You’ve trained pharmacists for over three decades as a community pharmacy leader at local, regional, and global levels. You have also led public health initiatives, such as the DOTS TB pharmacists project of IPA. What has been the impact of such initiatives in terms of disease detection rates, compliance with medicine regimens, etc?
Pharmacists have long remained a missing link in our health system, with their true potential yet to be fully tapped. However, I have always strongly believed that pharmacists are — and must be — an integral component of the healthcare team. With this conviction, I have continued my efforts to involve community pharmacists in people centered care through various initiatives. One of the key milestones in this journey was engaging pharmacists in the Revised National Tuberculosis Control Program (RNTCP). This was a pioneering example of a public–private partnership implemented from the local to the national level. In Maharashtra alone, during 2010-2012, 525 pharmacists from six municipal corporation areas were trained in TB care and control and almost 100 served as DOTS providers.
This was a historic development — more than 500 patients were treated at pharmacies, and trained pharmacists referred several TB suspects. Just to give an example: In the Bhivandi corporation area, 37 pharmacists referred 476 suspects, of whom about 14 per cent were confirmed positive cases. These were patients who might otherwise have been missed, and by identifying them, pharmacists played a significant role in breaking the chain of TB transmission.
The success of this PPP model had a multiplier effect — it was replicated by NGOs in different parts of the country. The training module developed by the Indian Pharmaceutical Association (IPA), in collaboration with the Ministry of Health and Family Welfare (MoHFW), was translated by NGOs into several regional languages to facilitate wider implementation. Perhaps the most significant outcome of this initiative was that policymakers and communities began to recognise pharmacists as a new pool of human resources for public health.
This experience reaffirmed my belief that when pharmacists are appropriately trained and supported within the right ecosystem, they can indeed become powerful change agents in public health. Building on the success and confidence gained from the DOTS TB Pharmacist Project, we have continued our efforts to engage pharmacists in national health programmes targeting noncommunicable diseases (NCDs) and vectorborne diseases. Although these initiatives have not yet yielded tangible results, sustained advocacy and collaboration with policymakers are ongoing. I remain hopeful that, with continued commitment and recognition of pharmacists’ value in the health system, their integration into these broader public health programmes will soon become a reality.
In an era where online pharmacy chains are outnumbering the corner chemist shop, at least in metros, you have a faceless doctor calling you up to verify your prescription. How can we enhance the role of pharmacists as gatekeepers of public health in India?
As stated earlier, I strongly believe that pharmacists can be true changemakers in population health. The interaction between pharmacists and patients is the most defining and valuable feature of pharmacy practice. While people increasingly turn to online platforms for purchasing medicines due to discounts and convenience, no technology can replace the human interaction and personal touch that occur in a pharmacy. Neither phone calls nor chatbots can replicate the empathy, reassurance and trust that come from face-to-face engagement with a pharmacist.
Although online medicine purchases cannot be completely prevented, the focus should be on strengthening the patient-centered role of pharmacists. By demonstrating their true value through personalised care, pharmacists can encourage patients to prefer in-person pharmacy visits over virtual transactions. Pharmacists must truly act as a vital link between the patient and the doctor, serving as approachable and knowledgeable medication counsellors.
Even small, consistent efforts — such as offering practical tips for responsible medicine use — can significantly enhance the pharmacist’s perceived value in the eyes of patients. Simple clinical services like blood pressure measurement or BMI calculation are easy to implement and can help position community pharmacies as accessible health hubs. Gradually, the vision should evolve towards a culture of “Think Health – Think Pharmacy.” Pharmacists can also play an essential role in connecting patients with community resources such as de-addiction centers, old-age homes, and nursing bureaus. Beyond medicine-related advice, pharmacists across the world are establishing themselves as key contributors to social prescribing — helping people access non-medical interventions that improve their overall well-being.
Pharmacists, often the most accessible healthcare professionals, are uniquely positioned to contribute to social prescribing and community health promotion. Their role extends far beyond dispensing medications; it encompasses empathy, communication and proactive engagement. Even small gestures of kindness and curiosity can foster trust and strengthen relationships. Issues such as loneliness and ageing populations are emerging as major social health challenges across the globe. Pharmacists, with their accessibility, empathy and clinical insight, can and should be part of the solution. While artificial intelligence and digital tools can support and complement pharmacy services, they can never replace the human connection that defines the essence of the pharmacist’s role.
How has the role of a pharmacist evolved globally? Are there any models that India can adapt/adopt to address the realities of our socio-economic status and health burdens?
Globally, the role of community pharmacists has expanded to such an extent that communities can confidently relate to the phrase, “Think Health – Think Pharmacist.” coined by the International Pharmaceutical Federation (FIP) In most countries, pharmacists are recognised as essential healthcare professionals who serve as a bridge between patients and doctors, contributing significantly to accessible, safe, and people-centered healthcare. Community pharmacies across the world now provide a broad spectrum of services — including drug-use reviews, clinical assessments, medication counselling, adverse drug reaction (ADR) monitoring, de-addiction support, health promotion, and vaccination services. In fact, in more than 56 countries, pharmacists are authorised to administer adult vaccines, reflecting their vital contribution to public health.
