Globally the role of the hospital pharmacist is shifting from a less product-centered to a more patient-centered focus. The pharmacist in most low income countries has, for a multitude of reasons, to try to balance both the product and the patient focus depending on the environment and specific need of his/her practice area. However, the hospital pharmacist’s overarching role remains that of optimizing patient outcomes through the judicious, safe, efficacious, appropriate and cost-effective use of medicines as well as contributing to overall health improvement.

In its broadest sense, the scope of hospital pharmacy practice would include:

• Medicines Management
• Extemporaneous preparations, aseptic compounding and admixture services
• Prescription review, interpretation, validation and dispensing and prescriber education and collaborative therapeutic decision making
• Patient education
• Medication therapy management
• Setting up reporting systems for:
• Poor quality medicines
• Adverse reactions to medicines
• Medication errors
• Medicine usage
• Medicine utilization reviews
• Hospital Formulary and Treatment Guidelines development
• Medicines and Therapeutics Committee activities
• Continuing Professional Development (CPD) for health staff on medicines related issues
• Research

Unfortunately many hospitals around the world particularly in sub-Saharan Africa do not have pharmacists and therefore the services provided tend to be limited to the most basic and most routine. Nonetheless especially where there are no pharmacists, it is important for the hospital managers and for those working in the pharmacy to have a sense of what a reasonable level of pharmacy service entails. Given that at the current rates of training pharmacists, it will be many years before every hospital employs a pharmacist, it is important that policy makers, health professionals and regulators do not bury their heads in the sand. The nature of pharmacy practice in hospitals with or without pharmacists needs to be defined and guidance provided on all the possibilities that exist so that these can be exploited fully.