A Case for Pharmacy Leadership in Global Health

Of all health professionals, Pharmacists probably have the strongest advocacy campaigns calling for the recognition of the capacity to provide services and care to patients beyond the current general scope of merely dispensing medicines. Across the globe, the pharmacy profession has experienced significant growth in the last decade.

While leading the International Pharmaceutical Students Federation on expanding the involvement of the federation in global health affairs especially with the World Health Organization, the United Nations, the International Committee of the Red Cross and Red Crescent, and more, there was a significant lack of guidance and precedence of engagement from the Pharmacy Profession on which we could build on.

Coming back to the local context, I once had a discussion with an authority in the health sector about the lack of Pharmacists in a managerial role such as Director of a Hospital or other non-clinical, administrative role in healthcare, they pointed out that it can only be blamed on Pharmacists not showing up with the capacity, but I believe there is bias to some extent. And in the past weeks, young pharmacists took it to twitter to send out complaints and arguments with other health professionals on similar issues.

Globally, a friend made an interesting revelation in a young pharmacists meet up, he said that the best school of medicine in the world will have a number of their prominent professors start their career in a clinical setting, getting into a policy decision making position in a ministry, international organizations, and conduct the most policy related researches before returning to teach at the school. While for the best school of pharmacy in the world, the prominent professor will have evolved at the school in a purely academic environment, in the country and mostly focused on pharmacy and pharmaceutical sciences directly related issues. Students from these schools will have completely different aspirations and capacity in their leadership positions.

During the 70th World Health Assembly in Geneva, a remark putting medical doctors above other health professions on global health leadership served to unite pharmacy, nursing and veterinary students present who started, under the hashtag #WeNotMe, to talk about the strength in diversity and what this diversity could bring to Global Health Leadership, reforms and advances that are long overdue.

I engaged my position as President of IPSF as stepping stone for my goal to be serving as a policymaker in a position that allows me to first-hand shape, build and strengthen health systems. I sought to learn about global health, to engage in health policy discussions, I used this blog as a platform to share my thoughts and ideas. But I kept having the impression that as a Pharmacist, it is a wrong goal to have. While I make my next steps, it is proving to be even more challenging to have entry points into a career path that would lead up to my goal. I speak for many of us who are growing up to discover the role of a pharmacist that goes beyond the status quo.

As we shape the future of the profession, I would mandate us, the young generation to bust the bubble, let’s remove limits on what we can or cannot do as Pharmacists. Although we still seek to justify our role in the health systems, let’s combine this fight with having more of us defining and shaping the future of these health systems and the future of Global Health. let’s take up roles beyond our limits, and by doing so, there is no way the profession will lag behind, we can make change happen from within the systems.

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Engaging Youth in The WHO African Regional Offices Transformational Agenda

Originally published at on.kigalian.com on June 23, 2017.


You may recall my letter, dating of 20 February 2017, to who would become the next WHO Director-General, with a persuasion for the leader to implement reforms in goal-directed efforts and sufficiently increase the role of youth and student-led organisations in decision-making processes at all levels of the World Health Organisation. As the WHO African Regional Office prepares to host the first ever Africa Health Forum in Kigali next week, I must give it up for Dr. Matshidiso Moeti, Regional Director, and her for recognising the need to engaging Africa’s youth towards achieving Universal Health Coverage. During the forum, WHO AFRO is organising a youth-led interactive side event as an avenue for the institution to strengthen its strategic partnership with the youth in the region and provide a platform for young people to speak about their own involvement in Universal Health Coverage.

In Rwanda, youth and student-led organisations have taken up the lead on several issues and proven to be effective over years. As examples, the Rwanda Pharmaceutical Students Association is known for hosting continent-wide conferences for students and young people with aim to advance pharmacy practice on the continent and worldwide; the Medical Students Association of Rwanda is at the forefront of combatting infectious diseases in their numerous campaigns against diseases like Malaria; the Rwanda Village Concept Project works in communities to address basic issues like sanitation by building clean toilets in rural areas; the Rwandan Children’s Cancer Relief organises a yearly campaign and walk to educate communities on cancers affecting children, among many other organisations and initiatives.

It is then indispensable for policy makers across Africa to channel this drive, support and partner with the youth and these unique organisations to make leaps in Universal Health Coverage indicators.

