Remodeling pharmaceutical care in Sub-Saharan Africa (SSA) amidst human resources challenges and the HIV/AIDS pandemic.

Pharmaceutical care, meant to complement a proper drug supply system, is a key component of a robust health care system and is the direct, responsible provision of medication-related care designed to achieve definite outcomes that improve a patient's quality of life. Beyond simply dispensing medicine, pharmaceutical care promotes adherence to therapeutic regimens and addresses problems such as overdosage, sub-therapeutic dosage, adverse drug reactions, medication errors, and untreated indications. The dearth of health care workers trained in pharmaceutical care coupled with inadequate access to medications creates multiple disease management challenges in Sub-Saharan Africa (SSA), which has 25% of the world's disease burden but only 1.3% of the world's health workforce. To prevent and treat HIV/AIDS, TB, malaria, and other maladies, the need is urgent to train and integrate the contributions of current workers who handle medications for major and minor health problems, especially those in licensed pharmacies and drug shops. On the aggregate in SSA, pharmaceutical care is in a nascent stage in most countries but needs to grow as a discipline as well as be tailored to specific country needs. The SSA solution lies in establishing health care system components where cadres of workers engage in pharmaceutical care practices, as well as store and distribute medications. Curriculum changes in pre-service education, more continuing education for the health workforce in place, and training pharmacists to supervise a lower cadre of assistants and others are among the elements in a pharmaceutical care paradigm shift which is the focus of this article. Copyright (c) 2009 John Wiley & Sons, Ltd.