Pharm. Ahmed I. Yakasai, FPSN, on the occasion of a courtesy visit to his excellency President Muhammadu Buhari, GCFR, on Thursday, 7 April, 2016
It is my privilege and honour to lead this delegation of the Pharmaceutical Society of Nigeria to your office on this auspicious occasion. On behalf of my colleagues, I wish to thank you immensely for granting us this audience.
The Pharmaceutical Society of Nigeria was founded in 1927 and registered under Section 21 of the 1922 Companies Act. It is the umbrella body of all the registered pharmacists in Nigeria with a vision to be recognised as a society whose members are accessible health care professionals responsible for the provision and rational use of safe, effective and affordable medicines, pharmaceutical care and the promotion of public health and quality of life.
This visit affords us an opportunity to interact with you and share our humble perspectives on the role that the pharmaceutical sector can play in national development, when carefully harnessed.
We shall also bring to your notice our thoughts on some contemporary issues, especially as it relates to healthcare delivery. These include:
- The continued instability in the health sector and the National Health Act 2014.
- Critical issues affecting Nigerian pharmaceutical manufacturers.
- Implementation of Pharm.D (Doctor of Pharmacy) programme.
- Implementation of NHIS.
- Reconstitution of the Pharmacists Council of Nigeria and Boards of Teaching/Specialist Hospital.
- Welfare of health workers in Nigeria.
- The Continued Instability in the Health Sector and the National Health Act 2014.
For a comprehensive, coordinated, safe health system that is responsive to the needs of the population, efficient use of resources, increased job satisfaction, with reduced stress and burnout of health professionals, we need collaborative practice, based on trust and mutual respect amongst the health care team.
Internationally, the World Health Professions Alliance (WHPA) brought together the International Pharmaceutical Federation, the World Medical Association, the International Council of Nurses, the World Dental Federation and the World Confederation for Physical Therapy for collaborative practice. It is possible to achieve the same goal in Nigeria when the federal government plays its much expected stabilisation role by insisting each player restricts his latitude to his area of due competence. Government must insist on allowing the rule of law to take roots by showing the way on how the law rules at all times.
Again, the full implementation of the National Health Act (NHA) 2014 will go a long way in stabilising the health sector. It is important to put on record that the NHA 2014 is probably the only statute that attracted the attention of a wide spectrum of stakeholders in health and the larger society.
Some pressing challenges in the health sector which have lingered for so long compel a dire need to appeal to Your Excellency to urgently look into the problems.
- Non employment of graduates of Pharmacy into federal tertiary hospitals as intern pharmacists or as registered pharmacists. Even federal health institutions in the catchment areas where pharmacy graduates are trained often times refuse to employ them.
- The attitude of the management in some of the federal health institutions is a major let down. Often times the Drug Revolving Funds which is a creation of the Essential Drug Act are decapitated because the funds are diverted to other endeavours, which is a violation of the Drug Revolving Funds manuals and guidelines in the enabling statute.
The Pharmaceutical Society of Nigeria finds it necessary to inform you on the viability of well-managed Drug Revolving Funds in public health institutions, as witnessed in public health facilities like the Pharmacy Department at the National Orthopaedic Hospital, Igbobi, Lagos.
- The federal government should make conscious effort to adhere to enabling statutes of various regulatory agencies in the health sector to avoid stress junctions and other disruptions in equilibrium.
At this point, the Pharmaceutical Society of Nigeria must seize the discourse to specially congratulate Your Excellency for your disposition to shun privatisation/commercialisation of public health facilities which would have derailed good and impactful health care in Nigeria.
- Critical Issues affecting Nigerian pharmaceutical manufacturers
The critical areas where Nigerian pharmaceutical manufacturers need robust engagement with the government aggregate in three main areas. These include:
- Priority status
The PSN wishes to commend the efforts of the Federal Ministry of Health in initiating a Drug Distribution Guideline for the country which offers a major opportunity in sanitising the chaotic drug distribution channels and by extension curtail the problem of fake and counterfeit pharmaceutical products in our system. The PSN, PCN, NAFDAC and FMOH have worked maximally on this project and we strongly urge the government to sustain the spirit in the current dispensation.
- We urge government to issue a policy directive for all government health care establishments to patronize pharmaceutical products manufactured in Nigeria for all Essential Medicines’ tenders and purchases. The Nigeria Drug Policy provides that 70 per cent of government purchase should be sourced from local manufacturers.
- We also humbly request the payments of longstanding debts owed to the industry, to reverse the current negative impact on the industry.
- Ecowas Common External Tariff (CET)
The implementation of ECOWAS CET which allows finished pharmaceutical products to be imported at zero percentage duty is a good gesture and same should be extended to raw and packaging materials which now attract a duty percentage ranging from five per cent to 20 per cent. This means that locally manufactured pharmaceutical products have become uncompetitive. The fall out is an imminent closure of all Nigerian pharmaceutical plants. We urge government to intervene on this critical issue.
- Implementation of Pharm.D (Doctor of Pharmacy) Programme.
Your Excellency, the draft Benchmark Minimum Academic Standards (BMAS) document for the Pharm. D degree which is clinical pharmacy as patient-oriented degree, is currently receiving final inputs at the National Universities Commission for eventual consideration of the Federal Executive Council through the Honourable Minister of Education. The FEC’s blessing of the document will bring the pharmacy training to same standards with what generally obtains all over the world, which is patient-centric.
