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Bridging the gap between pharmacy and public health

All throughout my professional experience, either in humanitarian programs or in international collaborative research, I have often been frustrated by the perception of pharmacy as a purely 'technical' issue.

26-04-17 - Raffaella Ravinetto

Image 1/2 : Raffaella Ravinetto in Burkina Faso

Many influential actors, including public health advisors and policy makers, consider pharmacy and pharmaceutical quality assurance as a bunch of complicated technical procedures and regulatory requirements, which are adequately dealt with by somebody else, somewhere else.

The field reality that I witnessed over time, in Sub-Saharan Africa and in Latin America, is quite different: poor pharmaceutical quality systems are not always adequately dealt with by somebody, somewhere. Poor-quality medicines are a real thing, and they put at stake the safety and wellbeing of patients, as well as the performance of health systems.

It is undeniable that there is growing awareness that poor-quality medicines are a threat to individual and public health. But pharmacy keeps on being confined to technical fora, and the observation and findings of field pharmacists hardly reach public health policy makers. I suspect that even when the QUAMED project was started at ITM, it may have been seen as a strange outlier: why should an 'operational program', which performs quality audits at pharmaceutical suppliers to orient the purchasing policies of NGOs and procurement centers, be incubated within an academic institution?

That’s why I am so happy to see that our seven-year collaboration has allowed us to build an innovative alliance between quality assurance experts (at QUAMED) and public health researchers (at ITM). And this is not only a theoretical stance. We have just jointly published an original research paper (*), led by Ariadna Nebot (in the frame of the master's thesis) and Benedetta Schiavetti, where we assessed the quality systems of pharmaceutical distributors active in Sub-Saharan Africa, based on data originally collected by QUAMED pharmacists during their 'operational' audits: this time, pharmacists’ findings did not stay confined to technical fora, but they fed research that will hopefully support advocacy for universal access to quality-assured medicines.

This paper is the first step of a broader research plan, that relies on QUAMED skills and data, as well as on the enthusiasm of young researchers. Kerlijn Van Assche is already completing a second analysis based on QUAMED database (started in the frame of her master thesis). We hope that this work has a real  potential to provide field-rooted, evidence-based knowledge to inform the scientific community and the policy makers in health systems, and contribute to the goal of universal access to safe medicines.

(*) Nebot Giralt A, Schiavetti B, Meessen B, Caudron JM, Marchal B, Massat P, Thys S and Ravinetto R. Quality assurance of medicines supplied to low income and middle-income countries: poor products in shiny boxes?. BMJ Global Health 2017;2:e000172. doi:10.1136/bmjgh-2016-000172

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