In April 1994, South Africa underwent the most significant change in its recent history with the disbandment of the policy of apartheid and the attendant race-based politics, which affected most aspects of the country and, of relevance to this review, the education, health delivery, and career choices that race groups could pursue. In the past 28 years, the South African government has tried to implement policies in order to advance political and socioeconomic shifts toward a more equitable society. The healthcare sector was an early target for transformation that was aimed at increasing access to services and the expansion of primary healthcare and hospital facilities to previously underserved areas. This paper seeks to discuss these changes in broad terms, but with specific reference to general health care and pharmacy practice in particular. It will look at the changes in the legislative framework and pharmacy education and factors impacting the pharmacy practices in South Africa over the past 28 years. A discussion of the critical issues that have affected the profession in the last three decades will also be delineated, and future prospects for the profession as a whole, in terms of pharmacy practice and perspectives, will be discussed. We review the current aspects of the pharmacy profession in South Africa today and how the education of those future professionals is a major contribution to the pharmaceutical climate.

South Africa’s (SA) quadruple disease burden comprises communicable diseases such as HIV/AIDS, tuberculosis, maternal and child mortality, non-communicable diseases (NCDs), and injury and violence. Two of these components, HIV and NCDs, generate demand for long-term medicines and are the focus of the review. To improve access to chronic medicines and to alleviate the pressure on overburdened public health facilities, the National Department of Health launched the Central Chronic Medicines Dispensing and Distribution (CCMDD) programme. Stable, compliant patients were granted access to patient medicine parcels (PMPs) via decentralised community pick-up points (PUPs), thereby reducing clinic congestion and improving patient convenience. Despite considerable scale-up, implementation has been inconsistent among provinces. While regional syntheses of differentiated service delivery models exist, no synthesis has yet consolidated the barriers and facilitators specific to the CCMDD across the full decade of its implementation. To understand the barriers and facilitators, a scoping review was conducted for studies published in English between 2014 and 2024. The search was filtered primarily for duplicates, then title and abstract screening, of which 31 articles met the inclusion and exclusion criteria. Data were analysed using inductive thematic analysis; resulting themes were subsequently mapped to the Consolidated Framework for Implementation Research (CFIR) to contextualise findings within implementation science. A grey literature search was also conducted through Google Scholar and Sabinet. Key facilitators of implementation included decentralised service delivery and community-based distribution, reduced patient waiting times, enhanced treatment adherence, reduced patient-borne transport and time costs and improved access to medicines. Limited access to pick-up points in remote areas, miscommunication regarding pick-up dates and poor staff service were cited as barriers. The findings revealed a gap between planned activities and implementation and have significant implications for policy and practice. It further highlighted the need for ongoing optimisation strategies to enhance the programme.