Integrating pharmaceutical systems strengthening in the current global health scenario: three ‘uncomfortable truths’

Abstract

The response to emergency public health challenges such as HIV, TB, and malaria has been successful in mobilising resources and scaling up treatment for communicable diseases. However, many of the remaining challenges in improving access to and appropriate use of medicines and services require pharmaceutical systems strengthening. Incorporating pharmaceutical systems strengthening into global health programmes requires recognition of a few 'truths'. Systems strengthening is a lengthy and resource-intensive process that requires sustained engagement, which may not align with the short time frame for achieving targets in vertical-oriented programmes. Further, there is a lack of clarity on what key metrics associated with population and patient level outcomes should be tracked for systems strengthening interventions. This can hinder advocacy and communication with decision makers regarding health systems investments. Moving forward, it is important to find ways to balance the inherent tensions between the short-term focus on the efficiency of vertical programmes and broader, longer-term health and development objectives. Global health programme design should also shift away from a narrow view of medicines primarily as an input commodity to a more comprehensive view that recognizes the various structures and processes and their interactions within the broader health system that help ensure access to and appropriate use of medicines and related services.

Understanding the factors influencing healthcare providers’ burnout during the outbreak of COVID-19 in Jordanian hospitals

“…The interviewees believe that nursing, physician, and pharmacist jobs put the healthcare providers and their families at great risk of exposure to COVID-19 due to acquiring the infection at work and taking the infection home to their family. This finding is supported by those of other studies conducted worldwide [ 5 , 9 , 14 , 25 – 27 ].…”

“…The principles of COVID-19 infection prevention and control strategies associated with healthcare suggest the need for administrative controls and hospital resources [ 27 ]. In addition, if the government, with strong leadership, develops stronger and more resilient health systems in preparation against emerging contagious diseases such as COVID-19, healthcare provides’ burnout will decrease.…”

Mental health issues impacting pharmacists during COVID-19

“…Overall, the pharmaceutical system itself could be strengthened, which could go beyond just mitigating drug shortages and help pharmacist workflow and wellbeing. Hafner et al report three issues that stand in the way of low-and middle-income countries being able to strengthen their pharmaceutical systems [56], which also applies to Canada as its pharmaceutical systems become strained due to COVID-19 and issues become apparent. Firstly, the process of strengthening a pharmaceutical system is lengthy and resource intensive [56], which may not be feasibly done in time during COVID-19.…”

“…Hafner et al report three issues that stand in the way of low-and middle-income countries being able to strengthen their pharmaceutical systems [56], which also applies to Canada as its pharmaceutical systems become strained due to COVID-19 and issues become apparent. Firstly, the process of strengthening a pharmaceutical system is lengthy and resource intensive [56], which may not be feasibly done in time during COVID-19. Secondly, strengthening pharmaceutical systems requires the engagement of government bodies and multiple stakeholders as well as policy and legislation reform [56], which Canada is currently engaging in for managing the immediate COVID-19 threat.…”

“…Firstly, the process of strengthening a pharmaceutical system is lengthy and resource intensive [56], which may not be feasibly done in time during COVID-19. Secondly, strengthening pharmaceutical systems requires the engagement of government bodies and multiple stakeholders as well as policy and legislation reform [56], which Canada is currently engaging in for managing the immediate COVID-19 threat. Finally, the interventions that work to strengthen pharmaceutical systems are not precisely known, which is an area of further research [56].…”