Health workers and volunteers read out handouts to local villagers on how to protect themselves from ebola virus, Liberia. (Source: Rex Features / Eyepress / SIPA)
Pharmacists working in West Africa have spoken about the overwhelming scale of the challenges they have faced in Liberia in the battle against the Ebola virus.
They paint a picture of a system unable to cope and a problem that is beyond the “capacity and responsibility of any single government”.
They speak of pharmacists ill-equipped to manage the disease and of pharmacy technicians dying because they lack the necessary protective clothing.
The frank disclosures come from Lloyd Matowe, program director for Pharmaceutical Systems Africa — an organisation devoted to developing sustainable supply chains in developing countries — and John H Harris, from the Liberian government’s health and social welfare department, where he is responsible for supply chain management.
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Drugs in development can be used for the treatment of Ebola, an international panel of ethics experts has recommended to the World Health Organization.
Marie-Paule Kieny, assistant director general of the World Health Organization, told the media that compassionate use of experimental treatments provided an opportunity to “right a wrong” (Source: AP / Press Association Images)
Drugs in development can be used for the treatment or prevention of the Ebola virus, an international panel of ethics experts has recommended to the World Health Organization (WHO).
But the panel of scientists, researchers and ethicists have attached a number of caveats to their unanimous decision, including a commitment that patient consent should be sought and that there should be freedom of choice.
The panel also agreed there is a moral obligation to share all data in cases where experimental drugs are used and to move these drugs into clinical trials.
The 12-person panel was convened by the WHO and met on 11 August 2014 in Geneva to consider whether it is ethical to make experimental treatments available to people affected by the Ebola crisis, even though there have been no clinical trials to prove they are safe for human use.
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World Health Organization takes steps to dampen public expectation about the potential of drugs in development to fight the virus.
Liberians read the ’daily talk’ chalkboard on the Ebola crisis in the capital Monrovia. According to statistics from the World Health Organization, as of 16 August 2014, 1,229 people have died from Ebola in West Africa (Source: epa european pressphoto agency b.v. / Alamy)
Pharmacists and pharmacy students in Liberia are to visit drug stores and pharmacies to give staff advice about preventing the spread of the Ebola virus in the country’s capital city Monrovia.
The initiative is being led by the Pharmaceutical Association of Liberia and will start on Wednesday 20 August 2014.
Pharmacists will also hand out flyers at premises across the capital, which explain how staff and the public can protect themselves and to help dispel myths that are circulating about how the virus is caught.
At the same time, the country’s medicines control authority is inspecting pharmacy premises to make sure that drug counterfeiters are not bringing fake Ebola products on to the market, exploiting the current climate of public fear.
“The profession has taken up health promotion and information dissemination sessions, starting with pharmacies and medicines stores,” explains Lloyd Matowe, program director for Pharmaceutical Systems Africa — an organisation devoted to setting up sustainable supply chains in developing countries.
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As West African countries struggle to manage the current Ebola outbreak, more needs to be done internationally to improve the capabilities of the local pharmacy workforce.
West Africa is currently in the grip of a terrifying outbreak of the Ebola virus disease (EVD). As of 26 August 2014, 3,069 people have been identified with the virus, of whom 1,552 (50.6%) have died. The outbreak currently involves Sierra Leone, Guinea, Liberia, Nigeria and, most recently, the Democratic Republic of Congo, and there are fears that it may elude stringent precautions and spread into further territories.
Governments and the international community are trying to bring the epidemic under control and to contain its spread. Some of the measures taken so far to limit the possible spread of Ebola to other countries include quarantining whole communities in affected areas, closing borders and reducing flights to affected areas. At the time of writing, British Airways, among other airlines, had stopped flights to Liberia and Sierra Leone — two of the most badly affected countries.
As the epidemic continues to wreak havoc within one of the world’s poorest regions, pharmacists, both in the affected countries and internationally, should reflect on what role their profession should play in epidemics such as this. In a 2012 article in The Pharmaceutical Journal, my colleagues and I called for pharmacists in developing countries, particularly those in Africa, to take a stronger position in the battle against the enduring epidemics of HIV/AIDS, malaria and tuberculosis. Little did we know then that Ebola would be spoken about in the same terms.
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Lloyd Matowe and colleagues look at how the role of pharmacists in developing countries could be enhanced. The definition of public health has evolved over the years. An early definition by Winslow described it as the science and art of preventing disease, prolonging life and promoting physical and mental health and well-being through the organised efforts of the community. Winslow went on to elucidate that these community efforts needed to encompass sanitation for the environment, the control of community infections, education of individuals in principles of personal hygiene and the organisation of medical and nursing services for prevention and early diagnosis of diseases.
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Lloyd Matowe, Pharmaceutical Systems Africa And Amani Thomas Mori, Muhimbili University Of Health And Allied Sciences, Tanzania
Population health deals with health beyond the individual. It addresses the combined impact of social determinants such as environment and social structure and includes health care. With the role of pharmacists traditionally centering on the supply and distribution of medicines, pharmacists, particularly in low and middle income countries, have been viewed as having little to do with population health. Yet ironically, the community pharmacy is often the first port of call for most people with minor ailments. Pharmacists are thus strategically positioned to provide essential services that promote, maintain and improve the health of the population in the broadest sense.
Pharmacy is an age old profession that deals with the science of making and administering medicines. Over the years, the profession has evolved to encompass a wide range of service areas. In high income countries these areas and roles are well defined and structured. In low and middle income countries, this is not the case. Often pharmacists in these counties have to carve their own individual career pathways that may not bear any relationship to their professional training. In most cases however, pharmacists in low and middle income countries work in dispensing roles, mainly in community pharmacies.