GPP policy asia tenggara

A Conference on GPP Policy and Plans for the South East Asia Region

Bangkok, Thailand June 27th – 29th, 2007

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TABLE OF CONTENTS

Executive Summary ……………………………………………...… iv

1. Background ………………………………………………..…...… 1 1.1) General Objectives ………………………………...……….……... 1 1.2) Specific Objectives ………………………………………...….….. 1 1.3) Expected Outcomes ……………………………………………….. 2

2. Actual Outcomes ……………………………………….……………….. 2 3. Session Summary ……………………………………………...…. 3

3.1) Inaugural Session ……………………………………………….… 3 3.2) Reports on GPP Status in SEA …………………………………… 4 3.3) Discussion on Proposed Regional GPP Policy …………………… 6 3.4) Experience Sharing on GPP Development & Implementation …… 6

3.4.1) Separation of Prescribing & Dispensing………………….. 6 3.4.2) National Strategic Plans & Plan of Actions …..….……… 8

3.5) Measures Taken: Accreditation of Pharmacies ............................. 10 3.5.1) Australia’s Experience……………………………………… 10 3.5.2) India’s Experience………………………..…………….…… 11 3.5.3) Thailand’s Experience…………………..……………..…… 11

3.6) Group Discussion on Country’s Policy & Plans ………………… 12 3.7) Supporting Organization’s Role & Responsibilities in GPP ……. 15 3.8) Support, Collaboration and Implementation Mechanism ……….. 17 3.9) GPP Strengthening Plans ………………………………………... 25 3.10) Open Discussion ……………………………………………...…. 26 3.11) Field Visits …………………………………………………….… 26

4. Conclusion & Recommendation …………………………………27

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Annexes 1. Self-Assessment Questionnaire …………………………..…….. 28 2. Conference Programme …………………………………..…….. 61 3. Bangkok Declaration on Good Pharmacy Practice In Community Pharmacy Settings ………………………….….. 65 4. Key Participant Information ……………………………...……. 69

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Executive Summary More than 70 pharmacists from 14 countries came to meet, share experience, discuss and brainstorm on GPP policy and plans for the South East Asia Region. This conference was technically and financially supported by international organizations (WHO and FIP), regional pharmaceutical fora (SEARPharm Forum and WPPF) and countries from South East Asia and Western Pacific Regions. Several good things were achieved during the conference. Besides sharing of knowledge and experiences, networking, collaboration and commitment on GPP development and implementation among participants and delegates from supporting organizations were obvious. They all helped identify ways to address current challenges and issues on GPP development and implementation. Two concrete outcomes aiming to promote GPP development and implementation were derived from the conference. First, 6 strategies and 61 tactics were achieved and ready to be adopted by interested participating countries. Second, “Bangkok Declaration on Good Pharmacy Practice in the Community Pharmacy Settings in the South East Asia Region” was adopted to show support and commitment in promoting GPP within the region. It is obvious that actual GPP development and implementation within individual participating countries depend on the dynamics and commitment of all local stakeholders. Therefore, it is highly recommended that constant stimulation via follow-up or experience sharing sessions among participants and supporting organizations be held on a regular basis. This can promote GPP development and implementation within the region to a certain degree.

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1. Background

Good Pharmacy Practice (GPP) in community pharmacy settings can promote health and well-being of the population if it exists and is observed. Countries in South East Asia Region are moving towards GPP, but at their own pace and direction. To expedite such movement, each country’s initiation and participation, experience sharing, and advice as well as support from resource countries and/or organizations are essential. This calls for a conference on GPP policy and plans, both in regional and country perspectives. The dynamics within the conference can certainly promote a good understanding, a unified direction and collaborations among all parties involved. As a result, the Pharmaceutical Association of Thailand under Royal Patronage in collaboration with the Thai Food and Drug Administration held a first Regional Conference on GPP Policy and Plans for the South East Asia Region at Royal River Hotel, Bangkok, Thailand during June 27 – 29, 2007. The Conference was supported by SEARPharm Forum, Western Pacific Pharmaceutical Forum (WPPF), FIP and WHO. The 13 countries to be originally focused in this conference are as follows:

• SEARPharm members o Bangladesh Bhutan DPR Korea o India Indonesia Maldives o Myanmar Nepal Sri Lanka o Thailand

• SEARPharm non-members o Cambodia Laos Vietnam

As GPP status of each targeted country is in different stages. Two types of objectives are illustrated as follows: 1.1 General Objectives

To increase awareness, acceptance, desire and actions related to GPP development and implementation within each participating country at his/her own appropriate pace 1.2 Specific Objectives

Specific objectives expected from the conference are: • GPP status of all 13 participating countries are presented • GPP regional policy is discussed, concluded and endorsed

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• At least, country policy & plans from five top priority countries are formulated. Those countries are: India, Indonesia, Nepal, Sri Lanka and Thailand

• Collaborations among parties involved are identified 1.3 Expected Outcomes

It was expected that more effective and efficient country plans would be achieved from the conference. Then, the plans would be discussed, fine tuned and approved with local stakeholders within each participating country. In addition, regional GPP policy and plans would be finalized and approved. The outcomes of the Conference would be used as presentation materials for the 67th FIP Annual Congress in Beijing, China during September 1-6. This would invite more comments, suggestions and/or supports; therefore, the strengthening of GPP activities in the regions would occur without any further delays. 2. Actual Outcomes The conference was attended by more than 70 pharmacists from 14 countries, comprising of public, private, academia, council and association sectors. Several resource persons were from the four supporting organizations, i.e., SEARPharm Forum, Western Pacific Pharmaceutical Forum (WPPF), FIP and WHO. Countries participating in the conference were:

Bhutan India Indonesia Maldives Nepal Sri Lanka Thailand Taiwan Japan Cambodia Laos Mongolia Vietnam Australia

The conference was accomplished as originally planned. However, a decision was collectively made during the conference. Focusing on individual country plans to formulate more effective and efficient ones was changed to a brainstorming session regarding GPP plans on a team basis via basket exercises. Therefore, actual outcomes became threefold: a) strategies and tactics to effectively and efficiently develop and implement GPP, b) networks of countries with common strategies and tactics, and c) GPP regional policy, entitled “Bangkok Declaration on Good Pharmacy Practice in Community Pharmacy Settings” Finally, it was expected that GPP development and implementation process in each participating country could be accelerated. This was because necessary strategies, tactics and collaboration among countries with common interests within the regions and with supporting organizations, i.e., SEARPharm Forum, WPPF, FIP and WHO were already identified.

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3. Session Summary 3.1 Inaugural Session Key persons delivered their remarks/address during the opening session included:

• Welcome remark by Dr. P.T. Jayawickramarajah, WHO Representative to Thailand

Dr. P.T. Jayawickramarajah, WHO Representative to Thailand delivered his welcome remark by expressing his pleasure to be associated with professions thinking about GPP. He then emphasized an importance of practicing GPP in twofold: a) practicing GPP not only helped solving irrational drug use, the weakest part of an “Essential Medicines List (EML)”, but also fulfilled a requirement of being professionalism. Relationships between the population and health care providers could become more of a social contract than a somewhat business one and b) practicing GPP could promote pharmacists in South East Asia Region to evolve, i.e., from a perceived image of “an occupation supplying medicine” to “a health care profession providing pharmaceutical care” and from “earning profit from medicine” to “charging fee for service”. Dr. P.T. Jayawickramarajah closed his remark by confirming that GPP was the way to go for professional pharmacists.

• Welcome remark by Dr. Peter J. Kielgast, Chairman, FIP Foundation for Education and Research

Dr. Peter J. Kielgast, Chairman, FIP Foundation for Education and Research, conveyed his greetings and emphasized three important issues as follows: a) an importance of GPP on public health and the health care system, b) a successful GPP implementation process through an integrative approach, i.e., not only pharmacists, but also back-ups were necessary, e.g., legislations, health strategic plans and educational system and c) FIP’s roles on GPP support at a national level. After three years of support at a national level, e.g. to Thailand, FIP’s support would come to an end; however, FIP would determine its path forward within the coming months. In addition, Dr. Peter J. Kielgast also expressed his sincere gratitude to Danish, Swedish and especially Taiwan members for their financial support and commitment to FIP. He concluded by wishing all participants receive useful information and ideas on how to develop and implement GPP in a complete process.

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• Welcome remark by Prof. Dr. Pavich Tongroach, President, the Pharmacy Council

Prof. Dr. Pavich Tongroach, President, The Pharmacy Council, welcomed everyone to Bangkok and to the conference. He familiarized the audience with the role of Pharmacy Council, i.e., a legal authority responsible for regulating and promoting a pharmacy profession in Thailand. From the Council’s point of view, a concept of GPP was seen as a strategic move to maintain high standard of professional conduct. Then, he outlined a joint effort with other professional bodies in Thailand to promote GPP in all pharmacy areas. Examples of success cases included: a) GPP in hospital pharmacy sector became part of a nation-wide hospital accreditation scheme and b) GPP in community pharmacy sector became a guideline for an accreditation of community pharmacies. Prof. Dr. Pavich Tongroach also pointed out that an accreditation of pharmacies had moved very slowly, and the Council had been working on improving the situation. Finally, he congratulated the organizer, thanked FIP and WHO for their support and hoped that the conference could bring some immediate solutions for an implementation of GPP in individual participating countries.

