Mega LifeSciences Nigeria Limited, a research based pharmaceutical multinational, has launched prostacare into the Nigerian market for the treatment of benign prostatic hyperplasia (BPH) symptoms in men.
Unveiling the drug at the Lagos office of the company on 8 October, 2014, the Product Manager, Pharm. Ifeanyi Offor emphasised the importance of Prostacare to every man, noting that one in every four normal Nigerian men from the age of 40 has the likelihood of developing BPH.
He described BPH as a disease of the prostate gland, characterised by benign enlargement of the prostate tissues causing difficulties in urination.
Quoting a report released by WHO in 2012, which placed the average life expectancy of Nigerian men at 53, Offor said more Nigerian men would be living with BPH symptoms.
He further explained that though BPH is not always a life threatening condition, it has tremendous negative impact on the quality of life of the patient.
Offor further noted that while some individuals consider the cost of treating BPH as prohibitive, the desease, if not detected and treated in good time, could lead to other complications such as severe urinary tract infections; bladder disease and obstruction of urinary tubules; and sexual dysfunction or acute urinary retention.
“Early detection is key to successful treatment”, he stressed.
Explaining the uniqueness of the newly launched product, the product manager said Prostacare is the only officially registered Saw palmetto brand with NAFDAC approval in Nigeria, and it contains lipophylic extract of Saw palmetto 320mg per capsule.
He noted that Saw palmetto is the most popular, effective and safe phytomedicinal agent used in the treatment of BPH since the late 19th Century.
On the usage of Prostacare, Offor said the drug “inhibits the action of a male hormone called dihydroxytestosterone (DHT) in the prostate tissue. Scientists believe that the action of DHT in the prostrate is responsible for prostate enlargement. Some conventional BPH drugs like Finasteride and Dutasteride also work this way. Also, Prostacare has been reported to relax the muscles of the prostate and bladder, helping to ease the flow of urine. For effective treatment, one capsule should be taken daily after meal with sufficient water, as relief in symptoms is seen after two weeks of continuous use,”
Describing the manufacturing practices of the company, Offor stated that Prostacare is manufactured in Thailand by Mega LifeSciences Public Company Limited and marketed and distributed in Nigeria by Mega LifeSciences Nigeria Limited, adding that Mega LifeSciences has two state-of-the-art manufacturing facilities in Thailand and Australia which are WHO approved manufacturing facilities.
On the safety of Prostacare, Offor said, “Prostacare is quite safe and highly tolerable. Prostacare does not have the significant side-effect of erectile dysfunction, delayed ejaculation or anorgasmia and cardiovascular side effects found in the conventional BPH drugs. Rarely, mild stomach disturbances like nausea can occur. No serious drug-drug interactions have been reported with Prostacare”, he assured.
He however advised patients to confirm from their pharmacist whenever in doubt of any medication.
While admitting the possibilities of patients confusing the disease for other infections, Offor advised community pharmacists, who are often the first port of call in the community for most health complaints, to be careful in handling such cases and make appropriate referrals since early detection is very crucial in the management.
“In severe lower urinary tract symptoms with much enlarged prostate volume, surgical intervention is recommended. The commonest surgical procedure is Transurethral Resection of the Prostate (TURP), where a surgical instrument is used to remove part of the prostate tissues. Studies have shown that 5 to 10 per cent of the patients undergoing TURP have erectile dysfunction and about 10 per cent of the men will have the procedure repeated after five years”, he said.
Also speaking with Pharmanews in an exclusive chat on BPH, Dr Rufus Ojewole, a consultant urologist at the Lagos University Teaching Hospital (LUTH), stated that the most important factor in the development of BPH is age.
“In men, prostate gland begins to increase in size in the fifth decade of life and continues to increase in size with increasing age. BPH is rare before middle age and very common after that. In fact, it is the most common clinical condition in ageing men,” he noted.
Ojewole, who said there was no specific data on the exact burden of prostate enlargement in Nigeria due to the paucity of community-based studies on clinical entity, however rated the prevalence of the condition very high in the country, according to hospital based studies.
On the symptoms of prostate enlargement, the urologist said this could manifest in two ways: asymptomatic and symptomatic. He defined asymptomatic BPH as an enlarged prostate without clinical manifestation or symptom, which could be called histological BPH. Digital Rectal Examination (DRE) and Ultrasound (US) imaging of the prostate gland usually detect this. It therefore means that someone may have an enlarged prostate and yet, no symptoms.
He added, on the other hand, that “when symptomatic, benign prostatic enlargement commonly manifests with various difficulties in passing urine, which nowadays is termed Lower Urinary Tract Symptoms (LUTS). LUTS is sub-divided into irritative (storage), obstructive (voiding) and post-void symptoms.
“Irritative symptoms are urinary frequency, nocturia, urgency and urge incontinence. Voiding symptoms consists of hesitancy, weak stream, straining and intermittency while post-void symptoms consist of feeling of incomplete bladder emptying and terminal dribbling.
“These symptoms may progressively worsen over time and culminate in episodes of acute or chronic urinary retentions, which are painful and painless inability to pass urine respectively. Other symptoms are haematuria, weak erection and symptoms suggestive of urinary tract infections like fever and supra-pubic pain”, he elucidated.
Ojewole also stated that some symptoms may occur due to complications of the disease, usually from lack of treatment or delayed/inadequate treatment. He listed these to include: facial puffiness; leg swelling; hiccups and vomiting, as seen in patients who develop renal failure from the obstruction caused by the prostatic enlargement. Others are loin pain, hernias and painful swollen testicles from infection (Epididymo-orchitis).
The urologist however emphasised that benign prostatic enlargement does not lead to prostate cancer, noting that prostate cancer may co-exist with BPH. Thus, he recommends thorough evaluation of enlarged prostates by urologists, who will utilise various tools, including Prostate Specific Antigen (PSA), DRE and Transrectal Ultrasound (TRUS), to arrive at accurate diagnosis.
He added, on a gloomy note, that as long as aging is inevitable, prostate enlargement is not preventable because it comes along with age advancement in men.
He therefore urged men to visit their caregivers, preferably urologists, for prostate check, noting that this will afford them the opportunity of early treatment of BPH and, more importantly, allow early detection with potential cure.
“As a matter of fact, all men should see a urologist annually from the age of 50years for prostate check whether symptomatic or not,” he counselled.
As community pharmacists in the country look forward to the next national conference of the Association of Community Pharmacists of Nigeria (ACPN), holding in Akure, Ondo State, next year, National Chairman of the association, Pharm. (Alh) Olufemi Ismail Adebayo, has assured members of a more improved conference. Speaking in an exclusive interview with Pharmanews in his office, the pragmatic leader also revealed some of the achievements, as well as challenges of his administration, as he prepares to hand over to the next leadership at the forthcoming conference. Excerpts:
Tell us some of your achievements and challenges since you became the national chairman of ACPN.
