Reduced-nicotine cigarettes ‘do not lead to increased smoking intensity’

24 Aug, 2014

Source: Medical NEWs Today

Rearchers have previously been concerned that cigarettes with reduced levels of nicotine could lead to smokers increasing the intensity of their habit in order to satisfy their nicotine cravings. A new study of the prolonged use of reduced-nicotine cigarettes suggests that this may not be the case.

Nicotine is the main addictive component in tobacco smoke, responsible for both the rewarding feeling that cigarettes give smokers and the feelings of withdrawal that arise when the habit is stopped. Nicotine is also considered to be one of the most difficult substances to give up.

The authors of a new study, published in Cancer Epidemiology, Biomarkers & Prevention, state that previous research has found that smokers aim to “achieve a desired nicotine dose and will adjust their smoking behavior to maintain this dose across products.”

If smokers are using reduced-nicotine cigarettes, the fear is that they would begin to smoke more in order to achieve their desired nicotine dose, and so increase their exposure to the other harmful components of cigarettes, such as tar and carbon monoxide.

With their recent study, the authors aimed to examine the changes in smoking behavior that arose with the smoking of reduced-nicotine cigarettes, and whether compensatory smoking occurred as a result. They also set out to investigate whether reduced-nicotine cigarettes affected smokers’ exposure to nicotine and nicotine withdrawal symptoms.

Read more:

Ebola Outbreak Claims 2,000 Victims, Kills More Than Half; Experimental Drugs Are On The Way

14 Aug, 2014

Source: Medical Daily


The Ebola outbreak in West Africa is completely out of control, and will most likely get much worse before it can get any better. On Wednesday, the World Health Organization (WHO) announced that rates of infection have continued to rise, affecting 1,975 people, with more than half dead.

The numbers come as the WHO, African governments, and other health organizations work frantically to control what has now become the deadliest Ebola outbreak in history. In just the past two days, there were an additional 127 cases and 56 deaths, CNN reported. The majority of the cases have occurred in the West African countries of Guinea, Liberia, Sierra Leone, and Nigeria.

Read more:

Fiji’s schools teach healthy living

22 Aug, 2014


Pupils at Khemendra Primary School in Fiji don’t just learn about healthy food, they help to grow their own. Each class is responsible for cultivating different types of fruit and vegetables in the school garden and greenhouse.


Health Promoting Schools programme

The project was started by teacher Mereani Ligaiviu after she attended a workshop run by Fiji’s Health Promoting Schools (HPS) programme that trains and supports staff to develop healthy food environments and promote physical activity. She says: “The HPS training empowered me to get people to stay healthy.”

In addition to the garden, Mrs Ligaiviu runs an aerobics class which is attended by 65 students 3 times a week.

Khemendra Primary is one of more than 84 schools participating in the HPS network, which receives resources from the Fijian Ministry of Health and the World Health Organization (WHO).

WHO guidance has been invaluable in helping the government in Fiji develop the policies which make up the HPS programme, such as the National School Canteen Guidelines. The advice which canteen operators receive about the foods and drinks they should restrict on their menus is based on WHO healthy eating recommendations.

“Habits start young and schools are a highly effectively setting to help cultivate healthy behaviours and teach the next generation how to prevent disease later in life,” says Dr Liu Yunguo, WHO Representative for the South Pacific and Director of Pacific Technical Support.

Healthier behaviour in children prevent chronic diseases

The HPS programme, running since 2009, aims to encourage healthy behaviour in children and address factors like obesity that can lead to diseases such as diabetes, cancer, stroke, and heart disease. Such lessons are badly needed. In Fiji, 20% of adult men and 41% of adult women are classified as obese—a widely acknowledged risk factor for NCDs.

HPS advisers help teaching staff to identify what their school needs to focus on most and come up with practical plans that will help keep their pupils healthy.

Dharmend Shankar, Head Teacher at Navoalevu Primary School, returned from HPS training full of ideas. “Let’s start something,” he said to his school manager, “No use learning it and not implementing it.” The result was a garden that is now the pride of the school, providing fruit and vegetables such as cassava, coconuts and cucumbers.

Parents and teachers alike are engaged in the project to ensure the school sets a healthy example in the community. Meanwhile, students are enjoying eating the results. “I like eating fresh vegetables and I like planting more vegetables”, said one student at Rabulu Sanatan Primary School, another Health Promoting School.; background-position: 0% 0%; background-repeat: repeat-x;”>; background-position: 0% 100%; background-repeat: repeat-x;”>

“Let’s start something, no use learning it and not implementing it.”

Dharmend Shankar, Head Teacher at Navoalevu Primary School

At Navai Primary School, some 80% of pupils were malnourished as a result of their junk food-dominated diets. When Head Teacher Dhavendra Datt returned from HPS training, he focussed on getting the school canteen to sell healthier food at affordable prices. The school has designated every Friday as “Fruit Day”, when teachers check to make sure each child brings a piece of fruit to school to share—and that they eat it.

Improving school food was also a priority for St. Mary’s Primary in Labasa, where HPS advisers identified obesity and tooth decay as priority problems. Canteen operators were briefed on the National School Canteen Guidelines, and junk food and fizzy drinks were replaced with blended fruit juice and fresh local fruit at affordable prices. “It did not affect our sales and profit in the canteen when we changed to healthy options,” said Head Teacher Vereniki Rusaqoli. “In actual fact, we seem to be making more!”

