The challenge to the profession of pharmacy and to FIP · 2008. 11. 25. · Jean PARROT, FIP...
Transcript of The challenge to the profession of pharmacy and to FIP · 2008. 11. 25. · Jean PARROT, FIP...
1
Responding to the HIV/AIDS crisis in resource-limited settings: the role of pharmacists in improving access to and use of medicines
Responding to the HIV/AIDS crisis in Responding to the HIV/AIDS crisis in resourceresource--limited settings: the role of limited settings: the role of pharmacists in improving access to and pharmacists in improving access to and use of medicinesuse of medicines
The challenge to the profession of pharmacy and to FIP
Jean PARROT, FIP PresidentTuesday 7 September 2004
The challenge to the profession of pharmacy and to FIP
Jean PARROT, FIP PresidentTuesday 7 September 2004
2
Alarming figuresAlarmingAlarming figuresfigures
What the HIV/AIDS pandemic is today:
• 38 million people were estimated to be infected with HIV in the world in 2003 (70% of them live in Africa)
• 3 million people died last year
• and 5 million people became infected with HIV
What the HIV/AIDS pandemic is today:
• 38 million people were estimated to be infected with HIV in the world in 2003 (70% of them live in Africa)
• 3 million people died last year
• and 5 million people became infected with HIV
3
Inequality in treatment accessInequalityInequality in in treatmenttreatment accessaccess
• 6 million people should receive a treatment
• but only 400,000 patients are getting it
• The HIV/AIDS pandemic highlights the current inequality in health-care access.
• 6 million people should receive a treatment
• but only 400,000 patients are getting it
• The HIV/AIDS pandemic highlights the current inequality in health-care access.
4
The needs in limited resource settings
TheThe needs needs in in limitedlimited resource settingsresource settings
ØMany healthcare systems are unable to respond to increasing demands related to the pandemic, due to:Ø
• lack of money and human resources• lack of basic infrastuctures (sanitation, water...)• poor geographical access
ØMany healthcare systems are unable to respond to increasing demands related to the pandemic, due to:Ø
• lack of money and human resources• lack of basic infrastuctures (sanitation, water...)• poor geographical access
5
132037.30%19.61%330,000Botswana
1,785,000
6256.70%3.75%1,110,000Kenya
32,000,000
22313.50%6.73%240,000Centrafr. Rep
3,800,000
620.80%0.44%41,000Senegal
10,100,000
50.20%0.09%5,000Denmark
5,360,000
20.40%0.20%120,000France
60,140,000
Infected persons per pharmacist
Infected adults (adult
rate)
Infected adults (total population
rate)
Infected adultsCountryPopulation
Sources : population : ONU 2004; infected persons and %: ONUSIDA 2004; pharmacists : OMS 1999; For Botswana : 2004 (Health ministry)
6
The needs in limited resource setting
TheThe needs needs in in limitedlimited resource settingresource setting
Ø Inadequacy of the health system to respond to the increasing demand related to the HIV/AIDS pandemicØLack of human resources ØLack of infrastructureØPoor geographical access
Ø Inadequacy of the health system to respond to the increasing demand related to the HIV/AIDS pandemicØLack of human resources ØLack of infrastructureØPoor geographical access
7
All is not darkAll All isis not not darkdark
ØOpportunities:
• stronger international determination:
- to increase human and financial resources;- to improve access to ARV medicines and provision
of care in developing countries
ØOpportunities:
• stronger international determination:
- to increase human and financial resources;- to improve access to ARV medicines and provision
of care in developing countries
8
MeansMeansMeans
Some financial response now exists at international level (Global fund, private foundations, NGOs) and at national level
But the outcome depends on the capacity of health professions to mobilise
Some financial response now exists at international level (Global fund, private foundations, NGOs) and at national level
But the outcome depends on the capacity of health professions to mobilise
9
I - The challenges for pharmacistsI I -- TheThe challenges for challenges for pharmacistspharmacists
10
The challenges for pharmacistsTheThe challenges for challenges for pharmacistspharmacists
ØContinuing education and training on ARV and other HIV related treatments
ØMobilisation to participate in local projects using international HIV/AIDS funds
ØContinuing education and training on ARV and other HIV related treatments
ØMobilisation to participate in local projects using international HIV/AIDS funds
11
The challenges for pharmacistsTheThe challenges for challenges for pharmacistspharmacists
1) To ensure efficient logistics of ARV drug supplying2) To give pharmaceutical care and support to patients treated with ARV drugs3) To achieve Quality Assurance throughout
all processes
1) To ensure efficient logistics of ARV drug supplying2) To give pharmaceutical care and support to patients treated with ARV drugs3) To achieve Quality Assurance throughout
all processes
12
1) HIV drug supplying1) HIV 1) HIV drugdrug supplyingsupplying
ØThe efficacy of HIV related treatment demands:
• quality of medicine sources (no defective oucounterfeit medicines)
• safe medicine management (transport and conservation)
• uninterrupted medicine supplying
ØThe efficacy of HIV related treatment demands:
• quality of medicine sources (no defective oucounterfeit medicines)
• safe medicine management (transport and conservation)
• uninterrupted medicine supplying
13
2) Treatment optimisation2) 2) TreatmentTreatment optimisationoptimisation
ØTo optimise the conduct of the treatment with the patient:
• - explain the treatment, its challenge, how to use the drug, when to take it, how to organise a care plan, ...
