New threats to health are continually emerging compounded by negative forces of globalisation, which prevent equitable distribution of resources with regard to public health, especially that of the poor. Though socio-economic factors like poverty, illiteracy and politics are major detriments to the public health, health services still have an imperative function to play. A lot depends on the pharmacists to perk up the health status of the people within existing constraints of socio-political system of the country. In this context, the question of the hour is: How geared up are the pharmacists in India? Does the country's pharmacy curriculum fit into the global context? The answer is an affirmative no. Agreeably, a new type of educational programme that will make the professional responsive to the needs of majority of the population is mandatory.
Pedagogical centres should come out of the conventional outlook and allow the strengths of students flourish copiously. This requires total recasting and streamlining of the existing curriculum. We ought to have progressive teaching methods and technologies that will prepare students for pharmacy practice today and for the years to come.
In this highly competitive and demanding scenario of globalization, students are keener on opting profession and courses, which will in the long run give them good returns and avenues. For revamping the education system, which has dominated the country for several decades, it requires the ability to have persuasive and powerful dreams or vision of human betterment. For offering world class services and to be at par with other pharma professionals globally, we must categorically create continuing education, which will equip our pharmacists with a lifelong learning attitude. With globalization, aspirations for gainful employment have become the catchphrase amongst students.
We need to have an innovative curriculum. A curriculum that would challenge students intellectually needs to be implemented. The undergraduate curriculum must contain certain courses to be globally competitive. They are:
Molecular biology, pharmaco-economics, pharmaco-vigilance, pharmaco-epidemiology, ICH, GMP, GLP, GCP, regulatory jurisprudence, clinical pharmacy, community pharmacy, gene characterization, proteomics, IPR, pharmacy administration, industrial pharmacy with changes in the existing curriculum and internship to have hands on experience on formulations.
Pharmacy curriculum should contain pharmacy administration comprising business and management studies so as to enable pharmacists to participate in pharmacy practice as part of business ventures. This should also be well connected to yet another newer dimension of pharmaco-economics. Also, for newer domestic and international legislations, which keep updating them into pharmaceutical law, regulatory jurisprudence is a must in the program of study for understanding and executing them.
In this era of patent regime, Indian pharmaceutical industry is taking rapid strides in restructuring their business to meet global standards and steering their growth towards world class R&D, global alliances, partnerships, collaborations, licensing etc. To keep pace with the changes in customer needs in the international scenario, pharmacists who pass out from the institutions should have skills in new drug research with adequate attention to innovations with respect to quality, costs and feasibility. These key elements must be kept in mind while framing industrial pharmacy curriculum.
The clinical dimension to the curriculum is very essential, since it would impart:
■ Communication skills for effective interaction with patients and practitioners of other health professions
■ Knowledge integration that is necessary for clinical exposure and application for solution for real problems
■ Responsibility for monitoring the drugs taken by patients including ADR reporting etc and also of the general methods of diagnosis and patient care specifically related to drug therapy
In a nutshell, clinical aspect of pharmacy should be included in the curriculum to have a multidisciplinary approach, including medical, nursing and pharmacy. Emphasis should also be laid on courses like pharmacovigilance and pharmacoepidemiology, which would be related to drug safety aspects and relationship between occurrence of a disease and environmental factors.
Molecular biology researchers use specific techniques native to molecular biology but increasingly combine this with techniques from genetics. Know how on genomics coupled with proteomics can pave for identification of newer drugs for treatment of diseases. And hence every student must have information on these vital components as well.
Good manufacturing practices (GMP), a holistic approach to regulating the manufacturing and laboratory testing environment, good laboratory practices (GLP), which helps assure regulatory authorities that data submitted are true reflection of the results obtained during the study and can be relied upon when making risk/safety assessments, good clinical practices (GCP) guidelines, which mainly includes protection of human rights as a subject in a clinical trial are a must during learning tenure in undergraduate days.
A well managed intellectual property right (IPR) is a must in every pharmaceutical organization for value added services. For this, we need IPR capabilities for drug discovery research, mechanization, new drug delivery systems, litheness in developing them and reliability of products. All this is possible only with an in-house training with respect to IPR during the course.