• Inaugural address by Dr. Siriwat Tiptaradol, Secretary – General, Thailand Food and Drug Administration

Dr. Siriwat Tiptaradol, Secretary – General of Thailand Food and Drug Administration welcomed participating organizations and individuals to Thailand and the conference. He then familiarized the floor with four important issues as follows: a) Government’s attempt to promote effective and efficient access to quality health services in Thailand through the 2002’s National Health Insurance Act, b) role of the Thai Pharmacy Council in promoting patient safety through an accreditation of pharmacies with Thai GPP as accreditation criteria, also in 2002, c) his gratitude on delegates from WHO-SEARO and FIP for their support on GPP through SEARPharm Forum and d) his expectation on the outcomes of this conference on GPP in South East Asia Region. Finally, Dr. Siriwat Tiptaradol concluded his address by declaring open the conference and wishing everybody all the success. 3.2 Reports on GPP Status in SEA Ms. Chongmas Nitisingkarin, Secretary General of Community Pharmacy Association (Thailand) presented major findings on GPP status in South East Asia Region. The status covered was that on: a) attitude towards community pharmacists, b) information on community pharmacists, c) continuing education system, for pharmacists, d) FIP/WHO standards for community pharmacies, and e) Legislation and National Drug Policy. Those findings were uncovered from the self-assessment questionnaire developed form FIP’s GPP

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implementation guidelines and surveyed between April and May, 2007. Within six out of ten countries in South East Asia (SEA) Region, i.e., Bhutan, India, Maldives, Nepal, Sri Lanka and Thailand, attitude towards community pharmacists varied between low and moderate levels. Population had low awareness on the role and responsibilities of community pharmacists, resulting in low requests for community pharmacist’s services at the pharmacy. Likewise, community pharmacists’ attitude on their own professional role was also low; however, their attitude on GPP was somewhat better, i.e., at a moderate level. In terms of other health professionals, their attitude on community pharmacists was at a moderate level, resulting in an average professional relationship with community pharmacists. Similarly, pharmacy owners’ attitude on community pharmacists was also at a moderate level. Regarding information on community pharmacists in community pharmacies, survey revealed an insufficient number of qualified pharmacists in the pharmacies. The ratio between community pharmacists and population served varied from 1:3,500 to 1:520,000. In some countries, pharmacy technicians or trained persons were qualified to work in the pharmacies. In addition, most pharmacies didn’t employ full-time pharmacists. Continuing education system for pharmacists existed only one out of six countries responded. However, the available system was on a voluntary basis. Based on FIP/WHO standards for community pharmacies, information on premises, dispensing processes, containers & labeling, patient medical records, health information & patient counseling was surveyed. It is obvious that most countries responded had a separate service area, a refrigerator and moderately clean premises. In terms of dispensing processes, prescription checking on adverse drug reactions and double checking routines prior to dispensing of medicines was mostly not accomplished. However, correct and clear instructions were moderately provided. Surprisingly, original packages were containers mostly used while labeling performed was lower than the minimum labeling requirements. Doses and frequencies were among those mostly labeled. Patient medical records intended to facilitate patient care and audit trials, were mostly not accomplished, neither was providing health information and patient counseling. In terms of Legislation and National Drug Policy, almost all countries had GPP policy in place; however, only one country had it implemented, but on a voluntary basis. In addition, the survey revealed that all countries responded had established their own National Drug List.

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In conclusion, within the six SEA countries responded, problems identified were: • Population attitude towards community pharmacists and community pharmacists’

attitude on their own professional role • An insufficient number of community pharmacists in community pharmacies • A continuing education system for pharmacists • Standards for community pharmacies:

o Dispensing processes - prescription checking, mostly not accomplished o Labeling - lower than the minimum labeling requirements o Patient medical records - mostly not accomplished. o Health information and patient counseling - mostly not provided.

• GPP policy – not fully implemented 3.3 Discussion on Proposed Regional GPP Policy Dr. Songsak Srianujata, Executive Committee Member of the SEARPharm Forum, familiarized the proposed Regional GPP Policy to the audience. Then, he emphasized on two important issues: a) GPP in community pharmacy could be one of the major steps for community pharmacists to be recognized as health service providers and b) successful GPP implementation needed collaboration among all stakeholders. Finally, Dr. Songsak Srianujata concluded his presentation by requesting the audience to think carefully about the proposed policy before finalizing it at the end of the conference. 3.4 Experience Sharing on GPP Development & Implementation

Dr. Th (Dick) FJ Tromp chaired the experience sharing session, consisting of three parts as follows:

• GPP development and implementation in relation to “Separation of Prescribing and Dispensing”, presented by delegates from Japan and Taiwan

• GPP development and implementation, “National Strategic Plan and Plan of Actions”, presented by delegates from Mongolia, Vietnam, Cambodia and Lao PDR

• Measures taken for GPP development and implementation: Accreditation of Pharmacies, presented by delegates from Australia, India and Thailand

3.4.1 Separation of Prescribing & Dispensing Speakers from Japan and Taiwan shared their experience on the separation of prescribing and dispensing as follows:

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o Japan’s Experience

Mr. Daisuke Kobayashi, Japan Pharmaceutical Association (JPA) shared experiences on two important points: a) history of the separation of medical professionals from dispensing, i.e., Bungyo (in Japanese) and b) patient-centered initiatives by the Government, JPA and individual pharmacies to promote Bungyo.

Bungyo started in 1889; however, it was not successful due to an insufficient number of qualified pharmacies and an exceptional permission to dispense, given to physicians by the Medical Act.

Equipped with an increasing cost of health care under the Health Insurance System and policies to provide its population with an efficient and high-quality health care, the Government decided to make Bungyo function with high quality. Examples included an offering of financial incentives to both physicians and pharmacists (1973) and four revisions of the dispensing fees in 1974, 1984, 1997 and 2000.

In terms of JPA and individual pharmacies’ initiatives, several projects were initiated to encourage pharmacists to provide more appropriate drug information and pharmaceutical consultation based on medical records and to take thorough measures to prevent dispensing errors. Examples included: a) an improvement of infrastructure (e.g., pharmacy distribution, drug stock centers and drug information & training centers), b) medical history management service, c) supply of drug information, d) spread & use of the drug notebook for individual patients and e) an expansion of relevant pharmacist’s roles and education.

Unfortunately, due to time constraint, Mr. Daisuke Kobayashi could not cover future vision and some public campaigns in Japan.

o Taiwan’s Experience

Ms. Shawn Hsiang-Yin Chen, Chairman, International Affairs Committee, Taiwan Society of Health-System Pharmacists shared experiences in threefold: a) a history of the separation, b) strategies for the implementation and c) an analysis of the driving forces.

The Separation of Prescribing and Dispensing Policy (Separation policy) was implemented in 1997, two years after National Health Insurance Act had allowed qualified community pharmacies to contract with the Bureau of National Health Insurance (BNHI).

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The implementation strategies used were: a) a district-to-district and a phase-in step, b) two tiers strategy, and c) a re-design strategy. It took them several years to complete a policy implementation in Taipei and Kaochung (1997), West of Taiwan (1998), East of Taiwan (1999) and the islands (2002). At that time, community pharmacies did not gain enough public trust, therefore, a two tiers strategy dealt only with clinics. Physicians in clinics were encouraged to release prescriptions to patients, and clinics were allowed to employ in-house pharmacists (Phase I).

In 1995, 38 prescriptions were released to BNHI contracted pharmacies, around 2 millions in 1997 and around 70 millions in 2005. Although they were quite successful, a re-design strategy was initiated (Phase II). Examples included a re-design of a) the NHI system to facilitate hospital’s release of prescriptions, b) restrictions to avoid front door pharmacy and house-in pharmacists in clinics and c) the system to accommodate quality generic substitution.

Ms. Shawn Hsiang-Yin Chen also pointed out three main driving forces for the Separation Policy as follows: a) relevant legislation, b) cooperation between the Government and Pharmacist Associations including local health authority and c) public education. These forces ensured: a) a release of prescriptions, b) quality of community pharmacies, pharmacists and pharmaceutical services, c) a network between hospitals and pharmacies and d) public awareness on their rights for services available at the pharmacies.

Ms. Shawn Hsiang-Yin Chen concluded by stressing that incorporating the concept of GPP into the execution of the separation policy would demonstrate the value of pharmacists.

3.4.2 National Strategic Plan & Plan of Actions Speakers from Mongolia, Vietnam, Cambodia and Lao PDR shared their National strategic plan and plan of actions as follows:

o Mongolia’s Experience

After introducing to the audience on her country, community pharmacy infrastructure and services rendered, Ms. P. Tsetsgee from Pharmaceuticals and Medical Devices Department, Ministry of Health, presented Mongolia’s GPP strategic plan. Several weaknesses and threats from SWOT analysis were focused in the plan. Examples included legislation implementation, pharmacist’s competence, pharmacy accreditation,

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prescription behavior and quality control. Within each objective of the plan, several plans of action were presented. For example, plans to improve implementation of legislation on GPP included: a) renewing national standard for pharmacies on general principles, b) developing and printing reference materials for GPP, c) training the trainers on GPP and d) conducting training on the use of computers in pharmacies. At the end, Ms. P. Tsetsgee concluded that pharmacy service standards would be raised up to a level that promotion of health and well-being of the population could be realized.

o Vietnam’s Experience

Mr. Chu Dang Trung, Vice Head of Division of Pharmaceutical, Legislation & Policy, Drug Administration of Vietnam was a speaker of this session. He presented that in response to the National Drug Policy, dated 20/6/1996, total quality management (TQM) in Pharmaceutical industry was initiated, and it dealt with quality assurance of both pharmaceutical products and clinical therapy.

In terms of GPP in Vietnam, it started in 2007 and composed of 3 chapters, i.e., general requirements, criteria (on staff, facilities and major activities within the pharmacies) and implementation guidance, based on WHO guidelines. Furthermore, incentives to practice GPP and implementation roadmap were already established. GPP implementation deadlines were set for different locations of pharmacies, e.g., pharmacies in inner big provinces (Hanoi, HCM, Can Tho & Da Nang), from 01/07/2007 and those in inner other provinces, from 01/01/2009. In conclusion, from 01/01/2011, GPP would be obligatory for all pharmacies. Those not complying had to be closed down. Mr. Chu Dang Trung also stated that weaknesses in part of legislation, regulatory authorities and the enterprises/pharmacies were the main obstacles to implement GPP in Vietnam.

o Cambodia’s Experience

Dr. Chroeng Sokhan, Deputy – Director, Department of Drugs and Food, Ministry of Health, mentioned that after 1996, a lot of legislation and regulation had been issued and implemented, and GPP was one of them. Since GPP guideline was recently set up and ready to be issued, not a lot of experience could be shared. However, he would share experience on establishing Cambodia pharmaceutical strategic plan instead.

Based on the information from SWOT analysis, Cambodia strategic plan focused on six key areas, i.e., health service delivery, behavioral change, quality improvement, human resources development, financing and institutional development.