Regarding our achievements, we have been able to bring ACPN into limelight through our various activities.We are now more visible, as we have been able to advertise the pharmacy emblem which is our symbol as community pharmacists to the people through various journals, educating them on the need to purchase their drugs from only registered pharmacists.And I am happy that the campaign is yielding good fruits as people are now enlightened and informed.
Secondly, we have been able to create a database for the association.It is already established and we have successfully signed a Memorandum of Understanding (MoU) with Globacom at the last national conference in Ilorin, Kwara State.
We have also been able to work cordially with our parent body, the Pharmaceutical Society of Nigeria (PSN). Presently,our parent body is an active member of JOHESU, which is a body for all healthcare professionals in the country. We are also on the lookout for a more befitting national secretariat for the association and, hopefully, something will happen soon.
The major challenge that I faced when I assumed office was the issue of finance, because funding an association that is non-governmental like this is always a challenge.But I want to appreciate my members for the trust they had and still have in me, especially when we increasedour capitation by hundred percent. The capitation had been the same for more than seven to eight years, since around 2006, without consideration for increase in the cost of living and even cost of travelling around and outside the country, which, as a national chairman, I cannot do without. So I appreciate them for bearing with us on the increment of our capitation and I am assuring them that I will not renege on my promise that the money will be judiciously used and that their welfare will be paramount in our hearts.
We also appreciate the efforts of the various companies that have always been there for us during our national conferences and major events – not only pharmaceutical but also telecom companies.If not for them, maybe we would have been running the association at a loss.
What positive changes should community pharmacists in the country expect at the next national conference in Akure?
We’ve always believed at the ACPN national office that every conference should come with a difference and, coincidentally, the next conference will be my last conference as the national chairman of ACPN.So we promise that there is going to be innovations, new ideas and better improvements on the last conference in Ilorin.
It has been our practice that, as soon we are through with a certain conference, we reappraise the event, and we try, as much as possible, to improve on it.So I promise my members that this is going to be a conference with a difference. And, being an election year, we want members to turn out enmasse to elect a good and pragmatic leader of their choice. Every vote counts; and we promise that the election will be free and fair.
We have taken note of the challengeswe had at the last conference, even though it was an improvement on the 2013 edition in Calabar. And we promise that we are still going to have more improvements.
What grey areas in the profession do you think stakeholders at the conference need to address?
The grey area that I want us to focus on is the issue of unity among pharmacists. We have technical groups, which involve the community pharmacists, the hospital and administrative pharmacists, the industrial pharmacists and pharmacists in academia.We should all live as one big family because we all have our various roles to play.If any of the technical groupshas a problem, it should be shared by all because we belong to the same profession.
Also, the National Drug Distribution Guidelines is one programme that, if well implemented, will solve the problem of fake and counterfeit drugs in the country. All pharmacists should support it and ensure it is well implemented so that it will benefit the professionals, as well as the general populace.
What is your general view of the current state of the healthcare sector?
We are happy that the society is now aware that there are other professionals, aside medical doctors, in the healthcare sector.I believe healthcare should involve team work, because everybody has his or her own role to play, and the focus should be the patient.Until this is done, we will still witness a lot of wrangling and unnecessary rivalry.
In this recent interview with Pharmanews, Managing Director and Superintendent Pharmacist of Victory Drugs, Festac Town, Lagos ,Pharm. Folasade Olufunke Lawalbares her mind on the happenings in the pharmaceutical industry and why she thinks pharmacy practice has progressed over the years. Excerpts:
How long have you been in the practice and how did it all begin?
Victory Drugs was established on 6 May, 1989 out of passion for a practice that would please God and be maximally beneficial to mankind, a patient-focused healthcare delivery. I graduated from the University of Ife (now Obafemi Awolowo University) in 1985 with a Bachelor of Pharmacy degree. I later got a master’s degree in Clinical Pharmacy in 2006 from the University of Lagos.
While in secondary school, my strength was in the sciences, with Mathematics being my best subject. I was caught between studying Mathematics and a medical sciencescourse. My closeness to my maternal grandfather, a herbal medicine practitioner, drew me closer to the medical sciences than to Mathematics. However, the thought of working in a hospital as a medical doctor was unappealing. In our day, pharmacy profession was very unpopular -so little was heard or known of pharmacists. However, I got to know more about Pharmacy through my secondary school classmate and close friend, Remi Oladeji.
I had my internship training at a community pharmacy and did my National Youth Service programme at a government hospital. Thereafter, I worked in a private hospital for one year. In none of these places was I able to express my passion the way I wanted to. So I took the bull by the horn and started my own retail pharmacy with about N7,500, for furniture and stock, and by God’s grace, we have evolved, over the years, to a standard retail pharmacy. The journey was tough but the Lord was, and is still on our side.
Tell us about some of the challenges you have faced in your practice and how they were tackled
Having practised as a community pharmacist in Victory Drugs for over25 years, challenges faced by me and my teamhave been enormous, but I will briefly enumerate the major ones.
Lack of adequate and regular supply of electricity is number one and, to overcome this, we have had to get generator sets and inverters. This, of course, results in very high running costs which cannot be passed on to clients.
Insecurity is another challenge that is limiting ouractivities and time of operation. What we have done is to employ the services of security companies. Of course, that is also additional cost. We have also had our fair share of the inter-professional rivalries rampant in our practice setting, but God has helped us to surmount this by teaching us to put ourselves in the shoes of others, see things more objectively and carefully pursuing peaceful ways of resolving conflicts whenever they arise. We have high regards for other healthcare professionals and see them as partners-in-progress; so we go out of our way to make friends with them in the best interest of our clients. We obey the biblical injunction that, as much as it lies within us, we should live peaceably with all men.
Another professional challenge borders on poor differentiation of roles by the various healthcare professionals. It is easier for a camel to pass through the eye of a needle than to get prescriptions from private hospitals, while it is also common that prescription drugs are dispensed without appropriate prescription or any prescription at all in community pharmacies. We all have our share of the blame for this unethical practice, with the government probably having the largest share.
Moreover, ours is a peculiar country where healthcare is often paid for, out-of-pocket, by people who would rather pay for “product” than “service”. Most services rendered in community pharmacies are not remunerated, and most patients are also not willing to pay reasonable hospital bills without accompanying medications. This has contributed in no small measure to the sub-optimal healthcare service being rendered in the country, making ethical practice rather difficult. It is a big and difficult challenge.
What we have done is to build a healthcare team around healthcare professionals who share our “Health for all”vision, using the principles of pharmaceutical care. When we pick up health challenges that need input of other healthcare professionals, we refer appropriately and politely ask for feedback which, more often than not, we get. By this, there is continuum of care, communication gap is avoided and the patient gets the best at minimal cost.
