| The HIV/AIDS epidemic is a significant health risk to individuals and
communities living in Commonwealth countries. The two regions reported
to have the highest adult prevalence rates are sub-Saharan Africa (8.8
per cent) and the Caribbean (2.4 per cent).1 It is appropriate and timely
that the Commonwealth Pharmaceutical Association (CPA) issues a statement
concerning the role of the pharmacist in the fight against HIV/AIDS.
Process
This statement is based on the outcomes of a symposium and workshop held
during the Eighth CPA Conference held in Ocho Rios, Jamaica, in August
2003. Over 200 pharmacists from 40 Commonwealth countries attended
the workshop.
During the symposium, delegates were updated on the latest epidemiological
situation and recent developments in approaches to prevention, care and
treatment of HIV/AIDS. At workshop sessions, participants combined information
and experience to define more prominent and constructive roles for pharmacists
in the fight against HIV/AIDS. Practical strategies for implementation
by national pharmaceutical associations as well as by pharmacists as
individuals, resulted from intensive discussion among the diverse groups
participating in the workshop.
CPA pharmacists were renewed in their conviction that they can contribute
proactively to the prevention of HIV infection and the treatment of HIV/AIDS
patients and they are committed to this in the interest of public health.
The findings of the CPA workshop reaffirmed many of the guiding principles
expressed in the 1997 joint declaration between the World Health Organization
and the International Pharmaceutical Federation.2
Outcomes from the Ocho Rios workshops
General statements
• Pharmacists are members of multiprofessional health care teams
• Pharmacists are the primary legal custodians of medicines and consumer
health educators. Walk-in access to pharmacies
and clinics enables any member of the community to consult directly
with a trained health professional
• Pharmacists play an important role in helping to break down the
stigma and discrimination associated with the disease, in providing
advice
and materials in relation to the prevention of HIV infections and
in providing
counselling and treatment in the care of HIV infected persons
• Pharmacists are committed to working collaboratively with other
health professionals to improve health outcomes for communities,
patients
and their carers
• Pharmacists will work to ensure that both undergraduate
and postgraduate training and education will prepare the
pharmacist to deliver professional treatment, advice and information
in a caring and confidential environment
• Pharmacists are committed to working with governments in the
development and implementation of policies and strategies to improve
access to
information and in the provision of affordable antiretroviral therapy
• The CPA and its member associations will work strategically with
the Commonwealth Secretariat and the World Health Organization
in facilitating and promoting the contribution of pharmacists to
the
fight against
HIV/AIDS
Opportunities for action
International level At the international level the CPA will:
• Work in collaboration with the priorities and programmes of the Commonwealth
Secretariat, United Nations organisations, national and international
agencies and other health-related non-governmental organisations, to
assist and promote the role and participation of pharmacists in all aspects
of prevention of HIV/AIDS and the treatment and care of AIDS patients
• Disseminate information on the latest developments and practices in
the care and treatment of HIV/AIDS patients
National level At the national level the CPA will encourage member pharmaceutical
associations to:
• Develop country-specific strategies and standard operating procedures
to assist pharmacists to fulfil their role in the fight against the HIV/AIDS
epidemic
• Adopt a multisectoral approach and work strategically with the ministry
of health, other related ministries and government agencies and promote
the involvement of pharmacists in the development and implementation
of strategies to combat HIV/AIDS
• Nominate pharmacists to positions on national government and professional
committees relating to HIV/AIDS
• Lobby politicians and government health agencies to involve pharmacists
in decision-making processes in policy development and implementation
to control and manage the pandemic
• Enable access to updated information necessary for pharmacists to fulfil
their role as part of the health care team
• Provide continuing education programmes on HIV/AIDS prevention and
management and facilitate access to courses provided by other institutions
• Ensure the ministry of education, universities and training institutions
