FIP National Level Intelligence Report-Preliminary Country Analysis: Pakistan

Over the year’s pharmacists have gained prominence and they are classed as the third largest healthcare professional workforce after doctors and nurses. However like in many low and middle-income countries, they are not yet recognised in Pakistan. Globally there is a substantial amount of economic and clinical evidence showing pharmacists’ contribution at primary, secondary and tertiary care levels1 in both high income and low income countries. This is evident from a range of policy examples from the development of national medicines policies, to improve the use and access to medicines; pharmacists have played a significant role to improve patients’ well being. With the advancement in treatment and changing global health landscape we see that this role is set to expand. Though a lot of work is being done recognising pharmacists as an effective health workforce, we still see gaps in consumers’, health professionals and policymakers’ understanding towards the role of the pharmacist in Pakistan at all levels. This includes key decision-makers in medicines use and access, academia, industry, community pharmacy, hospital as well as in the regulatory setting.

Pharmacists can play an important role to improve medicines use as well as to improve patient health outcomes in Pakistan. This is a large health workforce in the country, though the exact numbers are not known however it is estimated that a large number of pharmacies are run without pharmacists in the country. Only 5 per cent of more than 40,000 pharmacies in Pakistan have qualified pharmacists.

This poses significant challenges and to fully utilise the potential and unique skills of this workforce there is a requirement for structural, policy, and regulatory reforms at all levels. If provided ample opportunities, it can contribute to significantly improve public health, chronic disease prevention and management as well as minor ailments diagnosis and treatment in –primary care community settings. The countries where we see the pharmacist’s role evolving are the ones that are mostly high on the socio-economic ladder. However, in the recent past, many middle-income countries have gone up the ladder and many of them have successfully used pharmacists to improve the health of patients and the public. These countries include South Korea and Taiwan where dispensing separations were done and the pharmacist’s role strengthened as a result of the effort.

Pakistan can learn lessons from these countries to overcome these challenges. This brief report identifies some of the challenges pharmacists in Pakistan are facing; opportunities needed for capacity building and policy reform recommendations. An informal poll was conducted using a closed Facebook group ensuring engagement and comments from pharmacists across the various pharmacy sectors. The poll asked the pharmacists to comment on the concerns and challenges that the workforce in Pakistan is currently facing. 342 comments were received and analysed. Key themes were identified and aligned to the FIP Workforce Development Goals (WDG)