There is also the challenge of poor access of patients to information on their health and medication, thereby limiting or compromising our input into their care or management. For instance, patient Xmight have seen a healthcare professional who diagnosed malaria and gave him drugs without disclosing to him the name of the drugs. The patient could then visit us a few days later with same complaint, with test results still showing malaria but patient can’t tell what drug he took. It becomes herculean to choose the right medication because, apart from the risk of overtreatment, we also stand the risk of failure to treat in the event that we give him the same drug he just took that failed to cure the malaria. This is a case too many. We have tried to solve this by coming up with Medical Diary,which empowers patients, through documentation, to track their medical records and benefit from continuum of care or intervention from various healthcare professionals instead of the disjointed healthcare which exposes them to mismanagement.
How do you see pharmacy profession today compared to when you started?
Pharmacy profession, when I started, was more drug-focused than patient-focused. It was very unpopular to have pharmacists intervene in disease-prevention or the likes. Pharmacists hid behind counters and were not to be seen. Most people did not know what Pharmacy was. There were very few pharmacists and the few were hidden, not accessible. Perhaps, then, only the academic pharmacists were recognised in terms of their contribution to national development. I think there were only about five schools of Pharmacy in the country then.
Thank God,Pharmacy today has metamorphosed from drug-focused to patient/client-focused, with pharmaceutical care getting more entrenched in the country. Pharmacists now play leading roles in preventive healthcare, which is the strength of any healthy society. Today, the pharmacist is very visible and easily accessible. In fact, the community pharmacy today is the first port of call by the public and is thus an indispensable resource for preventive health.
What do you think government can do to improve the standard of pharmacy profession in Nigeria?
Government’s role in improving the standard of pharmacy profession in Nigeria is critical to national development. The higher the standard of pharmacy practice, the lesser the morbidity and mortality indices of the country and the healthier the nation. And the healthier the nation, the wealthier it gets.
The Nigerian government can improve the standard of pharmacy profession by sanitising the chaotic drug distribution which, as I mentioned earlier, has already been embraced by the government. Also, they should be empowering pharmacists to optimise their potentials by reviewing the statutory hindrances mentioned above with a view to promoting access to healthcare.
There should also be adoption of national guidelines on disease prevention and management, with the roles of each healthcare professional group clearly defined and measures put in place to enforce compliance.
Other suggestions include ensuring that national prescription and dispensing policy is adhered to; strengthening the health insurance scheme and allowing equal opportunities for all healthcare professionals to practise through adequate remuneration and adoption of pay-for-service; empowering community pharmacies through provision of easy-to-access loans with very low interest rates and provision of basic amenities like uninterrupted supply of electricity; making it attractive for community pharmacies to be set-up in rural areas; compelling all private establishments where drugs are handled to have pharmacists in their employ, either full-time or part-time as the case may be; and upholding the law that states that only pharmacists can own retail pharmacy outlets in Nigeria.
What are the most common health conditions that bring patients in this area to your pharmacy, and why is this so?
They are largely preventable diseases like malaria, typhoid fever and infections generally. Also gaining grounds are non-communicable diseases like hypertension, which accounts for the highest visits, diabetes and dyslipidemia.
These are pointers to not-good-enough health prevention strategies in the community and the country at large. For cases like malaria, apart from the mosquito-breeding environment, it seems like malaria is generally over-treated.Many people are not willing to be tested before treatment largely because of the cost to them. They have to pay to be treated and if, positive, will now pay for their medication.So they prefer to just buy antimalarial drugs. This is another area we need the government to invest in or cover with functional health insurance. To be effective, community pharmacists should be remunerated to carry out rapid malaria tests on people who ask to buy antimalarial drugs off prescription or who come with symptoms suggestive of malaria.
We need, as a country, to focus or expend more energy on effective preventive health strategies, thereby optimising pharmacists’ intervention.
Many people have canvassed for stiffer penalties to be meted out to drug counterfeiters. Do you support the motion?
If it will act as deterrent, why not?But I think the government needs to empower indigenous manufacturers to produce safe effective medicines at affordable costs. This will deter drug counterfeiters. With the current move by the government to sanitise drug distribution, I believe the population of counterfeiters will naturally reduce.
Finally, what’s your advice to pharmacists in Nigeria?
Dearly beloved pharmacist, the train of pharmacy best practices is moving.If you are not yet on board, please come on board and let us continue to fight the good fight of pharmacy best practices, armed with the biblical injunction that “godliness with contentment is great gain”.
The dividends of pharmacy best practices are great and should not be seen in terms of money alone. We shall all have our share if we do not get weary in doing good. The God who has called us to this noble profession is more than able to uphold us and make us fulfilled in Him. As men of honour, we join hands for pharmacy best practices – no compromise!
In appreciation of their unwavering loyalty over the years, no fewer than 78 trade partners were given awards and special recognition at the recent World Wide Commercial Ventures Limited (WWCVL) Partners Reward Function.
The colourful occasion which took place at Intercontinental Hotel, Victoria Island, Lagos, on 9 October, had several distributors, pharmacy owners, as well as the company’s top management staff, regional managers and sales representatives, in attendance.
The awards which came in three different categories – Platinum, Gold and Silver – attracted rounds of applause from the teeming audience.
While delivering a presentation, WWCVL’s head of special business unit, Mr Sanjay Upadhyaya, noted that a pharmaceutical distribution outfit like WWCVL couldn’t have made so much progress without the commitment and utmost loyalty of its partners.
He disclosed that the company was indeed pleased to be associated with every partner and distributor represented at the event.
“It has been said that a woman’s loyalty is tested when her man has nothing. On the other hand, a man’s loyalty is tested when he has everything. This is why we are appreciating your commitment today,” he stated.
Also speaking, WWCVL’s superintendent pharmacist, Pharm. Lucky Ubokor, declared that WWCVL, a subsidiary of Eco Health Limited since inception in Nigeria, was in partnership with over 16 multinational companies, maintaining 10 strategic distribution hubs scattered across the six geo-political zones as well as servicing 144 wholesalers and depots nationwide.
The superintendent pharmacist also reiterated that, aside having 450 staff across the country, the company’s new facility was recently commissioned by Dr Paul Orhii, the director-general of National Agency for Food Drug Administration and Control (NAFDAC).
While presenting the keynote address, another head of the company’s special business unit, Mr Santosh Kumar, announced that Nigeria’s pharma industry was worth N203 billion, which would have doubled up by 2018.
Using BMI (Business Monitor International) research report, Kumar assured that the challenge of counterfeiting in the pharma industry had drastically reduced.