Inspired by how quickly the children adopted better diets, teachers have been exploring other health initiatives. More stand pipes were installed near classrooms so pupils can easily get drinking water. In addition, children are taught and encouraged to have good personal hygiene habits, including washing their hands before and after meals, and after using the toilet.

WHO calls for stronger action on climate-related health risks

27 Aug, 2014


 Previously unrecognized health benefits could be realized from fast action to reduce climate change and its consequences. For example, changes in energy and transport policies could save millions of lives annually from diseases caused by high levels of air pollution. The right energy and transport policies could also reduce the burden of disease associated with physical inactivity and traffic injury.

Measures to adapt to climate change could also save lives around the world by ensuring that communities are better prepared to deal with the impact of heat, extreme weather, infectious disease and food insecurity.

First ever global conference

These are two key messages being discussed at the first-ever global conference on health and climate, which opens today at WHO headquarters in Geneva. The conference brings together over 300 participants, including government ministers, heads of UN agencies, urban leaders, civil society and leading health, climate and sustainable-development experts.; background-position: 0% 0%; background-repeat: repeat-x;”>; background-position: 0% 100%; background-repeat: repeat-x;”>

“The evidence is overwhelming: climate change endangers human health. Solutions exist and we need to act decisively to change this trajectory.”

Dr Margaret Chan, WHO Director-General

The health sector needs to act quickly and assertively to promote climate-smart strategies, climate and health experts warn.

“The evidence is overwhelming: climate change endangers human health,” says Dr Margaret Chan, WHO Director-General. “Solutions exist and we need to act decisively to change this trajectory.”

Cholera, malaria and dengue highly sensitive to weather and climate

WHO and its partners highlight the importance of acting now to help protect health in the present as well as the future. The health community is working hard to improve its capacity for surveillance and control of infectious diseases such as cholera, malaria and dengue, which are highly sensitive to weather and climate.

Climate change is already causing tens of thousands of deaths every year from shifting patterns of disease, from extreme weather events, such as heat-waves and floods, and from the degradation of water supplies, sanitation, and impacts on agriculture, according to the most recent WHO data.

“Vulnerable populations, the poor, the disadvantaged and children are among those suffering the greatest burden of climate-related impacts and consequent diseases, such as malaria, diarrhoea and malnutrition, which already kill millions every year”, notes Dr Flavia Bustreo, WHO Assistant Director-General, Family, Women’s and Children’s Health. “Without effective action to mitigate and adapt to the adverse effects of climate change on health, society will face one of its most serious health challenges,” she says.

“But the good news is that reducing climate change can yield substantial and immediate health benefits” says Dr Maria Neira, WHO Director, Department of Public Health, Environmental and Social Determinants of Health. “The most powerful example is air pollution, which in 2012 was responsible for 7 million deaths – one in eight of all deaths worldwide. There is now solid evidence that mitigating climate change can greatly reduce this toll,” she adds.

The conference aims to pave the way for careful consideration of health and climate issues in the upcoming UN Climate Summit, being organized by UN Secretary-General Ban Ki-moon in September 2014.

For more information please contact:

Samantha Bolton
Communications Officer, WHO
Mobile: +41 79 309 82 73

Nada Osseiran
Department of Public Health, Social and Environmental Determinants of Health, WHO
Telephone: +41 22 791 4475
Mobile: +41 79 445 1624

Ugandan team brings Ebola experience to Liberia

28 Aug, 2014


A team of Ugandan doctors and health workers are deployed by WHO to provide medical support for an Ebola treatment centre in Monrovia, Liberia. This team comes with vast experience in managing Ebola outbreaks, having faced many cases of this disease since 2000. They work shifts alongside their Liberian colleagues to provide around the clock care and to help maintain strict infection control measures.


Madira Lefa, assistant physician at Kagadi Hospital in Uganda, cried when he read what was going on in Liberia, one of the three countries most seriously affected by the Ebola outbreak. Immediately he started thinking, “I have to help my colleagues”. Madira is one of 14 Ugandan medical doctors and health workers now working in the Ebola treatment centre in JFK Hospital in Monrovia, having been deployed by the World Health Organization (WHO).

The Ugandan team comes with strong experience in Ebola outbreaks, having faced many cases of this disease in several outbreaks since the year 2000. “To deal with this epidemic, we need to have good case management of patients, an effective isolation area and community-based contact tracing,” says Ugandan Dr Atai Omoruto, who arrived in Liberia in July to train and support health workers and doctors in JFK´s Ebola treatment centre.

Providing around the clock care

Work continues in 3 shifts around the clock in the treatment centre. The Ugandan doctors and health workers work alongside their Liberian colleagues treating patients and helping to maintain the strict infection control measures that are necessary in the centre.

The outbreak of Ebola virus disease in west Africa has seen a high proportion of infection in doctors, nurses and other health workers. This cooperation between countries is a good example of how experienced professionals can help to improve safety.

“Health workers are at the heart of everything ,” says WHO Assistant Director-General, Health Security, Dr Keiji Fukuda. “They need to have the right training and the right environment to work safely. Their work is absolutely critical.”

An opportunity to help another country


“This is an opportunity to help another country,” says Awilo Sarah Layo, a nurse from Mulago National Referral Hospital of Uganda. As the mother of 4 children, Awilo is in daily contact with them to make sure that they study and do their homework.

“We are facing a lot of challenges. This outbreak is worse than the ones we faced in our country,” she says. “At first, people did not believe in Ebola. Now people are more aware but the cases are still increasing. If people get a fever, they must report it immediately,” says Awilo, who has worked as a nurse during all of Uganda’s recent Ebola outbreaks.

