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Journal of the American Pharmacists Association xxx (2022) 1e2

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journal homepage: www.japha.org

A DOSE OF INSPIRATION

Pharmacist leaders in public and global health: Nurturing
practitioners at the forefront of an ever-connected world
Priscilla L. Ko, Kya R. Norby, Diane Nguyen*

Pharmacists’ role and accessibility
poise them as ideal public and global
health practitioners. The Bristol Myers
Squibb Foundation and Rutgers University PharmD-Public Health Residency
trains graduates to address health carechallenges through two 6-month assignments in sub-Saharan Africa and theUnited States. While in sub-Saharan Africa, residents work with grant partners
to provide technical assistance inresearch, quality improvement, capacity
building, and outreach work through amodel that embraces mutual exchange
and joint development of sustainable
solutions. While in the United States,
residents support grant-making operations and policy and advocacy efforts
including reviewing proposals, developing governance materials, assessing
monitoring and evaluation reports, conducting literature reviews, and writing
policy briefs. Three alumni residentsdescribe how ﬁeld experiences and opportunities during their residency
enabled them to engage in sustainableglobal health programming, sharpen
skills and attitudes essential to tackling

Disclosure: Priscilla L. Ko is employed by Bristol
Myers Squibb Foundation, a sponsor of thePharmD-Public
HealthResidency
Programdescribed in this commentary. All other authors
declare no relevant conﬂicts of interest or ﬁnancialrelationships.
Funding: This Dose of Inspiration did not receive
any speciﬁc grant from funding agencies in thepublic, commercial, or not-for-proﬁt sectors.
* Correspondence: Diane Nguyen, PharmD,BCPS, Assistant Professor, Department of Pediatrics, Department of Education, Innovation, andTechnology, Baylor College of Medicine, 1102 Bates
St., FC Suite 630, Houston, TX 77030.
E-mailaddress:
diane.nguyen@bcm.edu(D. Nguyen).

dynamic health care challenges, andreﬁne their perceptions, professional
identities, and career paths.
Vignette #1dSustainable global
health programing
With dirt on the ﬂoor, an open window, and individuals entering thecleanroom without personal protective
equipment (PPE), the chemotherapy
cleanroom in Eldoret, Kenya, was not thesterile environment it was intended tobe. I recognized that the reasons underlying this issue were multifaceted:ﬁnancial, educational, and supply chain
to name a few. As we began to dialog, thepharmacy staff shared their insideperspective. First, the room was constructed incorrectly, but a renovation
was unlikely owing to administrative andﬁnancial factors. Second, there was ahigher level of acceptable risk in theKenyan culture than the United States,
which became evident as I listened,learned, and observed. Limited resources
coupled with a higher risk tolerance
resulted in less urgency to meet cleanroom guidelines. By having one foot in
the United States and the other in Kenya,
I learned to identify available resources
and help implement simple changes forthe biggest impact. By the time I left
Eldoret, the cleanroom was being
cleaned daily according to newly developed standard operating procedures. The
anteroom was demarcated into clean anddirty areas. Equipment was designatedfor cleanroom use only. Staff wereappropriately donning and dofﬁng PPE.
Structural issues remained, but therecent changes were effective and goingto last. These small sustainable changes

https://doi.org/10.1016/j.japh.2022.01.004
1544-3191/© 2022 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

would have a more meaningful impact
than a large unsustainable change. Most
importantly, the pharmacy staff wasempowered to advocate for their pharmacy’s needs and drive the changes they
identiﬁed, and I came to see the world as
one full of capable people with the keys
to lasting solutions.dPublic HealthResident 2018-2019