“Counterfeiting of products which was about 40 per cent in 2005 reduced by 30 per cent in 2010 and in 2014, it has been estimated to be around 20 per cent. This is an indication of better regulations and distribution practice,” he disclosed.
Kumar also attributed the noticeable reduction to the sustained efforts and campaigns of NAFDAC.
Appraising the rapid development in the industry, Kumar declared that Emzor Pharmaceuticals had become the number one company in Nigeria, in terms of products output; followed closely by the likes of GlaxoSmithKline, Novartis, May & Baker and Hovid respectively.
Among the eminent personalities who graced the event were Pharm. Ike Onyechi, managing director of Alpha Pharmacy; Pharm. Kunle Ara, managing director of Kunle Ara Pharmacy, Ibadan; Mr. Anant Narayan, managing director of WWCVL and Pharm. Lucky Ubokor, regulatory manager.
Others were Pharm. Yemi Olalere, WWCVL’s director; Mr. S. Kannan, head of finance and the duo of Messrs. Santosh Kumar and Sanjay Upadhyaya (heads, special business unit).
World Wide Commercial Ventures Limited (WWCVL) is a licensed vendor to all major healthcare providers in Nigeria. It has also been described as a one-stop solution for warehousing, pharma marketing, supply chain, leads, delivery and sales, regulatory and port clearance, transportation logistics and inventory management.
Pharm Ike Onyechi, managing director of Alpha Pharmacy (middle) receiving an award from Mr. Santosh Kumar, WWCVL’s head of special business unit and Mr. S. Kannan, finance head
In line with our core objectives at Pharmanews to educate and contribute to the capacity development of health care professionals, we are pleased to notify the general public of our health care management curriculum for the year 2015. (Click to download programme)
The 2015 training programme is focused on developing leadership and management capacity of health care personnel in West Africa. We believe that this focus is necessary to equip participants with the necessary skill-set and attitude required to engage a changing global health care industry.
The 2015 programme includes:
Three international workshop in Dubai, South Africa (new), and Ghana. Our international programmes offer exciting opportunities for learning, networking and tourism. They are designed to expose participants to international best practices.
Two clinical leadership and organisational change management workshops in Lagos, Nigeria.
One health care entrepreneurship workshop
Two academic service workshops for Pharmacy Technicians and Pharmacy support workforce.
All of our scheduled workshops are available for sponsorship. Clients can also demand for specific clinical leadership, leadership or academic service workshops for their firm or specific health care organisation.
For workshop bookings and enquiries, contact:
Cyril Mbata – 0706 812 9728
Nelson Okwonna – 0803 956 9184
Elizabeth Amuneke – 0805 723 5128
Pleaseclick hereto download the PDF copy of the 2015 Training Programme
In this interview with Pharmanews, Dr Wale Adeagbo, the executive director of Pharmaceutical Industry Practitioners’ Association of Nigeria (PIPAN), with over 15 years’ experience in corporate strategy across the public, private and voluntary sectors, speaks on the objectives of PIPAN and why he thinks members of the association can be unified, despite their diverse views. Excerpts:
What prompted your decision to take up the position of executive director?
I have some background in health policy and health governance, plus an academic interest in corporate strategy and social economics. I acted as a policy adviser to a minister in the UK and chaired some health networks in Europe, including the Non-Executive Directors’ Network of the UK NHS Alliance, and the Alliance of Community Oriented Primary Care Organisations, Netherlands (under the aegis of the European Forum for Primary Care).
Taking up this position with PIPAN is a privilege for me. I believe I was chosen for the role as I have a good understanding of the strategic purpose and intent of the organisation and I fully subscribe to the vision and innovative thinking of the founding agencies of PIPAN, especially that of the leadership of the associations that midwifed PIPAN.
Tell us about PIPAN. What are the objectives of the association?
PIPAN was established by NAIP and the following pharmaceutical trade associations: Pharmaceutical Manufacturing Group of the Manufacturing Association of Nigeria (PMG-MAN); Indian Pharmaceutical Manufacturers & Importers of Nigeria (IPMIN); Association of Pharmaceutical Importers of Nigeria (APIN); and the Nigerian Representatives of Overseas Pharmaceutical Manufacturers (NIROPHARM).
The objectives of PIPAN are targeted at common industry issues shared by the founding agencies. They include: better knowledge of employees and operatives by carrying out background checks to reduce loss to the industry; developing standardised, professionalised and accredited qualifications for sales reps and some associated roles in the industry; sharing of market /business intelligence that can inform and influence business development; and enabling coordinated approach to policy and practice – at national and international arenas.
You have taken up the task of harnessing an association comprising all practitioners in the pharmaceutical industry in Nigeria. Considering how diverse the practitioners are and their various business interests, which sometimes make them competitors, how optimistic are you that PIPAN members can speak with one voice on issues?
I am optimistic about the attainment of unified views and voices in the industry, despite the varied slants of the players. For starters, the establishment of PIPAN emerged through considerable thought processes, engagements and consultations with all key stakeholders; so the objectives and identified tasks are the common issues that challenge the industry. And all the trade associations recognise that these issues will be better tackled if hosted within a shared institutional tent.
Also, the leadership of each agency constitutes the governing board of PIPAN; so there is equal stake in terms of its strategic directions and activities. The governance structure of PIPAN also creates a space for policy and practice debate – which we have called the Governing Council. This will host all stakeholders in discussing common issues and arrive at agreed and consensual solutions to identified issues. The future is in collaboration, not competition, and the industry is well aware of this; hence the establishment of PIPAN is to future-proof the industry’s aspirations.
Since you took over as the executive director, what challenges have you encountered at PIPAN and how have you tackled them?
Noting that the establishment of PIPAN is an institutional solution to current and potential challenges facing the pharma industry, there is the need to constantly remind ourselves of the need for PIPAN and the necessity of all stakeholder agencies/associations to continue to support the organisation. The good news is that the leadership of all the leading agencies – NIROPHARM, APIN, NAIP, PMGMAN, IPMIN – are totally committed to this initiative and they see the challenges that PIPAN confronts as their challenges.
Where do you hope to see PIPAN in the next five to ten years?
I pray that, well before then, PIPAN would have achieved and will be sustaining its core functions. These will entail hosting of a detailed repository of data about sales force and marketing activities in the Nigerian pharma industry, so that we know what we sell/distribute, where we sell/distribute to, what we import, and what we manufacture – all this is to enable us ascertain how we can improve the health and well-being of Nigerians, while publicising the trends and developments of the industry.
By then, PIPAN would have birthed a full-fledged academy that will ensure the capacity development of the industry and provide certified and accredited courses for the field workers and associated employees. Working in partnership with mainstream associations, PIPAN would have become the clearing house of and for industry policy – at the national and international arenas.
