| Prospects of Pharmacy in Bangladesh |
| By Dr. Habibur Rahman |
| Introduction |
| Now-a-days internationally a well
pronounced slogan is: BECOME A PHARMACIST, A PHARMACY CAREER
MEANS A SALARY JOB OPPRTUNITY.
In fact, pharmacy career is more than a job. It is a rewarding
profession in the health care industry. The importance of
pharmacists in the health care system has been recognized
all over the world. In appreciation of the valuable contribution
of the pharmacists, Shaheed president Ziaur Rahman took the
initiative to promulgate the pharmacy ordinance -1976 to recognize
and promote pharmacy as a profession in Bangladesh.
The practice of pharmacy is the interpretation and evaluation
of prescription orders; the compounding, dispensing, labeling
of drugs and devices; the participation in drug selection
and drug utilization reviews; the proper and safe storage
of drugs and devices and maintenance of proper records; the
responsibility of advising of therapeutic values, content,
hazards and use of drugs and devices; and the offering or
performing of those acts, services, operations or transactions
necessary in the conduct, operation, management and control
of pharmacy.
A pharmacist is the person of drugs or expert on drugs. In
other words, a pharmacist is called “drug consultant”.
He is the only expert on drugs, for expertise regarding drugs
requires knowledge in depth in all the facets of pharmacy.
The physician, dentist and veterinarian may prescribe drugs
and primarily be interested in those drugs on the patients,
their therapeutic value and toxicology. The nurse may administer
the drug and be concerned with dosage forms, routes of administrations
and toxic manifestations, but the pharmacist is the only expert
on drugs. It is his legally granted responsibility to handle
drugs. It is his professional responsibility to know all about
those drugs. No educational program other than that in pharmacy
provides the background to understand completely about drugs.
The pharmacist, and the pharmacist alone, is in that unique
position of embracing complete drug expertise.
A health care team comprises of pharmacists and other health
care providers like physicians, nurses, medical technologists,
laboratory technicians etc. For better management of health
care always requires significant contribution from each of
these professional groups. As the drug and medicine play a
very crucial role within the health care system , the pharmacist
does play a very vital role in this regard.
Pharmacy is a highly specialized profession which requires
graduate level qualifications and is concerned with research
and development of drugs, their preparation, quality control,
proper and safe storage, dispensing, and the eventual use
and action on the human body. Pharmacy education includes
the study of appropriate combination of (a) chemistry (analytical
and organic) or biochemistry, (b) chemical engineering, (c)
microbiology, (d) pharmaceutical sciences and technology,
(e) pharmacology and toxicology, (f) physiology, or (g) other
related sciences. Pharmacy curricula are tailor made to meet
the highly specialized knowledge and expertise in the pharmaceutical
field. The career and scopes of the pharmacists have been
shown in Table 1.
| Industrial Pharmacy |
Government Agencies |
Hospital Pharmacy |
Community Pharmacy |
Academics |
Others |
| Production |
Drug Administration |
Clinical |
Chain drug store |
Research |
Entrepreneurship |
| Product Development |
CMSD |
Administration |
Supermarket |
Teaching |
Merchandizing |
| Quality Control |
Public Health Service |
Drug Information |
Independent drug store |
Administration |
Indenting |
| Quality Assurance |
Armed Forces |
|
Drug Information |
Publication |
|
| Dispensing |
Government Hospitals |
|
|
|
|
| Research & Development |
|
|
|
|
|
| Marketing |
|
|
|
|
|
(Table - 1)
|
| |
| Industrial Pharmacy |
In our country industrial pharmacy
offers opportunities to qualified graduate pharmacists in
an industrial environment. The greatest number of pharmacists
are involved in production, marketing and administration.
The section 13(1) of drug control ordinance (1982) categorically
says that the overall supervision of drug production must
be done by a qualified graduate pharmacist. Thereby, the production
supervisory positions in industrial plant are always held
by pharmacists with bachelor’s degrees. Apart from production,
there are many other areas in which an industrial pharmacist
can specialize. Pharmacists with master’s degree in
business find opportunities in pharmaceutical industries in
marketing, sales and legal departments. After 22 years of
the promulgation of drug policy(1982), the drug business has
jumped from 250 crore taka to almost 3000 crore taka. At the
same time the import of drugs has dropped from 90% to 5%.
This has been materialized by the efficient contribution of
pharmacists. In marketing and product management, determining
strategies, developing promotional materials and marketing
research are the areas of interest for pharmacists. Quality
control supervisory positions are also often held by pharmacists.
Pharmacists sometimes develop their career as research and
development personnel. Development of stable, aesthetic and
cost-effective pharmaceutical products is a highly specialized
area where an industrial pharmacist because of his pharmaceutical
know-how and multidisciplinary background plays the most vital
role. Because of high legal, ethical and moral responsibility,
the industrial pharmacists ensures the full compliance with
good manufacturing practice, good laboratory practice in an
industrial set up.