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Dr. Chroeng Sokhan also presented both strategies and expected outcomes of each key area of the strategic plan. For example, the expected outcome of the strategy on quality improvement, i.e., “strengthen the implementation of drug policies, laws and regulations for public safety through setting quality standards, capacity building, supervision and enforcement” was “health workers and consumers understand and comply with strengthened drug law and regulations which reflect registration quality, management and control requirements for all drugs and medical devices”. Upon pursuing the plan, it was ultimately expected that the health system and the use of drugs would become more efficient and effective.

o Lao PDR’s Experience

Dr. Sivong Sengaloundeth, Head of Administration Division, Food and Drug Department, Ministry of Health, stated that to ensure GPP in the pharmacies, 10 GPP indicators were initiated in 1995, two years after an introduction of the National Drug Policy. Those indicators were: 1) conditions of premises, space and order in the pharmacy, 2) banned drug, not available, 3) availability of essential drugs with generic name, 4) drug quality and expiry date, 5) correct drug purchase bill only; 6) dispensing practice, 7) selling behavior of malaria and diarrhea drugs, 8) selling antibiotics with prescriptions, 9) availability of essential materials for good dispensing practice (GDP) and 10) presence of professional staff. Then, Dr. Sivong Sengaloundeth briefly explained those ten indicators.

3.5 Measures Taken: Accreditation of Pharmacies Speakers from Australia, India and Thailand shared their experience on an accreditation of pharmacies as follows:

3.5.1 Australia’s Experience

Mr. John Ware, President of the Western Pacific Pharmaceutical Forum (WPPF) shared Australian experience regarding an accreditation of pharmacies. In Australia, a quality care program applied not only to pharmacists, but also to the pharmacy and all staff in the pharmacy.

In addition, Mr. John Ware pointed out five prerequisites for successful GPP development and implementation. Those requirements were: a) strong government legislation, b) education based on standards of competence at entry level, c) ongoing professional development, d) medicine and pharmacy legislations to protect the public and e) legislation encouraging professional practice. He also emphasized that the pharmacy

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associations/societies must be involved in the development and acceptance of professional practice standards which should also be in line with GPP standards recommended by FIP and WHO.

After walking through examples of good dispensing guideline (GDP) with the audience, Mr. John Ware concluded his presentation by illustrating that GDP would be GPP only when it was offered with important information and given in a manner acceptable to the patient’s level of understanding.

3.5.2 India’s Experience

Mrs. Manjiri Gharat from Indian Pharmaceutical Association - Community Pharmacy Division (IPA-CPD) shared experience gained from a pilot project (August 2006 – August 2007) on “Accreditation of Pharmacies in India” in two locations, i.e., Goa and Mumbai. This project was based on a collaboration between IPA-CPD, WHO, India Country Office and Drugs Controller General of India.

For this project, several GPP tools were developed. Accreditation worksheet, consisted of criteria and rating information, was used by assessors during the final accreditation period while accreditation manual showed detailed explanation / illustrations for the implementation of each criterion.

Those tools were introduced and distributed to participating pharmacies, i.e., around 40 in Mumbai and 25 in Goa. By the end of June 2007, those pharmacies would finish a 3-month period of implementing criteria and upgrading their own pharmacies. During that period of time, the project coordinators and pharmacy students would visit the pharmacies to monitor progress and to provide advice / help. Although feedback received was both positive and negative and the final inspection had not been completed yet, IPA had a plan to upscale this project for the whole country. Mrs. Manjiri Gharat concluded that with the GPP guideline from WHO, individual countries could come together, keep together and work together to find their own tools to make an accreditation of pharmacies effective.

3.5.3 Thailand’s Experience

Dr. Wirat Tongrod, a faculty member of Huachiew Chalermprakiat University, who has been actively involved in an accreditation of pharmacies in Thailand, assumed a speaker role. He oriented the audience on three points, i.e., a development of pharmacy accreditation in

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Thailand, an accreditation process and a key success factor.

An accreditation of pharmacies in Thailand started in 2001 with two aims in mind, i.e., to improve services provided and to decrease irrational drug use problems. Seven pharmaceutical bodies, representing pharmacists from community pharmacies, regulatory bodies and academic institutions, collaborated and worked together for two years to finish the Thai GPP guideline and to implement it in 2003.

The Thai GPP consisted of five standards as follows: a) Standard I - facility, equipment and auxiliary services, b) Standard II – quality management c) Standard III – good pharmacy practice, d) Standard IV – laws, regulations and ethics and e) Standard V – social and community participation.

In terms of an accreditation process, six steps were elaborated. They were: a) applications from interested pharmacies, b) self-assessment exercises for self-development purposes, c) appointments with surveyors for assessment visits, d) surveyors’ visits, e) surveyors’ reporting to the Pharmacy Council and the applied pharmacies and f) surveyors’ meetings for accreditation decision-making purposes.

Dr. Wirat Tongrod concluded his presentation by emphasizing that stakeholder’s collaboration was a key success factor for implementing GPP in Thailand. Examples of such collaboration were: a) the Thai Pharmacy Council initiated and ran the accreditation process, b) the Community Pharmacy Association of Thailand and the Thai Food and Drug Administration (FDA) supported and promoted and c) the Pharmaceutical Association of Thailand under Royal Patronage coordinated between local Thai Pharmaceutical bodies and international pharmaceutical organizations. 3.6 Group Discussion on Country’s Policy & Plans Prior to the group discussion session, the audience had an opportunity to participate in the presentation of Thailand’s GPP policy and plans presented by Ms. Werawan Tangkeo, Vice-President of Thai Pharmacy Advancement Sub-Committee and Deputy Secretary General, Thai Food and Drug Administration. This presentation aimed to be a show case for the group discussion session. As expected, continuous questions and answers were achieved after the presentation which included the following points:

• Thai GPP policy in community pharmacy settings was established in 2003, by collaboration among Thai Pharmacy Council, FDA, pharmaceutical associations and faculties of pharmacy.

• The policy dealt with community pharmacy’s aspects of providing an appropriate, safe

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and effective use of medicines as well as health promotion and disease prevention through an accreditation process of community pharmacies. However, it was not quite successful.

• Four challenges discovered during the self assessment questionnaire accomplished for this conference included:

o Low public and pharmacist’s awareness on community pharmacist’s role and responsibilities, resulting in low public request for community pharmacist’s service

o Quality of community pharmacists o Quality of community pharmacies and number of those with an accreditation

status o Relationship between community pharmacists and other health professionals

• As a result, the Thai GPP plan was revised accordingly to emphasize: o An integration of accredited community pharmacies with the National Health

Insurance System o Public awareness on professional pharmacy services provided within the

accredited community pharmacies o Further development of community pharmacist’s potential

Under a guidance of Dr. Songsak Srianujata, Executive Committee Member of the SEARPharm Forum, participating countries were divided into four groups. Facilitators in each group guided the discussion through the following topics: a) country GPP status, b) policy and plans to improve the status c) needs and d) possible sources of support. Then, facilitators shared the discussion outcomes with the whole audience.

Group #

Participating Countries

Facilitators

Group I • Mongolia

• India • Maldives

• Dr. Peter J. Kielgast • Mr. Kurt Fonnesbaek Rasmussen

Group II • Vietnam

• Thailand • Nepal

• Dr. Th.F.J. Tromp • Mr. John Ware

Group III • LAO PDR • Indonesia • Bhutan

• Dr. Kris Weerasuriya • Dr. Tom Ahaditomo

Group IV • Cambodia • Sri Lanka

• Mr. Prafull D. Sheth • Dr. Songsak Srianujata

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• Group I. -- Mongolia, India and Maldives

Mr. Kurt Fonnesbaek Rasmussen, a group facilitator, presented discussion outcomes of Mongolia, India and Maldives. GPP status in these three countries was quite similar to that of most participating countries, i.e., having legislation in place but problems existed in its implementation. Examples included: a) not perfect collaboration between physicians and community pharmacists, b) very few prescriptions filled at the pharmacies and c) not many pharmacists working in the pharmacies. They all needed to address GPP implementation issues and to be connected with other countries and supporting organizations to learn more and to be able to address those issues appropriately.

• Group II. -- Vietnam, Thailand and Nepal

Mr. John Ware, a facilitator of the group, presented discussion outcomes on Vietnamese Government’s decision to implement GPP on a compulsory basis within a short period of time. The group felt that it could be successful if the following issues were considered seriously:

o Government financial assistance should be provided to the existing majority

pharmacies to alleviate high cost problem associated with an upgrade of pharmacies up to a legally required size.

o Check list should be developed from the statue and used as a tool for inspectors during the inspections and for pharmacies during the development period.

o For an initial phase, inspectors should assume a role of an educator. This could help fasten the development period.

o Well publicity should be accomplished to communicate the Government’s expectation o Vietnam Pharmaceutical Association should also be more actively involved in

constant stimulation on its members regarding the urgent need to implement GPP.

Dr. Th.F.J. Tromp, another facilitator, presented discussion outcomes of Nepal and Thailand. The group pointed out some similar GPP situations between the two countries. They both had legislation (although in different stages) and GPP guidelines, they faced similar problem on low public awareness of what accredited (GPP) pharmacies were doing. However, educational problem was quite evident in Thailand. There was not enough GPP exposure to both students and young pharmacists. Unfortunately, connections to and commitments of the universities were perceived on a world-wide basis as one of the key success factors. Furthermore, the issue of GPP implementation speed was also discussed as the Vietnam’s deadline of 2011 was quite short while the Nepal’s deadline of 20 years was quite long. The group came to a conclusion that existing public awareness in both countries should be elaborated and executed further to solve the problem. In addition, there should be more

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opportunities to exchange ideas, information, tools, instruments, publications and documents among participating countries.

• Group III. -- Lao PDR, Indonesia and Bhutan

Dr. Tom Ahaditomo, a group facilitator, reported discussion outcomes of Lao PDR, Indonesia and Bhutan. After discussing the situation and policy & plans, the group concluded on common needs of GPP guideline documents, expert supports and regular communications with SEARPharm Forum. These needs could help them obtain GPP recognition, definite policy, model and plan of actions. In addition, they also discussed sources of support from local, regional and international bodies.

