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All the world's a stage...

Updated: Nov 3, 2021

Yesterday I had the pleasure of advising on content for an international pharmacy conference. It got me thinking... what would you do if confronted with the amazing opportunity of debating with the great and the good of the international pharmacy community?


What agenda would you set if given a stage, and a room-full of the world's chief pharmacists?


As you know, at Global Pharmacy Exchange we're passionate about empowering the pharmacy workforce, because we believe that in doing so we will address inequalities in healthcare and improve Access to Medicines. So you'll be unsurprised about my ideas for this global meeting. I've summarised them below - I'd love to hear your thoughts!


So, I picked four broad topics...

... and then proposed four key areas within each...

Emergency Health Response

The rapid deployment of staff and commodities to support an overwhelmed healthcare system following a Sudden Onset Disaster or conflict.

•Introduce the WHO Emergency Medical Team initiative

•Coordination during an emergency and activities of the MoH / NDRA (DoH / MHRA) etc


Resilience & Preparedness

Planning and preparing for emergencies that have the potential to impact a local area or the entire country.

•Education, training, stockpiling, coordination, transport, clearance…

•Dealing with Cat 3 & 4 emergencies i.e. without international intervention


The role of pharmacy professionals

In humanitarian aid, pharmacists and pharmacy technicians are under-represented and funded – a vicious cycle. The impact on the effectiveness and quality of health programming is shocking.

•Active promotion of the pharmacy skill set in humanitarian organisations, at all levels. •Empowering national pharmacists to influence and support strengthening of national health systems.


Immunization Campaigns

A cross-cutting theme with challenges routed in fair-pricing and R&D as well as logistics – that affects OECD nations as well as LMICs.

•Addressing patient education and acceptance

•Challenging the barriers to an effective vaccination campaign (see also Access to Medicines)

Research & Development

A huge disease burden exists in LMICs for which novel health products are urgently needed.

•A collaborative effort to fund/incentivise R&D in neglected areas

•“Open labs” and non-competitive initiatives


Pricing

Current models for the pricing of medicines are determined by the temporary, legal monopolies created by patents – thereby causing rationing or non-availability of novel essential medicines for most of the world’s population.

•The idea of delinkage as a business model to drive fair pricing.

•Current campaigns for fair pricing and opportunities for government lobbying.


Patents & Licensing

As above, but different discussion points.

•Current initiatives to improve access to patented medicines – Medicines Patent Pool, compulsory and voluntary licensing, TRIPs and the newly re-named CPTPP.

•Dealing with Investor-State Dispute Settlements (ISDS) – experiences and advice.


Supply Chain Strengthening

The work of pharmacy professionals in the development sector is frequently focussed on strengthening the pharmaceutical supply chain… because it is the primary obstacle.

•Policies, tools, training

•Current technologies, innovation and (open-source) software.

Registration

Some countries are “unattractive” to drug companies, or are unable to effectively consider registration requests, therefore compounding in Access to Medicine challenges.

•Harmonisation initiatives and the promotion of regulatory convergence

•Technical assistance and the opportunities for work-sharing arrangements.


Falsified Products

The threat to health represented by the counterfeit “industry” is unquantifiable, but extreme.

•Global intelligence sharing and cooperative opportunities.

•The application of pharmacovigilance and detection measures in tackling the challenge.


Substandard Products & Regulatory System Strengthening

Assuring the safety and efficacy of products on the national market is impossible for many countries, based on the competence and capacity of many regulatory authorities.

•International cooperative technical assistance to build GMP and GDP capacity.

•Incentivising investment in GMP and GDP, the implementation of minimum standards, cooperative agreements to hold multi-nationals to account.

•International prequalification schemes and information sharing.

AMR

The global threat of AMR is widely acknowledged, however the disproportionate impact on LMICs is less-well explored.

•Monitoring, reporting and information sharing initiatives (e.g. GLASS by the WHO).

•Joined up approaches to tackling the challenge e.g. rational use, addressing the use in livestock etc


Education

Building the competence of the pharmacy workforce to address global challenges – and improving awareness of “pharmacy” issues amongst other professional communities – requires an educational foundation.

•Introduction of global pharmacy issues into MPharm programmes.

•Increasing the awareness of global challenges relating to medicines amongst non-pharmacy professions.


Research & Funding

There are paltry opportunities for academic research in the humanitarian pharmacy space, which further undermines progress and innovation in the sector.

•Incentivising research into “non-R&D” pharmaceutical arenas.

•Enabling resources, collaboration and information sharing amongst research institutions.


Peer Support

Connecting pharmacy professionals, particularly those in clinical settings, to educate, empower and advance professional growth.

•Global Medicines Information scheme – particularly important due to the challenge of obtaining up-to-date and reliable reference sources.

•Global mentorship and buddying.


I've been very brief in my descriptions (which was a struggle!) but these are the things I'd like to debate with the world's most influential pharmacists. Given the opportunity, what would you do?


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Kate Enright © Copyright

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