Sometimes, manufacturers employ pharmacists as sales representatives
who provide the link between the manufacturers on one hand
and pharmacists and doctors on the other. |
| |
| Government Agencies |
Government services offer opportunities
to pharmacists in various capacities. In our country, although,
this particular sector is not that much healthy as compared
to that of advanced countries, there are many places where
pharmacists are working with dignity and prestige. At present
more than 20 pharmacists are working in Directorate of Drugs
Administration in different levels. But this number is quite
insufficient to monitor or control the overall drug situation
in Bangladesh.
A significant number of pharmacists can be employed in CMSD.
Currently, seven pharmacists are engaged in CMSD in our country.
However, there are ample opportunities still remaining in
this field. After decentralization of government CMSD in 1989,
local purchase is conducted by civil surgeon instead of the
Director, CMSD. Government can take advantage of saving huge
amount of money by taking proper decision in preparing the
Medical and Surgical Requisite (MSR) list. The involvement
of experienced Pharmacist in MSR selection committee of each
district can only ensure the rational preparation of the MSR
list. Such decision will indeed reduce the chance of over-expenditure
and misuse of drug products and increase the efficiency and
transparency of purchasing.
Pharmacy Council of Bangladesh (PCB) is another semi-government
agency that can provide scope for the graduate pharmacists.
The council can be considered as the controlling authority
of pharmacy education and practice. Recently, 8 pharmacists
are working in PCB with advanced level of performance. The
pharmacists working in this field ensure the highest standard
of quality required for pharmacy training and practice in
different academia.
Like other developed countries, pharmacists can also be employed
by the government in defense like Army, navy and the air force
where the health and ambulatory system will be coupled with
proper guidance and supervision regarding drug products.
|
| |
| Community Pharmacy |
The plethora of manufactured drug
products and the abundance of physicians coupled with the
propensity to prescribe multiple products for various concurrent
ailments present an opportunity for pharmacists in community
practice. The community pharmacy can broadly be considered
as community-based pharmacy. The main responsibilities of
a community pharmacy include compounding, counseling and dispensing
of drugs on prescription to the patients with care, accuracy
and legality. Appropriate procurement, storage, dispensing
and documentation of medicines are within the purview of its
professional responsibilities. It is an important branch of
the pharmacy profession and involves a qualified and pertinent
pharmacist. Being closely in contact with general people,
the community pharmacists should have the required education,
skills and competence to deliver the professional service
to the community.
.
Pharmacists in community pharmacy practice, whether independent
or chain settings, are slowly shifting their focus from the
drug product to patient service. Yet the shift of attention
from drug product to patient does not find its genesis solely
for the satisfaction of pharmacist needs, aspiration or even
in altruism. This change is an exigency for their professional
survival. Without a change in focus from drug product to patient
service, pharmacists, themselves will be in danger of displacement.
Refocusing from drug product to patient has caused the pharmacy
profession to develop newer skills and explore the diversified
dimension of community pharmacy which need insight both into
drug effects ( eg. understanding drug action, kinetics and
interactions) and patient dynamics (i.e. learning how to communicate
with and educate patients regarding drug, disease and dosage
regimen).
Though auspicious enough, the scenario of community pharmacy
is quite different in our country. As we know Mr. Nasser Shahrear
Zahedee President of Bangladesh Pharmaceutical Society (BPS),
delineated a clear status of community pharmacy in Bangladesh
in his presentation in National Conference on Community and
Hospital Pharmacy in 2002. At present, there is not a single
pharmacy graduate working in any pharmacy in the country.
There are more than 60,000, which Mr. Zahedee termed “
Pharmacy outlets” in our country but not a single “Community
Pharmacy”. Steps are continually being taken by BPS,
both individually and collectively with the government, to
convert and develop these “Pharmacy outlets” to
professionally operated community pharmacies. This development
will open an immense opportunity of occupational engagement
for the graduate pharmacists in near future. |
| |
| Hospital Pharmacy |
| Hospital and clinical pharmacy can
also provide the graduate pharmacists with ample prospect of
professional accommodation. This sector, though not in a completely
flourished state in Bangladesh, is critically important for
the benefits of the patients as well as for the reduction of
hospital budgets. Introduction of hospital and clinical pharmacy
in practice will certainly exert its manifold impact on total
health policy of a country. With the advent of the concept of
hospital pharmacy, the government will be benefited in terms
of cost by seemly utilization of finance and appropriate handling
of stock while the patients will be benefited in terms of prescription
standards and counseling. Additionally, the hospital pharmacists
can monitor indoor patient medication chart, provide updated
drug information, exchange technical view-point of drug related
clinical activities with other health professionals and provide
with statistical compilations of consumed drugs and expenditure
reports. Pharmacists can also be engaged in the administrative
positions of a hospital where significant contributions can
be made. Drug information centre in a hospital is another unique
area where pharmacists can build up their career. |
| |
| Academic |
Even before a decade or two, Department
of Pharmacy, University of Dhaka was the only academic institution
that served to develop the professional skill and competence
of young graduate pharmacists. With the passage of time, more
academia came forward with the facilities of pharmacy education.