Three Ways Community Pharmacist Could Support the Public Health Sector in Rwanda

Originally published on The Kigalian

Rwanda is recognised among the leading countries worldwide on Universal Health Coverage; and this has been mostly driven by strong policies on access to primary health care, where health centers and district hospitals have been empowered to offer optimised primary health care.

Despite this, the public health sector has been criticised over the past few months for ineffectiveness in public hospitals and patients overcrowding the available workforce and regression in diseases prevalence — like the case of Malaria.

On another hand, the number of retail and community pharmacies have significantly increased. This, for me, is an untapped opportunity for a public-private partnership that is much need to make leaps in primary health care indicators and access to basic health services if community pharmacists were empowered enough.

Beyond the popular belief that the role of a pharmacist is limited to selling drugs, their knowledge and skills in delivering clinical services and primary health care — on which they are trained — remains untapped. Pharmacists could easily relieve the public health sector of certain burdens.

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A note for the next WHO Director-General

The World Health Organization (WHO) is set to have a new leader elected in May and take office in July, these past months different actors have engaged, first the six candidates, and now the three remaining candidates, in debates and discussions over various issues in global development and international health, as well as their plans for the future of the WHO.

I have been thinking about what should be my expectations of the next WHO Director-General, as a young health professional, passionate about global health, with a keen interest to be a leader in shaping health policies and building health systems. I will allow myself to also write on behalf of other healthcare students or young health professionals with whom I share my passion and interests.

The International Pharmaceutical Students’ Federations that I lead is one of the only two organizations that represent young people -students and recent graduates- with official relations with the World Health Organization, the other being the International Federation of Medical Students’ Association (IFMSA). With our unique perspective on global health challenges, we form a particular group of non-state actors engaging with WHO.

Although we are invited every year to attend the WHO Executive Board Meeting and the World Health Assembly, We rarely receive invites for high level or technical meetings or call to provide inputs on specific initiatives’ development. Our involvement is limited to statements, that are often not considered as part of decisions making processes and we are usually disdained for partnerships and pushed down on speaking lists.

However, Together with IFMSA, we represent over 2 million of the future health workforce and leaders in global health, research, private sector acting in health. This affirms my belief in the need for a greater youth engagement in decision-making for health and ensures our opinion is equally considered as ones of experts.

There are leaders within the WHO who share this belief, demur against the existing state of affairs and reach out to us to partake in the work of certain departments. I henceforth expect the next WHO Director-General to emulate this approach which has allowed to us to comprehend, experience and increase our knowledge and capacities in certain areas. This also allows us to provide a very unique youth-focused perspective that no other actors in official relations with WHO could provide.

Our Generation of students and young professionals is living unprecedented changes in Global Health, we understand more than any other generation the need to change the narrative and transform healthcare. The state of the world has advanced to equip our generation with the capacity to drive the needed reforms if we are given a chance to play a part as actors and not always as beneficiaries. I hope for the next WHO Director-General to implement reforms in goal-directed efforts to sufficiently increase the role of organizations such as IPSF and IFMSA in decision-making processes at all levels of the WHO.

Africa needs to step up on preparedness and prevention of pandemics

Earlier this year, a new international coalition CEPI-the coalition for Epidemic Preparedness Innovations- was launched in Davos with aim of accelerating the development of vaccines for emerging infectious diseases in order to prevent future pandemics. pandemics of infectious diseases like Ebola. an Ebola vaccine was created in 2003 and tested in 2005 and sat in a freezer until 2016 when it was proven to be 100 percent effective at preventing infections. the vaccine stalled because it is extremely expensive to develop vaccines, it usually cost up to $1 billion to test vaccines in large clinical trials and the whole manufacturing process. Pharmaceutical companies do not invest in such when it comes to diseases like Ebola, which are and tend to hit poor countries, there is simply no significant return on investment.

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ON BEING AFRICAN

Originally published on The Kigalian

The danger of a single story. You will recall Chimamanda’s fabulous TED talk on when complex human beings and situations are reduced to a single narrative. It is often that we are very quick to bash all those non-Africans saying to be travelling to Africa, we want them to mention the specific country or region. We don’t like a narrative applied to Africa as a whole. There must be a specificity to one or some of the 54 African countries. Because if we are reduced to one, it’s our humanity being taken away, we say.

