
Students Rise to Address Healthcare Crisis
“Although current circumstances challenge us, they cannot shake our spirit – on the contrary, they further motivate us,” declare the pharmacy students from their protest blockade at the University of Belgrade. Their response comes at a crucial moment when Serbia’s healthcare system faces multiple systemic challenges.
As they state in their declaration, “Public pharmaceutical institutions represent crucial healthcare facilities that are constantly serving citizens, while also being key partners in educating future Masters of Pharmacy at the University of Belgrade’s Faculty of Pharmacy.”
Rather than accepting gradual privatization as the only solution to the system’s financial challenges, the students have proposed a detailed reform plan.
One of the most pressing issues in Serbian healthcare is the urban-rural divide in service access. The students specifically address this: “Special attention must be directed to pharmacies in rural and remote areas. Financial incentives, such as increased margins on medications and contracts with pharmacists, can contribute to their sustainability.”
To combat systemic inefficiencies and poor resource allocation, the students propose: “The first step involves centralized management of public pharmacies through the transfer of founding rights from local municipalities to the state or provincial level. This model enables more efficient planning, better resource allocation, and uniformity in service”
Addressing the crucial issue of underfunding and debt, the students emphasize that “Financial consolidation of public pharmacies is key to sustainability.” They recommend that the Ministries of Health and Finance conduct debt audits and implement monitoring systems to prevent future financial issues.
The Public-Private Divide in Serbian Pharmacy
The competition between public and private pharmacies in Serbia reveals deep systemic challenges. Private pharmacies often attract more customers through better accessibility, consistent medication availability, and extended operating hours. This creates a two-tier system that undermines equal access to healthcare.
The current system places public pharmacies in an untenable position. They must fulfill their public health mission - including operating in less profitable areas and providing educational opportunities for pharmacy students - while competing with private pharmacies that can focus solely on profitability. The students propose a solution that would level this playing field: “Clear criteria for opening new pharmacies must be equally applied to both public and private institutions, which would ensure more economical operations and better service accessibility.”
Recognising that private pharmacies will focus on profitable locations and services, the students insist that public pharmacies must maintain their broader social mission, including operating in less profitable areas and providing educational opportunities for pharmacy students.
Professional Exodus and Salary Challenges
The pharmaceutical sector in Serbia faces a critical staffing crisis. Public pharmacists typically earn between 80,000 and 100,000 Serbian dinars (RSD) per month (approximately 680-850 EUR), with Belgrade pharmacists averaging around 80,000 RSD monthly.
These salary levels contribute to a severe brain drain in Serbia’s healthcare sector. The Union of Doctors and Pharmacists of Serbia reports a shortage of approximately 13,000 medical workers across various specialties. Even more alarming, studies suggest that without increased emigration over the past decade, Serbia would have 50% more healthcare workers today. The United Nations predicts Serbia’s population could decline by over 15% by 2050, with professional exodus being a significant factor.
The students’ proposal partially addresses these challenges through its emphasis on professional development and improved working conditions. “Strengthening the pharmaceutical sector through employee education, institution accreditation, and quality system implementation would contribute to raising service standards,” their declaration states, recognizing that retaining qualified professionals requires both better compensation and enhanced professional opportunities.
Expanding the Role of Public Pharmacies
The students’ vision for public pharmacies goes beyond their traditional role of medication dispensing. They propose a significant expansion of pharmaceutical services that would both improve public health outcomes and strengthen the financial viability of public pharmacies.
“The Master of Pharmacy, beyond supplying and dispensing medical drugs and supplies, plays a vital role in implementing preventive measures for preserving, protecting, and advancing public health,” the students emphasize. Their proposal includes:
1. Preventive Health Services: Enabling pharmacists to take a more active role in public health prevention programs
2. Health Education: Utilizing pharmacies as centers for public health education and awareness
3. Primary Care Support: Expanding the scope of basic health services that can be provided at pharmacies
4. Monitoring and Follow-up: Allowing pharmacists to play a larger role in medication management and patient monitoring
This expanded role would be supported by financing from tne public health budget, ensuring that these additional services would be accessible to all citizens, not just those who can afford to pay out of pocket.
The students argue that this evolution in pharmaceutical care would serve multiple purposes:
– Improve access to basic health services, particularly in underserved areas
– Reduce the burden on other healthcare facilities
– Create additional revenue streams for public pharmacies
– Better utilize the professional expertise of pharmacists
A Model for Public Healthcare Reform
The striking students’ proposal represents more than just a response to privatization - it offers a model for preserving and strengthening public healthcare institutions. As they conclude from their occupied, semi-heated amphitheaters, “These measures are necessary for building a modern and efficient state pharmacy system that will respond to Serbian citizens’ needs and ensure equal access to quality pharmaceutical services.”
Their initiative demonstrates how academic expertise can be mobilized to address pressing social issues. While the immediate focus is on pharmacy services, the principles they advocate - centralization for efficiency, maintaining public access, and professional development - could inform reforms in other areas of Serbia’s healthcare system.