The challenge to the profession of pharmacy and to FIP

Transcription

1 Responding to to the HIV/AIDS crisis in in resource-limited settings: the role of of pharmacists in in improving access to to and use of of medicines The challenge to the profession of pharmacy and to FIP Jean PARROT, FIP President Tuesday 7 September

2 Alarming figures What the HIV/AIDS pandemic is is today: million people were estimated to to be be infected with HIV in in the world in in 2003 (70% of of them live in in Africa) 3 million people died last year and 5 million people became infected with HIV 2

3 Inequality in treatment access 6 million people should receive a treatment but only 400,000 patients are getting it it The HIV/AIDS pandemic highlights the current inequality in in health-care access. 3

4 The needs in limited resource settings Many healthcare systems are unable to respond to increasing demands related to the pandemic, due to: lack of of money and human resources lack of of basic infrastuctures (sanitation, water...) poor geographical access 4

5 Country Population Infected adults Infected adults (total population rate) Infected adults (adult rate) Infected persons per pharmacist France 60,140, , % 0.40% 2 Denmark 5,360,000 5, % 0.20% 5 Senegal 10,100,000 41, % 0.80% 62 Centrafr. Rep 3,800, , % 13.50% 223 Kenya 32,000,000 1,110, % 6.70% 625 Botswana 1,785, , % 37.30% 1320 Sources : population : ONU 2004; infected persons and %: ONUSIDA 2004; pharmacists : OMS 1999; For Botswana : 2004 (Health ministry) 5

6 The needs in limited resource setting Inadequacy of the health system to respond to the increasing demand related to the HIV/AIDS pandemic Lack of human resources Lack of infrastructure Poor geographical access 6

7 All is not dark Opportunities: stronger international determination: -- to to increase human and financial resources; -- to to improve access to to ARV medicines and provision of of care in in developing countries 7

8 Means Some financial response now exists at at international level (Global fund, private foundations, NGOs) and at at national level But the outcome depends on the capacity of health professions to mobilise 8

9 I - The challenges for pharmacists 9

10 The challenges for pharmacists Continuing education and training on ARV and other HIV related treatments Mobilisation to participate in in local projects using international HIV/AIDS funds 10

11 The challenges for pharmacists 1) 1) To ensure efficient logistics of ARV drug supplying 2) 2) To give pharmaceutical care and support to patients treated with ARV drugs 3) 3) To achieve Quality Assurance throughout all processes 11

12 1) HIV drug supplying The efficacy of HIV related treatment demands: quality of of medicine sources (no defective ou ou counterfeit medicines) safe medicine management (transport and conservation) uninterrupted medicine supplying 12

13 2) Treatment optimisation To optimise the conduct of the treatment with the patient: --explain the treatment, its its challenge, how to to use the drug, when to to take it, it, how to to organise a care plan, enhance adhesion to to the treatment --detect failure factors --give permanent support to to the patient 13

14 3) Quality Assurance, the heart of the process To To be be trusted by by possible partners as as a reliable professional, the pharmacist should be be able to to evaluate his contribution within an an HIV/AIDS project: Patient follow-up files files Analysis and and use use of of patient s data Evaluation of oftreatment conduct (adherence criteria, ) ) 14

15 II II - The challenges for pharmaceutical associations (national organisations, NGOs, ) 15

16 The challenges are: To show determination to to be involved in in projects developed in in their countries To represent the profession in in national working groups in in charge of of devising and implementing local projects To develop strategies and support (guidelines...) for training 16

17 An example: the ESTHER initiative in France ESTHER : Ensemble Solidarité Thérapeutique Hospitalière En En Réseau i. i. e: e: Together for for Solidarity, Hospital Network Care 17

18 III - The challenges for FIP 18

19 FIP s initiatives (1) FIP advocates the involvement of pharmacists at at global level In In 1997, FIP and WHO signed a joint statement highlighting the need for pharmacists to to contribute to to the prevention of of HIV transmission: The Vancouver Declaration In In 2004, a WHPA resolution Health professionals Issue a Wake up up Call on on AIDS 19

20 FIP s initiatives (2) Others statements or documents on limited resource settings: Statement of of policy on on Counterfeit Medicines Statement on on Quality and Safety of of medicinal products Policy document on on Good Practice in in the Donation of of Medicines A report, Good Pharmacy Practice in in Developing Countries: Recommandations for step-wise implementation 20

21 FIP s initiatives (3) FIP has created Regional Pharmaceutical Forums in in collaboration with WHO They gather national Pharmaceutical Associations and the WHO Regional Office for implementing local programs to meet local needs 21

22 Joint development of regional pharmaceutical forums by FIP and WHO Copenhagen, Denmark - EuroPharm Forum created in 1992 Washington, DC Americas Forum Created in 2000 Manila, Philippines Western Pacific Forum created in 2001 Brazzaville, Congo African Forum created in 2004 Cairo, Egypt Eastern Mediteranean Forum created in 2002 New Delhi, India SEARPharm Forum Created in

23 A new FIP achievement in 2004 An Online Resource Centre on HIV/AIDS for pharmacists: the International Network for Pharmacists on HIV/AIDS, launched in in September

24 A new FIP achievement (2) is is an oneline network: reserved for for pharmacists bilingual (English/French) It It provides pharmacists with: information, through links links to to many relevant international or or national organisations training modules for for pharmacists a place to to exchange with witheach other (mailing list) list) an an interactive Events Calendar 24

25 hivaids 25

26 The Network objectives (1) To promote the role of pharmacists in in the fight against HIV/AIDS To facilitate collaboration between individual pharmacists, professional associations and Regional Pharmaceutical Forums To facilitate global collaboration between pharmacists and other health professionals involved 26

27 The Network objectives (2) To provide an list for sharing experience between interested organizations and individuals To participate in in international AIDS conferences by organizing or supporting presentations relevant to pharmacists To collect and distribute information on pharmacy-related HIV/AIDS activities and pharmacy-based research on HIV/AIDS 27

28 CONCLUSION HIV/AIDS is is a challenge for society as a whole Pharmacists, among all health professionals, are uniquely embedded in in their local communities They have a duty to totake up that challenge and live up to to it. it. 28