Health
Private pharmacies critical to bridging HIV, TB treatment gaps — Report
Janet Ogundepo
Private pharmacies and drug shops may hold the key to improving access to HIV, tuberculosis and malaria services in Nigeria and other low- and middle-income countries as global health funding declines and public health systems come under increasing strain, a new report reveals.
The report, titled “Private Pharmacies as a Delivery Channel for HIV, TB, and Malaria Care,” published in June 2026 by healthcare consulting firm Salient Advisory, assessed opportunities across 12 countries in Africa and Southeast Asia and found that private pharmacies are already the first point of contact for many patients seeking care for infectious diseases but remain underutilised in formal health programme planning and funding.
The report assessed the role of private pharmacy channels in 12 countries across Africa and Southeast Asia, including Nigeria, Ghana, Kenya, Uganda, South Africa, Rwanda, Zambia, Mozambique, the Democratic Republic of Congo, Indonesia, Thailand and the Philippines.
It further noted that more than three million people living with HIV across the countries reviewed are yet to begin antiretroviral therapy, while over 700,000 tuberculosis cases remain undetected, and malaria test-before-treatment rates continue to remain low.
The study asserted that structured engagement of private pharmacies could support more than 650,000 additional antiretroviral therapy initiations, over 116,000 additional tuberculosis notifications and rapid diagnostic test-confirmed malaria treatment for up to 15.8 million patients.
The report, commissioned with funding from the Gates Foundation and in consultation with the Global Fund to Fight AIDS, Tuberculosis and Malaria, noted that patients are already turning to private pharmacy channels for reasons including privacy, speed, proximity and continuity of care.
It further highlighted the growing role of private pharmacies in healthcare delivery, noting that an estimated 188,000 licensed private outlets, including independent pharmacies, drug shops, pharmacy chains, digital platforms and software-enabled pharmacy networks, currently operate across the assessed countries and serve tens of millions of patients every month.
It stated that between 42 and 74 per cent of patients with tuberculosis symptoms and between 41 and 60 per cent of malaria patients in high-burden countries seek first-contact care through private channels.
It added that pharmacy channels are important, especially for people living with HIV, many of whom prefer private outlets to avoid stigma or potential legal exposure associated with visiting public health facilities.
It further noted that the regulatory environment in most of the countries already allows pharmacies to provide some services, including HIV testing and referrals, tuberculosis case finding, and malaria diagnosis and treatment.
For Nigeria specifically, the assessment found that private-sector care seeking remains substantial across disease areas.
It stated that about 67 per cent of tuberculosis patients in Nigeria first seek care in the private sector, but private providers contribute only about one-quarter of TB notifications, creating missed opportunities for early diagnosis and treatment.
The report also noted that Nigeria and Uganda recorded some of the highest rates of private-sector malaria care seeking at approximately 60 per cent, yet adherence to testing before treatment remained low.
The researchers argued that rather than creating new healthcare-seeking behaviours, governments and health programmes should strengthen systems around channels patients already use.
“Patients already use private pharmacies for HIV, TB and malaria care. Engagement does not need to create demand; it needs to meet it,” the report stated.
The assessment further projected that if private pharmacy channels are formally engaged and supported, more than 650,000 additional people living with HIV across the focus countries could potentially initiate treatment through pharmacy-facilitated testing and referral systems.
It added that structured engagement could generate more than 100,000 additional tuberculosis notifications and support millions of rapid diagnostic test-confirmed malaria treatments.
The report, however, stressed that any expansion of pharmacy-based services should work within existing regulations while identifying opportunities for reforms and task-shifting where necessary.
Based on 2024 data and findings from existing programmes, the report estimated that greater engagement of private pharmacies could significantly improve access to treatment and diagnosis across the three diseases.
The report also suggested that pharmacy networks could support the rollout of emerging HIV prevention and treatment products, including generic lenacapavir and Merck’s investigational antiretroviral drug, MK-8527, which is being studied as a potential pre-exposure prophylaxis product.
The report stressed that as global health financing contracts and public health systems face increasing strain, private pharmacies may offer a practical route to extending access to care and improving disease control outcomes.
It stated, “Private pharmacy channels, already embedded in patients’ care-seeking journeys, represent an infrastructure for closing gaps in HIV treatment access, TB case notification and malaria diagnosis at scale.”
Commenting on the findings in a press release shared with PUNCH Healthwise, Associate Director at Salient Advisory, Abdullah Yusuf, said available evidence points to a strong case for examining the role of private pharmacies in disease control efforts.
“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,” Yusuf said.
The firm called on governments, donors and global health institutions to commission country-level investigations in markets where healthcare delivery gaps, patient demand, regulatory feasibility and financing opportunities align.
It added that private pharmacies should be viewed as a practical complement to public healthcare systems rather than an afterthought in efforts to improve access to HIV, tuberculosis and malaria services.
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