include HIV/AIDS specific educational material in the training curriculum
of pharmacists, health professionals and pharmacy support staff
• Undertake promotional campaigns and provide relevant materials for
pharmacists to carry out consumer and staff information, education and
training activities
• Facilitate the participation of pharmacists in scientific and operational
research to continually evaluate and improve the quality of care and
treatment of HIV/AIDS
Individual level At the individual level the CPA will encourage pharmacists
to:
• Provide services without prejudice or discrimination and maintain
patient confidentiality
• Use all available channels to be informed and updated about HIV/AIDS
• Adequately train support staff to provide relevant information and
services to HIV/AIDS patients and their carers
• Participate fully in local and national HIV/AIDS consumer education
campaigns
• Provide consumers with information and provide an appropriate facility
for confidential counselling
• Collaborate with other health care providers to enhance the team effort
• Participate in operational research to continually evaluate and improve
the quality of care and treatment of HIV/AIDS
Implementing strategies
The CPA encourages all pharmacists and pharmaceutical associations
to adopt a multisectoral approach when implementing strategies, to acknowledge
cultural and social sensitivities and to promote equitable access to
all medicines, information and services. Working
with consumers and communities Globally, no more than than one
person in five has access to basic HIV prevention programmes.3 The CPA
encourages pharmacists to become more proactive in using proven prevention
programmes to increase community access to reliable information.
Pharmacists can inform, educate and communicate using a combination of
prevention strategies:
• Posters in pharmacies — designed to target specific groups,
eg, orphans, women, adolescents, mobile populations, intravenous drug
users and breast-feeding mothers
• Easy-to-read leaflets in local languages to increase awareness among
at-risk groups as well as the general population
• Videos and talks to schools, community organisations, religious organisations,
clubs, health fairs, women’s groups
• Pharmacist-operated hotlines
• Media presentations, eg, television, radio (phone-in programmes, newspaper
question-and-answer features)
• “Ask your pharmacist” campaigns
• Promotion of safer sex messages through peer group presentations
Pharmacists can deliver quality pharmaceutical care and treatment by
ensuring:
• Good dispensing practice
• Confidential counselling areas in pharmacies and clinics
• Follow-up support for patients and carers to promote adherence. (Support
services could include medication reviews and pharmacist-led clinics
for treatment of opportunistic infections.)
Working with governments Collaboration with government will increase
opportunities to:
• Build working relationships with parliamentary and political representatives
at local and national levels
• Participate in the development and implementation of healthy lifestyle
and safer sex campaigns
• Acknowledge the wider social, economic and financial implications of
HIV/AIDS
• Advocate for inclusion of antiretroviral drugs in national health lists,
protocols and systems
• Promote antiretroviral drug supply at lowest prices through:
• Development of consistent and effective policies and strategies
• Implementation of legislation and licensing, safeguarding public health
in compliance with the Trade Related Aspects of Intellectual Property
Rights (TRIPS) Agreement
• Embracing the safe use of quality generics
• Engage in operational research projects to gather evidence of pharmacy
input and impact
• Include pharmacist representation on relevant committees/ bodies
• Advocate remuneration of cognitive services
Working with other stakeholders Harnessing the strengths and resources
of diverse stakeholders will lead to:
• Involvement of professional and community groups, (eg,
faith-based groups, service groups, patient groups, employers) in both
prevention and treatment strategies
• Co-ordinated activities with other established HIV/AIDS groups at national,
regional and community level
• Utilisation of public–private partnerships to increase capacity
to deliver pharmacy services and negotiate prices of antiretroviral drugs
References
1. UNAIDS and World Health Organization. Regional HIV/AIDS statistics
and features, end of 2002. Geneva: UNAIDS; 2002.
2. International Pharmaceutical Federation and World Health Organization.
The role of the pharmacist in the fight against the HIV-AIDS pandemic.
The Hague, The Netherlands: FIP; 1997.
3. Global HIV Prevention Working Group. Access to HIV prevention:
closing the gap. May 2003. |
Commonwealth Pharmaceutical Association