- Implementation of NATIONAL HEALTH INSURANCE SCHEME (NHIS)
In the spirit of the broad spectrum of reforms, there is no reason why for six years now the NHIS encourages unlawful payment mechanisms, dubbed global capitation, while HMOs also capitate secondary and tertiary facilities which utterly disrupts the equilibrium of the health system.
We demand that the Federal Government direct the board and management of the NHIS to immediately adopt lawful payment mechanism to wit, capitation for primary providers and fee for service for secondary and tertiary providers.
Government must also redress the capitation modes by embracing international global best practices on what constitutes a primary facility for capitation in Nigeria.
- Reconstitution of the Pharmacists Council of Nigeria and Boards of Teaching/Specialist Hospital
Your Excellency, we do not wish to bore you with all the tragedies associated with the constitution and operations of the Pharmacists Council of Nigeria in a particular dispensation, specifically between 2009 and 2011.
In the short time we have had to run without a governing council, we have tried very hard to sustain the ideals of pharmacy practice in Nigeria. Fundamentally, disciplinary matters and accreditation of pharmacy facilities for training suffer in the absence of Council.
We urge Your Excellency to approve the immediate reconstitution of the Pharmacists Council of Nigeria. The Pharmacists Council of Nigeria is the regulatory agency of the federal government that regulates and controls pharmacy practice in all its aspects and ramifications in Nigeria. This gives it a specific approbation in law to register all cadres of premises where drug endeavours take place. Our concern remains that anything that disrupts full implementation of the Pharmacists Council of Nigeria mandate makes consumers of health vulnerable to the fake drug syndrome.
In the same vein, it is pertinent that we inform Your Excellency about the lopsidedness of appointments on the boards of teaching and specialist hospitals, as well as federal medical centres. In the last dispensation, pharmacists were represented on only five of the well over 55 boards of these federal health institutions. Our experience confirms that this lopsided appointment format affects health care plans and ultimately overall output. We therefore reiterate our previous appeal that at least one pharmacist be appointed on each of the boards of our federal health institutions.
- Welfare of Health Workers in Nigeria
It is pertinent to mention that we have valid court judgments, collectively bargained agreements, Memoranda of Understanding (MOUs) and even circulars signed with government which have remained implemented on a haphazard or discretionary basis by the federal health institutions, such as the following:
- Implementation of the spirit of the existing circular on promotion of our members from CONHESS 14 to 15 as directors which places premium on the need to sanction defaulting hospital managements.
- Specific steps must be taken by the Head of Service of the Federation to ensure the expedited issuance of an enabling circular authorising consultancy cadre for health professionals that have adhered to due process, to be vested with consultancy status, as a prelude to inculcating this cadre into the schemes of service of these health professionals. This must be worked out with the Federal Ministry of Health in line with the spirit of the circular on consultancy and specialist allowances Ref. SMH.491/S.2/VOL II.221 of 29 March, 1976, which authorises consultancy status for all health professionals, and the condition precedent of the National Industrial Court of Nigeria (NICN) that provides for a nod of the Federal Ministry of Health for the appointment of consultants.
iii. Payment of arrears of specialist allowances to qualified hospital-based health professionals, with effect from January 1, 2010, should be ensured.
- Full payment of arrears of the skipping of CONHESS 10 which remains outstanding since the year 2010.
- Release of the circular on adjustment of salary since January 2014 and immediate payment of at least two months arrears, while the balance is accommodated with proven evidence in the 2016 budget. This particular subject matter has lingered for some time, with threats of strike by health workers which was averted by the skills of Late Barrister Ocholi, the former Minister of State for Labour. Your Excellency, I appeal that in tandem with your progressive change mantra, that you facilitate immediate approval of this request.
- Sponsoring an amendment bill to correct the anomalies in Decree10 of 1985 (CAP U15 463) LFN 2004, especially in the following areas:
(a) LOPSIDED COMPOSITION OF THE BOARD OF MANAGEMENT
(b) APPOINTMENT OF CHIEF EXECUTIVE OFFERS (CEOs) OF FEDERAL HEALTH INSTITUTIONS
(c) APPOINTMENT OF CHAIRMAN MEDICAL ADVISORY COMMITTEE (C-MAC)
(d) APPOINTMENT OF DEPUTY CHAIRMAN MEDICAL ADVISORY COMMITTEE (C-MAC)
(e) TRAINING OF HEALTH PROFESSIONALS
(f) REMOVAL OF THE BORDERS OF RESTRICTION ON PERMANENT STAFF OF FEDERAL HEALTH INSTITUTIONS
Lastly, we find it imperative here to appeal to Your Excellency to redress the defects in the appointment of the Director General of NAFDAC in the immediate past dispensation. For the records, Your Excellency, the condition precedent to be appointed as Director General of NAFDAC is that eligible candidates must have a good knowledge of Pharmacy, food and drugs. Pharmacy is globally rated as a frontline profession. It is therefore logical to conclude, like the Office of the Attorney General and Minister of Justice did in 2001, prior to the appointment of Late Prof. Dora Akunyili, that only a registered pharmacist can meet the provision in Section 9 of the NAFDAC Act which unambiguously spells out the eligibility criterion for a prospective Director General of NAFDAC.
Your Excellency, we wish to convey our appreciation for your approval of this courtesy call. We have followed your progressive stride which is a flow of your rich antecedents and have no doubt that the ship of the state is headed for the right direction. We assure Your Excellency that we shall strive to evolve an invincible bilateral consortium with this administration in its march to reposition Nigeria in the comity of decent nations.
Thank you and may God bless Federal Republic of Nigeria.