Going Back in Time

Pharmacists are the third largest healthcare professional group in the world after doctors and nurses and their role in the healthcare system is rising with the development of new drugs, emergence of new resistant microbes and with the changes in the healthcare delivery systems. According to World Health Organization (WHO), for optimal healthcare delivery, one pharmacist is needed for every 2000 people (a ratio of 1:2000). This says that Pakistan needs 80,000 pharmacists for a population of 160,000,000; a target still far to be reached, as according to some estimates country has about 6000-8000 pharmacists.

Though the role of pharmacist in community pharmacies, hospitals and in drug regulatory authorities has been recognized world over but they still have a far way to contribute a significant role in the healthcare system of Pakistan. Despite heavy education and training they receive in terms of drug production, quality control, dispensing, distribution and safe usage of medicines, pharmacists are underused and most neglected healthcare professionals in the country. In Pakistan, a pharmacy assistant or dispenser can also open a pharmacy/medical store and can dispense all types of drugs. As a result of this practice the public is vulnerable to untrained drug traders and quacks. The pharmacist’s role in public hospitals is merely that of a storekeeper and they are hardly involved in safe medication practices and in patient care.

However, the recent decision by the Ministry of Health (Ministry accused of favouritism , Dawn 15th May , 2007 http://www.dawn.com/2007/05/16/nat18.htm) is certainly a final blow to the profession as well as to the public health. According to Ministry’s new rules for the recruitment of Assistant Drug Controller (ADC) in Drug Control Organization (DCO) “graduates other than pharmacist” such as biotechnologists, chemists and microbiologist are also allowed to apply, which was not the case earlier. (Previously only a pharmacist with a degree in pharmacy was allowed for an ADC position).

This is contrary to most of industrialized and developing countries, where drug regulatory authorities are heavily staffed, run and headed by pharmacists, definitely because of their expertise in medicine manufacturing, distribution as well as in quality use of medicines. Chemists, microbiologists and biotechnologist are not trained as drug experts as they do not even have rudimentary knowledge of medicines effectiveness and safety. They don’t study drug effects on the body (pharmacology), drug manufacturing and production (pharmaceutics) and pharmaceutical jurisprudence (drug laws). So it would be ironical to think that how these people would respond to drug policy issues, also in the absence of knowledge of Drug Act of 1976, it would be difficult for them to monitor proper enforcement of laws. Instead of moving forward, perhaps, this step by MoH is a giant leap “Back in Time”.

Policy makers and bureaucrats from Ministry of Health must understand that the drugs are not “simple chemicals” as usages of these chemicals are associated with risks as well as benefits to human health. If the pharmacists are not going to be properly utilized to improve medicine use situation, then turning a four year pharmacy degree (B.Pharmacy) into a five year Pharm D (Doctor of Pharmacy) and opening new pharmacy schools in the country is certainly questionable. Higher Education Commission (HEC), Ministry of Health (MoH) and Pharmacy Council of Pakistan should certainly think over it.