Investing in People: The Ethiopian Pharmaceutical Association

First established in 1974 (G.C.), the Ethiopian Pharmaceutical Association (EPA) has evolved to become one of the strongest and most exemplary professional associations in Ethiopia. Despite its longevity, prior to 2007, the EPA had limited capacity, staffing, and resources. The annual conference was the only time the EPA was able to engage its approximately 700 members. These organizational limitations severely constrained the association’s influence on policy decisions and its impact on pharmacy practices, especially in the private sector. In Ethiopia, the practices of the private sector were not evidence-based and pharmacists lacked sufficient knowledge about regulatory guidelines.

The weaknesses of the EPA in representing private sector pharmacists sidelined its members from government-sponsored trainings in critically important public health interventions. For example, when free antiretroviral therapy (ART) was introduced, people living with HIV complained that community pharmacists were not providing the counseling needed to properly manage their antiretroviral and related medications.

The US Agency for International Development (USAID)-funded Strengthening Pharmaceutical Systems (SPS) Program recognized that only a strong and vibrant professional pharmaceutical association could take ownership and sustain the investments being made in the pharmaceutical sector.

Forging a Partnership

SPS began working with the EPA to build its organizational and operational capacity from the bottom up; two experts were seconded to work collaboratively with the EPA staff. From the beginning, SPS and the EPA developed memoranda of understanding (MOUs) and joint work plans to ensure mutual understanding of roles and responsibilities as well as expectations. SPS provided basic office furniture and equipment to support EPA’s routine office activities and trainings. Since much of EPA’s training efforts were outside the capital city, SPS donated a vehicle to facilitate EPA’s work in the different regions of the country.

With the technical support of SPS, EPA began conducting trainings for public and private sector pharmacists on thematic topics including:

  • ART
  • Malaria
  • Ethical practices
  • Pharmacovigilance

SPS worked with the EPA to hold consultative meetings and workshops for its members to create consensus around key issues related to pharmacy education and practice. Under SIAPS, the EPA launched its own website for health care practitioners to share information, experiences, and best practices. In the future, EPA plans to use new web-based technology for continuing education.

“The technical and material support obtained from SPS and SIAPS has enabled EPA to register tremendous progress in terms of its performance and recognition of its roles by policy makers in the Ethiopian health sector.”

Dr. Ariaya Hymete, President of EPA

The Result: Ownership, Leadership, and Sustainability

The EPA has made remarkable progress in building its institutional capacity to meet the needs of an increasingly sophisticated pharmaceutical sector. Organizationally, the EPA has expanded its reach across five geographically strategic locations, each branch having its own budget, role, and responsibilities within the broader association. The branches manage projects in their catchment areas, include continuing education for pharmacists. EPA membership as a whole increased from 690 members in June 2007 to 1,830 members in 2013. Using its own resources, the EPA was able to employ four additional staff, increasing its manpower to six, and support routine office operations.

The EPA is now able to solicit financial support for its programs, both from domestic and international donors. Competing on a global level, the EPA won a “FIP Challenge on TB—Round One” grant from the Federation of International Pharmacists (FIP). Grants have become an important source of revenue for EPA, substantially increasing its financial resources. In June 2008, EPA had a balance of ETB 501,490. In June 2012, just four years later, EPA’s revenue rose to ETB 5,519,402—an increase of 1,100 percent. Last year, the EPA acquired a building with space for new office facilities. EPA has moved into the new building, thereby reducing operating costs and paving the way for greater self-sufficiency and sustainability.

Recognizing EPA’s professional capacity to lead, Ethiopia’s Ministry of Health has actively engaged the association in formulating health policy. The EPA is a member of the Health Professionals Registration and Licensing Council and the National Advisory Committee of the Ministry of Health, and is chair of the Education and Training Sub-Committee of the Ethiopian Health Professional Council. The Professional Code of Ethics developed by the EPA is considered a model by the Ministry of Health and is distributed to professional associations throughout the country. A milestone for the EPA occurred during a legislative session when EPA produced evidence-based arguments to amend proposed legislation that would have had grave consequences for the pharmaceutical sector.

The EPA was the first professional association in Ethiopia to develop continuing professional development (CPD) guidelines that are used as a model nationwide. Leading the process of CPD, the EPA was influential in revising and harmonizing the pharmacy training curriculum used by private and public sector institutions. Another first was EPA’s role in producing a comprehensive training manual on managing medical equipment, supplies, and reagents. EPA now trains pharmacists nationwide at hospitals and teaching institutions in partnership with the Pharmaceuticals Fund and Supply Agency (PFSA), which is responsible for the country’s pharmaceutical procurement and distribution.

EPA’s leadership in the nation’s pharmaceutical sector has been recognized by the Ministry of Health, and today, the EPA is an active participant in sector governance. EPA is actively engaged in developing, reviewing, and revising government proclamations, policies, regulations, and guidelines that affect the pharmaceutical sector.

The EPA Today

SIAPS continues to support the EPA in its leadership role, particularly in terms of training. SIAPS partnered with the Ethiopian Druggist Association to provide a special training program on the management and rational use of anti-malarial drugs to mid-level pharmacy staff. Working with SIAPS, the PFSA, and the Food, Medicine, and Health Care Administration and Control Authority of Ethiopia (FMHACA), the EPA is working to create 20 model community pharmacies throughout Addis Ababa in a pilot project.

The EPA is continuing to build its institutional capacity to strengthen Ethiopia’s pharmaceutical services to ensure better health outcomes for the Ethiopian people. The EPA is a success story in how SIAPS’s approach to investing in people promotes ownership, leadership, and sustainability.