Pharmacists are regarded as an integral part of the health system, sharing its responsibilities and strengthening the foundation of primary healthcare. In countries such as the UK and Canada, governments have actively encouraged the public to utilise pharmacists’ services for the management of minor ailments, thereby reducing the burden on general practitioners (GPs). Pharmacists in many countries now specialise in areas such as diabetes management, anticoagulant therapy, harm reduction services, allergy testing, and even specific women’s health conditions such as menopause — underscoring their expanding clinical roles and expertise. Indeed, community pharmacies have become the cornerstone of primary healthcare in many developed nations.
This transformation has been enabled by strong education, regulatory and policy frameworks that align to support pharmacy practice advancement. There is much that can be learned from these global experiences. However, as the saying goes, “Think global, act local.” Practice models from other countries cannot be replicated in their entirety in India due to differences in healthcare infrastructure, policy environments, and social contexts. Nevertheless, India can adapt and contextualise successful international models, particularly those related to the management of common ailments as developed in the UK and Canada. It is also essential to develop supportive resources for training, mentorship, and continuing professional development (CPD) of pharmacists, ensuring they are well-equipped to deliver high-quality, patient-centered care in the Indian context. FIP has developed wonderful resources and we should take benefit of the same.
In the National Health Survey, it has been brought out that when a member of a family falls sick in India, 14.4. per cent of the people surveyed preferred to go to a pharmacy for advice. How can we enhance this role through technology, digital strategies, etc?
Digitisation and the adoption of new technologies will play a transformative role in advancing pharmacists’ contributions to healthcare and enhancing patient care services. The use of digital tools for clinical decision support and medication adherence monitoring can greatly improve the quality, safety, and efficiency of pharmaceutical care. Developing an easy-to-use drug information database that provides ready-to-deliver medication instructions is an urgent need to support pharmacists in daily practice.
Similarly, digital inventory management systems can streamline operations, minimise wastage, and ensure the timely availability of medicines. The use of artificial intelligence (AI)–driven communication tools can strengthen patient engagement and follow-up, enabling pharmacists to maintain meaningful connections with patients even beyond the physical pharmacy setting. I see this as most useful and easy to use application of the technology which will really improve the patient connect.
To fully leverage these opportunities, digital literacy and practical technology applications must be integrated into undergraduate pharmacy education. Teaching students to use these tools effectively — through hands-on, practice-oriented training — will prepare future pharmacists to thrive in an increasingly digital healthcare environment and to deliver innovative, patient-centered services. To do this, teachers also need to be trained in newer technologies and its real world applications.
What are your recommendations for policymakers and governments to make pharmacists the gatekeepers of community health?
In India, the transformation of pharmacy practice is an urgent and essential need. Expanding the scope of pharmacists’ practice — supported by appropriate education, training, legal reforms, and a conducive policy framework — is critical to realising this change. Equally important is the awareness among consumers about the range of services they can rightfully expect from their pharmacies. India faces multiple public health challenges: an ageing population, a rising burden of noncommunicable diseases (NCDs), widespread selfmedication, irrational use of medicines, antimicrobial resistance (AMR), and low health literacy. In this context, strengthening the pharmacist workforce and modernising pharmacy practice are vital steps toward improving public health outcomes. This will strengthen primary healthcare. To achieve Universal Health Coverage (UHC) and last-mile healthcare delivery, pharmacists are must.
World Health Organisation (WHO), the Organisation for Economic Co-operation and Development (OECD), and FIP emphasise the critical role of pharmacists as healthcare professionals. The United Nations also recognises pharmacists as an important pillar of the healthcare system. I therefore urge policymakers and all stakeholders to give urgent and focused attention to the pharmacy sector. It is time to acknowledge that while India leads globally in the pharmaceutical industry, pharmacy practice — the patient-facing arm of the profession — still lags behind many other countries.
To bridge this gap and unlock the full potential of pharmacists, the following key actions are imperative:
- Develop a national competency framework for pharmacists, aligned with the needs and priorities of public health.
- Expand the scope of practice for trained community pharmacists, enabling them to clinically manage a defined set of minor ailments (e.g., sore throat, diarrhea, skin infections, hyperacidity, etc.).
- Involve pharmacists in the planning and implementation of national health programmes and public health initiatives.
- Ensure strict enforcement of the Drugs and Cosmetics Act and Rules, mandating the presence of qualified pharmacists in all pharmacies across India.
- Implement Good Pharmacy Practice (GPP) standards in every pharmacy to ensure quality and consistency of care.
- Introduce a remuneration system for pharmacists’ professional services — even if modest initially — to acknowledge and incentivise their contribution to healthcare.
- Reform and strengthen pharmacy education, which currently requires urgent attention to align with global standards and contemporary healthcare needs.
Together, let us unlock the full potential of pharmacists and bridge this missing link in India’s healthcare system — for the benefit of society and the health of our nation.
viveka.r@expressindia.com
viveka.roy3@gmail.com