Madira Lefa has also come with rich experience that he is now sharing with other health workers in Liberia. “I explain to them how to protect themselves, how to put on the protective equipment, what Ebola is and how to treat it,” he says. During these training sessions, memories of Madira’s past experiences with Ebola come flooding back, helping him to support his colleagues in Liberia.

WHO issues roadmap to scale up international response to the Ebola outbreak in west Africa

28 Aug, 2014


The aim is to stop ongoing Ebola transmission worldwide within 6–9 months, while rapidly managing the consequences of any further international spread. It also recognizes the need to address, in parallel, the outbreak’s broader socioeconomic impact.

It responds to the urgent need to dramatically scale up the international response. Nearly 40% of the total number of reported cases have occurred within the past three weeks.

The roadmap was informed by comments received from a large number of partners, including health officials in the affected countries, the African Union, development banks, other UN agencies, Médecins Sans Frontières (MSF), and countries providing direct financial support.

It will serve as a framework for updating detailed operational plans. Priority is being given to needs for treatment and management centres, social mobilization, and safe burials. These plans will be based on site-specific data that are being set out in regular situation reports, which will begin this week.

The situation reports map the hotspots and hot zones, present epidemiological data showing how the outbreak is evolving over time, and communicate what is known about the location of treatment facilities and laboratories, together with data needed to support other elements of the roadmap.

The roadmap covers the health dimensions of the international response. These dimensions include key potential bottlenecks requiring international coordination, such as the supply of personal protective equipment, disinfectants, and body bags.

The WHO roadmap will be complemented by the development of a separate UN-wide operational platform that brings in the skills and capacities of other agencies, including assets in the areas of logistics and transportation. The UN-wide platform aims to facilitate the delivery of essential services, such as food and other provisions, water supply and sanitation, and primary health care.

Resource flows to implement the roadmap will be tracked separately, with support from the World Bank.

For more information, contact:

Fadéla Chaib
Communications Officer, World Health Organization
Telephone: +41 22 791 32 28
Mobile: +41 79 475 55 56

Tarik Jasarevic
WHO Department of Communications
Telephone: +41 22 791 50 99
Mobile: +41 79 367 62 14


14 Aug, 2014



Dear Members,

Just when the last ketupat is about to be consumed, the Council of the Malaysian Pharmaceutical Society is inviting members to the Open House held on Saturday 16/8/14 at the Wisma MPS. The intentions are to provide an avenue for networking and spreading the message of goodwill among members. So for those who could spare the time, we would love to see you from 12.30 pm to 2 pm at the Wisma MPS to share some precious moments with us.

A historical event was held on 14/8/14 night when the President and 5 exco members of Malaysian Medical Association joined the Council Members of Malaysian Pharmaceutical Society and Malaysian Community Pharmacy Guild for a dinner to interact and network. The cordial function was held in a spirit of mutual respect and goodwill. Much ground was covered in discussing the dynamics of dispensing separation. All present were willing to share ideas and collaborate on a win/win basis. The meeting laid a strong foundation stone for future discussion and cooperation in the interest of the Rakyat.

World Pharmacist Day is a Day dedicated to highlight the contribution of pharmacists to World Health. We have made a strong presence in every arena and deserve to celebrate that success. This year Malaysia’s World Pharmacists Day will be organized by the Pharmaceutical Services Division, Ministry of Health and supported by the Malaysian Pharmaceutical Society during November 2014.

Meanwhile, preparations for 25th FAPA Congress 2014 are “gearing up”. Entries for the poster exhibition are being received. There will be is a special ribbon-cutting ceremony to declare the Poster Exhibition opened. YB Dato’ Seri S Subramaniam, the Minister of Health and YB Datuk Seri Dr Ewon Ebin, Minister of Science, Technology and Innovation have been invited to grace the Ceremony. Afterwards there shall be a Press Lunch for the media representatives. We are proud that many quality posters are being submitted which reflect the high standards of Research and Development by pharmacists.

The plenary session will begin with a “heavy-weight” speaker in the person of Mr Ash Soni, OBE who is the newly elected President of the Royal Pharmaceutical Society of Great Britain. His presentation will no doubt start off the 25th FAPA Congress 2014 “with a bang”. Many notable speakers will present high-quality papers at the Congress. The CPD points at the Congress shall be 20.

Moreover, the social events are specially prepared to ensure that every delegate has a chance to meet new friends and renew old acquaintances. Kota Kinabalu is ranked 6th as the most preferred destination by Trip Advisor and has one of the most beautiful sunsets in the world.

Special field trips are being arranged for Sunday 12th October 2014 and a Mountain climb to conquer the highest mountain in South East Asia and to admire the flora and fauna of Malaysia will also commence on 13/10/14. Every morning during the Congress, a Tai-chi master will conduct exercise sessions for delegates. Hence, please bring your exercise gear to keep fit.

While writing this message, I am being filled with excitement and anticipation with what is in store for delegates. So hurry, register online, send in your abstracts and posters and we await to help you gain an experience of a life time.

See you at 25th FAPA Congress 2014.

With Warm Regards,

Yours in MPS
(Datuk Nancy Ho)


Due to popular request the Abstract Submission is extended to 25th August 2014.

Please hurry to submit your abstracts before the closing date.

