with a focus on emergency trauma care and is closely integrated into regional emergency rescue services. While the medical treatment provided in a Bundeswehr hospital is the same as in a civilian hospital, there are differences when it comes to organisation and personnel structures. At Ulm Bundeswehr Hospital, civilian and military staffs work side by side. Figure 1: Bundeswehr Hospital Ulm7.
production facility in Ulm to ensure the supply of Bundeswehr members in mission areas under special threat scenarios as well as in case of large-scale emergencies and natural disasters. The Bundeswehr Hospital Pharmacy Ulm is the only pharmaceutical production facility of the Bundeswehr where medicinal products are manufactured on an industrial scale. It is not objective of the Bundeswehr to compete with the pharmaceutical industry. Instead, the aim is to manufacture mission-relevant medicinal products that are, or may, not be commercially available. Available capabilities consistently focus on manufacturing pharmaceutical products for crisis scenarios. The focus on crisis scenarios, however, requires increased flexibility in responding to unexpected requirements arising on short notice. This applies to antidotes to chemical warfare agents as much as what is considered to be standard antibiotics. Even their availability cannot be taken for granted anymore due to supply shortages.
The three main tasks of the Pharmacy, situated close to the Bundeswehr Hospital Ulm, are to manufacture pharmaceutical products, to ensure the supply of pharmaceutical drugs and medical devices, and to take care of all activities which may be summarized as pharmaceutical services. For this purpose, a new state-of-the-art pharmacy building was constructed between 1999 and 2004 in which some 2,500 different items are currently kept in stock. Provision and production of pharmaceutical products as well as pharmaceutical advice are the main benefits of a pharmacist in the past, but also today and presumably tomorrow. The following article will try to give an answer to the question of whether manufacturing and supplying a hospital with pharmaceutical products under one roof as practiced in Ulm is a challenge or a contradiction. Figure 2: Pharmacy of the Bundeswehr Hospital Ulm7.
Military requirements typically arise on short notice. At the same time, the Bundeswehr is competing with civilian customers. As a result, procurement cannot be initiated in time to reliably meet those requirements. This makes it rather evident why the local production of antidotes and other products is indispensable, for example in view of potential chemical or biological attacks. Antibiotics are produced for prophylaxis against and treatment of potential weapons-grade biological pathogens ("di rty dozen").
The production site cannot act without the consent of the Federal Ministry of Defence and the superior agency, the Bundeswehr Medical Service Headquarters. A ministerial decree authorizes the production at the pharmacy. It also determines the product portfolio of pharmaceutical products for crisis scenarios at present and in the foreseeable future. This formulary is a living document that is reviewed and adapted to new parameters on a regular basis. The Bundeswehr Hospital Pharmacy Ulm is subordinate to the Ministry and the Headquarters, performing tasks that, in many ways, resemble those of a contract manufacturer. Decisions on the type of product, volume, and production date are not made by the manufacturer, but the Ministry of Defence and the Bundeswehr Medical Service Headquarters, taking strategic, military medical and military pharmaceutical aspects into account.
∑ Colonel, Pharmacy Director, Bundeswehr Hospital Ulm.
Why does the Pharmacy in Ulm manufacture medicinal products for the Bundeswehr?
The Bundeswehr Joint Medical Service operates the
Correspondence: Dr. Roger MÜLLER-PFAFF Bundeswehr Hospital Ulm, Oberer Eselsberg 40, D 89081 Ulm, Germany E-mail: email@example.com * Presented at the 4th ICMM Pan-E