Pharmacists play an important role in health care delivery. Their potential to participate in public health, however, remains unutilised and indeed underrated. A silver lining is now starting to appear as the new information age ushers in to ignite changes in every aspect of society, including pharmacy. While governments are now beginning to see better roles of pharmacists in pursuance of public health goals, pharmacy profession is starting to embrace public health as a key area for future development.
The pharmacy profession has traditionally been focused on micro level activities such as dispensing and prescribing advice, health promotion, and medicines management rather than wider public health issues such as inequities in access to medicines and health.
However, recently there is evidence of growing attention to integrate public health and pharmacy, at the provider or “micro” level of practice, as well as at the population or “macro” level.
Many prevention and control programs can have a component to be implemented by community pharmacists, but only small minorities of community pharmacies are engaged in such programs. For example, a very small number of pharmacists are involved in immunisation delivery – one of the most common and fundamental preventive services.
Today in public health practice, there are nagging concerns about our capacity to respond to problems like a pandemic disease outbreak, widespread outbreak of disease as a result of terrorism or emergencies caused by disasters. Such scenarios would need provision of medicines and vaccinations to thousands of people over a large geographic area in a very short period of time, and is a complex undertaking requiring large number of well trained individuals.
Clearly, widespread adoption of community pharmacy based vaccination services would address this issue and provide the public health capacity to respond to large scale vaccine preventable disease outbreaks.
While it is fundamental to the community health status and disaster response, immunisation is only one of a number of community pharmacy based preventive health services that can be enhanced by closer collaborations between public health practice and pharmacy practice. Other examples include community pharmacy screening programs to increase early therapeutic interventions in numerous chronic disease states such as diabetes, hyperlipidemia, obesity and hypertension.
Macro level public health activities focus on the health status of the community as a whole and emphasise assessment, policy development, and planning and evaluation to assure needed services. Such activities include working with communities to diagnose and investigate community health problems; establishing community partnerships to prioritise solutions to health problems; developing policies and plans that support individual and community prevention efforts; managing, administering, and evaluating community health-promotion programs; educating the public on community health needs and public health policy issues; and conducting research on the effectiveness of public health activities and communicating the results of research efforts.
Increasing the participation of pharmacists in all levels of the public health system is fundamental to achieving substantial improvement in the health status of our population, as well as, achieving full preparedness to respond to any type of mass casualty event.
Pharmacy education is making efforts at addressing the goal of bringing pharmacy and public health together through improvements in curriculum and research, but there is an urgent need to bring academia and well trained pharmacy professionals at the state level of public health practice, talking to each other for the future of our public’s health.
Bringing about changes in system design, professional understanding and human behaviors are going to be challenging. Activities targeted at securing government and decision makers’ support, recognition by the pharmacy’s professional body to embrace public health, advocating incentives for community pharmacists to carry out such activities, and securing support from the wider public health community are all desirable activities.
Having said that, one needs to be cognizant that the market pull and push is working in a way to have pharmacists deliver services designed more for the consumers’ short term convenience than for the longer term goals of integrated health care delivery. Such market factors are the factors which might slow the process of getting pharmacy and public health goals come nearer together but only for a short period of time. The destiny of pharmacy and public health to be together has been written.
Ayyaz Kiani is a public health specialist. He heads Devnet – a network of development consultants. Based in Islamabad, he has travelled around the world and continues to do so to meet fellow travelers. He can be contacted at firstname.lastname@example.org
The views expressed by this blogger and in the following reader comments do not necessarily reflect the views and policies of the Dawn Media Group.