Also, in this globalization era, the healthcare reform has put an emphasis on primary healthcare. This emphasis coupled with lack of access, increasingly rising costs and concern for quality changed the role of pharmacists as a member of the primary health care delivery team. Considering this fact, many universities abroad offer Pharm.D courses to students. Understanding this expanded role of pharmacists in health care, Indian universities too must necessarily consider including Pharm.D course. It should be the goal of educators to foster within students the desire to learn and the ability to discover. The curriculum must be designed to encourage intellectual development and help the student become a competent and skilled professional pharmacist. This can only be accomplished through conceptual competence, technical competence, integrated competence and career marketability.
The pharmacy council of India (PCI) under the very eminent and dynamic management of Dr B Suresh has very strategically implemented several ambitious plans for India to contribute and evolve as a key player in the worldwide international pharmaceutical commerce. In the future, according to the current proposals, PCI shall have exclusive regulatory authority over pharmaceutical education across the country.
The global pharmaceutical market grew to US $643 billion in 2006, growing at a compound annual growth rate (CAGR) of 10.0 per cent between 1999 and 2006. However, year-over-year growth slowed to 6.8 per cent in 2006, largely as a result of increased competition from generic products and effects of continued healthcare cost containment across major markets. The global pharmaceutical market is forecast to grow to US $897 billion by 2011. To contribute to at least 50 per cent of world's generic production, Indian institutions must necessarily impart quality education with well defined missions and a vision to meet set goals in the near future.
Mission statement: Our mission should be to enhance the lives of diverse people of India through fineness and innovation in educating health care practitioners, researchers, imparting expertise to access knowledge base, providing pharmaceutical care and service and evolving knowledge through fellowship.
Vision statement: Our vision should be to evolve as a leader in the global healthcare scenario by developing and establishing niche areas for profitable business as part of the global innovation and business value chain. The goal should be to provide comprehensive and world-class healthcare services to the public.
India remains key market for majority of domestic companies, supplying around 70 per cent of the country's pharmaceuticals and also around more than 85 per cent formulations produced in India. The country is indeed self sufficient with respect to formulations. The proportion of revenue derived from India depends largely on the strategy of the individual company and its penetration into the overseas market.
Thanks to the non-infringing patent processes that are supported by the Indian patent Act 1970, which did not allow product patents in India. Industries really need to gear up to face the challenges, opportunities and concerns in the IPR regime. When there is so much upgradation happening in the Indian pharmaceutical scenario due to globalization, it is apt to focus on revising and updating pharmacy curriculum, to produce pharmacists who can stand on par with the global standards. Leading companies have indeed found ways not only to exist but also to thrive in the global pharmaceutical market. Hence, to deal with competition from within and without, the industry players, institutions and government must join hands and take up timely and effective approaches.
Globally speaking, there are countries which despite having made exciting developments in pharmacy education, still have a very 'curative approach' to the profession. Hence these countries and India needs to advocate preventive and promotive social based pharmacy.
Accreditation
The international gold standard for quality assurance and continuing quality improvement in pharmaceutical education is accreditation. It needs to follow 4 vital key points like:
■ Ensure: when developed, applied and improved in a systematic and unbiased manner over time, accreditation is the closest thing we have to a guarantee of quality educational programs
■ Insure: Accreditation can also serve to protect against loss of (resources, recognition, and ability to participate in various commercial and non-commercial enterprises)
■ Assure: Accreditation serves to assure students, their parents, employers, the government, society and ourselves that our education meets certain standards for entry into practice
■ Endure: commitment to a process of self evaluation and continuous quality improvement historically increased the ability of many types of organizations to prosper over time
Pharmaceutical education should be focused on nurturing future leaders who can lead private and public sector organizations with a sense of social mission. The curriculum should be empowering enough to produce human skill base that can create, innovate and deliver. Quality cannot per se be equated to excellence. Excellence needs to include meeting the needs of the society. It needs to be recognized that excellence is like a sea, it is a journey and not a destination.
(Yeole is with Institute of Pharmaceutical Education and Research, Borgaon, Wardha, while Dhanlaxmi Iyer is with Connoisseur, Mumbai)