Read the Conversation
EF: Could you elaborate on SAPC's role as well as your goals for this year?
VT: The Pharmacy Act of 1974 (Act 53 of 1974) established the South African Pharmacy Council as a statutory body to oversee South African pharmacies, pharmacy support personnel, and pharmacists. The first responsibility we have is to regulate pharmacy professionals. We also control the country's pharmaceutical education program and ensure appropriate pharmacy practice standards are followed. As the South African Pharmacy Council, we always strive to safeguard the public's rights to healthcare services, and we accomplish this by advocating for universal health coverage through sustainable patient-centred pharmaceutical services.
The strategy plan for the following five years, which would take us until 2028, was prepared in sessions with the newly appointed Council that began this year. First and foremost, the South African Pharmacy Council wants to ensure everyone has access to high-quality pharmaceutical services. South Africa has a significant gap between people with plenty of resources and those without. As a result, it may be viewed as an underdeveloped or developing country at different periods. However, from our point of view, all patients and clients should receive services regardless of their socioeconomic standing.
As a result, we collaborate closely with the Department of Health regarding licensing and pharmacists. Part of our goal has always been establishing pharmacies in rural areas so that patients can obtain pharmaceutical services without walking a significant distance or a great distance. Therefore, we license community pharmacies (independent and retail pharmacies like Clicks and Dischem). We also license hospital pharmacies, wholesale pharmacies, and manufacturing pharmacies that produce various medicines.
EF: What would constitute a modern regulatory institution in today's ever-changing healthcare environment?
VT: We were among the first statutory councils that assisted in the reaction to COVID-19 when it struck the country in 2020, and we were required to grant permits to all healthcare providers operating in the country, including hospitals, clinics, pharmacies, and doctor's practices. We incorporated technology into our company practices. As a modern regulator, we carry out online pharmacy inspections. This allows us to view the inspection results as soon as the inspection is completed and identify any problems that require improvement when an Inspection Officer is on the ground.
The South African Pharmacy Council assigns grades A, B, C, or D to pharmacies depending on the outcome of the identified inspection findings. As part of our efforts, we have worked to ensure that pharmacies are ready for the National Health Insurance program's introduction so that every pharmacy is compliant when it is introduced. As a statutory body, we have taken several measures to ensure that we collaborate closely with those we regulate and respond to their concerns as quickly as possible.
To prepare for the rollout of National Health Insurance, we had to evaluate the Pharmacy Support Personnel's credentials to ensure they met our standards. As pharmacy support personnel, they will collaborate closely with nurses in Primary Healthcare Clinics. Not only will they be sufficiently trained to perform the necessary tasks, but it will also lighten the pressure on the nurses at Primary Healthcare Clinics.
We have also looked into the Bachelor of Pharmacy (BPharm) qualification. As responsible regulators, we update the qualification every five (5) years to ensure it is current with market trends and adapts to changes in healthcare services. Additionally, we practice "international comparability," which means that the pharmacists we train in South Africa are not restricted to working in the country; they may work anywhere in the world. We are also currently collaborating with the government to bring in speciality pharmacists. Currently, we have two specialists registered with the South African Pharmacy Council: one specializes in Radiopharmacy, primarily assisting cancer patients, and the other in Clinical Pharmacokinetics, which focuses on medication dosage, especially for patients whose conditions require special attention to ensure appropriate dosage.
The third factor we examined concerning the shortage of human resources was applying technology to distribute medicines. We have reviewed the use of what is known as remote dispensing automated units, which enable a pharmacist to install an ATM-like device in a remote location and manage its distribution of medications. We have tested that program in the public sector but haven't yet expanded it to the private sector.
We also looked at the pharmacist-initiated management of antiretroviral therapy (PIMART). Without going into much detail, we believe access to pharmaceutical services is at the centre. We believe pharmacists should be key players when it comes to providing ARVs.
EF: How do you envision the future of pharmacies, particularly the role of online pharmacies and the state of pharmaceutical care in South Africa?
VT: As the South African Pharmacy Council, we published a standard for pharmacies operating online pharmacies in 2008. That standard outlines our requirements for online pharmacies, or what we refer to as internet pharmacies. We require that the pharmacy for you run an online or internet pharmacy since we need to know where it is located and where they receive their medications. We must inquire about this as we do not want a fly-by-night pharmacy to provide patients with counterfeit medicines. It is essential that the pharmacy has a physical presence at all times and that they have a license. We also must verify that the pharmacy complies with our requirements and that registered individuals are giving advice.
