Harnessing Potential of Pharmacists for TB Prevention and Care in Pakistan: Stakeholders Meet

Harnessing Potential of Pharmacists for TB Prevention and Care in Pakistan: Stakeholders Meet

 {Photo provided by Ayyaz Kiani of DEV-NET.}(Left to right): Dr. Khalid Saeed, President of the Pakistan Pharmacists Association; Dr. Sania Nishtar, Founder and President of Heartfile; Dr. Ejaz Qadeer, NTP Manager; Dr. Azhar Hussain, Director of Pharmacy, Hamdad University, Islamabad; and Dr. Gul Majeed Khan, Chairman of the Department of Pharmacy, University Quaide Azam, Islamabad.Photo provided by Ayyaz Kiani of DEV-NET.

A version of this post originally appeared on the SIAPS program blog.

"Health care is not about what doctors and nurses do in hospitals," said Dr. Sania Nishtar. "There are a range of different stakeholders that need to play their parts."

" href="https://twitter.com/SaniaNishtar">Dr. Nishtar, keynote speaker at the "Engaging Pharmacists in TB Care and Control in Pakistan" stakeholders' meeting last week in Islamabad, Pakistan, highlighted the importance of involving all care providers in tuberculosis (TB) diagnosis and treatment. The meeting of key stakeholders included representatives from the Ministry of Health, universities, and pharmaceutical manufacturers, among others.

Involving pharmacists in TB case detection, referral

Treatment for TB is long, and adherence to correct regimens is the cornerstone of tackling the epidemic. Because pharmacists have historically been underutilized in TB prevention and care, the National TB Program (NTP) of Pakistan partnered with the USAID-funded Systems for Improved Access to Pharmaceuticals (SIAPS) program to pilot an intervention to involve pharmacists in TB case detection and referral. SIAPS staff presented preliminary results from a baseline survey of TB knowledge among pharmacy sales staff in four urban areas of Pakistan at the meeting.

In recent years, the added value of including all care providers in TB control has been increasingly promoted by a variety of international organizations and donors. For example, the World Health Organization's (WHO's) Stop TB Strategy recognizes pharmacists as one of six pillars for delivering high-quality TB care. This recommendation has been echoed by the United States government and is a key methodology in many USAID programs, including SIAPS.

An impact evaluation study in Pakistan found that training laypeople in the community to screen for TB in private clinics--and then linking patients to free diagnosis and treatment from a NTP-approved private facility--was one of several interventions that increased case detection two-fold over that observed in the control area. However, Pakistan cannot afford to ignore the role of retail pharmacies in TB control, given their accessibility, the presence of few qualified staff, and lack of knowledge of both TB and the NTP.

Out of 75 participants at the stakeholders' meeting, 19 were community pharmacists, highlighting the NTP’s dedication to include perspectives of these providers in its national strategy for TB care. The event drew attention from a variety of local and international news media, including The News International.

Dr. Nishtar, a former federal minister and founder of the nonprofit think tank Heartfile, noted that private sector pharmacists are crucial partners in increasing the number of people who are properly diagnosed and treated for tuberculosis (TB); Pharmacists often have close ties to the community and frequently serve as the first point of contact with the health system.

Additional panelists included the NTP Manager, Dr. Ejaz Qadeer; the President of the Pakistan Pharmacists Association, Dr. Khalid Saeed; NTP Public-Private Mix (PPM) Coordinator, Dr. Farah Hafeez; Director of the Department of Pharmacy, Hamdard University, Dr. Azhar Hussain; and consultant for the Systems for Improved Access to Pharmaceuticals and Services (SIAPS) program, Mr. Ayyaz Kiani of DEV-NET

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Comments

V.Tata
This is a very laudable initiative. Pharmacists play a vital role in healthcare delivery. In urban areas, they service the needs of people by providing instantly needed medications without which death rates in towns and cities could be much higher. In rural and remote areas especially in developing countries, pharmacies are either not present or well regulated and monitored. As such, the population resorts to quacks that peddle medicines from doubtful origins with undetermined chemical compositions. These quasi pharmacist in such remote areas act as gate keepers of the patient population because with lack of financial resources to go to the doctor for proper diagnoses and prescriptions, they simply rush to quack pharmacists that diagnose, prescribe and supply medications for treatment. As awful as it sounds, these quack pharmacist are a great resource harness and use to improve healthcare outcomes in such areas. My hope is that this good partnership with pharmacists extends beyond city boundaries to rural areas.
Mr. Ayyaz Kiani
Thanks for the comment. The observations regarding quacks and their role, especially in the more rural parts of the population divide, are valid. The project organizers are cognizant of these pitfalls in the way of involving retailers and therefore want to move cautiously and in a phased manner moving from more organized and well managed urban pharmacies gradually to the rural areas as the regulation and performance of the retail pharmacy practices improve over the coming years. (Note: I work with DEV-NET as a consultant for the SIAPS program.)

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