In this exclusive interview with our reporter, Adebayo Oladejo, the recently appointed chairman of the Pharmaceutical Manufacturers Group of the Manufacturers Association of Nigeria (PMG-MAN), Pharm. Okey Akpa, speaks on the challenges facing pharmaceutical manufacturers in the country and his plans for the group. Excerpts:
What prompted your decision to serve as PMG-MAN chairman?
My decision to serve the group is coming from the point of view that everyone of us wants to contribute his or her own quota to create a better industry and, by extension, a better healthcare system for Nigerians.So it is simply to serve and contribute my quota to the development of the industry and nothing beyond that.
You are succeeding a chairman that has been extoled as an achiever. What are your plans to further take the association to higher level?
PMG-MAN has been blessed with very good leaders from inception.The immediate past chairman, Chief Bunmi Olaopa, was one of them, and before him were Mr Joe Odumodu, Mr Emma Ebere, Dr (Mrs) Stella Okoli and Mazi Sam Ohuabunwa.So you can see that it is a very strong leadership team that we have had and my intention, by the special grace of God, is to continue with the good work of these people over the years and obviously to execute projects which will take the industry to the next level.
Already a lot of good things are happening the World Health Organisation pre-qualification and others.So this leadership team,of which, by God’s grace, I am the chairman will endeavour to consolidate on all the great achievements of our past leaders and also look at new opportunities in the Industry for positioning the industry at the global level and creating a vibrant pharmaceutical sector.Those are the things that occupy our minds at the moment and making PMG-MAN an organisation that is well respected within government circle, the healthcare circle, within Africa and internationally.
A major challenge facing pharmaceutical manufacturing in Nigeria is the problem of fake drugs. How can this challenge be tackled?
Fake drug, as a phenomenon, is a global challenge and not only localised to Nigeria – though it occurs in all the countries at different proportions. Besides, if you look at it closely, you would realise that a lot has happened by way of improvement, because there was a time in Nigeria that made-in-Nigeria drugs were seen to be predominantly fake. This is no more so, and that shows that something good is happening.
In this regard, I will like to recognise the efforts of NAFDAC. Other professional bodies have also contributed and, of course, the manufacturers as well are eager to produce quality medicines.So there is an avalanche of quality medicines in the country that people can access and afford.This is important because, in the absence of quality medicines that are made in Nigeria, fake drugs will become a lot more available because people cannot do without using medicine.So,one of the ways that PMG-MAN is trying to contribute is to make sure that quality made-in-Nigeria pharmaceutical products are available, accessible and affordable.That, on its own, is a major pillar of fighting against fake drugs, as it makes fake drug business less attractive.So, we are winning the war.
You talked about affordability of drugs in the country.It is generally believed that drugs are more expensive in Nigeria, what can you say about this?
That’s people’s perception because the word “expensive” is relative. But when several factors are considered, you will discover that it’s just mere perception.
As one of the stakeholders in the pharmaceutical profession, what grey areas do you think the stakeholders at the November PSN conference should specifically address?
If you look at the theme of the conference, “Transforming Pharmacy Practice for Better Outcomes”, which centres on focusing on how to improve the practice of Pharmacy, you will see that the theme is apt and one must give the president of the PSN and other organisers kudos for packaging the conference in this way.
If you follow the programme for the conference, there is going to be a lot of sessions to discuss how to improve the practice of Pharmacy and there is going to be lots of brainstorming sessions and panel discussions. I think it’s the right thing to do because Pharmacy is a profession that takes care of people; so it must continue to evolve and find relevance in meeting the needs of people.
So, how would you assess the contribution of conferences to the development of the profession?
Sincerely, conferences are very important as they bring all pharmacists in the country together.Considering the fact that Pharmacy has different dimensions of practice – the industry, community practice, pharmacists in academia, the hospital pharmacists, the researchers, and even pharmaceutical journalism – conferences bring all the professionals together and we share ideas and review all that is happening around us.And it has been so far so good.
It has been discovered that over 70 per cent of our drugs are imported.How do you think government can improve local manufacturing of drugs in the country?
One of the key points of the National Drug Policy of the country is an objective to produce 70 per cent of the drugs to be used in the country locally, and it is the desire of PMG-MAN that government should help Nigerian pharmaceutical manufacturers to achieve this or even surpass it.
One of the means of supporting them is for government agencies and parastatals to patronise Nigerian manufacturers and pharmaceutical products., Secondly,the industry needs appropriate protection because many of the drugs we are using in Nigeria are imported, which should not to be so because we have the capacity to produce most of these products locally. So,government must develop the political will to do the right thing and discourage the importation of items that we can manufacture locally.That, on its own, is a very strong way to encourage local manufacturing
Also,we must look at the general infrastructure which affects not only pharmaceutical but every manufacturing effort in Nigeria. The more government improves the infrastructural base, the better.Look at what is happening with electricity.
Funding is another challenge.It is the wish of Nigerian manufacturers that government looks at making funds for development of pharmaceutical manufacturing available to the industry.Of course, we are not asking for free money but money that can be accessed at a competitive rate and that will make investment in the industry to be possible. As soon as these things are put in place, the industry will grow better.
What is your view about current happenings in the health sector?
The provision of health to any society is a team effort, and the health sector should be more of teamwork. Any disharmony is against the principle of teamwork and it is my desire and prayer that all the different stakeholders in the sector will realise this and come together and work as team.
South Jersey Healthcare wanted to improve patient care by providing critical data to medical professionals across multiple campuses. To improve efficiency, South Jersey Healthcare replaced manual medication-distribution processes with an automated dispensing system from Omnicell that runs on Microsoft technologies. Because the solution shares information across multiple applications and devices, medical staff have better visibility into patient care and more control of their workflow. By using the automated solution, the pharmacy has cut delivery time for patient medication from two hours to 18 minutes. In addition, South Jersey Healthcare can more easily meet electronic health-record regulatory requirements, improve inventory control and simplify IT management.
After a 42-day period without new cases of Ebola in the country, the World Health Organisation (WHO) has declared Nigeria Ebola free. According to a WHO representative, Rui Gama Vaz who addressed a press conference in Abuja on Monday, he said “Nigeria is now free of Ebola”.
According to a report from Aljazeera, Vaz said: “The virus is gone for now. The outbreak in Nigeria has been defeated. This is a spectacular success story that shows to the world that Ebola can be contained”.
The pronouncement by the world’s apex health institution was a welcome development in the country, as the average Nigerian is relieved of the phobia of contracting the disease in his environment. However, health officials want people to celebrate but to remain cautious, as Nigeria borders is open to all and sundry.
Nigeria becomes the second country in West Africa to be declared Ebola free in the past week. On Friday, the UN health agency declared Senegal free of Ebola after it passed the 42 day landmark.
“WHO officially declares the Ebola outbreak in Senegal over and commends the country on its diligence to end the transmission of the virus,” the WHO said.