That's why we introduced the Remote Automated Dispensing Units (RADU) located within the pharmacy. We permit a pharmacy to use remote automated dispensing machines because they aid in both medicine storage and dispensing and reduce errors in dispensing medication. In that sense, as a council, we support pharmacists and concur that individuals should be able to obtain prescriptions online. To prevent dispensing medications from unidentified sources, we mandate that pharmacists verify the legitimacy of the prescription and that it originates from a licensed healthcare provider. Our counterpart, the Health Professions Council, can check if an individual is a doctor and is registered with them, and they may verify utilizing online systems.
We also urge pharmacists to ensure that, when dispensing medication, they give patients the right medication advice. From our point of view, it is important that pharmacists take their work seriously and counsel patients so that they feel taken care of, whether they are receiving in-person or online services. As a result, we would like to accredit the services provided.
For instance, patients can obtain their prescription at any Clicks Pharmacy location in Cape Town, Durban, or any other city. The same is true for Dischem. Prescriptions would be available in a public hospital pharmacy with these online platforms, making patient records easily accessible. I am aware that the Department of Health is working toward tracking and tracing patients and knowing what medications they are taking at any given time. We would want to see the healthcare industry go in this direction.
EF: How does the South African Pharmacy Council provide patient safety and medication access?
VT: Regarding how we view business, the South African Pharmacy Council is a forward-thinking regulator and an enabler. The use of paper-based applications is no longer prevalent. For instance, after COVID struck, passing an intense exam was one of the conditions for completing a year-long internship and becoming a certified pharmacist in this country.
We make an effort to make it as simple as possible for people to understand the purpose of each standard when we publish it. We recently released the guideline that states vapes and e-cigarettes cannot be purchased from pharmacies. This demonstrates that in addition to being regulators, we are also enablers, as we instruct pharmacists that they are not allowed to sell electronic cigarettes or treat patients trying to quit smoking while also dispensing medication. We deal with these issues; although it may seem profitable, no pharmacist should participate in certain areas, no matter how lucrative.
We undertake several measures, such as mandating pharmacists to engage in continuous professional development (CPD). They must submit their CPD online, fill out the entries, and explain what they have learned and how it has helped them in their practice. Our online solutions are designed to eliminate clients needing to come to our office in person for services. They can complete it online, and we reply to the person or organizations, the pharmacist, and the pharmacy schools as quickly as possible. We react to market developments in real time, so we were quick to address the issue of the rise in teenage pregnancy and suggest that pharmacists could assist with family planning. We create the course so that the pharmacist can subsequently register for it. In the instance of immunization, we moved rapidly to design courses accredited providers and pharmacists could enrol in to administer vaccinations.
With the rise in cancer cases in our country, one of the most important areas we are examining is pharmacies that provide oncology treatments. We're creating guidelines to ensure that cancer patients can receive pharmaceutical services in the same setting as their doctor visits. They don't have to travel far to receive care. We are working to create a standard for the appearance of a dispensary in those therapeutic settings. The main goals are to safeguard the patient and ensure that services are accessible to them near their place of treatment.
EF: Do you have any final remarks you want to share with our readers?
VT: There will be close collaboration between the Federation of International Pharmacists (FIP) and the South African Pharmacy Council. Cape Town, South Africa, will host this year's FIP World Congress. The SAPC created the local program; therefore, it is not only an international program. Together with FIP, we will be commenting on matters about pharmacies nationwide. Working closely with the Southern countries to see if we can look into university accreditations and potentially form regional collaborations is one aspect of the work we will undertake over the coming year or two.
We may start by looking at simple, fast wins like the country-within-a-country Swaziland and Lesotho as examples. They have just one university in the area that trains pharmacists, so if we could accredit it, the only thing individuals who graduate from it would need to know is pharmacy law. Registering as a pharmacist if you are a foreigner can be tedious. We are working to improve these procedures by streamlining the registration process for pharmacists and healthcare professionals while ensuring that we do not accept fraudulently qualified applicants.
In the next year or two, we want to expand to the African Union to enable pharmacists to travel freely. We need mechanisms to be in place to ensure that the individual we are connecting with patients is qualified and experienced in their role. These regional collaborations are a component of our future work.