Please note also that abstracts will only be accepted for presentation and publication in the Abstract Book if the presenting author has registered and paid by 15th Sep 2014. Abstracts presenters who haven’t registered and paid the fee by this date will be disqualified; these abstracts cannot be presented and will not be published


In order to encourage pharmacy students to participate, the Malaysian Pharmaceutical Society Council has decided to offer each Pharmacy Educational Institutions 5 scholarships for final year and post-graduate students at RM300.00 each for the registration fees to be rebated at the end of the Congress.

The Pharmacy Educational Institutions are to submit a maximum 5 names enbloc from each Pharmacy Educational Institutions. Only those recommended by the Institution will be considered. Please register and pay first before rebate which will be reimburse when the student present themselves at the Congress. Some Universities like Josai International University in Japan is requesting a special session for student pharmacists to interact. Hence, we would encourage Heads of Schools of Pharmacy to submit 5 names as soon as possible to expose student pharmacists to the International and National Pharmaceutical scene


In the earlier iBulletin article about Survey on Smoking Cessation Services the updated link to the survey is:

This survey is being conducted to identify the perceptions on barriers encountered by pharmacists in Klang Valley in providing smoking cessation services. It is part of the research being conducted by a third year Bachelor of Pharmacy student of the Faculty of Pharmacy in Cyberjaya University College of Medical Sciences (CUCMS) and supervised by Madam Shairyzah Ahmad Hisham and co-supervised by Mr. Masro Mohamad. Your participation in this research will help as a guide for possible interventions to improve smoking cessation services and increase the cessation rate. The questionnaire will take approximately 15 minutes to complete. All data collected in this study will be treated with utmost confidentiality. Agreeing to participate in this study is taken as your consent. To participate please fill out the form Perception on Barriers in Conducting Smoking Cessation Counselling Among Practising Pharmacists in Klang Valley given above.


The following article was received from a community pharmacist:-

With reference to your article on Migraine in the Pharmacy Today April 2014 issue, there is nothing new to give relief and cure to the sufferers of this migraine beast.

The aetiology and relief for migraine pain has already been known since 1986. Why medical science has not adopted this breakthrough discovery. I fail to understand I have personally adopted this discovery to bring relief to my clients for the last 15 years.

This breakthrough discovery was the work of a bio-chemist Professor Rodolfo Low while as an advisor for the Ford Foundation in 1961 with most of the work done at Pontifical Catholic University at Bogota. His work was strongly endorsed by Norman Canfield MD of Yale School of Medicine, Larry A. Pearce MD – Wake Forest University and Fredric W Pullen MD – President of Hearing Education and Research Foundation Miami.

In this study, a person suffering from migraine has an unusually sensitive pancreas which overreactsto even small quantities of glucose. It overreacts to glucose with the secretion of insulin too large to maintain an equilibrium in the body and the person suffers symptoms of hypoglycemia.

In order to maintain equilibrium in the body, adrenaline and other catecholamines are then secreted in an attempt to rectify this hypoglycemia by conversion of glycogen into glucose. Adrenaline is a powerful vasoconstrictor. This is the key to unraveling the mystery of migraine.
At the same time that excessive adrenaline attempts to balance the body’s metabolism,, other effects also are magnified. This brings about visual disturbance just prior to the onset of pain.
The body has a strong need to maintain its state of equilibrium. After a period of time, this vasoconstriction is followed by its opposite i.e. a vasodilation of blood vessels in the head which is brought about by Prostaglandins. The pain of migraine begins when the blood vessels in the head expand.

In short, the intake of refined sugar can lead to the pain of migraine. All pains due to clinical conditions such as cancer and injuries are not included as they need only strong pain killers.

This is essentially preventive measure that works permanently through nutrition. To apply this one needs to :-

  1. Avoid all refined sugar in all foods and drinks
  2. Avoid hunger ? eat food at 3 hour interval ? non-sugar foods
  3. No alcohol as it causes hypoglycemia.

Drinks made from vegetables like celery, carrots, tomatoes, cucumber and juicy fruits eg. apples, oranges, papayas, guavas are preferred. Natural fruits are alright as they contain natural sugar (fructose), which are not refined sugar. However do not drink it in excess.

Avoid all aerated drinks, sweet cakes, ice-creams and cookies. However, biscuits like cream crackers without sugar are allowed.

Therefore, one needs to change his/her lifestyle for a healthy life free from migraine and without drugs.

Reference “Victory over Migraine” – Professor Rodolfo Low

Bernard Woo
(contact available on request)


Malaysian Academy of Pharmacy shall be organising seminar on Impact of Pharmacy on Healthcare

Date : 23rd August 2014 (Saturday)
Time : 11.30 pm – 5.30 pm
Venue : MPS Building, Puchong

Features of this seminar would be a lecture by Prof Brian Furman from University of Strathclyde, Glasgow who will be speaking on Impact of Pharmacy on Healthcare in the 21st Century ? A UK Perspective; Implications for Pharmacy Education.

Next, would be a lecture by Mr Amrahi Buang from University Malaya Medical Centre on Update on Dispensing Separation.

There also will be an Update GST on Medicines.

For registration, please fax registration form to: 03-8070033 or email:



Malaysian Academy of Pharmacy shall be organising seminar on Updates on Neuropscycho-Pharmacology of Nicotine Addiction, Pharmacotherapy and Behavioural Interventions for Smoking Cessation.

Date : 26th September 2014 (Friday)
Time : 8.30 am – 1.00 pm
Venue : MPS Building, Puchong

Features of this seminar would be a lecture by Dr Renee Bittoun from University of Sydney who will be speaking on Updates on Neuropscycho-Pharmacology of Nicotine Addiction, Pharmacotherapy and Behavioural Interventions for Smoking Cessation.

