E-DRUG: Collapsing community pharmacy practice in Ghana
---------------------------------------------------
In Ghana you will sit in a pharmacy for hours without prescription. This is mainly because the Private hospitals without qualified pharmacy staff are stocking almost every drug they deem necessary. Where do they get these drugs? From pharmaceutical wholesalers managed by pharmacists. Is there regulation? A question that should be answered by the Pharmacy council. Anybody in Ghana can move to become a wholesaler and buy any medicine.
I'm bringing this up for discussion so members from both develop and developing countries can share the experience in their various countries.
From Kofi Baryeh
Deputy director pharmaceutical services
Ghana
albaryeh@yahoo.com
E-DRUG: Collapsing community pharmacy practice in Ghana (2)
----------------------------------------
As pharmacists we can go overboard with regulations that are really designed to protect our business rather than the public from unsafe practices.
There has to be a balance between good solid regulation for public safety
and adequate scope for pharmacists to use their professional ability in
supplying medicines to the community.
There also needs to be recognition that the consumer should be free to
decide whether they want to obtain their meds in a cheap and easy manner
because they know what they want and have probably used it before thereby
sacrificing the value of a pharmacists knowledge in supplying added value to the purchase. That is their choice.
In Australia we have an emerging number of cheap warehouse style operations that whilst they do provide professional advice do not promote it. On the other hand there are very professional practices with all the "bells and whistles" available for those that want them.
If the situation in Ghana is as you describe then you have the opportunity
to strike the correct balance that takes account of consumer need and
public safety. It is an exciting time for you and I often wish we in developed countries had the chance to "wipe the slate clean" and start all over again in building a pharmaceutical care and supply service. I am sure in Australia we would not end up with anything like what we have now.
Rollo Manning
Darwin
Australia
rollom@iinet.net.au
E-DRUG: Collapsing community pharmacy practice in Ghana (3)
---------------------------------------
This is an unfortunate and to the extreme level in failure of system. The Pharmacy Council should intervene and try to bring some strict rules and regulations to control such unethical issues. The Pharmacy Council should show silence or be an observer in this issue. If the Pharmacy Council does not take any measures, it is going to have negative consequences in the society and it may lead to many problems, already as whole globe is under the AMR threat, bad practice of injections, etc,. This practice is present in the most of the developing countries but the situation varies from country to country.
Thank you.
Parimalakrishnan. S
Assist. Prof.
Department of Pharmacy
Annamalai University
Annamalai Nagar
Tamil Nadu, India.
+919025211742
chit1_2000@yahoo.com
E-DRUG: Collapsing community pharmacy practice in Ghana (4)
----------------------------------------------------
I agree with Kofi. The situation in Ghana is not unique to Ghana because similar practice abounds in the whole of the West African region with Republic of Guinea being the worst. The issue is very complex and is not even restricted to licensed wholesalers selling directly to the public and doctors without qualified personnel dispensing. In most cases, street medicines vendors who can not even read the name of their wares sell thermolabile substances advertised under the balzing sun of Africa. It is a sorry state indeed, yet most of these countries, especially Nigeria and Ghana, make so much noise through their regulatory agencies that several billion naira (Nigeria's corrency) worth of counterfeits have been destroyed. There is usually so much fanfare with media publicity during such destruction activities! One then wanders whether such actions actually is deterrent or actually promotes or advertises this death trade.
What needs to be done is that the pharmaceutical sector should do a self-regulation. What do I mean? They should take the bull by the horn. Afterall, the pharmaceutical wholesalers are supposed to be their members! They should be able to regulate them. No amount of lamentations will stop this because money is involved! Pharmacists in West Africa should face reality. Governments can not do it for us! It is known that self-regulation is more effective than official regulation backed by legislation. For example, in Nigeria, Road Transport Workers Union effectively and efficiently controls their members. These are largely illiterates. If this group can do, and even the government recognizes that they do and often dialogue with them, then a professional group should be able to do more.
Let pharma manufacturers and wholesalers play the game according to the rules.
Let the Regulatory agencies do their work professionally and not politically or with monetary reward at the back of their minds. If we do these, it will surprise all of us that the problem is self-inflicted.