• Group IV. -- Cambodia and Sri Lanka

Mr. Prafull D. Sheth, a group facilitator, presented discussion outcomes of Cambodia and Sri Lanka. The group agreed on four key drivers to GPP implementation as follows: a) National Health Policy, b) National Medicine Policy, c) Essential Drug List and d) a linkage to GPP through an accredited pharmacy system and a health insurance scheme. Mr. Prafull D. Sheth further presented on situation, plan & policies, it seemed that both countries experienced difficulties in GPP implementation. Major needs that they had to focus on, in order to alleviate those difficulties were: a) strengthening legislation and enforcement, b) improving quality of pharmacists through universities and continuing education programs and c) self regulating through Pharmacy Council. In terms of local sources of support, governments, councils and associations were discussed while SEARPharm Forum, FIP and WHO were recognized as their regional and international sources of support, respectively. 3.7 Supporting Organization’s Role & Responsibilities in GPP Four supporting organizations presented their role and responsibilities in GPP development and implementation as follows:

• World Health Organization (WHO)

Dr. Kris Weerasuriya, Regional Advisor, Essential Drugs and other Medicines, South-East Asia Region, WHO, illustrated WHO role in the development of GPP. The role of pharmacists in the health care system was discussed in several WHO meetings, i.e., in 1988, 1993 and 1994, respectively. Within WHA 47.12 (May 1994), pharmacists and their professional associations everywhere were called upon to support WHO Revised Drug Strategy by practicing professional services, i.e., GPP in short.

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Dr. Kris Weerasuriya added that GPP was part of the quality in health care delivery and could show its value for money in terms of saving the increasing cost of health care. This saving could gain attention from policy-makers. Only when pharmacists were recognized as a profession and their services were included in the comprehensive health care scheme, i.e., medicinal costs and professional fees were available for pharmacists providing services, GPP could be achieved in South East Asia Region. Although achieving a professional status for pharmacists was a long–term objective, pharmacists could and should further practise GPP as best as possible.

• International Pharmaceutical Federation (FIP)

Dr. Th (Dick) FJ Tromp, Vice President FIP, familiarized the audience with the role and responsibilities of FIP on GPP development and implementation. As FIP recognized GPP as the way to implement pharmaceutical care and to increase patient (medication) safety, FIP supported GPP in several ways either alone, in collaboration with and/or endorsement by WHO. Examples included: a) issuing and revising statements on GPP and other documents, e.g., documents on “GPP in Community and Hospital Pharmacy Settings” and “GPP in developing countries, b) developing Regional Pharmaceutical Forums on a world-wide basis, c) piloting an FIP’s GPP Outreach Programme in selected developing countries, e.g., in Thailand and Uruguay, then, marketing lessons learnt and benefits of GPP to WHO and the “World” and d) organizing a toolbox of reference materials on GPP. FIP’s member organizations and individual members could apply those statements and documents as well as utilize FIP unique networks to their fullest benefits.

• South East Asia Pharmaceutical (SEARPharm) Forum Dr. Tom Ahaditomo, President of SEARPharm Forum, stated that development and enhancement of GPP was one of SEARPharm Forum objectives as it could improve health in South-East Asia Region. Therefore, SEARPharm Forum encouraged an implementation of pharmacy service and pharmacy practice projects by National Pharmaceutical Associations. He also presented the Forum’s eight next steps to implement GPP policy and plans in South East Asia Region:

o Close dialogue and cooperation on GPP programmes between FIP, WHO and member associations

o Work with local governments and National Pharmaceutical Associations in GPP development and implementation

o Facilitate an implementation of pharmacy practice through projects at national level

17

o Integrate WHO policies to the basic, postgraduate curriculum and continuing education of pharmacists

o Measures for development and implementation of pharmacy accreditation

o Formulate policy statements on health issues of concern to pharmacists

o Monitor and update database yearly in Forum ExCo

o Seek cross border collaboration between Forums

Dr. Tom Ahaditomo expected to further define and promote GPP model developed from this Bangkok conference and put it into practice in the near future (3-year period).

• Western Pacific Pharmaceutical Forum (WPPF) Mr. John Ware, President of WPPF described the Forum’s objectives of supporting GPP, quite similar to those of SEARPharm Forum. WPPF realized the language difference within the region; therefore, GPP documents developed were translated into many languages to ensure understanding. In addition, part of each ExCo meeting was scheduled to discuss GPP. Mr. John Ware also showed the audience some pictures of GPP promotional materials used in different member countries.

In addition, Mr. John Ware mentioned some good observations derived from the Forum’s experience in supporting several country programs. Good advice, networking and self initiation could move the project better than just waiting for financial support. Furthermore, international network could have a profound impact on the governments/decision-makers. 3.8 Support, Collaboration and Implementation Mechanism As already mentioned in section 1.3: Expected Outcomes, there was a change in the program. Basket exercises were initiated to produce concrete and practical strategies and tactics on GPP development and implementation as well as networks of countries with common strategies and tactics. It was expected that the identified networks could further promote supports and collaborations within the regions. Issues/problems identified during the conference were grouped and put in six (originally planned for five) baskets for further discussion as a team. Those baskets were:

• Changing perception of the role of pharmacists among themselves

• Improving the quality of pharmacy practice

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• Documentation and dissemination of the value and benefits for the society and the patients of pharmacies in the supply chain

• Raising public awareness of the added value of the role of pharmacists/pharmacies

• The role of the associations/forums

• Educations

Under the guidance of Mr. Kurt Fonnesbaek Rasmussen and Dr. Th (Dick) FJ Tromp, the whole group of participants brainstormed and concluded on strategies and tactics that addressed the identified issues/problems; then, signed up for participation as follows:

• Basket I: Changing perception of the role of pharmacists among themselves

Interested Countries

SEA Western Pacific

#

Items

Bhu Indi Indo Mal Nep Sri Tha Cam Jap Lao Mon Viet

1 Attitude of pharmacists

-- -- -- --

2 Consensuses between stakeholders

-- -- -- -- -- -- --

3 Tie-up with institutions / influencing education

-- -- -- -- -- -- -- -- -- --

4 Update knowledge of pharmacists

-- -- -- --

5 Communication skills of pharmacists

-- -- -- -- -- -- -- -- -- --

6 Change management

-- -- -- -- -- -- -- -- -- --

7 Role models -- -- -- -- -- -- -- -- --

8 Support by owners of pharmacies

-- -- -- -- -- -- -- -- -- --

9 Seven star pharmacist concept

-- -- -- -- -- -- -- -- -- -- --

19

• Basket II: Improving the quality of pharmacy practice


SEA Western Pacific

#

Items


1 Setting standards -- -- -- -- -- -- -- --

2 Institutionalizing pharmacy services (promote the strategy of GPP)

-- -- -- -- -- -- --

3 Accreditation of quality/GPP pharmacies

-- -- -- -- -- -- -- --

4 Education in GPP implementation

-- -- -- -- --

5 Enforcement of existing regulations and updating standards

-- -- -- -- -- -- -- --

6 Process of implementation of standards (e.g., TQM)

-- -- -- -- -- -- -- -- --

7 Increasing networking within pharmacy groups and outside

-- -- -- -- -- -- -- -- -- -- --

8 Promote small success stories

-- -- -- -- -- -- -- -- -- -- -- --

9 Benchmarking and transfer of best practices

-- -- -- -- -- -- -- -- -- --

10 Defining Job description

-- -- -- -- -- -- -- -- -- --


-- -- -- -- -- -- -- -- -- --

20

• Basket III: Documentation and dissemination of the value and benefits for the society and the patients of pharmacies in the supply chain


SEA Western Pacific

#

Items


1 Impact of GPP -- -- -- -- -- -- -- --


-- -- -- -- -- -- --

3 Collaboration between pharmaceutical bodies and universities

-- -- -- -- --

4 Collaboration between pharmaceutical bodies & universities (exploit research in GPP)

-- -- -- -- -- -- -- -- -- -- --

5 Integration between clinical & social science

-- -- -- -- -- -- -- --

6 Small success stories

-- -- -- -- -- -- -- --

7 Bringing outcomes of scientific activities to the general public in the area of GPP

-- -- -- -- -- -- -- --

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• Basket IV: Raising public awareness of the added value of the role of pharmacists/pharmacies


SEA Western Pacific

#

Items


1 Increasing the role of pharmacists in health care system

-- -- -- -- -- -- -- -- --

2 Rational drug use awareness to the public

-- --

3 Pharmacists as a health promoter

-- -- -- -- -- -- -- -- --

4 Survey patients and other health care providers on expectations and satisfaction

-- -- -- -- -- -- -- -- -- --

5 “Ask your pharmacists about medicines” campaign (Associations)

-- -- -- -- -- -- -- -- --

6 Campaign on special week/day on “World Pharmacy Day” dealing with special issues

-- -- -- -- -- -- -- -- -- --

7 Promotion together with new activities

8 Change of attitude of pharmacists to be more open about pharmacy/pharmacist activities

-- -- -- -- -- -- -- --

9 Creating drug information centres

-- -- -- -- -- -- -- -- --

10 Educate patients about their rights in pharmacy

-- -- -- --

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SEA Western Pacific

#

Items


11 Introduce concepts like “home pharmacy”

-- -- -- -- -- -- -- -- -- --


-- -- -- -- -- -- -- -- -- -- --

• Basket V: The role of the associations/forums


SEA Western Pacific

#

Items


1 Negotiation & representation for the advancement of the profession

-- -- -- -- -- -- --

2 Defining Job description

-- -- -- -- -- -- -- -- --

3 Separation of the role between pharmacists and physicians & research into the impact

-- -- -- -- -- -- -- -- --

4 Networking with national and international bodies

-- -- -- -- -- -- --

5 Set standards / guidelines

-- -- -- -- -- --

6 Support in implementation, motivation, education, etc.

-- -- -- -- -- -- -- --

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SEA Western Pacific

#

Items


7 Use associations as a database/center for public information on pharmacy practice at a national level

-- -- -- -- -- -- -- -- -- -- -- --

8 Establish / review / renew implementation strategies

-- -- -- -- -- -- -- -- -- --

9 Incentives for pharmacies maintaining GPP

-- -- -- -- -- -- -- -- -- -- -- --

10 Ethics and code of practice

-- -- -- -- -- -- -- -- --

11 Sustainability of SEARPharm Forum - GPP projects

-- -- -- -- -- -- -- --


-- -- -- -- -- -- -- -- -- -- -- --

• Basket IV: Educations


SEA Western Pacific

#

Items


1 Competency based curriculum

-- -- -- -- --

2 Mindset reorientation of faculty staff

-- -- -- -- -- -- -- -- -- -- --

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SEA Western Pacific

#

Items


3 Close collaboration between pharmaceutical bodies and university staff

-- -- -- -- -- -- -- -- --

4 Practice oriented teachers

-- -- -- -- -- -- -- --

5 Workforce issues -- -- -- -- -- -- -- -- -- -- --

6 Pharmacists’ support staff training (skill mix issues)

-- -- -- -- -- --

7 Practice oriented curriculum

-- -- -- -- -- -- -- --

8 Continuing professional development, self-training materials, etc.

-- -- -- -- --


-- -- -- -- -- -- -- -- -- -- --

10 Ethics and code of practice

-- -- -- -- -- -- -- -- -- --

In conclusion, 6 strategies and 61 tactics were collectively identified. Individual countries were encouraged to start working on the strategies and tactics signed up. They could also consult and/or share ideas with other countries of common interests and the four supporting organizations.