For registration, please fax registration form to: 03-8070033 or email:



  • Pharmacist/ Johor Bahru, Johor/ Sin Ming Pharma/ Mr Su: 019-7904968
  • Pharmacist/ Caring Pharmacy/ Ms Wong: 03 7782 1988/
  • Retail Pharmacist/ Penang /Biopharmalink Pharmacy (Sg. Dua, Pg)/ Mr Khong 019-4719716/
  • Pharmacist/TTDI, Kuala Lumpur/ Dr Sangeet: 012-324 6737 or / Mr Vivek: 017-522 2016 or
  • Pharmacist/ Balik Pulau, Penang/ Ms Ang: 04-8665421/
  • Pharmacist & Locum Pharmacist/ Johor Bahru, Selangor & Kuala Lumpur/ D’ Apotic Pharmacy/ Mr Maal: 016-7028654/ Pn Rohana: 016-7028655
  • Pharmacist / Nationwide / Lovy Pharmacy / Contact: Ms. Ye 05-2418484 / Email:
  • Operation Pharmacist & Community Pharmacist/ Klang Valley/ Constant Pharmacy/ Mr Loh –
  • Retail Pharmacist/ Farmasi Goodmedic/ Mr. Siah: 03-91333395, 012-3388152

– See more at:


1 Aug, 2014



Dear Members,

This is a special message from the Organizing Committee of the 25th FAPA Congress 2014.

After years of preparation, the Organizing Committee is entering the final 70 days before the Opening Ceremony of the 25th FAPA Congress 2014 to be held on 9/10/14 at 4.00pm in the Magellan Sutera Hotel, Kota Kinabalu Sabah. The Guest-of-Honor shall be YB Dato’ Seri Dr S. Subramaniam, Minister of Health, Malaysia and Dignitaries from the Health Ministry, State Chief Minister’s Department, Ministry of Tourism and Culture, Malaysia, State Ministry of Tourism, Culture and Environment, Universities, Captains of the Industry, Corporate Leaders will join delegates to witness the colorful Opening Ceremony.

Delegates from the 18 Member Countries will spend the next three days in a learning environment. Top-notch speakers have been invited including those from UK, Philippines, Cambodia, Thailand, Australia, Hong Kong, Indonesia, Iran, China, Singapore, Taiwan, USA, Korea, Vietnam and proudly from Malaysia.

The Ministry of Health, Malaysia has spared no efforts to support the event by sending distinguished delegates to learn and share their knowledge.

In the private sector, delegates from the Private Sector in the States include:-

No States Private Sector Participants
1 Johor 0
2 Melaka 2
3 N.Sembilan 2
4 Selangor / KL 51
5 Perak 3
6 Penang 4
7 Kedah 2
8 Perlis 0
9 Pahang 1
10 Kelantan 1
11 Terengganu 0
12 Sarawak 9
13 Sabah 30
  Total 105

The Area Committee Chairpersons have worked hard to motivate their members to participate. We expect that the Area Committee Chairpersons are still hard at work to send a strong delegation from the respective States. Please visit to learn the latest programme and to register.

We are also happy to announce that 2 Institutions of higher learning had taken up the scholarship offered to the students for participation at the Congress. They are IMU and CUCMS. The offer dateline has been extended till 15th August 2014. So please hurry to submit names of students keen to learn.

The social programme are just as exciting with food, culture, sights and tours in the offering. For those who want to climb Mount Kinabalu, please find out more in the website. Golf can also be arranged. Morning exercise is part of the programme. Hence bring the right gear to “Relearn, Relax, Recharge and Rejuvenate”.

We look forward to welcome you. Meanwhile, the countdown continues…

With Warm Regards,
Yours in MPS

(Datuk Nancy Ho)
President Cum Organizing Chairman of 25th FAPA Congress 2014


The MMA- TPPA Committee held a round table discussion on TPPA .

Representing the MPS at this discussion is En Amrahi bin Buang, the Deputy Vice President.

The speakers for the day were Mr Lim Chin Wei who spoke on ” Issues of costs of Medicines & Other Health costs , Mr Fauwaz Abdul Aziz , “Liberalisation of the Health Services Sector ” Prof Lekhraj Rampal “Tobacco Control the TPPA” Datuk Khaw Lake Tee ” Human , Social Rights & the TPPA , YB Dr Jeyakumar ” Overview of the TPPA

The TPPA stands for Trans-Pacific Partnership Agreement . It is a multilateral free trade agreement currently being negotiated by 11 countries led by the USA. Malaysia is one of the countries in negotiations on the terms of the TPPA . It aims further to liberalise the economies of the Asia -Pacific Region . It covers a broad spectrum of areas and has 29 chapters ( and still counting ) Some areas affect the public health environment, healthcare and practice . Though it is labelled as a Trade Agreement and there are 29 chapters , only 5 chapters are related to trade


  • There is absolute secrecy in the discussions even after 19 rounds of negotiations
  • What we know is in bits and pieces provided by those who have attended these meetings and by whistle blowers .
  • The price of drugs , generics , ever-greening of patency , extension of patency , freedom for HMOs , entry of foreign players into the Health sector including stand alone clinics , and hospitals are some of the worries

MMA will hold further discussions, collate facts before meeting with MITI to raise our concerns and objections if needed

Dr NKS Tharmaseelan 
MMA-TPPA Committee


The following message was received from PhAMA:-

The Pharmaceutical Association of Malaysia (PhAMA) is an organization which represents multinational companies involved in the Research & Development, Manufacturing, Marketing and Sales and the Distribution of innovative medicines in Malaysia. The association was formed in 1972 and our members currently stand at 44. Our member’s activities are centered towards providing access of innovative medicines to improve the health and quality of life for all Malaysians.

