Community pharmacies and pharmacists in Brazil: A missed opportunity.

The Brazilian National Health System (BR-NHS) is one of the largest public health systems in the world. In 2019 Brazil had 114,352 community pharmacies (76.8% private owned), that represent the first point of access to healthcare in Brazil due to their wide distribution. Unfortunately, from the government's point of view, the main expected activity of private and public community pharmacies is related to dispensing medicines and other health products. Public community pharmacies can be part of a healthcare center or be in a separate location, sometimes without the presence of a pharmacist. Pharmacists working in these separated locations do not have access to patients' medical records, and they have difficulty in accessing other members of the patient care team. Pharmacists working in public pharmacies located in healthcare centers may have access to patients' medical records, but pharmacy activities are frequently under other professional's supervision (e.g., nurses). Private pharmacies are usually open 24/7 with the presence of a pharmacist for 8 hours on business days. Private community pharmacies have a very limited integration in the BR-NHS and pharmacists are the third largest healthcare workforce in Brazil with more than 221,000 registered in the Brazilian Federal Pharmacist Association [CFF - Conselho Federal de Farmácia]. A University degree in pharmacy is the only requirement to entry into the profession, without any proficiency exam for maintenance or career progression. The Brazilian pharmacist's annual income is ranked as the 2 better-paid profession with an annual average income of EUR 5,502.37 (in 2020). Description of clinical activities for pharmacies by the CFF increased in the recent years, however there is still a long way to effectively implement them into practice.