Africa is rising. The African emancipation. LOL. We are not. It is more of a reaction, a response to globalisation. I mean the global evolution is imposing us to adopt new measures and build infrastructure just to adapt.

Anyway, that’s not my point. I want to point out how we approach our emancipation. We now identify as one. We are 54 identical children of mother Africa.

I see the danger of the single story within us and that’s exactly what we reflect to the world, being one. Before being elected President of the International Pharmaceutical Students Federation (IPSF), I was fortunate enough to hold several other positions within the African region. It gave me an opportunity to engage with many other Africans — from, I can confidently say, 45 of the 54 countries. As I discussed and asked questions about society, lifestyle and history, the fact is our differences in culture, principles and history is quite striking. We grow up being taught that before colonisation we had monarchs and everything was similar everywhere, well, except for Egyptians and the Ethiopians who made it to the bible.

I don’t like to use this example, but you can easily distinguish a German from a Portuguese when you talk to them. They will always reflect their unique values. They — at least those I have had a chance to interact with — rarely identify themselves as “proud Europeans.” I have also come to believe that the strength of the European Union is in what each country contributes, its uniqueness and how to leverage that for the best of all.

The danger of a single story within our “emancipation” won’t allow us to identify what is unique about each of us and to a maximum advantage, acknowledge and build on each society’s uniqueness and strength. Pan-Africanism initiatives, African Leadership Academy or, say, the Young African Leaders Initiative and other school of thought that are supposed to be driving our emancipation tend to make us think that we are similar and we need a one-size-fits-all solution to our problems.

We think we all (or want to) share the same values and cultural principles, and want to call them ‘African roots’, and it is okay. Is it okay? I wonder.

Have something to say about this blog? Share it in the comments.

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How Zipline Drones Will Improve Health Care in Rwanda

Originally published at TheKigalian on September 10, 2016.


Last year, Rwanda achieved and surpassed health-related Millennium Development Goals. MDG4, reducing child mortality; and MDG5, improving maternal health. Key indicators at core for the 15 years of MDGs are the decrease of infant mortality to 32 deaths per 1000, from 109; maternal mortality per 100,000 live births decreased to 210 deaths from 1071; 91% of deliveries are assisted and in health facilities; among others.

This success can be attributed to Universal Health Coverage policies implemented; where, to name a few, each sector has a health center, each district has a hospital and each province has a referral hospital (or near-referral, for some). Additionally, drugs supply chain moved from a pull system — where patients would be seeking drugs after treatment — to a push system, where essential drugs are directly distributed to health centers and district hospitals. This makes it easier for patients to purchase drugs.

With aim to surpass MDGs achievements, the Government of Rwanda is collaborating with Zipline to deliver medical supplies that do not fit into the existing supply chain system.

Here are the impacts that I think drones will make on our health system:

1 — Blood, oxygen and emergency drugs supply

We have very few blood collection, manipulation, and Oxygen production centers in Rwanda. And those that exist are mostly located around referral hospitals. Most health centers or district hospitals may not be adequately equipped to store blood bags. With difficulties in predicting the kind of conditions a health facility may encounter, some drugs may not be supplied or just even supplied in small quantities in the usual supply chain system, but can still be needed in an emergency situation.

It usually takes a lot of time to have the blood, oxygen and emergency drug delivered or having a patient transferred, and this usually increase the risk of preventable death or incurable conditions in the process. Having a safer and faster way to deliver blood, oxygen and emergency drugs would significantly reduce maternal mortality, among other preventable deaths.

2 — Cold chain and vaccine supply

In order for vaccines to work effectively, stringent handling, transport, and storage guidelines must be precisely followed. Vaccines are fragile biologics, and even slight temperature changes or small delay in transportation can alter their molecular structure, rendering them ineffective or toxic. This apply to other medical supplies that need to refrigerated and frozen.

When it comes to the transport of fragile, refrigerated and frozen vaccines or drugs, there are guidelines for containers and packing materials, specific guidelines for vehicles and drivers, and a need for alternative plans in the event of inclement weather. These guidelines include the use of a calibrated temperature monitoring devices with continuous monitoring and recording capabilities during transport.

Drones are the best alternative for the safe transportation and deliveryfor cold chain and vaccine supply.