I say this with all sense of responsibility. I have Chaired several committee nationally on Drug Distribution in Nigeria, regrettably our major antagonists have been pharmacists in the Federal Ministry of Health, National Agency for Food Drug Administration and Control (NAFDAC) and Pharmacists' Council of Nigeria (PCN). On each occasion, we were frustrated!!! If we rid ourselves of our big enemy, the cankerworm, (aka: CORRUPTION), we shall have a better terrain to practice our noble profession.
Professor 'Fola Tayo
President, West African Postgraduate College of Pharmacists
Retired Professor of Clinical Pharmacy, University of Lagos and
Former Professor of Pharmacology, Ogun State University Medical College. Nigeria.
folatayo2001@yahoo.com
E-DRUG: Collapsing community pharmacy practice in Ghana (5)
--------------------------------------------------
This is surprising because the news we get is that pharmaceutical sector or practice is well regulated in Ghana. Is there no other practice for the community pharmacy/pharmacist apart from waiting for prescription?
Dr. (Mrs.) B.A. Aina
Lagos, NIGERA
Tel +234 8023091623
bolajokoaina@yahoo.com
E-DRUG: Collapsing community pharmacy practice in Ghana (7)
-----------------------------------------------
This is an issue that needs urgent attention and drastic measures needs to be taken.
I have worked in Ghana and Cameroon as a Pharmacist and was really taken aback by the way government and the Pharmaceutical council reacted to the illegal supply and selling of drugs.
The situation is even worst in Ghana, where just anybody could open a Pharmacy. All they need is to have enough money to buy a Pharmacist's License and Capital to run the business. I raised this issue a couple of times in two similar situations in Ghana but the people around only laughed and told me. "This is Ghana, not Cameroon".
In Cameroon, the situation is not far from this. The big time Customers of most of our wholesale Pharmaceutical Companies, especially those dealing in Generics are unqualified market and roadside sellers of medications.
A good number of times Syndicate(Pharmacists) mobilise to fight against this practice but so far there have been no positive results.
Anita Verla Forchu
Cameroon
vas2001185@yahoo.com
E-DRUG: Collapsing community pharmacy practice in Ghana (8)
-------------------------------------------
Dear colleagues,
Given that we are dealing with a complex mix of challenges that we find affecting pharmaceutical services in many of the developing countries, particularly in this subject matter, is it not worth looking at how some countries are attempting to create the necessary safeguards, controls and the promotion of good, basic pharmaceutical services? I would like use to refer to the Accredited Drug Dispensing Outlets (ADDO) programme (in Tanzania and similar projects that are being considered by governments particularly in other parts of Africa), as a way of controlling access to essential medicines in an environment where the public have limited access to public health services, and where the public have a choice in seeking seeking treatment.
In an environment of limited pharmacists facing an overwhelming demand for pharmaceutical services from communities in urban to rural areas, there simply is a need to find solutions that provide access to quality pharmaceutical services and / or products, and through such arrangements, look after the health of the general public.
The situations described in Ghana, Cameroon, are not unique to these countries as we already know, but are found right across the world. The question is how governments and the profession of pharmacy can attend to these challenges in a way that provides for access to quality medicines and basic pharmaceutical services. Governments are now stretched to breaking point as countries mature and citizens demands and expectations of public and indeed private health care sky- rocket. As stated by others, there are simply not enough pharmacists and physicians around to address public health agenda; and there are not enough of these cadre, particularly with sufficient capital, to set up services in the most needy / vulnerable locations (both urban and rural settings). So, alternative and probably more innovative (short- to- medium term) solutions are needed, since clearly the challenges faced by the public health sector are unlikely to be addressed through application of traditional strategies alone.
Regards,
Bonnie
Bonface Fundafunda PhD., MBA., B.Pharm
Manager, Drug Supply Budget Line
Ministry of Health,
P.O. Box 30205,
Ndeke House,
Lusaka,
Zambia
Tel: +260 211 25 41 83
Fax: +260 211 25 33 44
Mobile: + 260 979 25 29 00
Email: bcfunda@hotmail.com