75th Congress of the International Pharmaceutical Federation

High-Calibre Specialist Presentations

At the very start of the international congress, the host Germany was introduced to the international audience in a highly regarded symposium entitled "Pharmacy in Germany". High-calibre speakers from universities, the pharmaceutical industry and professional associations presented pharmacy in Germany in all its facets. 

Fig. 1:Colonel MC (Pharm.) Krappitz, Chief Pharmacist of the GAF

Military pharmacy in the GAF - a summary

The German Armed Forces' Chief Pharmacist, Colonel MC (Pharm.) Arne Krappitz, presented the extensive roles carried out by pharmacists and food chemists in the GAF and provided a detailed insight in the broad spectrum of services provided by military pharmacy. He started with the sub-sectors of scientific and practical pharmacy and food chemistry, as well as medical material logistics, that are of significance to healthcare in the GAF; his presentation provided a comprehensive portrait of the many and varied capabilities of military pharmacy, ranging from the routine analysis of medicine and medical products of food and drinking water to the production of blood products and the large-scale production and management of emergency medicines. In particular, the fact that these tasks are being largely carried out in comparable quality on foreign deployments based on the GAF Professional Guidelines, as well as the key role of military pharmacy both in the context of preventative healthcare and in patient care, met with considerable interest. 

Krappitz also discussed the basic, advanced and extended training of pharmacy medical officers and their deployment in areas beyond the confines of military pharmacy. The broad spectrum of roles within the Federal Ministry of Defence, from involvement in personnel management and medical information technology to activities in quality management and defence medicine research, impressed the international audience and was the subject of many conversations after the presentation. 

Sovereign roles and self-management in the armed forces

Colone MC (Pharm.) Matthias Meyer supplemented the contributions from the GAF Chief Pharmacist with a presentation on the legal framework conditions, the standards applied and the execution of public law monitoring duties in relation to the operation of military pharmacies and the traffic of medicines and medical products within the GAF. Of note, it was recorded that the "Medicines Monitoring Officer of the GAF" (AMÜBBw) is a separate authority within the self-management remit of the GAF set up to monitor compliance with the legal regulations applicable in Germany, including the laws on pharmacies, medicines, anaesthetics, transfusions, transplants and medical products. The close collaboration between the AMÜBBw, who holds equal authority to the respective federal state bodies, with the federal states and its representation on the various regional / state committees and working groups ensures that new developments in pharmacy and the production of medicine, including blood and tissue preparations, and the execution of clinical trials for the GAF, are taken into account and implemented in harmony with civilian specifications. This ultimately ensures that the affiliates of the GAF are also not put at any advantage or disadvantage compared to civilians with regard to medicine supplies and medicine safety.

In-house production of medicines and medical products

From the Federal Ministry of Defence in Bonn, Captain (Nvy) MC (Pharm.) Dr. Christian Froben reported on the strategic reorientation of the manufacture of pharmaceutical products in the GAF. He demonstrated that the findings of the Federal Audit Office and the recommendations of the Public Accounts Committee of the German Bundestag on the issue of medicine production in the GAF were largely identical to the results of the analyses obtained by the armed forces themselves and therefore provided a basis for further development.

In accordance with the ministerial framework specifications, the scope of large-scale manufacture of medical materials within the GAF is limited to relevant products that are not available or not reliably available on the market and which may not be able to be stocked up on in a compensatory manner. The ability to manufacture auto-injector devices, especially for the delivery of C-antidotes, was especially highlighted as outstanding and pioneering. Their independent availability is able to resolve the critical conflict between military deployment demands on a background of rapidly changing security situations and a market situation that is largely characterised by monopolies and in some cases long-term inabilities on the part of the industry to deliver. The scheme also includes products for which unrestricted availability is essential; however, guaranteeing this availability is not always possible as a result of transport logistics. The example cited was that of oxygen for medical use with a content of 93% thanks to the mobile oxygen production and pumping systems that will be available from the start of 2016.

The new self-understanding of the GAF own manufacture on and for deployments also includes the realisation that the efficient use of capacities always takes account of the possible integration of partner nations and therefore the multi-national deployment reality and approaches such as "pooling and sharing" or the Framework Nation Concept can be integrated.