In all, eight people died out of 20 confirmed cases in Nigeria’s biggest city, Lagos, and the oil hub of Port Harcourt, while nearly 900 people were monitored for signs of the disease.
More than 4,500 people have died and nearly 10,000 have been infected with the haemorrhagic fever, most of them in West Africa, since the start of the year.
That the Nigerian pharmaceutical market is in a messy state is not news to many in the industry or even the customer. The problems and challenges facing the industry are known to many of us. They have been identified, analysed and endlessly discussed at various forums and yet we sit in the same cesspool of failure to perform at the highest professional level. What’s even more shocking is the failure of stakeholders to find and implement solutions to the problems. And so, the malaise persists.
But all is not lost. There are solutions that we can begin to implement now and they begin with the superintendent pharmacist, the one key player that can take a leadership role in resolving some of the challenges we face today. In subsequent articles, I will address other segments and players in the industry and offer some practical steps we need to take as an industry to avert further disaster. For now, though, we must evaluate the role of the superintendent pharmacist in both creating and getting us out of the current embarrassing situation.
Superintendent pharmacists occupy a unique role in the practice of Pharmacy in our society. In a normal environment, they anchor the industry, serve as principal officers responsible for maintaining the integrity of the system and, where necessary, act as agents of change. In that last capacity, they are sorely lacking in Nigeria today and I would like to call on them to step up to this role. In doing so, they can move the industry forward and help reverse some of the damages that years of neglect have done to the pharmaceutical market.
A superintendent is “a person who manages or superintends an organisation or activity.” A direct extrapolation of this definition will make the superintendent pharmacist the overseer, administrator, manager, supervisor or controller of the organisation that he presides over. By law, he is the legal “face” of the pharmaceutical outlet, premise or factory. He is the representative of the Pharmacist Council of Nigeria (PCN) and without him the pharmaceutical organisation will not be registered.
The superintendent pharmacist is the protector of the public interest, ensuring that there is a balance between the profit-making goals of the enterprise and the discharge of ethical responsibilities expected of a pharmaceutical business.
The failure of superintendent pharmacists to play their part has contributed in no small measure to the mess that we are currently in. We would have been able to eliminate or, at least, control the battery of unethical practices that currently pervade the entire system.
How did we get to this level where more than 90 per cent of commercial activities in Pharmacy are out of control? If you are a superintendent pharmacist, you bear part of the blame for this malaise. Many superintendent pharmacists like the title and the financial compensation associated with the position but often fail to discharge the corresponding duties. The failures are stunning: abdication of responsibilities demonstrated in the popular but nefarious “Register and Go” activities, and shocking lack of appreciation of the enormous responsibility associated with the superintendent pharmacist’s office.
Over the years, the pharmaceutical regulatory authority has also been permissive and complicating its oversight of the profession: registration is “static”(occurring once a year) and there are no institutionalised procedures in place to interface with the organisation and the superintendent pharmacist, apart from sporadic inspections, usually following pressure from other pharmacists.
The superintendent pharmacist can help change the face and practice of Pharmacy for good in Nigeria. The duties associated with the position entail more than premises and product registration. Everything involving pharmaceutical products should start and end with the superintendent pharmacist, including raw materials procurement, manufacturing, quality control, distribution, sales and dispensing of drugs.
We must, therefore, do everything possible to empower the superintendent pharmacist. They must be sufficiently equipped to discharge the responsibilities attached to the post; this goes beyond the possession of a Bachelor of Pharmacy degree. They must also be held accountable for their performance. Furthermore, the industry needsto organise regular workshops for all pharmacists who have chosen to work as superintendent pharmacists.
In 2012, the Association of Industrial Pharmacists of Nigeria (NAIP) organised a special workshop for superintendent pharmacists as part of its 15th Annual Conference. The workshop was attended by more than 250 superintendent pharmacists and the PCN, led by the then acting Registrar, Pharm (Mrs) Gloria Abumere, FPSN. At the end of the workshop, a standard operating procedure (SOP) for superintendent pharmacists was produced and sent to the PCN for action. Regrettably, nothing has been done to give effect to the SOP, which we consider a good tool for the superintendent pharmacists.
I am reproducing the SOP with this article, with the hope that the relevant authorities in PCN and PSN will make use of it as appropriate.
God bless Pharmacy in Nigeria.
Draft Procedure to Operate as a Superintendent Pharmacist in the Pharmaceutical Industry
Purpose:
This document prescribes the conduct of a Superintendent Pharmacist in the Pharmaceutical Industry with the objective of ensuring a compliance with the code of ethics guiding the practice of Pharmacy as regulated by the relevant authorities.
Scope:
This procedure is applicable to all Pharmaceutical Industries as regulated by the relevant authorities.
Responsibility:
It is the responsibility of the Superintendent Pharmacist and the relevant authorities with the cooperation of the top management of Pharmaceutical Industries to ensure the implementation of this standard operating procedure.
Procedure:
To operate as a Superintendent Pharmacist, the following attributes and standard are expected:
He/she should be knowledgeable, skilled, licensed by and responsible to the Pharmacists Council of Nigeria.
He/she should have the overall professional control of a set standard of planning, implementing and executing the approved Pharmaceutical Policies of a premise in accordance with Act. P17 LFN, 2004.
He/she should set standards and policies for the pharmaceutical aspect of the business.
He/she should ensure that all Legal, Professional and Regulatory requirements in relation to pharmaceutical aspect of the business are complied with.
He/she should ensure that there are appropriate policies setting on the number of staff and their required experience.
He/she should respond appropriately to any system failures or concerns that may arise.
He/she should ensure that all professional activities undertaken within the premises are adequately covered by professional indemnity.
He/she should ensure the registration and annual licensure of the premises and also of all Pharmacists working in the organization.
He/she should set standards and policies for the pharmaceutical aspect of the business.
He/she should be professionally accountable for the day to day level of practice.
He/she should be responsible for the over-all quality assurance of the establishment, according to Section 4(3) of the PCN Act.
He/she should be sufficiently positioned:
to supervise the Production and Quality Control Managers or at least have a dotted line relationship with the key officers in accordance with Section 4(4) of the PCN Act.
To review the Sales marketing practices of the company and bring them in line with ethical practices.
He/she should ensure that every agreement pertaining to the pharmaceutical aspect, entered into by his company is done according to professional ethics and within the ambits of the law.
He/she should ensure that starting materials are purchased following due process in line with specified standards.
He/she should ensure that all processes and procedures that are necessary for compliance to the principles of good manufacturing practice are properly carried out by qualified personnel on a timely basis.
He/she should approve all working document before implementation by production and quality assurance/control department.
He/she should approve all test results before release for use or sale.
Where the business is IMPORTATION only:
He/she should be aware and approve the source(s) of supply.
