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The Pharmaceutical Journal Vol 265 No 7112 p333-334
September 2, 2000 International

Pharmacy World Congress

Health, wealth and biotechnology

The sound of zithers and trombones greeted pharmacists from all over the world to Vienna, venue of the Pharmacy World Congress 2000 and the 60th international congress of the International Pharmaceutical Federation, which took place from August 27 to 31. The theme of the congress was "Pharmacy in the 21st century: the way forward"

Despite constant attempts at control by politicians, the costs of fighting disease and preserving health will continue to rise, the president of FIP, Mr PETER KIELGAST, said at the congress opening ceremony on August 27.
At present, people aged over 65 years constituted 16 per cent of the population in Western Europe. By 2030, the figure would have risen to 25 per cent, and by 2050 to 30 per cent. However, the innovations of the pharmaceutical industry would ensure that there would be better and more expensive drugs to treat "the ageing world".
Mr Kielgast said that pharmacists could be pleased to be in a market of growth: the consumption of drugs would increase concurrently with the biological ageing of the population. Yet, there were some who believed that pharmacists were a threatened species. Was that because pharmacists belonged to a group that was unwilling to change. "In a world with rapid changes, we must have the courage to question whether what we do every day is a manifestation of the most cost-effective exploitation of our competence," said Mr Kielgast.
He reminded the audience that FIP was a global organisation whose task was to set standards for good pharmacy practice and to ensure that national pharmaceutical organisations had a forum for further development. But it had another professional role: that of a co-operating partner with the World Health Organisation which would secure the active involvement of the pharmaceutical profession when the WHO's various strategic aims and operation plans were to be implemented.

Austria Center
Conference venue: the Austria Center, by the River Danube in Vienna

Health improvement

Although disease did not distinguish between rich and poor, the largest health problems were found in developing countries. As a consequence, the director general of the WHO had appealed to the worlds' political leaders to invest in improving health. Improved health would result in increased productivity and wealth, and increased wealth would provide the possibility for channelling more resources into the fight against disease.
To illustrate this point, Mr Kielgast mentioned malaria and AIDS, both of which were spread mainly in developing countries and both of which represented two of the most prioritised areas of action for the WHO.
Malaria could be prevented, treated and cured. Ninety per cent of the world's cases occurred in Africa and it had been estimated that the disease cost African countries some $12bn annually. The disease could be kept under control for a fraction of this amount. The most important effort as far as malaria was concerned was the provision of information, and pharmacists had a role to play in that.
Africa, too, was the continent most badly hit by AIDS. According to an estimate by the United Nations, 25 million of the 34 million people infected world-wide lived in Africa, where 19 million people had died of the disease. In the highly technologically developed part of the world, AIDS was becoming a disease like any other, because efficient treatments were now available and infected persons could be kept alive for much longer than before. It was the economical aspects of treatment that made this impossible in Africa. Poverty increased the problem, and 10 years from now life expectancy for a citizen of Botswana would have dropped to 29 years - lower than it had been 1,000 years ago.
However, poverty did not cause AIDS: a virus did. And even though the pharmaceutical industry had been urged strongly to make medicines available at affordable costs, the most efficient solution to the AIDS problem in Africa was increased information provision. AIDS was, after all, mainly a sexually transmitted infection and effective preventive efforts would have to take this tabooed theme - in most parts of Africa - into consideration.

Peter Kielgast
Peter Kielgast: FIP will in future have to deal with some important issues with a profound effect on the pharmaceutical profession