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3.9 GPP Strengthening Plans

Dr. Songsak Srianujata presented a series of pictures portraying stories of GPP project activities in Thailand from the founding period until the present time. Then, he invited Dr. Tom Ahaditomo, President of SEARPharm Forum to read out the “Bangkok Declaration on Good Pharmacy Practice in Community Pharmacy Settings” to the audience. Representatives from all participating countries and supporting organizations signed up to render their support to the Bangkok declaration”

Those representatives were from:

• SEARPharm Forum ○ Bhutan ○ India ○ Indonesia ○ Maldives ○ Nepal ○ Sri Lanka ○ Thailand

• Western Pacific Forum ○ Cambodia ○ Lao PDR ○ Mongolia ○ Vietnam ○ Taiwan (signed at a later stage)

• Supporting Organisations ○ FIP ○ SEARPharm Forum ○ Western Pacific Forum

All participating countries and supporting organizations agreed to harmoniously pursue the following policy on GPP in the community pharmacy settings in their countries:

• Collaborate to create best practices according to the guidelines established by FIP and WHO and adapt them to fit within their own national context

• Develop and implement GPP as one of the major steps to integrate community pharmacists as a partner in the health care team of the national health policy in their country

• Establish and strengthen collaborations among participants • Acquire cooperation among all stakeholders and sectors, both government and private,

providing pharmaceutical services to achieve full potential of medicines during distribution, storage and dispensing

Then, Dr. Kris Weerasuriya, Regional Advisor, Essential Drugs and other Medicines, South East Asia Region, WHO, was invited to convey an official closing remark. Based on WHO objective, i.e., “Better health for the population that it serves”, he addressed his satisfaction on what had been achieved at the conference as follows:

• The conference was quite successful in terms of increasing awareness on GPP, discussing GPP policy and plans and creating a community of pharmacists whose physical area of work served about half of the World population.

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• The conference was a beginning of the first step towards achieving a professional status for pharmacists. This is because practicing GPP is one of the tools that could demonstrate an obvious value for money of pharmacist’s role in: a) the health care system, b) the WHO Revised Drug Strategy and c) the better use of medicines

Although what could be achieved after this conference depended upon each participating countries, Dr. Kris Weerasuriya was quite satisfied that at least plans and efforts to develop and implement GPP were evident at the conference. Finally, he expressed his best wishes and a sincere support to the audience. Before the meeting was adjourned, three individuals conveyed their gratitude. First, Dr. Songsak Srianujata, on behalf of the organizing committee, thanked participating organizations and individuals for their contribution and support on the conference. Second, Mrs. Manjiri Gharat from Indian Pharmaceutical Association – Community Pharmacy Division thanked the organizing committee, staff and facilitators on behalf of all participants. Third, Dr. Peter J. Kielgast, Chairman, FIP Foundation for Education and Research, expressed his great experiences on GPP in this part of the World. Those experiences were: a) the formation and growth of the two fora, b) Thailand’s commitment, effort and hard work on GPP development and implementation which could be recognized as a show case and a role model for collogues and c) a strong advocacy role of WHO officials, especially Dr. Kris Weerasuriya. Finally, Dr. Peter J. Kielgast concluded by encouraging the audience that although GPP development and implementation was not easy but the results could be achieved one day. 3.10 Open Discussion

An open discussion session on a boat cruising along the Chao Phraya River was arranged for all participants. This offered opportunities for them to discuss GPP issues within and beyond the scope of the conference openly and informally. Even though not all participants could participate, individuals on board were seen to enjoy discussing their unsolved issues.

3.11 Field Visits About 30 participating individuals were divided into 5 groups; each group had a chance to visit two community pharmacies, accredited by the Thailand Pharmacy Council. Participants were offered an opportunity to join each pharmacy briefing, observe services provided and ask community pharmacists at the pharmacies.

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4. Conclusion & Recommendation

The conference was mostly run as originally planned. Participants were provided with several pieces of useful information. Examples included: GPP status in South East Asia Region, experiences on GPP development and implementation from several countries, GPP policy and plans of several countries including role and responsibilities of supporting organizations. Even though some changes occurred, they were still in line with the original plans and even broaden participant’s perspectives. Six strategies and 61 tactics to develop and implement GPP were collectively identified via basket exercises. In addition, network of countries with common interests were also achieved. This helped participants gain more confidence in developing and implementing GPP in their own country. As a result, Bangkok Declaration on GPP in Community Pharmacy Settings: a Regional GPP policy was agreed and endorsed by all participating countries. In general, successful GPP development and implementation takes time, effort, commitment and collaboration among all parties involved and the dynamics within each participating country. Therefore, it is highly recommended that constant stimulation should take place to accelerate an application of the conference outcomes. This can be accomplished through either follow-up or experience-sharing sessions.

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Annex 1: Self-Assessment Questionnaire

This self assessment questionnaire is part of collaborations among South East Asian countries to promote health and well-being of the population via a development and an implementation of “Good Pharmacy practice (GPP)” in community pharmacy settings. To this end, information on the GPP status in each country is needed to determine a unified GPP mobilisation direction at both regional and country levels at a conference on “GPP Policy and Plans for the South East Asia Region” in Bangkok around June-end..

Therefore, please answer this questionnaire as best as you can and return via e-mail by May 17th. Only the truth can help us mobilise GPP within the region as effectively and efficiently as possible. As well, please be assured that information uncovered will be kept confidential and will be used to serve the above stated purpose only. I. Contact Person Information

Name………………………………………………….. Title………...………………………. Organisation………………………...….………. Address………………………………………………………………………………………..……………………………………..……………. ………………………………………………..…….… Country…………………………..….…. Zip Code………..…..………………

Tel……………………….….... Fax……………….………….. Website………….…...………………… E-mail……………….……..…….… II. Respondent Information

# Name Title Organisation Remarks 1 2 3

Date of response:……………………………………………………..……..

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III. Country Information

3.1 General Information (in 2006 2005 2004 …....)

3.1.1 Total Population:…………..……………..…… million persons 3.1.2 Population Growth Rate: …………………………..……..…% 3.1.3 Country Area:…………………………….….............….. sq.km. 3.1.4 GDP:………………………………………………...… US$* 3.1.5 Per Capita Income:…………………………………….. US$* 3.1.6 Average Drug Expense / person:………….……...…… US$*

Note: *exchange rates:…………………………. 3.2 Quality Control Information

3.2.1 Are there any quality control systems on drug manufacturing in your country? no What do drug manufacturers rely on? ………………………………………………………………..……………….. yes What are they? GMP PIC/S Others……………………………………...….. (Please specify)

Are they required by laws? no yes Are they well observed? no yes

Comments: ………………………………………………...………………………………………………………………………... ………………………………………………………………………………………………………………………………………..

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3.2.2 Are there any quality control systems on drug inventory & transportation in your country? no What do drug suppliers / pharmacy owners rely on? …………………………………………………………...…….. yes What are they? ……………………………………………………………………………………………………..…..


Comments: ………………………………………………...………………………………………………………………………... ………………………………………………………………………………………………………………………………………..

3.2.3 Are there any quality control systems to minimise drug counterfeits in your country? no What do pharmacy owners / pharmacists rely on? …………………………………………………………...........….. yes What are they? ……………………………………………………………………………………………………..…..


Comments: ………………………………………………...………………………………………………………………………... ………………………………………………………………………………………………………………………………………..

3.2.4 Is there a “National Drug List for Pharmacies” in your country? no What do pharmacy owners / pharmacists rely on? ……………………………………………….…………………… yes Are they required by laws? no yes

• Are they well observed? no yes

Comments: ………………………………………………...………………………………………………………………………... ………………………………………………………………………………………………………………………………………..

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3.2.5 Are there any “National Drug Procurement Policy and Procedures for Pharmacies” in your country? no What do Pharmacy owners / pharmacists rely on? ……………………………………………….…………………… yes Are they required by laws? no yes


Comments: ………………………………………………...………………………………………………………………………... ………………………………………………………………………………………………………………………………………..

3.2.6 Are there any “National Policy and Procedures for Reporting Incidents” in your country? Examples of incidents include adverse drug reactions and avian flu outbreaks.

no What do Pharmacy owners / pharmacists rely on? ……………………………………………….…………………… yes Are they required by laws? no yes


Comments: ………………………………………………...………………………………………………………………………... ………………………………………………………………………………………………………………………………………..

3.2.7 Does pharmacy accreditation exist in your country? no What is the quality control system currently used? ………………...………………………………………..….…….. yes Who is responsible for the accreditation process?.…………………………………………………………….....….....

Is it required by laws? no yes How many accredited pharmacies are there in your country at this moment? ……………………...…………………

Comments: ………………………………………………...………………………………………………………………………... ………………………………………………………………………………………………………………………………………..