At present there are 4 public universities and at least 10
private universities where pharmacy is being taught (Table
2).
| Sl. |
Name |
Location |
Estd. |
| 1. |
University of Science and Technology,
Chittagong |
Chittagong |
1994 |
| 2. |
The University of Asia Pacific |
Dhaka |
1996 |
| 3. |
University of Development Alternative |
Dhaka |
2002 |
| 4. |
East-West University |
Dhaka |
2003 |
| 5. |
Manarat University |
Dhaka |
2003 |
| 6. |
State University of Bangladesh |
Dhaka |
2003 |
| 7. |
Northern University |
Dhaka |
2003 |
| 8. |
Primeasia University |
Dhaka |
2003 |
| 9. |
Gono Biswabiddyalay |
Savar |
1998 |
| 10. |
Stamford University |
Dhaka |
2003 |
| 11. |
Southeast University |
Dhaka |
2003 |
(Table 2)
Every year, about 300 students earn their graduation in this
subject and accordingly get involved in professional outlets
in home and abroad. Although, the trend of enrollment of students
with better intellectual performance in this subject was always
higher than the others, in the nineties, students showed greater
propensity to get themselves admitted into the subjects related
to IT and computer science in University of Dhaka. However,
the trend has been changed in the recent years as the students
topping the merit list are taking admission in Pharmacy and
the pattern is almost the same for all other national universities
where pharmacy is being taught. Greater job availability,
job security, satisfactory remuneration package and higher
professional variability and diversification are the underlying
causes for such proclivity of the students toward pharmacy
education.
Research and development in the field of newer drug molecules,
novel drug delivery systems or improved health care concepts
is another prospective arena of pharmacy education. In Bangladesh
a good number of pharmacy graduates are involved in research
in different institutions. This area of pharmacy profession
is certainly carries better prospect both in home and abroad. |
| |
| Others |
Since the very beginning, a good
number of pharmacy graduates involved themselves in trade
and business and this trend still persists. The pharmacist,
being trained on different aspects of pharmacy practice, manufacturing
and marketing, can get involved in manufacturing and merchandizing
of drug product, raw material, intermediate chemicals and
pharmaceutical equipment with skill and efficiency. In the
context of Bangladesh, this is indeed a challenging career
that can be undertaken by pharmacy graduates.
A pharmacist is a person with specialized skill and knowledge.
As a result, he has a broader avenue to work in the specialized
field of drugs in home and abroad. From the very beginning
of pharmacy profession, a significant number of pharmacy graduates
migrated to western countries where they ensued their career
successfully. In abroad, pharmacists get the scope to build
his career mainly in retail pharmacy, hospital pharmacy, and
industrial pharmacy. As a fraction of skilled population,
the rate of migration of pharmacists to foreign countries
is increasing almost linearly with time as can be observed
from Figure 1.

The figure illustrates that, the migration of unskilled personnel
soared up to a maxima during the year of ’94—’95
after which their rate started to decline. On the other hand,
the emigration of skilled personnel, though less in number
than those of unskilled people, is increasing steadily. The
rate of migration of the pharmacists, as skilled personnel
shows almost the same pattern. Pharmacists graduated from
Bangladesh are mainly going to the USA, Canada, Middle East,
Japan and also some other European countries. The rate of
going abroad of pharmacist can be clearly manifested from
Table 3 and the country wise distribution of these emigrant
pharmacists are illustrated in Fig. 2. Table 3 shows that,
a total number of pharmacy graduates those have been registered
by PCB is about 2300 among which only 1000 is working in Bangladesh
and the rest of them have gone abroad. Figure. 2 also illustrates
that, most of pharmacists graduated from Bangladesh are migrating
to the USA, and Canada since these two countries offer better
scope for career development. |
| |
| Country wise distribution of pharmacists graduated
from Bangladesh: |
| Country / Region |
Number |
| Total number of A-grade pharmacists
graduated |
2381 |
| Total number of pharmacists working
in the country |
1050 |
| Total number of pharmacists working
abroad |
1331 |
| Woking in the USA |
830 |
| Working in Canada |
150 |
| Working in the Middle-east |
120 |
| Working elsewhere |
231 |
Source: Pharmacy Council of Bangladesh

|
| |
| Conclusion |
| Pharmacists and the profession of pharmacy
are at the crossroads of healthcare. Opportunities for the creation
of new forms in the profession abound. In the advanced countries
like the USA, pharmacy profession is the third largest health
profession. It is a trusted profession because of the care and
service it provides. It is a career with a blend of science,
healthcare, patient care, computer technology and business.
The demand of the profession is extremely high. Opportunities
are also tremendous. With the new drugs coming out the employment
future is very good. Thus a pharmacist gets job security, recession
proof employment, well paid job and above all financial security.
In our country with the creation of new opportunities, the demand
of this pharmacy profession is hoped to be increased in geometric
fashion in near future. Now the fastest growing and demanding
subject both in private and public universities is pharmacy.
Health is a cardinal sector which is to be restored in every
aspect- whether at individual level or at the national level.
And to restore of this either individual health or national
health, there is no other alternative to pharmacy profession.
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