Mapping the human genome

Turning to the recent mapping of the human genome, Mr Kielgast said that this was a fantastic scientific conquest - a significant triumph at the symbolic time of the beginning of a new millennium. He said: "Although this marks the beginning rather than the goal of scientific research, it constitutes the access to a target-oriented search for medicines with no side effects and diagnostic agents which will make it possible to increase the number of diseases that can be treated or even cured."
But here was an area which was scientifically and ethically unmapped. For example, it would usually be considered an advantage for a physician to have a comprehensive genetic profile of his patients. Yet that advantage might not seem so obvious if employers or insurance companies had the same knowledge. It became even more unpredictable when the consequences of genetic engineering in the human embryo were considered.
A related area was genetically modified food, about which there had been much controversy, especially in Europe, where manufacturers and retailers had been pressed to banish the goods from warehouses and shelves.
But, potentially, GM foods had a lot to offer. They could be grown more easily, they could be stored for longer, they could be less likely to trigger allergies - and they might even taste better. So why had this development not been applauded as the answer to pest control and to feeding the millions of people who went to sleep hungry every night? Why had big, multinational companies that had patented GM foods and saw a thriving business ahead been met with protesters and powerful activists under the banner of the Prince of Wales?
So far, there had been less concern over biotechnological medicines. People seemed more readily to have accepted that genetic engineering could lead to better drugs and clearer diagnoses that would improve their lives.
But why this difference between medicines and food? "I think it is because it is more obvious that the consumer stands to gain quickly from advances in medicine, while that gain is not so evident in food, where those who patented new methods for farmers stood to gain a speedy return of investments," said Mr Kielgast. "For consumers in the rich world, the benefit of super-yielding soybeans is less evident: there, there is already more than enough food stored in warehouses."
Concern about the long-term effects of genetically modifying Mother Nature was understandable, and scientists, multinational companies and governments all shared a responsibility to inform and educate consumers about the benefits of scientific research.
In the area of biotechnology, it was crucial that science was not isolated from the rest of society and left to laboratories. There was a need for scientific ambitions to be co-ordinated with existing standards of practical life.
To that end, Mr Kielgast was pleased that two FIP boards - the board of pharmacy practice and the board of pharmaceutical sciences - were establishing policy committees. Indeed, the board of pharmaceutical sciences was currently working on a policy statement on genomics.

Important issues

Concluding his presentation, Mr Kielgast said that FIP would in the future have some important issues to deal with that would have a profound effect on the pharmaceutical profession. These included safeguarding genetic information, expanding diagnostic knowledge into cures, and looking at the cost-effective supply of medicines.
"We operate in a field which will remain the focus of politicians and the media," he said. But society needed the competence of pharmacists and pharmaceutical scientist, even though what they did was constantly supervised and questioned, If pharmacists could withstand public scrutiny, they would always be in demand.

André Bédat award

Mr Joep Winters, of the Netherlands, was presented with the André Bédat award during the opening ceremony of the congress on August 27. The award, which is presented every two years, is FIP's premier award for a pharmacist who has made "an outstanding contribution to international pharmacy".
The award was presented by Mr Colin Hitchings, of Great Britain, who is FIP's professional secretary. Mr Hitchings told the audience that Mr Winters was a practising community pharmacist and had been head of the Dutch delegation to the Pharmaceutical Group of the European Union from 1988 to 1996. He had been closely involved in the establishment of the Europharm Forum and, over the past three years, had been working with the Pan American Health organisation and the regional office of the World Health Organisation to set up the Pharmaceutical Forum of the Americas, to which he had been appointed technical director in 1999.

Honorary memberships bestowed

At the congress opening ceremony on August 27, honorary membership of FIP was bestowed on Dr Jo Eirik Asvall, of Norway, and on Mr George B. Griffenhagen, of the United States.
Dr Asvall, who is medically qualified, is the first non-pharmacist to be presented with honorary membership since the founding of FIP in 1912. He received it for his contribution to the development of a partnership between FIP and the World Health Organisation in the European region and for his recognition of the benefit of the pharmaceutical profession in achieving the goals of the WHO's "Health for all" policy. He was WHO's regional director for Europe from 1985 until February this year.
Mr Griffenhagen's award is for "his contribution to the pharmacy profession in general and to the development of the International Pharmaceutical Federation in particular". He is director of international affairs at the American Pharmaceutical Association, and serves FIP as observer to the WHO and to the Pan American Health Organisation. He is also an honorary member of the Royal Pharmaceutical Society of Great Britain.
Both men received their certificates of honorary membership from Mr Peter Kielgast, FIP's president.

FIP science awards

The FIP Foundation for Education and Research made two awards to pharmaceutical scientists at the congress opening session on August 27.
Professor Aquiles Arancibia, of Chile, was presented with the foundation's FIP Pharmaceutical Scientist award, and Professor James T. Doluisio, of the United States, was presented with the FIP Lifetime Achievement in the Pharmaceutical Sciences award.
Both awards were presented by Dr Dieter Steinbach (chairman of the foundation).
The congress heard that Professor Arancibia was one of the most outstanding scientists in Latin America. He had made a significant contribution to the dissemination of modern concepts of the pharmaceutical sciences in the Latin American countries.
Professor Doluisio had received his award because he had provided significant leadership to the profession of pharmacy by dedicating his five-decade career to the principle that excellence in the pharmaceutical sciences underpins excellence in pharmacy practice.