In a proud moment for Sefako Makgatho Health Sciences University (SMU), Dr Karmishtha Maharaj was conferred with a PhD in Pharmacy during the university’s recent autumn graduation ceremony. Her achievement is not only a personal milestone but a significant contribution to advancing pharmacovigilance within the private healthcare sector, particularly in the context of HIV treatment in South Africa.
Now 39 years old, Dr Maharaj is currently based at Ampath Laboratories in Centurion, where she serves as a Pharmacogenomics Specialist. Her professional journey with Ampath spans over 13 years, beginning in 2011 as a Phlebotomy Facilitator. Originally from Newcastle in KwaZulu-Natal, Maharaj’s career has been deeply shaped by her upbringing in a close-knit family and an enduring desire to bridge patient care and pharmaceutical science.
“My interest in medicine began early,” she reflects. “From weekends volunteering at a private hospital to shadowing my uncle at his pharmacy, I was always drawn to helping others. I first trained as a nurse and later transitioned into pharmacy, blending the clinical and pharmaceutical sides of patient care.”
Maharaj’s doctoral research, conducted through SMU’s School of Pharmacy, focused on the use of routine laboratory tests as early indicators of adverse drug reactions (ADRs) in patients on Highly Active Antiretroviral Therapy (HAART). Her study, conducted at a major private HIV treatment practice in Pretoria, sought to address a critical gap in South Africa’s pharmacovigilance data, particularly within the under-researched private healthcare sector.
She strongly believes laboratory-based monitoring should become a standard in ADR surveillance. “It enables early detection of toxicity before symptoms appear, allowing timely interventions. This approach not only improves patient safety and adherence but fills major gaps in traditional pharmacovigilance, especially when managing complex cases involving multiple medications.”
Despite the private sector being relatively well-equipped, with access to electronic health records and accredited laboratories, Maharaj points out that systemic challenges remain. “There’s no coordinated pharmacovigilance framework in private care. Proactive monitoring is still underutilised, and pharmacogenomics testing is limited due to cost and lack of awareness.”
Her study reviewed 267 patient files from a private HIV clinic in Pretoria. Elevated creatinine and liver enzymes served as early warning signs of renal and hepatic toxicity. She observed that patients on concomitant medications had heightened risks, and that ART changes were most commonly associated with drugs like efavirenz and lopinavir.
“My research offers valuable insights that can contribute to national health policy,” she says. “It provides a model for integrating lab data into national pharmacovigilance frameworks, updating HIV treatment guidelines, and improving surveillance beyond clinician reporting.”
She is also eager to expand the research to public health settings and rural areas. “We need to ensure the research represents the broader HIV population. Exploring regional differences and building scalable, risk-based models could strengthen provincial and national responses to HIV care.”
Looking ahead, Maharaj envisions several research paths, including prospective studies, cost-effectiveness analysis of lab-based surveillance, and the feasibility of implementing pharmacogenomic testing and therapeutic drug monitoring locally.
She also hopes to see her findings incorporated into national medical training and treatment guidelines. “Empowering healthcare providers with these tools through education would support a more predictive, personalised approach to care.”
Completing a PhD while working full-time was no small feat. “It required planning, discipline, and self-care. My support system—family, mentors, friends—was essential. There were moments of doubt and setbacks, but also incredible breakthroughs that reminded me why this work matters.”
Now that she has earned her PhD, Maharaj plans to continue blending academic research with public engagement. “I want to raise awareness around drug safety and help integrate personalised medicine into routine care.”
She hopes her legacy is one of improved patient safety and inspired future researchers. “For young women from underrepresented backgrounds, I say: believe in your potential. Your voice matters, and your journey can change lives.”
Summing up her journey, Maharaj shares, “The rewarding challenge of pioneering new paths. As Elizabeth Blackwell said, ‘It is not easy to be a pioneer – but oh, it is fascinating!’”
By Tumelo Moila
