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INTERNATIONAL MEMBER UPDATE

Expanding Oncology Pharmacy
on a Global Level

Kathryn Yee, PharmD

Department of Clinical Pharmacy, School of Pharmacy,
University of California–San Francisco

San Francisco, CA

In 2013, the Global Burden of Disease Center Collaboration report- Kathryn Yee, PharmD, (second from left) with intern pharmacists at their weekly
ed 14.9 million cancer cases and 8.2 million deaths worldwide.1 case discussion at the main pharmacy of the Windhoek Central Hospital
With the rise in overall cancer incidence and increased lifespan
through improved prevention and treatment of communicable The medical oncology infusion center at the AB May Cancer Centre at Windhoek
diseases, cancer poses a major threat to public health. Low- and Central Hospital
lower-middle-income countries will feel this burden dispropor-
tionately because their health systems are not designed to treat Dr. Yee (third from left) with the technologists who help facilitate laboratory and
complex and expensive disorders such as cancer.1 There is a grow- didactic courses at the University of Namibia School of Pharmacy
ing need for pharmacists worldwide,2 but stable infrastructures,
education, and resources are required for developing countries to
address this need. Local pharmacists in all countries need to be
motivated to ensure pharmacy involvement in the evolution of
cancer prevention, treatment, and supportive care.

I am fortunate to have developed a partnership with a local
pharmacy initiative through my participation in the University of
California–San Francisco (UCSF) Global Health Clinical Scholars
Program3 as a PGY-2 oncology pharmacy resident. Through this
experience, I learned about the challenges of global health and
the continual need of pharmacist involvement to help solve these
issues. The University of Namibia School of Pharmacy (UNAMSOP)
was established in 2010 and is the first pharmacy training program
in Namibia. Its vision is to build a sustainable workforce with
the skills to increase access to and improve the use of essential
medicines by having pharmacists at the forefront of patient care.4
The role of pharmacy is currently in development, and clinical
pharmacy expertise is limited to a few disease states. With the
increased incidence of cancer, UNAMSOP and the local hospitals
are invested in developing oncology pharmacy specialists as part
of a multidisciplinary team. Therefore, my global health project
was a clinical audit of the standard-of-care practices at the AB
May Cancer Centre at the Windhoek Central Hospital (WCH) in
Windhoek, Namibia. The purpose was to help UNAMSOP develop
a clinical-based rotation for its postgraduate master’s of pharmacy
(MPharm) students to participate in clinical training in oncology.

Serving a population of 2.1 million,5 Namibia now has three
state hospitals and four private hospitals.6 WCH is centrally located
and is currently the only cancer center collecting data for the Na-
mibia Cancer Registry.6 As a result, almost all patients with cancer
are assessed and treated at WCH. Within the past year, approxi-
mately 14,000 cancer patients were treated in the medical oncol-
ogy unit.6 Namibia is a lower-middle-income country, with access
to cytotoxic chemotherapy agents and monoclonal antibodies to
provide many patients with standard-of-care treatment. The most
common malignancies treated at WCH’s medical oncology unit are
breast cancer, leukemia, and lymphoma. After patients are seen

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