‘Have we understood the importance of healthcare system in India?’
Pharmacy education in India was an ignorant sector till now, but has gradually scaled up to match international standards. However, there are still many loopholes that exist. Sashikant Joag, General Secretary, Indian Pharmaceutical Alliance (IPA) discusses the problems of pharmacists and pharmacy trends, in conversation with Arshiya Khan
What are the problems faced by pharmacists in India?
There are more than 800 pharmacy colleges in India and there are many more still coming up. Even if we consider 50-60 students graduating every year from each college, imagine the number every year. Will these students get the right job? Are there enough employment opportunities? Will they get salary as compared to other graduates? These are few key questions. The industry is growing, the pharma sector is growing, but the need of pharmacists is decreasing because of automation. Pharmaceutical engineering is becoming more popular and industry will generally prefer engineers over pharmacists sooner or the later. What can be done of these pharmacists? The best way to tackle this issue is to get these pharmacists in to healthcare. Especially at a time when there is a high requirement of pharmacists in the rural area. So it will be apt to utilise the human capital where there is availability and requirement. What can be done is that pharmacists should be reprocessed and allowed to prescribe medicines. The best way to explain this is when there is a natural calamity—floods or other disasters, doctors can just prescribe the medicines, and pharmacists will take it further by guiding the patients on dosage management. The pharmacist could also be a service provider in the disease management especially in TB, AIDS, diabetes etc where you have regular monitoring and more so in family planning programmes.
How advanced in pharmacy education in India?
When pharmacy education came to India, we did not have proper standards, GMP practices etc in India. So the need of the hour was to have an industrial pharmacy in India and hence our focus. We have recently introduced the Pharm D course in India which will start from this year in some colleges in India and it is equivalent to Pharm D course of US. Through this course students can practice pharmacy in India. When pharmacy education came to India in 1935, we did not have proper drug standards, GMP, etc in India. Now the situation has changed and there is a need to change our focus and it should be the healthcare of our society. Pharm D could be one step in this direction.
Can you give us details in the curriculum and faculty associated with the Pharm D course?
The curriculum for the Pharm D course has been decided by the Pharmacy Council of India. We at present have not outsourced any faculty as we believe that there is enough talent in India to teach Pharm D courses. However, there are certain specialised topics that may require extra efforts. Besides that, the criteria for colleges including the course is that they will have to be affiliated to hospitals with at least 300 beds. As said, we have enough talent and expertise in India, and if anything is still otherwise required, we might explore the possibility of outsourcing faculty from US or other countries.
Besides the Pharm D course, what are the recent developments at IPA?
IPA conducts conferences, seminars and workshops regularly almost every corner in India throughout the year through its divisions and state and local branches. For example a two day conference on topical, transdermal and cosmeceutical is being held in Mumbai from 9th-10th December, at Hyatt Regency in association with AAPS, FIP and APSTJ. People have started realising the importance of topical and transdermal formulations, and this segment has picked up pace was the reason for selecting this topic. As we see the population of India is 1.3 billion and the growth of this area is 25 percent. Therefore there could be domestic and global business opportunities to our formulators as well as to researchers because we have never targeted this audience before.
How has pharmacy as a profession progressed in India?
Pharmacy as a profession has picked up pace in India and the same is evident from the number of pharmacy colleges that have come up and are still coming up in India. Besides this the world is looking at India for its cost effectiveness and pharmacy graduates from India. The US pharmacopoeia and EDQM has shown their willingness to join hands with India. There are on going talks on harmonising pharmacy standards globally. ICH, which is presently working on this project. The member countries have laid down good guidelines on various subjects. The change is gradually seen in India as it has also become quite proactive now. Besides this USP, which deals with pharma standards has set up an office in India (Hyderabad). USP has formed a stake holder forum and IPA is a member of the same. The forum conducts regular training programmes and meetings. Besides IPA also has a representation on the Drug Technical Advisory Board (DTAB).
What have been the trends in the Indian pharmacy industry and how are they different from US and EU?
Generally, pharmacists in other countries like US or Europe are considered as a part of healthcare system and not as a pharmacist for the industry. His focus remains as a healthcare provider counselling people on various health issues. In these countries he is not primarily taken as an industrial pharmacist or as an R&D scientist, so that’s the major difference. Now the focus has changed because the need for pharmacists has been understood by us and by the government.
To take this a step further we regularly organise programmes. Last year IPA conducted TB Fact Card Project successfully jointly with CPA and IPSF. Similarly, IPA CPD is also going to have a nation-wide programme of accreditation of pharmacies, as the pharmacies in our country are not ideal ones and they have not come up to that mark and standards as that of US or EU. However, there are certain pharmacies like Apollo and Medicine Shoppe which are good ones. They are very well organised. For others to scale up to that standard, accreditation is a must and there are certain norms to be followed for doing the same. In India at present there is no such accreditation agency for pharmacy accreditation. As one step ahead IPA would wish to shoulder this responsibility.
IPA is doing the same by hosting training programmes and spreading awareness amongst the pharmacies and pharmacists. They are further inspected, evaluated and then accredited. Compared to India, a pharmacist is US enjoys a much better social position, because the pay scale is high. However, in India a pharmacist must be earning roughly around Rs 4,000 to 5,000 maximum, which for him is just a source of income.
Now as we have a diploma in pharmacy and a post graduation in pharmacy and are also starting up with Pharm D course, a person can become a registered pharmacist, but the limitation in that is there will be no further promotion and increase in the salary, it gives stagnancy and no future. So for them it still remains a source of income rather than a satisfactory job.
How can this problem be solved?
We observe national pharmacy week, through which we spread awareness about the pharmacists. We make people aware of the existence of pharmacists and to take their help. This is done through free medical camps, blood donation camps and street plays etc. We conduct programmes on good pharmacy practices all over India and train pharmacists.
Besides revision in the salary structure, what other problems do pharmacists face?
Low pay scale is only in the healthcare system. If you go to the industry the pay scale is high and also comparable to the US, nowadays. The Pharmacy graduates generally do not accept job in pharmacy and the registered pharmacists in pharmacy are mostly having diploma in pharmacy. The irony is that over the years distribution of drugs is in the hands of traders and not in the hands of pharmacists. We have to change this situation either through law or education.
So why is the gap?
The gap is because we have not understood the importance of healthcare system in India. It is a failure from the government. And they are hardly doing anything for that. Most of the programmes that take place, a pharmacist is not even given the due consideration like doctors, engineers, architects. These people are always on the higher class, where a pharmacist may or may not be there. Besides, there are a lot of challenges which we have to build in to opportunities. Also because of the economic slowdown there is going to be a lot of brain drain.
Are there any guidelines that pharmacists in India have to follow?
In India there were no guidelines to be followed by the pharmacists. But IPA has come out with guidelines on good pharmacy practices with the help of WHO and Drugs Controller General India (DCGI) office. It is part of our objective being a professional issue.
What are the loopholes in Indian pharmacy?
Indian pharmaceutical industry is now considered as developed and not a developing sector. But if you see most of the new concepts and regulatory developments are coming either from US, Europe or Japan. We are just following them. The standards of drugs and formulations at global level are drawn by USP or British pharmacopoeia (BP) and Indian pharmacopoeia has yet to find place on world map.
What are you future plans?
IPA is coming up with its own building within the premises of Bombay College of Pharmacy, which will be operational by 2010. We have many plans in mind but it would be premature to talk about them at this juncture. Please wait and watch. However, we will continue to have education programmes. We also have plans of bringing FIP to India. And if this works out then you will see international pharmaceutical congress in India. The only hurdle is that we don’t have a good convention centre of international standard yet.