PhAMA is pleased to announced that this year we will kick off our inaugural PhAMA Awards 2014 as an important initiative to encourage and recognize the innovation and research, and community impact that students, researches, members of the academia, health care professionals as well as members of the public has contributed to the society. The contest is divided into two categories i.e. the Minister of Health Innovation & Research Award and the PhAMA President’s Community Impact & Awareness Award.

  • Minister of Health Innovation & Research Award – [ Details ]
    Grand prize winner will receive RM 12,000; and the first runner-up will receive RM 6,000.
    The objective of this award is to celebrate the innovation and research of individuals or team efforts with significant contribution to healthcare and / or standards of care in Malaysia. 
  • PhAMA President’s Community Impact & Awareness Award – [ Details ]
    Grand prize winner will receive RM 8,000; and the first runner-up will receive RM 4,000.
    The objective of this award is to celebrate the impactful efforts or initiatives contributing towards improving an aspect of community health, wellbeing, awareness or standards of care within Malaysia. The scope of the projects can be from articles, campaigns or corporate service responsibility in which efforts are not profit oriented.

Closing date for submission is 15th October 2014

All submissions shall be made online through the website


The following article appeared in the NST on 11th Jul, in response to an article on “Docs’ right to dispense medicine” by the Association of Specialists in Medical Practice.

FROM time immemorial, the dispensing of medicines is considered a professional obligation of the pharmacists. The Arabs separated the art of apothecary and physicians in the 8th century and the Europeans followed through with the edict of Frederick II of Hohenstaufen in 1240.

Thus, for many centuries, in most countries in the world, other health professionals are not allowed to dispense medication. In Malaysia, in 1985, doctors and pharmacists had a formal understanding to recognise dispensing as the professional role of pharmacists.

However, because of the severe shortage of pharmacists, doctors, especially general practitioners (GPs), are legally allowed to dispense medications.

Now, with at least 2,000 new pharmacy graduates here every year and more than 19 local universities offering pharmacy degree programmes, pharmacists are now ready to do what they have been trained for.

While dispensing medicines, the pharmacists come in contact with the patients and thus enhancing several professional roles that go beyond dispensing. Dispensing of medicine now involves intricate knowledge and skills in pharmacology, clinical pharmacy, pharmacoeconomic, pharmaceutical technology, physiology and forensic pharmacy in order to ensure the right medicine is given to the right patient at the right time. These are the basic ingredients of a pharmacy degree programme

However, a formal separation between prescribing and dispensing medicines is an enormous task as it involves various stakeholders.

It is not only confined to community pharmacists and GPs. Among the issues that need to be addressed:

  • COST.
  • RESCHEDULING the current poisons’ list.
  • ESTABLISHING a generic substitution policy.
  • ESTABLISHING pharmacist-physician patient referral.

One of the problems in Malaysia is that doctors and pharmacists do not really appreciate each other’s roles.

Pharmacists are highly trained professionals in the rational use of medicines.

With the changes in the curriculum of pharmacy schools across the globe, pharmacist undergraduate training becomes more patient than drug oriented.

Written by: Associate Prof Dr Mohamed Azmi Ahmad Hassali,deputy dean, (Student Affairs & Networking), School of Pharmaceutical Sciences,Universiti Sains Malaysia

>> For the detail write up


A survey is being conducted to identify the perceptions on barriers encountered by pharmacists in Klang Valley in providing smoking cessation services. This is part of the research being conducted by a third year Bachelor of Pharmacy student of the Faculty of Pharmacy in Cyberjaya University College of Medical Sciences (CUCMS) and supervised by Madam Shairyzah Ahmad Hisham and co-supervised by Mr. Masro Mohamad.

Your participation in this research will help as a guide for possible interventions to improve smoking cessation services and increase the cessation rate.

The questionnaire will take approximately 15 minutes to complete. All data collected in this study will be treated with utmost confidentiality. Agreeing to participate in this study is taken as your consent.

To participate please fill out the form Perception on Barriers in Conducting Smoking Cessation Counselling Among Practising Pharmacists in Klang Valley at:

For any enquiries, please contact Huong Siew Ching at 017- 4361110.


On the 12th April 2014, a workshop on medication related issues and handling was given by the Pharmaceutical Services Division (PSD), Ministry of Health Malaysia (MoH). This workshop was organized by KaMU (Karnival Mesra Ubat) committees and was coordinated by Datin Mariani Ahmad Nizaruddin. It was held from 8.30 a.m. to 6.00 p.m. at Al-Razi of CUCMS.

The main purpose of the workshop was to train and prepare for Karnival Mesra Ubat (KaMU) as well as all pharmacy students who are interested to join. Facilitators from the PSD include Mr. Mohd Dziehan Mustapa, the Principal Assistant Director of the Pharmaceutical Services Division (PSD), Ministry of Health Malaysia, Miss Leow Chuan Ying (pharmacist of Pejabat KesihatanTitiwangsa Kuala Lumpur), Mr Kamarul Azhar Bin Dato’Kamaruddin, Senior Assistant Director (JabatanKesihatan WP Kuala Lumpur & Putrajaya).

