AACP Delegation Emphasizes Importance of Learning International Pharmaceutical Systems

The American Association of Colleges of Pharmacy (AACP) led a bilateral pharmacy education seminar for pharmacy educators who visited the school of pharmacy at Universidad de la Habana and other pharmaceutical organizations in Cuba. Some of the most valuable lessons for the faculty involved cultural differences in medication, administration, and compounding, as well as the use of polyclinics.

The AACP Delegation to Cuba (Image From Malhotra)

The program featured presentations and seminars and included Cuban and 15 American pharmacy faculty members.1 The delegation also visited Policlinico Universidad (a Cuban polyclinic); a local pharmacy; Centro para el Control Estatal de Medicamentos, Equipos y Dispositivos Médicos (Cuba’s equivalent of the FDA); and Centro de Inmunología Molecular (email communication, January 29, 2024).¹

Ashim Malhotra, PhD, MS, PharmBS, FAPE, assistant vice president of institutional effectiveness and accreditation at California Northstate University in Elk Grove and leader of the delegation, said in a Pharmacy Times interview the members aimed to establish a pipeline in Cuba where pharmacists could collaborate and learn about the cultural differences between the countries. In partnership with Universidad de la Habana, the faculty got to discuss and attend presentations that focused on the future of pharmacy, the public perceptions of pharmacy, and pharmacy education in both countries.

Gayle Brazeau, PhD, a professor in the Department of Pharmaceutical Sciences at Marshall University in Huntington, West Virginia, and editor in chief of the American Journal of Pharmaceutical Education (AJPE), invited the Cuban faculty to contribute to the journal, and a special collection of articles is under consideration (email communication, January 29, 2024). In a Pharmacy Times® interview, she said that one of her greatest takeaways was being able to visit with faculty in a different country and open doors for them to submit papers to the AJPE. She added that Cuba tends to use a lot of natural medicine compared with the United States, which tends to use manufactured drugs. Malhotra echoed this, adding, “They also use a lot more natural medicine, like phytochemicals, basically plant products or animal products, which is understandable because they have a lack of resources, but I feel that they use it quite effectively.”

In Cuban pharmacies, a lot of traditional Chinese medicine practices, such as acupuncture, are used for patients, Malhotra added. He said it was nice to hear that Cuba is also using Ayurveda, a classical Indian system of traditional medicine. He added that it is hard to prove the standardization of the techniques, but it is interesting that the United States does not have any pieces of traditional medicine in pharmacy curricula.

“I think one aspect of cultural competency that is getting a little bit eroded in the United States is that when we teach...a lot of our education is based in Western medicine and Western systems of practice. It seems almost as if we have completely eroded the indigenous practices,” Malhotra said in the interview.

Further, an executive summary of the delegation sent to Pharmacy Times stated that in Cuban polyclinics, pharmacists use a lot of grassroots, community-based approaches to care (email communication, January 29, 2024). Malhotra said a polyclinic can be compared with primary care visits in the US. However, in polyclinics, patients can walk in and see their physician without an appointment, then see their pharmacist.

“The polyclinic seems to be very well integrated and in touch with the immediate health care disparities and needs of their local community, and I think that’s a very interesting lesson for many of us,” Malhotra said in the interview. He added that he hopes students can benefit from learning about indigenous systems of medicine and practices to help apply more culturally competent care. He said that in Canada, some of his colleagues are looking at indigenous Canadian medical practices to see whether there is anything they can apply. He hopes that these teachings from the delegation can be an introductory example to students.

In a Pharmacy Times interview, Lee Vermeulen, MS, BSPharm, FCCP, FFIP, executive vice president and CEO of AACP, said this is not the first delegation that AACP sent to Cuba. “AACP has many international partners, and as a member organization in the International Pharmaceutical Federation, we collaborate with pharmacists, pharmaceutical scientists, and pharmacy educators from around the globe. This sort of hosted delegation is essential to making anything happen,” Vermeulen said.

“As for future delegations to Cuba, I would say that we need to evaluate the value of the one that just occurred and carefully monitor the diplomatic relationship between our countries before answering,” Vermeulen added. “AACP is developing a new agenda for international engagement, and we have a number of other priorities that will need to be considered before committing to another visit to Cuba.”

In addition to Brazeau and Malhotra, the faculty from the United States included the following: David Rhys Axon, PhD, MPharm, MS, from The University of Arizona; Penni Black, PhD, from the University of Kentucky College of Pharmacy; Daniel Brazeau, PhD, from Marshall University; Michael Crouch, PharmD, MBA, FASHP, from Samford University in Birmingham, Alabama; Neyda Gilman from Binghamton University, State University of New York; Elizabeth Hageman, PharmD, BCPS, BCOP, from Binghamton University; Patricia Jumbo-Lucioni, MD, PhD, from Samford University; Tyler Kiles, PharmD, BC-ADM, from The University of Texas at Austin; Robert Mueller, PharmD, from Concordia University Wisconsin in Mequon; Heather Petrelli, PhD, MA, from the University of South Florida; Terri Warholak, PhD, RPh, CPHQ, FAPhA, from the University of Health Sciences and Pharmacy in St Louis in Missouri; Brian Wenger, PharmD, BCPS, from The University of Texas at Austin College of Pharmacy; and Dayanjan Wijesinghe, PhD, from Virginia Commonwealth University School of Pharmacy in Richmond.

References

1. Marshall professors participate in pharmacy education exchange program in Cuba. News release. Marshall University. January 10, 2024. Accessed February 7, 2024. https://www.marshall.edu/news/2024/01/marshall-professorsparticipate-in-pharmacy-education-exchange-program-in-cuba/