off record
Shaukat Ali Jawaid

What do you do when
the Dog comes?


Sometime ago I had gone to see the owner of a leading national pharmaceutical company as I was collecting some information about the pharmaceutical industry in Pakistan. We had hardly discussed a few things when his PA came in and said “Sir Drug Inspector so and so has come and he wishes to see you”. Why he wants to see me, the owner asked to which his PA replied “Sir I do not know”.  He had a pause for a while and then asked his PA “What do you do when the Dog comes?” The PA kept quiet. Then the owner said “When the dog comes, throw him a bone and he will go away”.  Ask someone from the accounts department to see him and get lost.

I protested on this saying that he should have some respect for these people and this was not the way to deal with them. At this he said, “You do not know the ground realities. If you try to know this, your views will also change”. Unfortunately most of these drug inspectors (exceptions are there) have no or least knowledge about the job they are supposed to do but they have been given too many powers which they use to harass the Pharma industry on one pretext or the other. They think that everyone working in the Pharma industry was a criminal and hence it is their right to create problems for them instead of being facilitators. Businessmen are not foolish enough to spend millions and billions of rupees to set up industry and then indulge in unethical practices or do not care for the quality assurance and current Good Manufacturing Practices. Of course there may be a few who do not deserve any sympathy and authorities must take action against them but the way some of the drug regulators try to deal with everyone in the Pharma industry is highly objectionable. The drug regulators should first make sure that the personnel they select for such jobs are competent, knowledgeable and then they should help, guide and assist the Pharma industry to make up their deficiencies if any to ensure that quality drugs are made available to the patients and the drug manufacturers follow the latest guidelines in current Good Manufacturing Practices.”

After delivering this sermon, he called his PA and asked him what happened to the Drug Inspector?. At this his PA said that accounts department gave him an envelope and he went away. At this the owner of the pharmaceutical firm turned towards me and said “Had this drug inspector for whom I had expressed lot of sympathy, an iota of dignity and self-respect, his attitude would have been different. He would have insisted to see me but he had come with a purpose and when it was accomplished, he went away”.

I was convinced of his viewpoint to a great extent a few days later when I was attending a Clinical Trials symposium at a university. One of the young gentlemen sitting in the back rows stood up to ask a question to one of the speakers. He was finding it difficult to speak in English and then started speaking in Urdu and struggled to ask a question. After the symposium at the tea interval I asked this gentleman who he was? At this he introduced himself as the Federal Drug Inspector.  I looked at him carefully, he was wearing a slipper, a trouser which was not washed perhaps for few weeks and he was wearing a shirt which too was not clean enough.

During the last couple of years, just like medical and dental colleges, there has been a mushroom growth of pharmacy institutions in the private sector which are producing pharmacy graduates of highly sub-standard quality.  Looking at that Drug Inspector, I felt that these pharmacy graduates also need to be taught not only communication skills but also how to dress up and how to go to attend a scientific meeting. If this was not enough, I was amazed and surprised when attending a function of pharmacy faculty in one of the public sector universities few days later. I noticed that the Dean of the faculty was finding it extremely difficult to read the speech written in Urdu. It was then I realized that if this is the state of affairs of the teaching faculty, one cannot expect a better product from these institutions and became fully convinced of the view point of my friend owner of the national pharmaceutical company to whom I had protested about the way he was treating these professionals during our meeting.

It is also a fact that most of these pharmacy graduates are those who could not get admission to the medical colleges and thus also suffer from inferiority complex. They do not enjoy any recognition and respect from the medical profession as well as all others working in the health services. My friend Mr. Latif Sheikh Director of Pharmacy Services at Aga Khan University who has not only established a state of the art pharmacy service at AKU and has trained a large number of pharmacists is right when he says that “Pharmacists need to change their mind set”.   Mr. Lateef Sheikh is proud of being a Pharmacist and like a few others; he enjoys a tremendous respect in the medical profession and is also held in high esteem by the drug regulatory authorities. He serves on various experts committees as well. He enjoys this respect and recognition because of his competence, ability and expertise.

Pharmacists are an important member of the healthcare team and they are contributing in numerous fields in the developed civilized world. Apart from serving in different section in the pharmaceutical industry, they are members of the pharmaco therapeutic committees, join doctors in ward rounds and their views are not only accepted but also respected because they help minimize medical errors, reduce drug related adverse events, save cost of therapy, reduce hospitalization period, help reduce drug interactions giving advice to the doctors to ensure rational prescriptions.  If the pharmacy profession in Pakistan has failed to get appropriate recognition and respect which is their right, it is the pharmacy profession itself which is responsible for all this to a great extent.  There is a dearth of professional competent leadership in the pharmacy profession, they lack unity among their ranks, teaching and training of pharmacy graduates leaves much to be desired. We have failed to establish Hospital and Community Pharmacy services. We do see some change taking place, some intelligent pharmacists who have knowledge of production, quality assurance, are well trained and qualified, have started joining the Drug Regulatory Authority and the pharmacy faculties in teaching institutions but this change is very slow. It needs to be accelerated. Mr. Jamshed Ahmad Chief Operating Officer in PharmEvo, himself a pharmacist and his colleagues in the pharmacy profession have realized some of these short comings and that is why they are keen to build the professional capacity of the pharmacists. They have started organizing training courses, workshops for pharmacists inviting eminent pharmacists to address these meetings so that the pharmacists can earn self respect and become useful members of the healthcare team whose views are accepted and respected. All this needs to be accelerated so that pharmacists can play their role in improvement of health services.

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