…Study says structured pharmacy engagement could help deliver over 650,000 additional HIV treatments, improve TB case detection and provide malaria care to nearly 16 million patients.
Key Points
- Healthcare consulting firm Salient Advisory has called for country-level investigations into the role of private pharmacies in delivering HIV, tuberculosis (TB) and malaria care.
- The report covers 12 countries across Africa and Southeast Asia, including Nigeria.
- Pharmacy engagement could support more than 650,000 additional antiretroviral therapy (ART) initiations, over 116,000 additional TB notifications, and RDT-confirmed malaria treatment for up to 15.8 million patients.
- The report estimates that around 3.6 million people living with HIV across the 12 countries are not receiving ART, while about 764,000 TB cases remain undetected annually.
- Researchers say private pharmacies already serve as the first point of care for many patients and should be integrated into national disease control strategies.
Main Story
A new report by healthcare consulting firm Salient Advisory has urged governments, donors and global health institutions to investigate how private pharmacies can be better integrated into the delivery of HIV, tuberculosis (TB) and malaria services, arguing that the channel could significantly improve access to care amid declining global health funding.
The report, titled Private Pharmacies as a Delivery Channel for HIV, TB, and Malaria Care, examines the potential of formalising pharmacy-based healthcare services across 12 countries in Africa and Southeast Asia, including Nigeria, Kenya, South Africa, Ghana, Uganda, Rwanda, Zambia, Mozambique, Democratic Republic of the Congo, Indonesia, Thailand and Philippines.
According to the report, approximately 3.6 million people living with HIV across the 12 countries are not yet receiving antiretroviral therapy (ART), while about 764,000 tuberculosis cases go unnotified each year. In addition, adherence to the recommended “test-before-treat” protocol for malaria remains low in several high-burden countries.
Researchers found that private pharmacies already play a critical role in healthcare delivery, with an estimated 188,000 licensed outlets—including independent pharmacies, drug shops, pharmacy chains, digital platforms and software-enabled pharmacy networks—serving tens of millions of patients every month.
The report noted that private pharmacies are often the first point of care for between 42 and 74 per cent of tuberculosis patients and 41 to 60 per cent of malaria patients. For many people living with HIV, pharmacies also offer a more discreet option for accessing healthcare, helping patients avoid stigma or legal concerns associated with visiting public health facilities.
It further observed that regulatory frameworks in most of the 12 countries already permit pharmacies to provide selected services such as HIV testing and referral, tuberculosis case identification, and malaria diagnosis and treatment, creating opportunities to strengthen their contribution within existing health systems.
Drawing on programme evidence and 2024 health data, the report estimates that structured engagement of private pharmacy channels could facilitate more than 650,000 additional ART initiations, over 116,000 additional TB notifications, and rapid diagnostic test (RDT)-confirmed malaria treatment for up to 15.8 million patients.
The report also highlighted the potential role of pharmacy networks in supporting the rollout of emerging HIV prevention and treatment products, including generic Lenacapavir and MK-8527, an investigational antiretroviral drug being developed as a potential pre-exposure prophylaxis (PrEP) medicine.
Evidence from existing programmes demonstrates the potential impact of pharmacy-led care. In South Africa, a pharmacy chain-based antiretroviral therapy pick-up programme maintained viral suppression in 97 per cent of patients after 12 months, matching outcomes achieved through facility-based care. In Kenya, a diagnosis-linked reimbursement model increased malaria rapid diagnostic test uptake fourfold while reducing treatment costs by between 50 and 80 per cent per patient.
The Issues
Despite their widespread presence and accessibility, private pharmacies remain underutilised within many national disease control programmes. The report argues that limited formal integration, inconsistent financing mechanisms and regulatory constraints continue to restrict their contribution to HIV, TB and malaria service delivery.
With global health financing becoming increasingly constrained, researchers warn that governments may need to explore alternative service delivery models capable of expanding healthcare access without placing additional pressure on already stretched public health systems.
What’s Being Said
Abdullah Yusuf: “The conditions we found—delivery gaps, channel presence, documented care-seeking, regulatory permissions, and proof points from programmes already operating—amount to a case for taking the channel seriously, examining its potential market by market, disease by disease. The question is where those conditions converge sufficiently to justify moving from evidence to action.”
What’s Next
Salient Advisory is urging governments, development partners and international health organisations to commission country-specific assessments to determine where structured pharmacy engagement would be most effective.
The firm said future investigations should focus on countries where healthcare delivery gaps, patient demand, regulatory feasibility and sustainable financing mechanisms align, allowing private pharmacies to complement public health systems in expanding access to essential HIV, TB and malaria services.
Bottom Line
As governments grapple with shrinking global health funding and growing demand for healthcare services, the report makes the case that private pharmacies can no longer be viewed solely as medicine retailers. Instead, they should be recognised as strategic partners capable of helping countries close treatment gaps, improve disease detection and strengthen healthcare delivery for millions of patients.
