I recently attended my son’s elementary school holiday event. Besides all of the merriment associated with the upcoming season, the school’s chorus sang “We are the World.” Many of you, like me, probably have not thought about or heard this song in a long time. Listening to the children sing brought back many emotions associated with the song and the message it conveyed.
To refresh your memories, this song was written and produced in 1985 with the goal of raising awareness and funds for African famine relief.1 Some of the most popular artists of the day sang together, with the release of the single being one of the best selling to date. It was great to watch the video again and listen to the lyrics 27 years later.
One of the first lines of the song is “the world must come together as one.” I had the privilege of attending the 100th anniversary of the International Pharmaceutical Federation (FIP) in Amsterdam, the Netherlands, last October. I have participated in this international meeting in the past few years and have thoroughly enjoyed leaning about hospital practice around the world and meeting many people who practice in these settings. I am always impressed by everyone’s commitment to the profession of pharmacy and how friendships and collaborations can transcend country-specific politics.
During a special ceremony, a representative of each of FIP’s 127 member organizations signed the Centennial Declaration. It begins with the following statement: Pharmacists and Pharmaceutical scientists accept responsibility and accountability for improving global health and patient health outcomes by closing gaps in the development, distribution, and responsible use of medicines. Society can contribute to these objectives by supporting the advancement of pharmacy practice and the pharmaceutical sciences.2 The words “responsibility” and “accountability” demonstrate the explicit roles pharmacists have toward patients and the integrity of the drug product. Unfortunately, not all countries have systems that allow practice in accord with this mandate.
Even though the role of the pharmacist varies by setting and nation, there are some countries where pharmacists do not need to be licensed or trained to dispense medications. They are free to open a community pharmacy in their village, dispensing medications and providing advice to patients. In some countries, hospitals operate without pharmacist oversight for medication preparation. Continuing education is not an expectation for maintenance of licensure. These are things we take for granted in the United States.
In other countries, the desired workplace is the pharmaceutical industry or academia, not patient care. The best graduates flock to these research positions because of their prestige or better salary. Some nations have limited educational opportunities and institutions and are not able to train the number of pharmacists needed to support the health care infrastructure demanded by society.
With limited numbers of trained pharmacists, the ownership of the medication distribution system cannot exist to the desired level in these nations. This establishes opportunities for counterfeit medications to be introduced—making the care system dangerous to the patient. Of course, there are also differences in health care infrastructure and economics on what can be afforded. All of these forces create variations in pharmacy practice that are observed across the world.
Having the endorsement of such a collaborative document in the form of the FIP Centennial Declaration will provide strategic planning and focus to governmental agencies, academic institutions, and professional pharmacy organizations to steer the activities of pharmacists toward being accountable and responsible for patient care.
We have an obligation to “come together as one” in advancing the patient-centered practice of pharmacy.
Stephen F. Eckel, PharmD, MHA, BCPS, FASHP, FAPhA, is assistant director of pharmacy, University of North Carolina Hospitals and clinical assistant professor, University of North Carolina Eshelman School of Pharmacy.
1. We are the world. Wikipedia website. http://en.wikipedia.org/wiki/We_Are_the_World. Accessed December 1, 2012.
2. Improving global health by closing gaps in the development, distribution, and responsible use of medicines. International Pharmaceutical Federation website. http://fip.org/www/uploads/database_file.php?id=339&table_id=. Accessed December 1, 2012.