He/she should approve the product for sales after receipt into the warehouse.
He/she should order periodic testing of the products to ensure that they are safe for public consumption.
In all cases, He/she should review, at a regular interval(monthly), the sales procedures in the company, confirm that customers are fit and proper person or companies licensed to handle drugs.
A written report of the exercise in (s) above should be kept in the company record for PCN inspection.
He/she should be personally involved in all decision making that may impact on products.
He/she should liaise with regulatory agencies as the sole responsible officer of the facility.
He/she should ensure that standards of practice are up to date, understood and followed by both management and staff of the facility.
He/she should ensure proper documentation by institutionalizing a culture of accurate, up to date and accessible record keeping, with controls where necessary.
He/she should make sure clear lines of accountability exist and that a retrieval or recall process is in place in case of product failure.
He/she will be held RESPOSNSIBLE and ACCOUNTABLE for any unethical practices that may take place in the procurement, production, marketing, Sales and distribution of the products in the company.
References for Implementation:
Laws of the Federation of Nigeria, Pharmacists Council of Nigeria Act (1992 No. 91)
Pharmacists Council of Nigeria Act (1992 No. 91). Registration of PharmaceuticalPremises Regulations, 2005
Pharmacists Council of Nigeria Act (1992 No. 91). Inspection, Location and Structureof Pharmaceutical Premises Regulation 2005
Code of Ethics for Pharmacists in Nigeria.
Membership of Association of Industrial Pharmacists(AIPN).
A testimonial of compliance to be obtained from AIPN before PCN is approached for registration.
References for Continual Improvement:
A forum or an Association of Superintendent Pharmacists within the ambit of AIPN is imperative to encourage interactions, sharing of experiences, counselling, personal development and networking.
At least 3 years post qualification experience or 1 year post NYSC exposure is necessary before a registered Pharmacist becomes a Superintendent Pharmacist or handles importation of drugs.
iii. The Pharmacists Council of Nigeria should develop computer software that would detect multiple full time employments of Pharmacists.
In this in-depth interview with Adebayo Folorunsho-Francis, Pharm. (Sir) Gilbert Umeadi Echezona, Fellow of the Pharmaceutical Society of Nigeria and former director of pharmaceutical services in Anambra State from 1997 to 2007, recalls several significant events in the growth of Pharmacy in Nigeria, as well as offering practical suggestions on advancing the profession and strengthening its umbrella association, the Pharmaceutical Society of Nigeria. Excerpts:
Tell us a little about your background
My early life was shaped by my maternal uncle who was a teacher with the Catholic Mission. I started my early education in 1954 in Sobe, a town about 12 miles from Auchi in present day Edo State (Mid-West Nigeria). For my secondary education, I attended the famous College of Immaculate Conception, Enugu, from 1962 to 1966.
My educational pursuit was disrupted by the civil war (1967-1970). During the war, like most young men at the time, I joined the militia and,later, the Biafra Organisation of Freedom Fighters(BOFF) from 1968-1970. At the end of the war, I was offered admission to the University of Nigeria, Nsukka (UNN), to read Pharmacy. I obtained bachelor’s degree in Pharmacy in 1975.
I started my pharmacy career as an intern pharmacist at the University of Nigeria Teaching Hospital, Enugu (1975-1976). I did my one year mandatory National Youth Service Corps programme in Yelwa Yauri, Sokoto State, from 1976 to 1977. In August 1977, I joined the Anambra State Civil Service as Pharmacist Grade 1. I also served Anambra State in various capacities, holding different positions and retired in 2007,after 30 years of meritorious service.
How would you describe your career in government?
Without exaggerating, my career in government was exciting and fulfilling. As a young pharmacist, I had a lot of exposure in the service, such as attending a store management course in Ghana for three weeks, and appointment as instructor and head of department at the College of Health Technology, Oji-River, an institution that trains middle-level manpower. I will tell you some other major posts I held in the course of our discussion.
Why did you decide to study Pharmacy?
At the end of my secondary education in 1966, I wanted to study Geology. However, my contact with a herbal ‘doctor’ in the course of military assignment during the civil war changed that. At UNN, where I attended, the introductory lectures in Pharmacognosy reassured me that I did not make a mistake. In the university, other students had high regard for pharmacy students.
Three months after graduation, as intern pharmacists, we were granted car loans for cars of our choice. The house officers received more money. We did not understand and were too excited to probe.
Did you eventually discover the reason?
Yes.The reason became clear when I finally took up a permanent appointment with the government. I discovered, to my utter disappointment, that pharmacists were discriminated against in the civil service. The conditions of service for pharmacists were very poor. Pharmacists were not included in policy-making committees in the hospital hierarchy. They were denied promotions and stagnated. Many of my contemporaries became disillusioned and left for the private sector. Those of us who were patient stayed and, by the grace of God, broke through the man-made bottlenecks and made it to the top.
Even in the private sector, it is the same story. Quacksand charlatans have taken over the profession. In spite of all these, I still believe I made the right choice. Today, a lot has changed. We now have pharmacists in top political positions as governors, ministers, legislators, ambassadors, commissioners, etc. I believe the future is still very bright for pharmacists and Pharmacy. I have nothing to regret.
Tell us about your work experience
I worked first as a hospital pharmacist, then as an administrative pharmacist. As a Grade 1 pharmacist, I served under a senior pharmacist for three years before being postedto head a hospital pharmacy. In those days, one was not allowed to function unsupervised until one had had five years’ post qualification experience, the internship and NYSC periods inclusive.
What was the profession like in your day compared to today’s practice?
As at then, safe and good quality drugs were available in adequate quantities. The out-of-stock syndrome was non-existent. Patients received all the medicines in their prescriptions and at no cost to them.The drug distribution/supply chain was reliable and coordinated. Fake counterfeit medicines did not exist. There was paucity in the number of pharmacists employed to function in government hospitals, arising from discrimination in recruiting pharmacists. Consequently, non-pharmacists (pharmacy technicians and pharmacy assistants) were used to cover pharmaceutical duties in some hospitals.
Job satisfaction was equally lacking. Pharmacists in government served under poor work environment, poor remuneration package, not being included in decision-making committees in the hospital hierarchy, career stagnation, and limitation of professional privileges.
Tell us more about controversial issues that characterised your time
Discrimination against the profession was not limited to pharmacists in state service. It permeated the specialist and teaching hospitals and even the army. It was not until 1980 that the Federal Chief Pharmacist was upgraded to Director of Pharmaceutical Services, GL 16. My classmate who joined the Nigerian Air Force had to leave because he was started on GL 07.
During our time, pharmacists in government service were denied the right to private practice. We did not have the opportunity of coordinated continuing education programmes in Pharmacy,as is the case today.