Activities include Mood Meter, identifying fake and genuine drugs. There were presentations on “What Is a Drug?” “Important Aspects in Use of Drug”

This workshop has received tremendous support from the participants with a new and great style in presentation. The Organisers were indeed grateful that the respected facilitators and Datin Mariani have given full support and sacrificed their precious time to the workshop. The day ended with knowledge, creative and joy. We sincerely hope that more workshops or trainings may be organized in the future.

Prepared by,
Chen Mei Fei

>> For a detail report

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Taking your medicine

17 Aug, 2014


Is the call for the separation of prescribing and dispensing roles in healthcare a positive step for patients?

A DOCTOR’S duty and responsibility to his patient is clearly defined in law: “… all matters dealing with the medical management of the patient shall rest in the hands of the registered medical practitioner.”

In this respect, the continuum of care from the moment a patient consults a doctor for a medical complaint, all the way to treatment and the eventual response and recovery to treatment or otherwise, is and shall remain as the duty and responsibility of your doctor.

Patients expect this basic requirement from their doctor-patient relationship.

The act of prescription and dispensing is an integral part of this continuum. It is also the statutory duty and responsibility of the doctor to see that this is done correctly.

In our existing healthcare landscape, the doctor may opt to delegate the act of dispensing to a pharmacist. He will only do so if he is of the opinion that the pharmacist is properly qualified, trained and can be trusted with the welfare of his patient.

Likewise in general, doctors will only agree to this separation provided the system in place has proper safeguards and regulations to minimise dispensing errors and harm to patients.

To do otherwise is a dereliction of his sworn duty and exposes the patient to unnecessary risks.

Why all the hype?

The recent hype calling for separation of roles is an expected development as mega businesses have now moved in with the objective to corner the dispensing market.

Let us be clear about this. This is purely a business move to prepare the groundwork for a protected oligopolistic dispensing system for the future.

There is no basis or need to denigrate the role of doctors, as well as their training and expertise in prescribing and dispensing medicines.

The principles of good medical practice in this respect is also clear. It is also the duty of the doctor to know his medicine, and how it impacts his patients in all aspects. Failure to do so opens the doctor to civil negligence action and prosecution.

Separation of prescription and dispensing – is it safer?

Research done in the US and UK have also clearly indicated that errors in dispensing by pharmacists are just as serious in systems practising separation of roles.

In their memorandum presented to the UK Parliament in 2009, by Professor Bryony Dean-Franklin and Professor Nick Barber, dispensing errors were noted to account for 3.3% of all items dispensed and up to 9.8% of dispensed items in secondary care.

Indeed, in the UK, the government had found it fit to have criminal liability for dispensing errors. Pharmacists in many countries also are required to take up professional indemnity insurance.

Is the dispensing pharmacy landscape in Malaysia ready for such important changes?

Studies in the US have estimated that the rate of dispensing errors in an ambulatory setting can be up to 24% of prescriptions. In 1999, an investigation carried out on 51 Massachusetts pharmacies in Boston revealed that 4% of prescriptions dispensed by community pharmacists contained errors, of which 88% of these involved wrong drug or strength.

Clearly, dichotomy of prescriptions and dispensing is not a proven safe option for the Malaysian public.

Is physician-based dispensing better?

The physical act of dispensing involves rather standard operating processes like retrieving the right medication from storage, batching, packing, labelling and handing over to the patient.

These are things that a properly trained dispensing assistant can handle.

In physician-based dispensing practices, the process of sighting and verification can also be done immediately and by the prescribing doctor. This cannot be done in off-clinic pharmacy-based dispensing.

In all proper medical consultations, the process of counselling of medication would have already been done by the prescribing doctor at the time of consultation. This would have included proper dosing, drug-to-drug interactions, allergies, interaction with food and other relevant details.

It would also encompass how the dosing, indications and contra-indications relate to the patient’s personalised medical details like status of blood, kidney, liver and other vital organ functional status.

All these are part and parcel of proper medical training of a doctor.

Without the complete medical information of the patient on hand, the dispensing pharmacist will unlikely be able to do better than the dispensing doctor.

Should doctors continue to dispense?

We have yet to see for ourselves the proposed Pharmacy Bill, which is due for tabling in Parliament. We can expect this to be soon as the Dasar Ubat Nasional (DUNAS) is scheduled for full roll-out in 2015.

Central to everybody’s concern is the constant unhealthy lobbying for separation of prescription and dispensing in the build-up to this Act.

When the dust finally settles, even the poor independent pharmacist practices will themselves be squeezed out of business and the patients and public will be left to the mercy of mega oligopolistic pharmaceutical chains.

It is also clear that even with the proposed new Pharmacy Act, doctor’s prescriptions and dispensing duties remain unchanged.

The statutory duty of the doctor to dispense is clearly stated in the Poisons Act and the PHFS Act 1998/Regulations 2006, and shall remain.

We expect new regulations that will try to even the playing field between the dispensing pharmacists and doctors. It will, however, cut both ways. Would the public like to see doctors’ clinics dealing with OTCs like shampoos, soaps, toiletries plus all the trims and frills of the high street pharmacies?

Instead, the proposed Act should focus on the provision of common platforms where doctors and pharmacists can mutually work together to minimise errors rather than create unnecessary turf-protecting silos.

More stops, more cost

In a private clinic, the income from dispensing is an essential component to meet the running cost of providing the service of a one-stop treatment facility.

Historically, private doctors have been providing a single package fee for their services and medicines. With this system, one doctor with one clinic assistant can cost-effectively look after the basic medical needs of thousands of patients.

This has worked well to control the cost per visit for patients. No other system can be more cost-effective than this.