• - enhance adhesion to the treatment• - detect failure factors • - give permanent support to the patient
ØTo optimise the conduct of the treatment with the patient:
• - explain the treatment, its challenge, how to use the drug, when to take it, how to organise a care plan, ...
• - enhance adhesion to the treatment• - detect failure factors • - give permanent support to the patient
14
3) Quality Assurance, the heartof the process
3) 3) QualityQuality Assurance, Assurance, thethe heartheartof of thethe processprocess
Ø To be trusted by possible partners as a reliable professional, the pharmacist should be able to evaluate his contribution within an HIV/AIDS project:
§ Patient follow-up files§ Analysis and use of patient’s data§ Evaluation of treatment conduct (adherence criteria, …)
Ø To be trusted by possible partners as a reliable professional, the pharmacist should be able to evaluate his contribution within an HIV/AIDS project:
§ Patient follow-up files§ Analysis and use of patient’s data§ Evaluation of treatment conduct (adherence criteria, …)
15
II - The challenges for pharmaceutical associations (national
organisations, NGOs, …)
II II -- TheThe challenges challenges for for pharmaceuticalpharmaceutical associations (national associations (national
organisations, NGOs, …)organisations, NGOs, …)
16
The challenges are: TheThe challenges are: challenges are:
Ø To show determination to be involved in projects developed in their countries Ø To represent the profession in national working
groups in charge of devising and implementing local projectsØ To develop strategies and support (guidelines...)
for training
Ø To show determination to be involved in projects developed in their countries Ø To represent the profession in national working
groups in charge of devising and implementing local projectsØ To develop strategies and support (guidelines...)
for training
17
An example: the ESTHER initiative in France
An An exampleexample: : thethe ESTHER ESTHER initiative in Franceinitiative in France
‘ESTHER’: ‘Ensemble Solidarité Thérapeutique Hospitalière En Réseau’
i. e:‘Together for Solidarity, Hospital Network Care’
www.esther.org
‘ESTHER’: ‘Ensemble Solidarité Thérapeutique Hospitalière En Réseau’
i. e:‘Together for Solidarity, Hospital Network Care’
www.esther.org
18
III - The challenges for FIPIII III -- TheThe challenges for FIPchallenges for FIP
19
FIP’s initiatives (1)FIP’s initiatives (1)FIP’s initiatives (1)
ØFIP advocates the involvement of pharmacists at global level• In 1997, FIP and WHO signed a joint statement
highlighting the need for pharmacists to contribute to the prevention of HIV transmission: The Vancouver Declaration
• In 2004, a WHPA resolution “Health professionals Issue a Wake up Call on AIDS”
ØFIP advocates the involvement of pharmacists at global level• In 1997, FIP and WHO signed a joint statement
highlighting the need for pharmacists to contribute to the prevention of HIV transmission: The Vancouver Declaration
• In 2004, a WHPA resolution “Health professionals Issue a Wake up Call on AIDS”
20
FIP’s initiatives (2)FIP’s initiatives (2)FIP’s initiatives (2)
ØOthers statements or documents on limited resource settings:• Statement of policy on Counterfeit Medicines• Statement on Quality and Safety of medicinal
products• Policy document on Good Practice in the Donation of
Medicines• A report, Good Pharmacy Practice in Developing
Countries: Recommandations for step-wiseimplementation
ØOthers statements or documents on limited resource settings:• Statement of policy on Counterfeit Medicines• Statement on Quality and Safety of medicinal
products• Policy document on Good Practice in the Donation of
Medicines• A report, Good Pharmacy Practice in Developing
Countries: Recommandations for step-wiseimplementation
21
FIP’s initiatives (3)FIP’s initiatives (3)FIP’s initiatives (3)
ØFIP has created Regional Pharmaceutical Forums in collaboration with WHO
