A needs-based education strategy allows local systems to best assess the needs of its community and then develop (or adapt) the supporting educational system to produce a workforce relevant to these needs. National health care demands are diverse and complex, often varying widely within and between regions. Although broad and general frameworks may be beneficial at the macro level, a one-size fits-all system does not offer the authenticity needed for full engagement and sustainability at the local level.
Pharmaceutical Human Resources continue to be a priority issue for FIP Education initiatives (FIPEd) to engage collaboratively with all stakeholders; we need to work together towards developing a profession that can meet present and future societal and pharmaceutical health needs around the world.
KEY MESSAGES .................................................................................
Access to quality medicines and competent, capable health care professionals are fundamental aspects of any health care system. Pharmaceutical human resources should ensure the uninterrupted supply of quality medicines to the population, their management, and responsible use, as vital components in improving the health of nations.
Multi-stakeholder collaboration incorporating best available evidence is required to inform needs-based pharmaceutical human resources planning. When relevant, well-informed stakeholders partner to address workforce issues, there are greater possibilities for coordinated workforce planning and implementation.
Pharmacy workforce per capita varies considerably between countries and regions and generally correlates with country level economic development indicators. Countries and territories with lower economic indicators, such as those Africa, tend to have relatively fewer pharmacists and pharmacy support workers. This has implications for observed inequalities in access to medicines and medicines expertise. In addition, some countries and territories have many times more pharmacies than pharmacists, which may imply a renewed need for supervision of medicines and medicines use.
Strategic frameworks and policies related to the pharmacy workforce are being successfully developed and implemented at the country level through multi-stakeholder processes involving ministries of health, health professional associa tions, regulators, and educators to drive and achieve both competence and practitioner excellence for care quality.
Improving workforce performance productivity, capability and the ability to adapt to new roles is an on going challenge in the increasingly dynamic environment of rising health care costs, increased demand for health services, and increased burden of chronic diseases. Fuelled in part by an increased focus on patient care and inter-professional collaboration, these elements provide the opportunity for pharmacists to use their professional skills to provide safe, high quality, and cost-effective pharmaceutical services for the benefit of populations. Leadership is a key aspect in empowering pharmacy professionals to maximize these opportunities and to innovate and shape their practice.
Investment in transforming and scaling up professional education is crucial, as education provides the foundation for building a capable health care workforce. The capacity to provide pharmaceutical services in each country is dependent upon having an assured, competent workforce and an integrated academic workforce to train sufficient numbers of new pharmacists and other support staff at both foundation and advanced levels. Ongoing effort is needed to ensure capacity building of skilled medicines expertise meets the pharmaceutical health needs of populations.
The Kampala Declaration and Agenda for Global Action in 2008  acknowledges that the highest attainable standard of health is a fundamental human right, and highlights the need for immediate action to resolve the accelerating global health workforce crisis. It calls for concerted governmental, civil society, private sector, and professional organisation action to ensure that health workforce issues are addressed. The G8 Communiqué of July 2008  states that members will work towards increasing health workforce coverage towards the WHO threshold of 2.3 health workers per 1000 people. It also supports efforts by partner countries and relevant stakeholders in developing robust health workforce plans and establishing specific, country-led milestones.
The WHO report on social determinants of health  recognises that a competent, supported health workforce is fundamental to developing robust health systems and for reaching health and development goals. It calls for whole system action on social determinants of health that must involve the government, civil society and local communities, business, global fora, and international agencies. It states that to be effective policies and programmes must embrace all sectors of society not just the health sector - and that providing more health workers alone will not reduce health inequalities.
The High-level Taskforce on Innovative International Financing for Health Systems  calls for different mechanisms for financing national health care systems in order to meet the MDGs. The Venice statement on maximizing positive synergies between health systems and global health initiatives  makes a number of recommendations and calls for the health systems strengthening agenda to be infused with a sense of ambition, scale, speed, and increased resources and to promote country capacity for strong national planning processes and better alignment of resources with national planning processes.
In many countries, pharmacists are the most accessible of all health care workers and as such play a key role in the delivery of health care services, particularly the safe distribution of medicines at all levels. In an era of rapidly accelerating change in health care delivery, the roles of pharmacists are constantly being redefined, as roles, competency, and training requirements change. Thus, understanding the current work- force and the factors that influence it are key components to human resource planning in pharmacy. As the recent report from the Office of The Chief Pharmacist to the US Surgeon General states, a health system improvement that is well sup- ported by the evidence-base is to maximize the expertise and scope of pharmacists and minimize expansion barriers for an already existing and successful health care delivery model .
Claire Anderson, Professor of Social Pharmacy and Tapash Roy, Research Associate, Division of Social Research in Medicines and Health, School of Pharmacy, University of Nottingham, UK.
Increased demand for health services and increasing expectations for service delivery have a significant effect in shaping workforce dynamics.
Contemporary issues surrounding the global pharmacy workforce identified from the literature include the importance of working conditions and job satisfaction on retention, workforce development and revalidation, wide ranging supply and demand factors affecting the workforce and migration.
To support growth in the establishment of pharmacy practice and its aspiration for increased patient focused care, work force needs and other trends will need to be factored into pharmaceutical service development plans.
2.1 The global policy context
The world s health workforce is facing significant challenges. With an estimated shortage of more than four million health workers worldwide, the global health workforce crisis is possibly the greatest health system constraint on countries seeking to meet their 2015 Millennium Development Goals (MDGs). Increased demand for health services and increasing expectations for service delivery have had a significant effect in shaping labour market dynamics. As a result, health workforce issues have generated huge interest and international action to bring about change. The publication of the World Health Report in 2006  highlighted health workforce issues and stimulated widespread investigation and international action to bring about this change. This report was a major driving force for expansion of the international health workforce in order to meet the health related Millennium Development Goals. There have since been a number of calls to action. The 2008 World Health Report  states that the health workforce shortages and inefficiencies are also seriously hampering effective implementation of primary health care. The 2010 World Health Report  identifies that health workforce shortages are hindering the expansion of health service coverage and calls for more efficient and equitable use of financial resources. The 2011 WHO resolution on health workforce strengthening recognises the centrality of human re- sources for health to the effective operation of health systems .