The Service Capabilities of the Military Pharmacy in Detail

In addition to the professional presentations at the Düsseldorf Congress Centre, the Host Nation Day on 1 October 2015 was another particular highlight for the delegates from the military and emergency pharmacy section. Under the patronage of the Chief of GAF Medical Services Lieutenant General MC Dr. Michael Tempel, Col MC (Pharm.) Krappitz presented a services showcase at the military base in Cologne-Wahn, detailing the skills and abilities of the pharmacy medical officers of the GAF in a clear and accessible manner. The international audience were given the opportunity to take a rare glimpse behind the scenes and to learn about the range of services provided both at home and on foreign deployments. 

Fig. 2:The visitors to the MEPS in front of the officers' club in Cologne-Wahn

To gain an initial impression of the facility, the visitors were shown the areas of the military pharmacy's activity within the various organisational divisions of the GAF with poster articles. The clearly laid-out boards provided information about the roles and services of military pharmacy in the Army, Air Force, Navy and armed forces, as well as within the German Armed Forces' medical service. Lively debate provided the perfect opportunity for an in-depth exchange of experiences between German and international colleagues in the field of military pharmacy. 

Fig. 3:Col MC (Pharm.) Dr. Klaubert (ZInstSanBw Munich) explains the inspection of auto-injectors

The MEPS conference delegates devoted particular attention to the GAF tent and container-based medical facilities that had been set up especially for the international congress and which offered an interesting look at the workplace of German military medics and in particular of military pharmacists on foreign deployments. Visitors were able to see a pharmacy container in which medicines for soldiers in the deployment country can be manufactured directly on site following the same formulas as a conventional civilian pharmacy. In the medicines investigation container, the experts from the Central Institute of the GAF Medical Service (ZInstSanBw) in Munich demonstrated the possibilities of a highly mobile investigative laboratory in which both raw materials used in formulas and ready-made drugs are tested for their identity, purity and content using wet chemistry but also chromatographic and spectroscopic methods. 

The specialist expertise on display in the field of food chemistry and the ability to investigate and expertly assess food and drinking water, which are services that are in demand both at home and on foreign deployments in regard to all issues affecting food safety and consumer protection, also met with tremendous interest. The food chemistry laboratory containers give the medical service mobile deployment laboratories with the opportunity to investigate food and drinking water for chemical contaminants.  The congress delegates also followed with interest the demonstrations by the medical personnel present, which covered the full bandwidth of the complex investigative capabilities available, from pesticide monitoring in fresh food supplies to the rapid analysis of warfare agents.

The presentation of the three types of container demonstrated in an impressive manner how military pharmacy activities can be carried out competently and with consummate professionalism independently of a fixed infrastructure, even in small spaces, thanks to the optimised use of the space available and suitably trained specialists. 

The services showcase was supplemented by a mobile oxygen generation and pumping system, which had been set up and demonstrated in this comprehensive configuration for the first time. As a result, pharmaceutical-grade oxygen can be produced independently on site in the deployment zone using molecular sieves. An armoured rescue station for the immediate medical care of injured soldiers added the finishing touch to this aspect of the programme. In addition to the opportunity to take a look at the German Aerospace Centre (DLR), the German Air Force's MEDEVAC Airbus had also been flown in for visitors to take a look at. The flight surgeon on duty explained the aircraft's duties and equipment brilliantly to the assembled guests. 

Fig. 4:The flight surgeon explains the duties and equipment of the MEDEVAC Airbus

International Recognition and Networking

The international visitors to the service showcase were all impressed by the professionalism and performance of the GAF Medical Service and by the range of activities and capabilities of the German pharmacy medical officers. The Chinese Chairman of the MEPS, Senior Colonel Zheng-Yu, especially praised this at the concluding Section Dinner. Even greater cooperation was also agreed with Col Krappitz, in his role as Chairman of the Technical Commission for Pharmacy (TC Pharm) of the International Committee of Military Medicine (ICMM), between these two institutions that are of such great importance for the coordination of the activities of military pharmacists all over the world.

Fig. 5:Colonel Zheng-Yu, President of the MEPS, and Col MC (Pharm) Krappitz, Chairman of the TC for Pharmacy of the ICMM, agreed even greater collaboration in the field of military pharmacy

Image sources:

Fig. 1:Pharmazeutische Zeitung / Müller

Fig. 2 - 5:German Armed Forces Medical Service / Bannert

Author:

Colonel MC (Pharm) Arne Krappitz

HQ German Armed Forces Medical Service

Senior Pharmacy Officer of the Bundeswehr

Chairman of the Technical Commission for Pharmacy of ICMM 

Von-Kuhl-Strasse 50

56070 Koblenz

E-mail: arnekrappitz@bundeswehr.org

Date: 12/24/2015

Source: MCIF 4/15