3 — Sample transportation for laboratory testing

A high number of patients are transferred from hospital to hospital due to limitations in diagnosis caused by a lack of equipment and capacity to perform laboratory tests locally. This then increase the cost of treatment and burden to patients’ families.

Drones would make it easier to transport blood samples for tests without the need to transfer the patient and the treatment would be optimized without burdening the family with opportunistic expenses.

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A Note to mentors in Kigali

Originally published on The Kigalian

In the past year or so, I have tweeted a number of times to complain on the fact that I don’t get appropriate mentorship from my seniors whether at university or even from outside; trying to understand why.

I would attribute this to mainly two causes. First, I haven’t met a senior who really understands my passion and career goals. Second, seniors tend to not be that open to mentorship principles.

It is also evident that the job market is getting too competitive, where skills and competencies can be considered over a degree and experience. This, to a point where a person who is twenty to thirty years older will tend to look at you as a competitor, hence reduce their interest to open doors and show you the way, give you proper guidance.

On another note, look at most of our Twitter inter-generational conflicts, where some are more open on certain topics and vehement criticism while others prefer to gossip about it in a bar with a close circle of friends and keep a “clean” Twitter timeline.

We need to stop thinking and looking at this as an “us versus them” conversation, but instead strive to close the knowledge gap between generations.

When you’re in your forties and fifties, you realise that you’re not in touch with the present and the future the same way young twenty-something’s are. We are more open-minded and instantly linked to the technology of our future.

Mentorship, in our case, has to be redefined in a way where each individual should be acting in the capacity of a mentor as well as a mentee, and express a genuine need to learn from, and share with, the other. In fact, if you are ten years to retirement, you better get to make allies below you. They young co-worker that you promote is more likely to move past you in the ranks over the next ten years and have a say on how long you can stay in the organisation.

In a win-win situation, the younger colleague would benefit from your experience and you would benefit from his competencies and learn something new. As long as each one is open to pushing themselves outside their comfort zone and try new ways of thinking—open to seeing situations from different angles—and have the will to overcome indifferences in the styles of communication. After all, we all communicate differently.

Tok Tok

He gently taps on her door.
“The canoe ride is ready…” He softly whispers.
She springs up from the chair, clears her throat covering her mouth with a cushion, “Coming…” She says.
Final mirror check, she has changed her outfit 5 times in an attempt to get the colours right, “A dab of blush on my cheeks, maybe the blue shorts would have been better, oh gosh where’s my waterproof mascara…..”

It might be a canoe ride but after endless eye glances at the dinner last night this might be more than a canoe.

Final check
Hair tied nicely, check!
Colgate smile, check!

I might need a relaxant at this rate, she thinks to herself. How complicated it has become to dress up for a ride in the water…
Heart racing she runs to the door. “slow down…, it’s just a canoe ride, nothing hectic” she assures herself

Unbeknown to her, he has had his fair share of panic attacks.

His knuckles are swollen because he spent the whole night practising how to knock on her door
Not too loud not too soft…
The 2-metre walk to her room has felt like a walk from Cape to Cairo.
Heart thumping. He hears her footsteps. He stands boldly like a soldier. “not too firm not too relaxed, calm down…” he scolds himself.

She opens the door, their eyes meet.

There is a deafening silence.
“I hope my mascara is on point…” she thinks
“I hope I shaved properly…” he thinks
“Who should say hi first?” she thinks
“will she hug me today?” He ponders
“Should I hug him, I wonder?” She questions herself
“I hope she can’t hear my beating…” he thinks
“those dimples… Oh my gosh” she thinks

In one split second their thoughts have raced to mars and back

It feels like a pinch of eternity, gazing at each other for one second…

The day has only but begun…

The Patient

It’s in the morning, a sunny good morning, it has been raining for a quite a few days. A young man entered the pharmacy and asked if we had electronic cigarettes, we didn’t have them and they were nowhere to be found in Kigali. He then asked what I can advise for smoking cessation.

It was my third day in the pharmacy doing my first ever internship. I have been, for those days, struggling to memorize all medicines, quickly locate them in shelves and being able to offer proper medicine information and patient counselling, the latter is a practice we rarely do or learn in class.

All other workers in the pharmacy were women. Being the only male, the gentleman felt more comfortable to discuss with me about ways to stop smoking. He must never had taken a look at my badge to see that I’m just an intern, it was so much confidence for me to deal with. Continue reading