In the majority of cases, the doctor’s professional fee in these package bills was and remains to be really very nominal.

Even today, doctors are continuing to subsidise the cost of medicines from their professional fees.

The Federation will continue to champion our existing one-stop consultation, prescription and dispensing system for the convenience and cost-effectiveness for the patients.
Indeed, most of our patients, including those from other countries, like the one-stop facility.

There is no evidence whatsoever to suggest that separation of roles in the Malaysian healthcare scenario will be any better than what we have existing now.

A dichotomized system has also been shown to increase rather than decrease the cost of care and is not patient-friendly.

Imagine a mother with two feverish fretting kids in tow, sick and vomiting, risking life and limb crossing the crowded streets of KL or PJ looking for a pharmacist to fill their prescription when they could have easily sorted everything in the doctor’s clinic.

It is thus not in the patient’s best interest. The choice of where to get her medications is the right of the patient. It is not in the patient’s interest to take away this right.

We must preserve a system that prioritizes the rights and interests of the patient and ensures that the doctor continues to uphold his statutory duty and responsibility to provide continuity of care.

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PHARMACISTS: Prescribing vs dispensing

6 Aug, 2014


WE refer to the debate on the separation of roles of doctors and pharmacists in the dispensing and prescribing of medication in the Letters section of the New Straits Times since last month.

Pharmacists, dietitians, physiotherapists and other healthcare professionals have been working with doctors as members of the healthcare team to provide comprehensive healthcare in hospitals and other healthcare institutions, including medical health centres.

Doctors, including consultant specialists, have no qualms about working with other healthcare professionals for the benefit of the patients, or to seek the pharmacist’s professional advice on medications.

What we do not understand is why, when these doctors go into private practice, the pharmacist’s services are no longer of use to them or their patients?

Pharmacists are the only professionals who are trained and professionally qualified as well as recognised in medicine dispensing all over the world.

Yet, pharmacists in the private sector in Malaysia are not treated as such.

The duties of most community pharmacists are reduced to over-the-counter service, dealing with health supplements and minor medications, like creams, cough and flu medicines.

They are not involved in the prescribing and dispensing functions, when the Health Ministry has already expanded their scope of functions and services. Why the double standards?

The argument by some quarters that dispensing by pharmacists will cause inconvenience to the public, or that there are shortages of pharmacies in rural areas, does not hold water anymore.

For the past three years, under the eMass programme, pensioners can have their prescriptions for medicines, which are not available from the government health facilities, from private pharmacies.

As for the shortage of pharmacies in the rural areas, have they not heard about the spontaneous progression on supply-and-demand economic dynamics?

Without receipt of prescriptions for supply of medicines, do these people expect pharmacies to be set up in rural areas, or to be open 24 hours?

Even doctors will be reluctant to set up such clinics in remote areas where the population is too small.

The separation of roles in the dispensing of medicine is not a Western phenomenon. It had been practised in many countries, even in Asia and the Middle East, as mentioned by Associate Professor Dr Mohamed Azmi Ahmad Hassali of Universiti Sains Malaysia.

Indonesia and India have had this system in place for a long time and these countries have much larger rural and isolated areas than Malaysia. Other Asian countries such as the Philippines, Taiwan, Korea and Japan, have also switched to this practice.

If the practice is not beneficial, why are more countries adopting it? Malaysia and Singapore, which share the same historical background in medicine, are among the very few countries in the world where doctors are still allowed to dispense medicines.

Another favourite argument is that the cost of medical treatment will escalate. The power of supply and demand mechanics will ensure that clinics which overcharge will be shunned by the people. Many more private clinics, too, will be opened, especially when there is an over production of doctors in the last decade or so.

Moreover, the charges of the medicines supplied to patients by clinics are too high, even though, in most cases, the clinics buy these medicines at much cheaper prices.

We are often rated as having one of the best public healthcare provision-system in the world. This is because the population has access to a government health facility within 5km from their residence — government health centres — where the dispensing of medicines and medication counselling are performed by pharmacists.

Having pharmacology as a subject in one year of the usual five-year course in medicine does not mean doctors are trained to do the work of a pharmacist.

Pharmacologists spend several years learning pharmacology but they are not allowed to prescribe or dispense medicines unless they are clinical pharmacologists, that is, they are also doctors.

Pharmacists too, are trained in clinical pharmacy where they also learn about diseases, symptoms and treatment.

They are also taught to access patient conditions in the clinical ward rounds but this does not mean they can do the work of the doctors. Pharmacists and doctors are two different professions.

Under the Poisons Act, 1952, doctors are allowed to supply medicines to their patients, mainly because from those pre independence days to the 1980s, there were very few pharmacists in our country.

However, there is no provision for private doctors to delegate dispensing to unqualified workers.

Doctors are expected to dispense medicines to patients. But how many private doctors dispense the medicines themselves? In almost all the private clinics, the medicines are dished out by unqualified clinic assistants.

Most of these dispensers are not pharmacists, but school-leavers with in-house training in basic dispensing and without the supervision of doctors who are in separate consultation rooms.

And, they do not even adhere to the basic requirement for dispensed medications, like the correct labelling with the names of the medicines as stated in the Poison Regulations.

It is for the protection of the patients that prescribing and dispensing need to be separated. Patients’ safety should never be compromised. In the developed world, pharmacists are requested to contribute more to the primary healthcare so that doctors can provide better and more accurate diagnosis and treatment, the main area of their training.

Gan Ber Zin, Seremban, Negri Sembilan

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