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3.3 Prescription System Information

3.3.1 In your country, where does the population have his/her prescriptions filled? And at what percentage? Hospital …..……% Clinics…..……% Community Pharmacies …..……% Others …..……%

3.3.2 If the prescriptions are now being filled at community pharmacies:

3.3.2.1 Do the following quality control systems exist? How are they accomplished? Are they well observed?

Are they well observed? QC Systems

(Y/N)

How are they

accomplished? 0% 1-

25%26-

50%51-

75%76-

100%

Remarks

Rational use of drug prescribed

Generic drug substitution

Double checking with prescribers

Double checking on pharmacy service

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3.3.2.2 What are the advantages of filling prescriptions at community pharmacies?

………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………

3.3.2.3 What are the disadvantages of filling prescriptions at community pharmacies? What needs to be improved? And how?

………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………………

34

3.3.3 If the prescriptions are now not being filled at community pharmacies:

3.3.3.1 In your opinion, should they be filled? Why? ………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………

3.3.3.2 Does you country have a policy to promote access to prescription medicine via community pharmacy channel? And what is

the current status? ………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………

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3.4 GPP Information

3.4.1 From your country’s perspective, are there any endeavours to define GPP?

no yes Who is/are responsible? ………………………………………………………………...……………………………...

What is your definition of GPP? …………………………………………………..…………………………………... …………………………..………………………………………………………………………...…………………...

…………………………..………………………………………………………………………...…………………... …………………………..………………………………………………………………………...…………………...

3.4.2 From your country’s perspective, are there any endeavours to develop GPP?


What is the current status? ………………………….……………………………..…………………………………... …………………………..………………………………………………………………………...…………………...

…………………………..………………………………………………………………………...……………….…... …………………………..………………………………………………………………………...…………….……...

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3.4.3 From your country’s perspective, are there any endeavours to implement GPP?


What is the current status? ………………………….……………………………..…………………………………... …………………………..………………………………………………………………………...…………………...

…………………………..………………………………………………………………………...………………….... …………………………..………………………………………………………………………...…………….……...

3.5 Legislation Information

3.5.1 Are there any legislations controlling the following items in your country?

Drug related

Manufacturing Registration Costs of local drugs Costs of imported drugs Advertising Distribution/Selling Post marketing Others ………………………….

……………………………………………………………………………………………….……………………… ……………………………………………………………………………………………….…….. (Please specify)

37

How many types of drugs legally sold in community pharmacies? What are they? Any required selling conditions?

# Types of Drug* Selling Conditions Remarks 1 2 3 4 5 …

*Note: Types of Drug Sold = Prescription drugs, Pharmacist’s supervision only, OTC, etc.

Community Pharmacy related Registration • How many types of community pharmacy registration are there in your country? What are they?

Qualifications** # Types of Community Pharmacy Registration

Types of Drug Sold* Owners Operators

Remarks

1 2 3 4 5 …

Note: * Please refer information from the previous table ** Qualifications = Investor, Health Professionals, e.g., Medical Doctors, Pharmacists, Nurses, etc.

38

• Which organisation is responsible for community pharmacy registration? …………………………..…………….

…………………...……………………………………………….…………………………………………….……

Renewal • How long is the renewal period? …………………………………………………………………………………… • Which organisation is responsible for community pharmacy renewal? …………….………………..…………….

…………………...……………………………………………….…………………………………………….…… • Is renewal automatically applied?

no What are the conditions for renewal?............................................................................................... …………………………………………………………………………………………………….. ……………………………………………………………………………………………………..

yes

Pharmacist related Licensing • Is licensing of pharmacists required in you country?

no yes What are the conditions for licensing?.............................................................................................

…………………………………………………………………………………………………….. ……………………………………………………………………………………………………..

• Which organisation is responsible for issuing licenses? ……………………..……….………………..…………… • How long is the licensing period? ……………………………………………………………………………...……

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• Is renewal automatically applied? no What are the conditions for renewal?...............................................................................................

…………………………………………………………………………………………………….. ……………………………………………………………………………………………………..

yes

Ethics: Which organisation is responsible? …………………...………………………….………………………………

Disciplinary actions: Which organisation is responsible? …………………...…………………..………………………

3.5.2 Are those legislations sufficient to produce / promote quality pharmacy services? What should be done to improve the situation?

………………………………………………………………………………………………………………………..……………... ……………………………………………………………………………………………………….………………….…………...

……………………………………………………………………………………………………………………….………….……

…………………………………………………………………………………………………………………………..…………...

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3.5.3 Are those legislations well observed and enforced? What should be done to improve the situation?

………………………………………………………………………………………………………………………..……………... ……………………………………………………………………………………………………….………………….…………...

……………………………………………………………………………………………………………………….………….……

…………………………………………………………………………………………………………………………..…………...

3.5.4 Are there many lawsuits relating to services provided in community pharmacy in your country? What are the top five most frequent cases?

………………………………………………………………………………………………………………………..……………... ……………………………………………………………………………………………………….………………….…………...

……………………………………………………………………………………………………………………….………….……

…………………………………………………………………………………………………………………………..…………...

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IV. Community Pharmacy Related Information

Community Pharmacy is defined as an area of pharmacy practice in which medicines and other related products are sold or provided directly to the public from a retail (or other commercial) outlet designed primarily for the purpose of providing medicines. The sale or provision of the medicine may be either on the order or prescription of a doctor (or other health care worker), or “over the counter” (OTC). 4.1 Attitude towards Community Pharmacy

4.1.1 Population’s Attitude towards Community Pharmacy Items 0% 1-25% 26-

50% 51-

75% 76-

100% Remarks

Approximated quantity of health conscious population Approximated quantity of price sensitive population How well is the relationship between the population and community pharmacy settings?

How well is the population aware of the roles and responsibilities of community pharmacists?

How well is the population’s attitude towards community pharmacists?

How well does the population call for community pharmacists when requiring services from community pharmacies?

How well does the population demand good pharmacy practice from community pharmacists?

42

4.1.2 Physician’s Attitude towards Community Pharmacy Practice

Items 0% 1-25% 26-50%

51-75%

76-100%

Remarks

How well is physician’s attitude towards services provided by community pharmacists?

How well is the professional relationship between physicians and community pharmacists?

4.2 Personnel Information

4.2.1 Information on Personnel Number, Training / Education & Licensing Requirements (in 2006 2005 2004 …....)

Number Training / Education Licensing Requirements

Types of

Personnel* # # / 100,000 pop.

Trained by..+

# of Years

Certified by.. +

Credentials Received++

CE(Y/N)

Yes / No

Licensing Body

Community Health Care Worker

Unqualified Pharmacy Technician

43

Number Training / Education Licensing Requirements

Types of

Personnel* # # / 100,000 pop.

Trained by..+

# of Years

Certified by.. +

Credentials Received++

CE(Y/N)

Yes / No

Licensing Body

Qualified Pharmacy Technician

Pharmacist

Notes: * Community Health Care Worker: A person who is trained to provide simple, low level health care commensurate with the level

of training. Unqualified Pharmacy Technician: A person who is involved in the dispensing of medicine, but who has only received “on the

job” or “in house” training. Qualified Pharmacy Technician: A person with formal dispensing training (at a lower level than a pharmacist) involved in the

dispensing of medicines. (The training or at least a part of it, would have taken place at a recognised training institution and a certificate or license would have been issued.)

Pharmacist: A person with a formal higher qualification such as a three-year (minimum) university degree or diploma in pharmacy

+ Trained / Certified by..: Professional Pharmaceutical Body, University or Others (please specify) ++ Credentials Received: Certificate, Diploma, Degree - Bachelor/ Master or Others (please specify)

CE: Continuing Education: The responsibility of individual persons for systematic maintenance, development and broadening of knowledge, skills and attitudes, to ensure continuing competence as a professional, throughout their careers.

44

4.2.2 Educational Contents Related to Community Pharmacy Provided to Pharmacists

Topics/Subjects Educational Level Name Descriptions Status

# of Graduates (in theYear ………..….)

Comments

Good Pharmacy Practice (GPP)

Guidelines on GPP in community pharmacy settings

Required Electives Not Available

Community Pharmacy

Technical & business management knowledge

Required Electives Not Available

Bachelor Degree (General)

Pharmaceutical Care

Technical knowledge Required Electives Not Available

Bachelor Degree (Pharm D)

Pharmaceutical Care

Technical knowledge Required Electives Not Available

45

4.2.3 Qualifications of Pharmacists Working in Community Pharmacy Settings

Current Practice Qualifications

Required by Laws (yes/no)

Yes No

Remarks

Degree: • Bachelor Degree in Pharmacy • Bachelor Degree, specialised in Community

Pharmacy or Pharmaceutical Care

• Master Degree, specialised in Community Pharmacy or Pharmaceutical Care

Active License 4.2.4 Educational Capacity

4.2.4.1 How many Universities / Educational institutions that can produce legally qualified pharmacists to work in community pharmacy settings are there in your country? ……………………………………………………………………………............

4.2.4.2 What is the total growth rate of those pharmacists per year? ........................................................................................................ 4.2.4.3 What is the latest ratio of those pharmacists to community pharmacy settings? …………………………… (In the year 200...)

46

4.2.5 Professional Development & Regulation

4.2.5.1 Organisations that have authority to develop and regulate pharmacists working in community pharmacy settings:

Authority areas Organisations Remarks Training & Development

Public Relations

Recognition & Awards

Disciplinary Actions

Other…………………….……(Please specify)

Other…………………….……(Please specify)

47

4.2.5.2 Which organization has gained the most respect from all pharmaceutical bodies? And why? …………………………………………………………………………………………………………………………………... …………………………………………………………………………………………………………………………………... …………………………………………………………………………………………………………………………………...

