E-DRUG: Public health pharmacist

I refer to the list of competencies that Suryawati proposes for the
     "public health pharmacist" in her note to E-DRUG:

From my personal view, the pharmacist you called "public health pharmacist"

should be equipped with inter-professionals communication skills including
oral presentation techniques and assertive training, practical methodology on
drug use study, techniques of feedback, writing skills, skills in selecting
and assessing sources of information, skills in providing information,
qualitative techniques, anthropology, public education, pharmaceutical
management (including evaluation techniques on each step of pharmaceutical
management), management of pharmaceutical information system, health
economics (micro and macro), teaching techniques, etc.

     We might all propose some variations or changes in emphasis, but I
     think that this reflects the profile of a category of health
     professional that we all know is needed, the type if person who could
     in principle accomplish much in improving the efficiency and
     effectiveness of pharmaceutical use.

     My major question is where this person would work. I can imagine a few
     institutions which would see the value (with modest sensitization) of
     hiring such a person:

     1. academic institutions with an innovative pharmacy training program
     2. NGOs with a large health service delivery component
     3. teaching hospitals with an active QA program

     However, to make the program that would train such people viable, there
     needs to be a market for them in the private sector or within
     ministries of health. Countries with large numbers of people in
     insurance or capitated care programs might see the value of this person
     in cost-containment/quality assurance, but how many such environments
     are there? Most ministries of health employ pharmacists so far below
     their level of qualification at present, how likely is it that they
     will create productive and appealing career opportunities for even more
     highly-trained pharmacists?

     I do not wish to appear pessimistic about the concept of public health
     pharmacist, since I think such a professional is needed. However, I
     think it is important to think critically about the long-term
     implications of creating a new category of health professional.