathering direct evidence prevents broader adoption of flow physics as a tool for indoor health. This study helps provide such evidence.”

Joining Bourouiba on a paper about the work are Yash Kulkarni, a postdoc at IMES, who led the fluid and aerosol physics components; Kubra Naqvi, lead author and a postdoc at UT Southwestern; Michael Shiloh, a professor at UT Southwestern, who led the multiyear effort to reestablish a classic tuberculosis transmission model; Hui Ouyang, an assistant professor of aerosol engineering at UT Dallas; Yuhui Guo, Deepak Sapkota, and Arabella Martin, all UT Southwestern PhD students; Pei Lu and Victoria Ektnitphong, research associates at UT Southwestern; Shibo Wang, a University of Minnesota researcher; Beatriz Dias, a UT Southwestern instructor; Bret Evers, an associate professor at UT Southwestern; and Lenette Lu, assistant professor at UT Southwestern.

Opening the black box

When people exhale, talk, cough, or sneeze, tiny microdroplets and bioaerosols launch from their mouths, carried forward by a cloud. If infected by a respiratory disease, these bioaerosols can contain pathogens that can infect others. Disease transmission depends on pathogen survival in the air, which is influenced by temperature, humidity, and ventilation.

In 1882, German physician and microbiologist Robert Koch first established an animal model for the study of tuberculosis pathogenesis. Decades later, researchers demonstrated airborne transmission of tuberculosis between people and animals.

These early experiments have proven difficult to replicate in today’s modern, biosafety-grade facilities. This new study reveals the difficulty comes from stringent containment and ventilation requirements, which can dramatically influence airflow in experiments.

“Host-to-host transmission is an obligatory evolutionary phase of respiratory pathogens, yet it has been considered too intractable or complex to be amenable to systematic investigation, hence is commonly relegated to a black box. Our work opens that black box,” says Bourouiba, who is professor in MIT’s departments of Mechanical and Civil and Environmental Engineering, and an IMES core faculty member.

To quantify how local airflow patterns impact infectious disease transmission, the researchers redesigned and modelled the early studies for modern high-containment lab facilities — including their seal, inflow, outflow, and exhaust pathways — and quantified particle and bacteria-laden particle release and dispersal. They released tracer particles and bacteria into a compartment and modelled recovery from air sampled on the other side under differing airflow rates, designs, and leak configurations.

The MIT team carried out computations, benchmarked against particle release experiments. The results revealed how important seemingly small details such as leakage paths could be.

“Even a small leak could short-circuit the airflow by drawing fresh air directly toward the exhaust, rather than drawing contaminated air across the containment chambers,” says Kulkarni. 

Advancing TB research

To date, uneven indoor airflow patterns have not been fully harnessed as part of a risk mitigation strategy. 

“By systematically defining how airflow and design influence biological exposure, we were ultimately able to restore transmission and create a system that can now be used to ask fundamental questions about the bacterial, host, and environmental factors that determine tuberculosis spread,” says Naqvi.

“I began working to reestablish this seminal TB animal transmission model nearly 10 years ago, and it proved far more challenging than I anticipated,” says Shiloh. “I hope this work serves as a reminder that meaningful scientific advances often require patience and perseverance.”

“This work illustrates how crucial it is to support synergistic collaborations integrating complementary disciplines to tackle research bottlenecks – and to standardise reporting norms across laboratories,” Bourouiba says. “If different labs have varying airflow patterns from uncontrolled leaks or seal details, that physical variability can overwhelm the biological signals researchers seek. Beyond its foundational impact for TB transmission studies, our work shows that opening the black box of transmission provides mechanistic insights: Detailed airflow pattern control can enhance or mitigate airborne transmission – making it exploitable as a prevention measure in crowded gathering spaces.”

This work was supported, in part, by the National Institutes of Health, the National Science Foundation, the Burroughs Wellcome Fund, MathWorks, and the Translational Research Institute for Space Health.

by Zach Winn, Massachusetts Institute of Technology

This story is republished courtesy of MIT News (web.mit.edu/newsoffice/), a popular site that covers news about MIT research, innovation and teaching.