The public notice issued by the Directorate of Health & Family Welfare, Nagaland, mandating the appointment of registered pharmacists in pharmacy outlets reflects an important and commendable effort to strengthen public healthcare standards. Ensuring that medicines are dispensed under the supervision of qualified professionals is a necessary step toward patient safety, reducing drug misuse, and improving healthcare delivery. However, while the objective of the policy is both necessary and well-intentioned, an equally important question demands attention: Is Nagaland presently equipped to implement such a mandate uniformly across the state? Policies designed to improve healthcare must not only be legally sound but also practically achievable. In a state where healthcare infrastructure, workforce availability, and geographic challenges remain significant concerns, immediate enforcement without adequate preparation may unintentionally create hardships for the very citizens the policy seeks to protect. The discussion, therefore, should not be about opposing reform, but about ensuring that reform is introduced in a realistic, balanced, and sustainable manner.
The Core Issue: Shortage of Qualified Pharmacists
The primary problem is not unwillingness from pharmacy owners to comply with the law. The real issue is the severe shortage of qualified pharmacists (B.Pharm and D.Pharm holders) available in Nagaland. The seriousness of the manpower shortage is reflected in official data itself. Citing the February 2025 report from the department, Nagaland currently has 1157 Pharmacies operating across the state, but only 278 registered pharmacists of which 252 are government employed and only 26 are available. This enormous gap clearly demonstrates that full compliance, at present, is practically impossible under existing circumstances. Further, reports have also indicated that approximately 300 pharmacists may currently be unemployed in the state. At first glance, this may appear to suggest that sufficient manpower exists. However, a closer examination of the numbers presents a different reality. Even if all 300 unemployed pharmacists were immediately absorbed into the system, combining them with the existing 26 registered pharmacists would bring the total to approximately 326 pharmacists. This still falls far short of meeting the needs of the state’s 1,157 operating pharmacies. In practical terms, more than two-third of Nagaland’s pharmacies would still remain without qualified personnel. Moreover, manpower availability on paper does not always translate into manpower availability on the ground. Several factors influence actual deployment, including location preferences, salary expectations, accessibility, family responsibilities, housing availability, and the willingness of professionals to work in remote areas with limited infrastructure. The issue, therefore, is not merely the existence of unemployed pharmacists; it is whether there is an adequate and realistically deployable workforce to meet state-wide demand. This is why the present challenge should not be viewed by the department as a question of repeated notices or unwillingness to comply with regulations. The central issue remains the shortage and uneven distribution of qualified pharmacists within Nagaland. Pharmacy owners cannot appoint professionals who are simply unavailable or inaccessible in sufficient numbers.
Therefore, immediate strict implementation may punish pharmacy owners for a problem rooted not in negligence, but in systemic shortages and infrastructural limitations.
Rural Nagaland Will Be the Worst Affected
If strict enforcement leads to closure of pharmacies in remote areas:
In areas where transportation remains limited and unreliable, travelling to the nearest medical hub to purchase even basic medicines would involves significant transportation cost, long travel hours, and loss of daily wages for rural citizens.
Emergency access to medicines for fever, infections, BP, diabetes, asthma, and child illnesses may become difficult.
Elderly patients and economically weaker families will suffer the most.
Areas already lacking doctors and hospitals may become completely dependent on distant towns. In many rural areas, local pharmacies are often the first and only point of healthcare access for common illnesses. Closing them overnight without providing alternatives could create greater harm than the problem the order seeks to solve. A Good Policy Implemented Too Early Can Become Counterproductive There is no disagreement that medicines should ideally be dispensed under the supervision of qualified pharmacists. That is the global standard and Nagaland should move in that direction. However, policies must also consider:
Ground realities
Resource availability
Geographic challenges
Existing healthcare gaps A policy can be legally correct yet practically premature. When implementation outpaces infrastructure and manpower availability, the burden ultimately falls upon ordinary citizens. Why the Government Should Consider another 4–5 Years Transition Period Instead of immediate punitive action and closures, the government should adopt a phased implementation strategy. A reasonable transition period of 4–5 years would allow:
The government to build a proper workforce database and adopt a phased implementation strategy.
More students to complete D.Pharm and B.Pharm courses.
Rural healthcare systems time to adjust gradually.
Pharmacy owners sufficient time to find and recruit licensed pharmacists.
Small pharmacies to financially prepare for increased staffing requirements. A phased approach would achieve compliance without disrupting public healthcare access.
Suggested Practical Solutions Rather than immediate closure or legal action, the government can consider the following balanced measures:
- Phased Enforcement
Enforcement in major urban centres and towns in 6 -12 months. Gradual enforcement in rural and remote areas over 4–5 years. - Rural Relaxation Policy
Temporary exemptions or conditional licenses may be granted to pharmacies operating in: Remote villages Difficult terrain Areas with no nearby medical facilities Lack of/Unreliable transportation - Mandatory training programs until adequate pharmacists become available: Existing pharmacy operators can undergo certified short-term training programs. Regular inspections and monitoring can be strengthened.
- Expansion of pharmacy education
The state should actively:
Increase pharmacy seats
Encourage local youth to pursue pharmacy education
Provide scholarships and incentives - Incentives for Pharmacists
The government may encourage pharmacists to work in rural areas through:
Salary support
Rural service incentives
Accommodation assistance
Special allowances Pros of the Order The order does have several important long-term benefits:
Ensures safer dispensing of medicines
Reduces misuse of antibiotics and prescription drugs
Improves professionalism in pharmacy practice
Creates employment opportunities for pharmacy graduates
Strengthens public trust in healthcare systems
Aligns Nagaland with national healthcare standards These objectives are necessary and beneficial. Cons of Immediate Enforcement However, immediate strict implementation without adequate manpower may lead to:
Closure of numerous pharmacies
Medicine shortages in rural areas
Reduced healthcare access
Increased burden on already overstretched hospitals
Growth of illegal or unregulated medicine supply chains
Hardship for poor and remote communities In attempting to solve one healthcare issue, another larger crisis may emerge. Public Welfare Must Remain the Highest Priority Healthcare policies must balance regulation with accessibility. A pharmacy operating imperfectly in a remote village may still be better than having no access to medicines at all. The ultimate objective of any healthcare regulation should be:
Patient safety
Medicine accessibility
Gradual system improvement
Sustainable implementation Sudden enforcement without adequate preparation risks weakening healthcare access in the very regions that are already underserved. Conclusion The Drugs Control Authority deserves appreciation for attempting to improve pharmacy standards in Nagaland. The vision behind the order is correct and necessary for the future. However, reform must be introduced in a manner that does not unintentionally punish the public, especially those living in remote and vulnerable areas. Nagaland first needs:
Adequate numbers of trained pharmacists,
Better healthcare infrastructure,
Stronger rural support systems, before such regulations can be uniformly enforced state wide. A phased implementation period of at least 4–5 years would be a far more balanced, humane, and practical solution — one that protects both public safety and public access to essential medicines. The goal should not merely be enforcement of rules, but strengthening healthcare delivery for every citizen of Nagaland, regardless of geography.
Vilhoubeizo
Dimapur