They gather national Pharmaceutical Associations and the WHO Regional Office for implementing local programs to meet local needs
ØFIP has created Regional Pharmaceutical Forums in collaboration with WHO
They gather national Pharmaceutical Associations and the WHO Regional Office for implementing local programs to meet local needs
22
Copenhagen, Denmark - EuroPharm Forum created in 1992
Brazzaville, Congo – African Forum created in 2004
Cairo, Egypt – Eastern Mediteranean Forum
created in 2002
Washington, DCAmericas ForumCreated in 2000
New Delhi, IndiaSEARPharm
ForumCreated in 2001
Manila, PhilippinesWestern Pacific Forum
created in 2001
Joint development of regional pharmaceutical forums by FIP and
WHO
Joint development of regional Joint development of regional pharmaceutical forums by FIP and pharmaceutical forums by FIP and
WHOWHO
23
A new FIP achievement in 2004
A new FIP A new FIP achievement achievement in 2004in 2004
ØAn Online Resource Centre on HIV/AIDS for pharmacists:
the International Network for Pharmacists on HIV/AIDS, launched in September 2004
www.fip.org/hivaids
ØAn Online Resource Centre on HIV/AIDS for pharmacists:
the International Network for Pharmacists on HIV/AIDS, launched in September 2004
www.fip.org/hivaids
24
A new FIP achievement (2)A new FIP A new FIP achievement (2)achievement (2)
Øwww.fip.org/hivaids is an oneline network:§ reserved for pharmacists§ bilingual (English/French)
Ø It provides pharmacists with:§ information, through links to many relevant international or
national organisations§ training modules for pharmacists§ a place to exchange with each other (mailing list)§ an interactive Events Calendar
Øwww.fip.org/hivaids is an oneline network:§ reserved for pharmacists§ bilingual (English/French)
Ø It provides pharmacists with:§ information, through links to many relevant international or
national organisations§ training modules for pharmacists§ a place to exchange with each other (mailing list)§ an interactive Events Calendar
25
http://www.fip.org/hivaidshttp://http://www.fip.orgwww.fip.org//hivaidshivaids
26
The Network objectives (1)TheThe Network objectives (1)Network objectives (1)
ØTo promote the role of pharmacists in the fight against HIV/AIDSØTo facilitate collaboration between individual
pharmacists, professional associations and Regional Pharmaceutical ForumsØTo facilitate global collaboration between
pharmacists and other health professionals involved
ØTo promote the role of pharmacists in the fight against HIV/AIDSØTo facilitate collaboration between individual
pharmacists, professional associations and Regional Pharmaceutical ForumsØTo facilitate global collaboration between
pharmacists and other health professionals involved
27
The Network objectives (2) TheThe Network objectives (2) Network objectives (2)
ØTo provide an e-mail list for sharing experience between interested organizations and individualsØTo participate in international AIDS conferences
by organizing or supporting presentations relevant to pharmacistsØTo collect and distribute information on
pharmacy-related HIV/AIDS activities and pharmacy-based research on HIV/AIDS
ØTo provide an e-mail list for sharing experience between interested organizations and individualsØTo participate in international AIDS conferences
by organizing or supporting presentations relevant to pharmacistsØTo collect and distribute information on
pharmacy-related HIV/AIDS activities and pharmacy-based research on HIV/AIDS
28
CONCLUSIONCONCLUSIONCONCLUSION
ØHIV/AIDS is a challenge for society as a whole
ØPharmacists, among all health professionals, are uniquely embedded in their local communities
ØThey have a duty to take up that challenge and live up to it.
ØHIV/AIDS is a challenge for society as a whole
ØPharmacists, among all health professionals, are uniquely embedded in their local communities
ØThey have a duty to take up that challenge and live up to it.