4.2.5.3 Which organization is the most appropriate body to promote GPP in your country? And why? …………………………………………………………………………………………………………………………………... …………………………………………………………………………………………………………………………………... ……………………………………………………………………………………………………………………………………

4.3 Financial Information

4.3.1 Drug Expense in Community Pharmacy

4.3.1.1 Average drug expense in community pharmacy / patient …………………….. US$ (exchange rates:………………………….)

48

4.3.1.2 What are the remuneration systems for drug expense in pharmacy? Out-of-pocket From private insurers From government Others …………………………………………………………………………………………………..(Please specify)

4.3.2 Source of Income Items 0% 1-25% 26-

50% 51-

75% 76-

100% Remarks

Drugs • Prescription Drugs • Non-Prescription Drugs

Professional fees from the following services: • Prescription review • Dispensing • Generic substitution • Extemporaneous preparation • Counselling • Chronic disease management • Disease screening programs • Smoking cessation • Follow-up • Home health care • Others ………………………………….……. • Others ………………………………….…….

Other pharmaceutical products Non-pharmaceutical products

49

4.3.3 Level of Income

4.3.3.1 Is community pharmacy considered as a good business investment in your country? 0% 1-25% 26-50% 51-75% 76-100%

Comments…………………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………

4.3.3.2 Are there any financial incentives for community pharmacies to provide the best possible pharmaceutical care to the population?

no yes What are they? ……………………………………………………….………………...……………………………...

………………………………………………………………………………………………………………...…… ………………………………………………………………………………………………………………...……

50

4.4 Community Pharmacy Information

4.4.1 Community Pharmacy Information by Types of Owner (in 2006 2005 2004 …....)

Number Distribution Types of Pharmacy # %

%

Urban %

Rural

Growth Rate (%) / year

Remarks

Stand Alone --- • Pharmacist-Owned --- • Investor-Owned -- • State-Owned --

Franchise -- Other:…………….….… (Please specify) -- Other:……………..…… (Please specify) --

Total Number 100 100 100 ………...

51

4.4.2 Community Pharmacy Information by Pharmacist’s Hours of Operations (in 2006 2005 2004 …....)

Number / Ratio Distribution Types of Pharmacy # # / 100,000

population

% Urban

% Rural

Remarks

Pharmacies with pharmacists all working hours Pharmacies with pharmacists some working hours Pharmacies with no pharmacists on duty Legally acceptable = …..…..

Illegal = …………………… Other:……………...…….…… (Please specify)

Total Number 100 100

4.4.3 Types of Service Provided Items 0% 1-25% 26-

50% 51-

75% 76-

100% Remarks

Provision of prescription medicine Provision of non-prescription medicine for minor illness

Extemporaneous preparation Drug Counselling Drug monitoring within community pharmacy settings

Provision of advice on health promotion and disease prevention, e.g., smoking cessation

52

Items 0% 1-25% 26-50%

51-75%

76-100%

Remarks

Working with other health and social care professional

Community pharmaceutical service, e.g., home health care

Others …………………………………….…………. Others …………………………………………….….

4.4.4 Premises and Facilities Available

Items 0% 1-25% 26-50%

51-75%

76-100%

Remarks

A strong building, separated from the surrounding areas

Cleanliness, tidiness with hygienic conditions Well protection from exposure to excessive light and heat, e.g., refrigeration available

An area suitable for servicing and counselling, provided or identified

A separate, confidential room or facility for servicing and counseling, provided

53

4.4.5 Equipment Available

Current Practices Equipment Required by Laws 0% 1-25% 26-

50% 51-

75% 76-

100%

Remarks

Medicine trays Medicine Containers Labels Auxiliary labels Follow-up cards Refrigerators Bath Scales Height Scales Blood pressure monitoring device Glucometer Reference materials, e.g., standard medicinal treatment guidelines

Internet access Knowledge brochures Knowledge boards Others................................................................... Others................................................................... Others...................................................................

54

4.5 Management Issues

4.5.1 Attitudinal Issues

Items 0% 1-25% 26-50%

51-75%

76-100%

Remarks

How well is community pharmacy owners’ attitude towards community pharmacists?

How well is community pharmacists’ attitude towards community pharmacy services?

How well is community pharmacists’ attitude towards GPP in community pharmacies?

4.5.2 Management of Business Operations

Items 0% 1-25% 26-50%

51-75%

76-100%

Remarks

At what level are practising community pharmacists involved in decision-making process of the following areas:

• Pharmacist-Owned Community Pharmacies o Business related o Professional service related

55

Items 0% 1-25% 26-

50% 51-

75% 76-

100% Remarks

• Investor-Owned Community Pharmacies o Business related o Professional service related

• State-Owned Community Pharmacies o Business related o Professional service related

4.5.3 Management of Service Provided

4.5.3.1 Instructions & Labelling

Items 0% 1-25% 26-50%

51-75%

76-100%

Remarks

Only verbal instructions provided Verbal instructions and labels affixed to drug containers

Verbal instructions, labels affixed to drug containers and counselling

Verbal instructions, labels affixed to drug containers, counselling and information leaflets provided

56

Items 0% 1-25% 26-

50% 51-

75% 76-

100% Remarks

Labelling information on drug containers: • generic name • strength • dose • drug regimen • duration of course • date of dispensing • name of patient • name of pharmacy

Label preparation • manual • printing

57

4.5.3.2 Drug Containers Utilised

Items 0% 1-25% 26-50%

51-75%

76-100%

Remarks

Air-tight plastic envelops/bags Air-tight, rigid containers, e.g., bottles Air-tight, rigid containers with a child resistant closure

Manufacturer’s original packaging Others…………...….. (Please specify) Others…………...….. (Please specify)

4.5.3.3 Are there any systems set up to ensure quality of service provided?

4.5.3.3.1 Are there any double-checking systems to confirm accuracy of service provided? no yes What are they? ………………………………………………………………………………………..

……………………………………………………….…………………….....………….……………

………………………………………………………………………………………………………...

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4.5.3.3.2 Are there any standard operations procedures (SOP) available in the pharmacies? Are they well observed?

Items 0% 1-25% 26-50%

51-75%

76-100%

Remarks

SOP on procurement of pharmaceutical products

SOP on temperature control SOP on an evaluation of prescriptions

SOP on dispensing procedures SOP on drug counselling SOP on patient’s monitoring SOP on patient’s referring Others ……………………………………

Others ……………………………………

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4.5.3.4 Documentation & Usage

Items 0% 1-25% 26-50%

51-75%

76-100%

Remarks

Patient drug profiles • Manual • Electronic

Adverse drug reactions documented & reported to the authorities

Incidents documented & reported to the authorities

Others …………………………………… Others ……………………………………

V. Open Comments …………………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………………………………………………………

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…………………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………………………………………………………

Please e-mail back by May 17th

61

Annex 2: Conference Programme I. June 26th, 2007—Tuesday : Arrival of delegates to the conference and SEARPharm

Forum ExCo meeting (15.00 - 17.00) II. June 27th, 2007—Wednesday : Conference session

08:00 – 08:30 Registration 08:30 – 08:55 Session I: Opening Session

Welcome Remarks • Dr. P.T. Jayawickramarajah, WHO Representative to Thailand • Dr. Peter J. Kielgast, Chairman, FIP Foundation for Education

and Research • Prof. Dr. Pavich Tongroach, President, The Pharmacy Council

Opening Address • Dr. Siriwat Tiptaradol, Secretary – General, Thailand Food

and Drug Administration 08:55 – 09:15 Photo Session

• All Delegates • All Participants

09:15 – 09:30 Session II: Presentation of GPP Status in SEA Region (Ms.

Chongmas Nitisingkarin) 09:30 – 09:45 Session III: Discussion of Proposed Regional GPP Policy (Dr.

Songsak Srianujata) 09:45 – 10:30 Session IV: Experience Sharing Session [Dr. Th(Dick)FJ Tromp]

IV.1) GPP Development and Implementation in relation to Separation of Prescribing and Dispensing (15 mins./country)

• Japan Pharmaceutical Association • Korean Pharmaceutical Association • Pharmaceutical Society of China Taiwan and Taiwan Society of

Health-System Pharmacists 10:30 – 10:45 Coffee Break

62

10:45 – 12:30 Session IV: Experience Sharing Session [Dr. Th(Dick)FJ Tromp] – continued

IV.2 GPP Development and Implementation, National Strategic Plans and Plan of Action: Case Story (15 mins./country)

• Mongolia • Vietnam • Cambodia • Lao PDR

IV.3 Measures Taken for GPP Development and Implementation, Accreditation of Pharmacies: Country Perspective (15 mins./country)

• Australia • India • Thailand

12:30 – 13:30 Lunch 13:30 – 15:00 Session V: Discussion on Country’s GPP Policy & Plans

Facilitators: Mr. John Ware, Mr. Kurt Fonnesbaek Rasmussen, Dr. Th(Dick)FJ Tromp, Dr. Peter J. Kielgast, Dr. Kris Weerasuriya, Dr. Tom Ahaditomo, Mr. Prafull D. Sheth and Dr. Songsak Srianujata

V.1 Plenary Discussion (13:30 – 14:15) • Thailand

V.2 Concurrent Group Discussion (4 groups; 3 countries/group) (14:15 – 15:00)

2.1 First four countries 15:00 – 15:15 Coffee Break

15:15 – 16:45 V.2 Concurrent Group Discussion (4 groups; 3

countries/group) – continued 2.2 Second four countries (15:15 – 16:00) 2.3 Third four countries (16:00 – 16:45)

16:45 – 17:00 Session VI: Priority Setting Session on Country’s Help Needed

Areas (Dr. Songsak Srianujata) 17:30 – 20:30 Open Discussion

63

III. June 28th, 2007—Thursday : Conference session

08:30 – 9:30 Session I: Presentation of Role & Responsibilities in GPP

Development and Implementation • WHO - Dr. Kris Weerasuriya (8:30 – 8:45) • FIP – Dr. Peter J. Kielgast (8:45 – 9:00) • SEARPharm Forum – Dr. Tom Ahaditomo (9:00 – 9:15) • WPPF – Mr. John Ware (9:15 – 9:30)

09:30 – 10:30 Session II: Identification of Support, Collaborations and

Implementation Mechanism (Mr. Kurt Fonnesbaek Rasmussen and Dr. Th(Dick)FJ Tromp)

• 3 countries (@ 20 mins.) 10:30 – 10:45 Coffee Break 10:45 – 12:30 Session II: Identification of Support, Collaborations and

