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Brazil is a vast country with a total surface area of 8.5 million km2, covering 47% of South America.1 It is the fifth most populous country in the world, with a population estimated at more than 207 million in 2015.2 The country is divided into 5 regions encompassing 26 states, 1 Federal District (Brasília), and 5570 municipalities. Brazil is a country of continental dimensions, and plenty of diversity exists with regard to both human development and the health needs of its population. The states with the largest areas have low population densities because of environmental issues, such as a high concentration of rivers and wetlands, which hinder settlement; furthermore, the provision of health care services is a challenge because of population dispersal.3 This variability also affects the pharmaceutical practices and profiles of pharmacies (Figure 1). In this context, this article presents information about pharmaceutical practice in Brazil and how it is organized, according to the “building blocks” of the World Health Organization's Health Systems Framework. Over the past few decades, the demographic and epidemiological profiles of Brazil have changed. Currently, the country’s profile is similar to those of other developed countries. In 1991, the average life expectancy at birth was 66.9 years; by 2013, this value had increased to 78.5 years for women and 71.2 years for men.4 Similarly, infant mortality rates have decreased by 70.7% over 25 years. Birth rates have also decreased by 39.3%, from 23.4 per thousand in 19915 to 14.2 per thousand in 2013.6 Today, the Brazilian population is experiencing a double burden of disease, related to both noncommunicable and communicable diseases. As the epidemiological transition begins, noncommunicable diseases are starting to replace communicable diseases; however, infectious conditions continue to be highly prevalent in the country.7,8 In Brazil and other countries, a high burden of noncommunicable diseases exists, accounting for 72% of all deaths.9 The major causes of death include cardiovascular disease (30.7%), cancer (16.9%), external causes (13.4%), and respiratory disease (11.6%).5 The death rates due to infectious diseases were 6.2% in 1990 and 4.5% in 2011. Improvements in access to basic sanitation services, the development of new technologies, and the expansion of access to health care services are some of the interventions responsible for this reduction.5

Pharmacy in Brazil: Progress and Challenges on the Road to Expanding Clinical Practice