So you're not searching for a cure?!
My sister, Sophie, does not have a clue about what I do. During my fellowship at the National Institutes of Health, she was under the impression that I was conducting research in search for a cure for HIV. The look on her face when she learned otherwise was priceless.
It is not unreasonable that she, nor many others including pharmacists, would not understand the role of a public health pharmacist. Far few postgraduate opportunities and jobs are available for pharmacists in the global health arena when compared to physicians.
I work in the Bureau for Global Health at USAID. The Bureau has approximately 800 employees in the Bureau and approximately 75 physicians. The number of pharmacists? Three. Hence the genesis of Temporarily Disguised as a Pharmacist – to inform and inspire pharmacists that are interested in learning more about the global health arena. The next few posts will provide you with an overview of my roles and responsibilities. My three functional roles are 1. HIV Clinical Pharmacist; 2. Quality Assurance Program Manager; 3. Country Support Specialist.
In 2003, President George W. Bush passed the U.S. Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 which gave birth to the President’s Emergency Plan for AIDS Relief (PEPFAR). PEPFAR has also received strong support from President Barack Obama, President Donald Trump, and bipartisan support from Congress. PEPFAR is the largest program by any country to combat a single disease. You can learn more about PEPFAR by visiting www.pepfar.gov.
Within in the Bureau for Global Health, I work in the Office of HIV/AIDS. The Office of HIV/AIDS is responsible for implementing the programs of USAID in response to PEPFAR. My responsibility is to offer a clinical pharmacist’s perspective to global health problems. I’ll give you an example.
The US Food and Drug Administration (FDA) tentatively approved lopinavir co-formulated with ritonavir in the form of pellets. To administer lopinavir/ritonavir pellets, a care giver opens an appropriate number of capsules over a bowl of porridge or breast milk and then administers it to an infant. As we began to plan for the introduction of the lopinavir/ritonavir pellets several questions came to mind. What is the appropriate dose per weight for this formulation? Which formulations would be replaced with the introduction of the lopinavir/ritonavir pellets? What is the cost of the pellets? What types of educational materials should we create? What types of training sessions should we offer? Which national medicines regulatory authorities have registered this product for use in their countries? Which countries have included pellets in their national HIV treatment guidelines? What are the shipping and storage requirements for the pellets? What is the manufacturing capacity of the manufacturer of the pellets? Which countries are prohibited from accessing the pellets due to patent regulations? I think you get the idea. Acquiring answers to these questions requires loads of meetings and conference calls. This is where we come in. Pharmacists are positioned to answer these questions by virtue of their skillset.