The role of pharmacists and pharmacy team members in the prevention, preparedness, response and recovery of outbreaks – a global rapid systematic review

Background Pharmacists and their teams can undertake pharmaceutical public health roles during outbreaks within the World Health Organization (WHO) emergency cycle of prevention, preparedness, response, and recovery. These may be at micro- (individual), meso- (regional or organisational) or macro- (national) levels. The primary outcome was to identify pharmacy team members' roles in outbreaks (excluding COVID-19) and classifying these within the WHO emergency cycle and intervention level. Methods We conducted a rapid systematic review (PROSPERO: CRD42024617152) in Embase, Medline, and SCOPUS databases including articles published from 2014 to Feb 2025. After duplicate removal, titles/abstracts and full texts were screened, extracted and assessed for bias by one reviewer, with 10% second-checked. Thematic synthesis was used and described narratively to reflect variability in the studies. Results From 161 articles across all WHO regions, 145 distinct roles were identified. Most were in the response stage (46%), followed by prevention (29%), preparedness (15%), and recovery (10%). Roles were primarily at meso-level (37%) and micro-level (35%), with fewer at macro-level (28%). About 34% of articles reported contributions to reducing health inequalities. Reported barriers were clustered into five themes: knowledge/training gaps, regulatory restrictions, resource and infrastructure constraints, communication issues, and cultural factors. Conclusion Pharmacy team members have key roles during non-COVID outbreaks across all stages of the WHO emergency cycle and at all levels. However, their expertise remains underutilised in recovery, and macro-level interventions. Integrating pharmacy roles into emergency frameworks, supported by regulatory reform, sustainable funding, and training, is essential to strengthen health system resilience.