Implementation Mechanism (Mr. Kurt Fonnesbaek Rasmussen and Dr. Th(Dick)FJ Tromp) – continued

• 5 countries (@ 20 mins.) 12:30 – 13:30 Lunch 13:30 – 15:10 Session II: Identification of Support, Collaborations and

Implementation Mechanism (Mr. Kurt Fonnesbaek Rasmussen and Dr. Th(Dick)FJ Tromp) – continued

• 5 countries (@ 20 mins.) 15:10 – 15:25 Coffee Break 15:25 – 15:45 Session III: Observations from the Project Management - What

have we achieved? (Mr. Kurt Fonnesbaek Rasmussen and Dr. Th(Dick)FJ Tromp)

15:45 - 16:30 Session IV: Wrap-up on Plans for Strengthening of GPP in

Community Pharmacy Settings in SEA Region (Dr. Kris Weerasuriya & Dr. Songsak Srianujata)

64

IV. June 29th, 2007—Friday : Field Visits

08:30 - 14:00 Field Visits to Thai “Quality Pharmacies” (Team)

65

Annex 3:

Annex 4: Key Participant Information I. Participating Countries in SEARPharm Forum 1.1) Bhutan Title Name Position Organisation Mobile/tele/fax E-mail Remarks Ms. Ngawang Dema Pharmacist Drug Regulatory Authority, Royal

Government of Bhutan 00975-17611744 ngawangdema@health.

gov.bt

Ms. Manusika Rai Senior Pharmacist Drug Vaccines and Equipment Division, Ministry of Health

00975-17604512 [email protected]

1.2) India Title Name Position Organisation Mobile E-mail Remarks Mrs. Manjiri S Gharat Secretary IPA Community Pharmacy Division,

Indian Pharmaceutical Association 91 9869128246 [email protected] Accreditation

speaker Mr. Raj Vaidya Vice President &

Chairman Indian Pharmaceutical Association 91 9422962286 hindupharmacy@gmail

.com GPP policy & plans speaker

1.3) Indonesia Title Name Position Organisation Mobile E-mail Remarks Mr. Saleh Rustandi The President Director PT Kimia Farma Dr. Sahat Saragi Pharmacist PT Kimia Farma [email protected]

or [email protected]

Dr. Hendra Purnomo ISFI (National Pharmacist Association)

62-21-345 1473, 3503921/25

fx: 62-21-350-5611

[email protected]

Mr. Imam Fathorrahman

ISFI (National Pharmacist Association)

[email protected]

1.4) Maldives Title Name Position Organisation Mobile E-mail Remarks Ms. Shasma

Mohamed Assistant Pharmaceutical Officer

Maldives Food and Drug Authority 9607710373 [email protected]

Ms. Aminath Mohamed

Assistant Pharmaceutical Officer

Maldives Food and Drug Authority 9607720866 [email protected]

1.5) Nepal Title Name Position Organisation Mobile E-mail Remarks Dr. Balkrishna

Khakurel Registrar Nepal Pharmacy Council 9851070227 [email protected]

Mrs. Rajani Shrestha Nepal Bureau of Standards and Metrology +97-98412-8217 [email protected] 1.6) Sri Lanka Title Name Position Organisation Mobile E-mail Remarks Mr. Shalutha Athauda Senior Vice

President Pharmaceutical Society of Sri Lanka +94 777 636424 coo@ceylincopharma

.com

Ms. Chinta Abayawardana

General Secretary

Pharmaceutical Society of Sri Lanka +94 777 656133 [email protected]

Allergic to beef

1.7) Thailand Title Name Position Organisation Mobile E-mail Remarks Mr. Teera

Chakajnarodom President The Pharmaceutical Association of

Thailand under Royal Patronage 66 08 1811 9935 [email protected]

Dr. Pavich Tongroach President The Pharmacy Council 66 08 1372 8273 [email protected]

Title Name Position Organisation Mobile E-mail Remarks Mr. Prasit Wongnijasil President Drug Stores Club of Thailand 66 08 1544 5489

66 08 9127 [email protected]

Mr. Jittawut Limsirisrethakul

President Thai Pharmacies Association 66 08 1819 5021 --

Mr. Teerawudh Pongsretpaisal

President Community Pharmacy Association (Thailand)

66 08 7501 1510 [email protected] [email protected] [email protected]

Ms. Chongmas Nitisingkarin

Secretary Community Pharmacy Association (Thailand)

66 08 1847 9270 [email protected] [email protected]

GPP status speaker

Dr. Wiwat Arkaravichien

Lecturer Faculty of Pharmacy, Khonkhan University

66 08 9350 3131 [email protected]

Dr. Wirat Tongrod Lecturer Faculty of Pharmacy, Huachieu Chalermprakiet University

66 08 7011 9168 [email protected] Accreditation speaker

Dr. Siriwat Tiptaradol Secretary General Thai Food and Drug Administration [email protected] Ms. Weerawan Tangkeo Deputy-Secretary

General Thai Food and Drug Administration [email protected] GPP Policy

speaker

Title Name Position Organisation Mobile E-mail Remarks Mr. Visid

Pravinvongvuthi Chief Office of Pharmacy Advancement

Project, Drug Control Division, FDA

[email protected]

Dr. Duangtip Hongsamoot

Consultant Office of Pharmacy Advancement Project, Drug Control Division, FDA

[email protected]

Mrs. Sirirat Tupichart Committee Community Pharmacy Association, Thailand

[email protected]

II. Participating Countries in Western Pacific Forum 2.1) Australia Title Name Position Organisation Mobile E-mail Remarks Mr. John Ware President Western Pacific Pharmaceutical Forum 0408 349 163 [email protected] Accreditation

speaker

2.2) Cambodia Title Name Position Organisation Mobile E-mail Remarks Mr. Yim Yann President Pharmacist Association of Cambodia Ph 855-12-919892

fx 855-3-880696 [email protected] [email protected]

Ms. Mam Boravann Officer Pharmacist Association of Cambodia ph 855-23880969 fx 855-23-880696

[email protected]

Mr. Tiv Sothearith Officer Pharmacist Association of Cambodia 855-12-75-3848 [email protected] [email protected]

Ms. Sar Lada Officer Pharmacist Association of Cambodia [email protected] Dr. Tep Lun Director General

for Health Ministry of Health 855-12 91 98 92 [email protected]

[email protected]

Dr. Chroeng Sokhan Deputy Director Department of Drugs and Food, Ministry of Health

855-12 86 20 10 [email protected] [email protected]

2.3) Japan Title Name Position Organisation Mobile E-mail Remarks Mr Daisuke Kobayashi Member International Affairs Committee, Japan

Pharmaceutical Association 81-90-7905-2686 [email protected] Separation

speaker

2.4) Lao PDR Title Name Position Organisation Mobile E-mail Remarks Dr. Sivong

Sengaloundeth Head of Administration Division

Food and Drug Department, Ministry of Health

85620 2208014 [email protected], [email protected]

National Plans speaker

2.5) Mongolia Title Name Position Organisation Mobile E-mail Remarks Ms Munkhdelger,

MOH [email protected]

Ms. P. Tsetsgee

Officer Pharmaceuticals and Medical Devices Department, Ministry of Health

976-99897870 [email protected] ?? [email protected]

National Plans speaker

Professor

Dungerdorj President the Mongolian Pharmaceutical Association [email protected]

Dr. Tseveen Davaasuren

Head Pharmaceutical Technology and Pharmacy Management Department, Pharmacy School, Health Sciences University of Mongolia

976-99860945 [email protected]

2.6) Taiwan Title Name Position Organisation Mobile E-mail Remarks Ms. Hsiang-Yin, Chen

(Shawn) Director Department of Pharmacy, Taipei

Medical University Municipal Wan-Fang Hospital

+886 968-718-775

[email protected] Separation speaker

Ms. Su-Yu, Chien Director Department of Pharmacy, Changhua Christian Hospital

+886 936-829-135

[email protected]

Ms. Mei-Ling, Hsiao Director Genernal Bureau of Health Promotion, Department of Health Taiwan

[email protected]

Prof. Weng-Foung Huang

President The Pharmaceutical Society of Taiwan +886 932955194

[email protected] Dinner talk speaker

Dr. Wen-Shyong, Liou President Taiwan Society of Health-System Pharmacists

+886 933-223-660

[email protected]

2.7) Vietnam Title Name Position Organisation Mobile E-mail Remarks Mr. Chu Dang Trung Vice Head Division of Pharmaceutical

Legislation and Policy, Drug Administration of Vietnam

0903432065 [email protected]

Mr. Nguyen Van Dinh Vice President Vietnam Pharmaceutical Association [email protected] National Plans Speaker

III. Supporting Organisations 3.1 WHO Title Name Position Country Mobile E-mail Remarks Dr. Kris Weerasuriya Regional Advisor,

EDM [email protected]

ho.int

Dr. P.T. Jayawickramarajah

WHO Representative to Thailand

[email protected]

3.2 FIP Title Name Position Country Mobile E-mail Remarks Dr. Peter J. Kielgast Chairman [email protected] Mr Kurt Fonnesbaek

Rasmussen Consultant Denmark +45 2020 3920 [email protected]

Dr. Th.F.J. Tromp Vice President The Netherlands +31 38 3371412 [email protected] Mr Xuanhao Chan Project Coordinator Singapore/Netherlands +31625066964 [email protected] 3.3 Western Pacific Forum Title Name Position Country Mobile E-mail Remarks Mr. John Ware President Australia 0408 349 163 [email protected] 3.4 SEARPharm Forum Title Name Position Country Mobile E-mail Remarks Dr. Tom Ahaditomo President Indonesia +62811950363 [email protected] Mr. Prafull D. Sheth Professional

Secretary India +91-98103-35405 [email protected]

Mr. M. V. Siva Prasada Reddy

Executive Secretary India +91-98718-77117 [email protected]

Title Name Position Country Mobile E-mail Remarks Mr. Subodh Priolkar ExCo Member India +91-98679-45678 subodhpriolkar@valois-

india.com

Dr. Songsak Srianujata ExCo Member Thailand 66 08 1343 3580 [email protected]

Methanee Twinprawate [email protected]

July 4th, 2007

GPP policy asia tenggara

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