As designated by the International Pharmaceutical Federation (FIP) Council 25th September marks the annual World Pharmacists Day. Pharmacy is the health profession that links the health sciences with the basic sciences, committed to ensuring the safe and effective use of medication. Historically from medication, compounding and dispensing, the role of pharmacists globally has transformed over the last two decades to extended pharmaceutical care where they are more responsible for patient care and better health outcomes.
Access to safe medicines is still one of the major problems in many parts of the world and qualified pharmacists play a key role throughout the health system supply chain towards improving access to medicines. A study in 2012 by the IMS Institute for Healthcare Informatics quantified that 500 billion USD could be saved every year if responsible use of medicines is achieved and pharmacists have been identified as a strong health work force and an under-utilized asset that could achieve the goal of using medicines responsibly.
But pharmacists in the developing countries are underutilized and do not get the recognition that they deserve. One reason for this is the limited interaction they have with the public. Employment opportunities are grim for graduates from pharmacy schools. Corporate pharmaceutical companies hire pharmacists into marketing roles and eventually a specialized skilled health sector human resource goes up the management ladder, leaving behind a critical shortage of clinical and community pharmacists.
While WHO recommended one pharmacist for a population of 2000 for adequate delivery of health services, there are several issues infesting the profession. These range from acute shortage of pharmacists to lack of separation of functions between the doctor and the pharmacist in dispensing of medicines. The curricula and training of pharmacists presently caters for the industry needs, which focuses primarily on production side of pharmaceuticals. Other issues include the lack of quality in medicines, medication available without proper prescription, untrained retailers selling drugs and weak regulation further complicating the situation.
Comprehension of the disease process and subsequent treatment of illness is both technically complicated and daunting. The reason is that clinical manifestations of underlying processes vary from patient to patient. There are environmental, social and illness specific complications that need to be dealt with at a very short timeline. It is the pharmacist who is strategically placed within this medical conundrum that can ensure effective treatment plans are executed and patients attain better health. Their contribution in therapeutic procedures is necessary to better the use of medicines, eradicate medication errors and ensure safe access.
Their role needs to be recognized and broadened within developing countries health systems. Pharmacists in Pakistan need to have expanded opportunities providing population based care in immunization programs, emergency preparedness and response, contraceptive services, the prevention and control of infectious diseases, chronic disease management and injuries.
Collaboration between different health care providers can lead to improved health outcomes. Communication gaps between health professionals need to be addressed so that expectations around each other’s roles can be better understood. Besides, there is also dire a need for pharmaceutical policy research to institutionalize the clinical and social pharmacy practice and augment the role of Pakistan Pharmacy Association.
With the changing landscape of global health, complex problems are being tackled through innovation in medicine, treatment science and health workforce working together more effectively. Pharmacists and pharmaceutical scientists’ contribution and help in enabling change within the health sector for the greater good cannot be over emphasized.
Dr. Anis Kazi
The author is a public health professional based in Islamabad. A medical doctor by training, he graduated from the London School of Hygiene and Tropical Medicine, where he was involved in research around polio in Pakistan. He has interests around social determinants of health, Universal Health Coverage and health sector reforms, and is presently working as Senior Manager, Policy Advocacy and Research at Heartfile, NGO-Health think tank.
Rita Robert says
In the field of primary care, community pharmacists occupy an ideal position between the prescriber and the patient, and also have the knowledge and skills necessary to provide information about the correct processes to use medicines in a responsible and effective way
Zeeshan Zahoor says
Thank you for writing this note Dr. Anis.
I strongly agree to the fact that most of the pharmacists settle into corporate pharmaceutical companies where they play a role in marketing and sales. And the only motive in such case is that they are better paid than any other field in pharmacy resulting in under utilization of the skills that they are actually capable off (and those are obviously of clinical /hospital and community practices).
Pharmacy profession is also being ignored at Government level and they do not seem serious in resolving the issue. One more predicament to this picture is the role of pharmacy colleges. These colleges seem more interested in making a good business by enrolling enormous student bodies who unwillingly take admission because they couldn’t score for mbbs but again that lies on the shoulders of government (because they are permitting every other person to open a pharmacy college who has small premises to accommodate the students).
This is truly a serious issue and needs to be sorted.