Vignette #2dProfessional identity
formation“Remember those who need help themost but can’t always get it.” I often
reﬂect on this patient encounter as theimpetus to my start in health care. As apharmacy student, I engaged with people
who faced difﬁcult choices between
paying for medications or for rent,
depended on patient assistance programs,
and drove hundreds of miles to see aspecialist. Despite living in a high-income
country, I recognized the inequities ofresource distribution that left the society’s most vulnerable neglected andsought to address these disparities.
Through the residency, I learned the roleof health philanthropy and the importance of a grant maker’s commitment tohealth equity. Financial resources areused as a catalyst, funding innovative solutions that must work in tandem withother systemic changes to have long-term
impact. Partnerships must be multisector
to collectively address social determinants of health, segment healthdisparities data, and engage with policy
and advocacy groups to spotlight issues
and solutions. I came to understand thattrust is built by mutual agreement, progress occurs over a multitude of steps, andDEPARTMENTS
P.L. Ko et al. / Journal of the American Pharmacists Association xxx (2022) 1e2

systemic change is made incrementallyover the course of time. After residency, I
had the opportunity to continue my workin health philanthropy and contribute toteaching the next generation of learners
about global health principles andcorporate social responsibility.dPublic
Health Resident 2014-2015

Vignette #3dCareer development“Delicious!” his sister exclaimed. He
grinned widely with satisfaction at having
prepared a healthy snack that his family
enjoyed. Sitting around their kitchen, I
witnessed a home-based intervention
program for youth with or at risk of type 2
diabetes in the Navajo Nation. Collaborating with Family Health coaches, whowerenativeparaprofessionals,I
strengthened the referral process for atrisk youth, enhanced program policies
and procedures, and developed diabetes
training curricula. The work focused on
both clinical care management andbroader program operations management. Program participants and coaches
made an immense and lasting impact on
me. They invited me into their homes andshared their Navajo culture and beliefs.
The emphasis on the family, its vital rolein society, and principal institution of theyoung generation opened my eyes to adifferent, countercultural way of living.
The coaches, all of whom were successful
young women, had committed themselves to returning and serving theircommunities. They inspired me to reﬂect2

on my own career trajectory, how thatintertwined with my personal choices,and gave me courage to chart my adventure into the unknown: a new global
health position that had not yet existed, ina space that had not known a pharmacist.
The breadth of skills and experiences
during residency in programming, operations, and community and partnershipengagement directly launched me into
my global health career and gave me
conﬁdence to transform the nebulous intooutcomes. My experience with the Navajo
Nation resonates many years later, having
formed part of my professional and personal identity.dPublic Health Resident
2013-2014
These experiences empowered residents to broaden the scope of pharmacist
services and pursue careers as global
health practitioners. Although the reﬂections of each residency alumni areunique, the impact on their development
can be distilled in three main ways. First,residents established an understandingof sustainable health programming,
which is a fundamental aspect ofresponsible and ethical global healthactivity. This understanding encompassed developing a personal perspective on community-based interventions,
reciprocal knowledge sharing, and anappreciation for the value of operating
within a long-term, locally driven
mindset. Second, residents cultivated a
deeper awareness of the structural andsystemic forces and the interplay of cultural, political, and economic histories
that have affected marginalized com-munities. Ultimately, this inspired residents to a career serving vulnerable
communities and striving toward healthequity. Finally, residents developed
unique skill sets that served as alaunchpad into a global health career not
clearly deﬁned for pharmacists. Residency ﬁeld assignments have ambiguousboundaries and circumstances, requiring
resilience that enhanced the residents’threshold to thrive in the face of uncertainty, fostered adaptive skills forresponding to changing needs of communities, and empowered residents totrailblaze their own career path.

Acknowledgments
John Damonti, MSW, Patricia Doykos,PhD, Phangisile Mtshali, Joseph Barone,PharmD, Michael Toscani PharmD, andEvelyn Hermes-DeSantis, PharmD, areacknowledged for their mentorship ofresidents in the program.
Priscilla L. Ko, PharmD, Director, Corporate Contributions, Department of Corporate Philanthropy,
Bristol Myers Squibb Foundation, Lawrence Township, NJ; at the time of the study, Director, CorporateContributions, Bristol Myers Squibb Foundation,
Lawrence Township, NJ.
Kya R. Norby, PharmD, Pharmacist, Department ofPharmacy, Santa Fe Indian Hospital, Indian HealthService, Santa Fe, NM.
Diane Nguyen, PharmD, BCPS, Assistant Professor,
Department of Pediatrics, Department of Education,
Innovation, and Technology, Baylor College of Medicine, Houston, TX; at the time of the study, Directorof Global Programs, Baylor College of Medicine International Pediatrics AIDS Initiative, Houston, TX.