Perhaps one can say some of the controversiesback then included poor working conditions for pharmacists in the public service; reluctance of most state governments, teaching and specialist hospitals to accept newly qualified pharmacists for internship training, leading to a great number of them roaming the streets for placement; and dominance of doctors as heads of hospitals at all levels.
Others included cheap substitution in hospitals for pharmacists using sub-professional health personnel; open drug markets and circulation of fake, counterfeit and substandard medicines; practising doctors keeping drug stores and dispensaries,in defiance of extant drug laws; and protest from the Nigerian Medical Association (NMA) against the appointment of a pharmacist as Minister of Health in 1993, the very first pharmacist to be so appointed.
There was also the proliferation of patent and proprietary medicine vendors in the cities and the complete lack of political will by government to curb the situation. Then came thepoisoned paracetamol syrup episode in which about 109 Nigerian children died. This dealt a devastating blow on the image of pharmacists.We had not fully recovered from the shock when the tragic death of Miss Cynthia Osokogu was reported,leading to the arrest of a young pharmacist, who is currently standing trial for murder.
In your opinion, what are the main challenges facing pharmacy practice in Nigeria and how can they be surmounted?
The pharmacy profession has a multitude of challenges to contend with. Many of the challenges have been there over the years. For instance, our laws in pharmacy practice are unwieldy and are not supportive of theprofession. There are manyoverlaps, leading to conflicts and faulty implementation. This problem can be overcome if the PSN is given the statutory function of formulation of policies and execution of laws governing the practice of Pharmacy.
Another challenge is absence of professional recognition. Pharmacists in government are engaged under poor conditions of service. The number employed is usually grossly inadequate,leading to cheap substitution with sub-professional health personnel to render pharmaceutical functions in hospitals. They are poorly remunerated and not promoted as and when due, leading to stagnation and frustration. Pharmacists in hospitals are not involved in decision making committees of the hospitals.
Pharmacy also has the issue of uncoordinated drug distribution and the menace of fake and counterfeit medicines. The flushing outof quacks and charlatans will help reduce the situation. Pharmacists should also be encouraged to move into rural areas. Government should develop the political will to implement the guidelines on drug distribution.
Are there still some other burning issues?
Yes. There is the problem of fragmentation in the PSN. We should work hard to achieve internal consolidation in the PSN. There is a need for the PSN to be seen as one house, speaking with one voice. A situation where the position of a state branch on an issue conflicts with that of the national body on the same matter does not augur well for us.
Professional jealousy is yet another. The opposition that greeted both the appointment of a pharmacist as Minister of Health in 1993 and the creation of the Pharm. D. programmeare two clear cases. I have already talked about the professional jealousy, in respect of hospital pharmacists.
Another challenge is doctors’ strikes.Should the federal government be negotiating with the NMA, a non-labour body?This is one of the many occasions the government treats doctors as sacred cows. It is rather embarrassing.
What solution would you proffer to these problems?
To tackle these challenges, the PSN must be seen as one house. Individual Pharmacists must be disciplined, and must develop both professional and political clout. We should avoid fighting back as response to provocation and conflicts, but rather adopt the more effective approach of dialogue and due process. We should understand and respect one another. Above all, more pharmacists should be encouraged to occupy positions of strength.
How would you rate Nigerian pharmacists?
We are not doing badly. You will recall that a pharmacist was appointed Minister of Health in 1993. Same year, Prof. O.K. Udeala was appointed Vice Chancellor,University of Nigeria, Nsukka.The late Prof. Dora Akunyili was D.G. of NAFDAC and later Minister of Information.
Pharmacists are today governors and deputy governors in their states. We also have pharmacists as ambassadors, commissioners, captains of industries and permanent secretaries. I recall that, in 1996, a Nigerian pharmacist represented the third world countries on the executive board of FIPfor community pharmacists. We are doing well. We still pray that more pharmacists occupy these positions of strength.
How best do you think the issue of fake drugs and counterfeit medicines can be curbed?
Many years back, we had a beautiful and reliable supply/distribution system for drugs. This system was destroyed in 1980 when government started issuing import licences to businessmen who are not pharmacists. This led to the involvement of quacks and charlatans in drug distribution, the development of open markets and the circulation of fake drugs.
To curb the circulation of fake and counterfeit drugs, we must evolve a new drug supply/distribution chain that will eliminate the involvement of quacks and charlatans in drug distribution and supply. The open drug markets must be dismantled. The federal government’s”guidelineson drug distribution” is the answer. Government should develop the political will to implement the guidelines.
I expected that, by now, various state governments should have set up StateDrug Distribution Centres (SDDC), as demanded by the guidelines. I also expect the PSN to take the lead in the implementation of the guidelines,as this is the only sure way pharmacists can reclaim the drug business in Nigeria.
The Anambra State PSN has registered a Mega Drug Distribution Centre (MDDC) in Onitsha. The centre is yet to take off because government lacks the political will to enforce compliance.
What were your key involvements in pharmaceutical activities?
I was appointed State Director of Pharmaceutical Services(DPS) in1997 before I retired in 2007. This implies that, for close to a decade, I was monitoring pharmacists and the practice of Pharmacy. I was chairman of the Pharmaceutical Inspection Committee (PIC), member of National and State Executive Councils of PSN.
As DPS, I was also a member of the governing council of the Pharmacists Council of Nigeria (PCN) for two tenures, and served as a member of the Appointment, Promotion and Disciplinary Committee of the council. I served in the Enugu/Anambra Joint Task Force on Fake and Counterfeit Drugs,and was later appointed chairman of the Task Force in Anambra State. I regularly attended PSN meetings and conferences, both at national and state levels.
Were there some major awards given to you in recognition of your selfless service?
Aside from my being made a Knight of the Roman Catholic Church in 1999, I was made a Fellow of the Pharmaceutical Society of Nigeria ten years later (2009). In appreciation of my valuable service as a member (1999-2002), the PCNhonoured me with a PCN Certificate. Same recognition was accorded me during the 2003-2006 and August 2006-November 2007 regime,in acknowledgement of my contribution to the PCN. I was also aPSN Anambra State Merit Award Winner in 1998.
I equally have in my possession a PANS Certificate of Honour (UNN 1974-75), in appreciation of my excellent service as a member and secretary of the Pharmaceutical Association of Nigerian Students.
How do you see the annual PSN national conferences?
In the past, the national conference of the PSN was like a ritual. Every year we gathered and discussed matters affecting the profession. In some of the topics, we would fail to reach agreements,and where resolutions were reached, most of them were either partiallyimplemented or not implemented at all. The following year, the same topics would be presented again, and so on.
Today,a lot has changed. Most decisions are followed up. However, one feature of the AGM that has not changed is its rowdy nature, which is a reflection of the fragmentation within the PSN. It is also believed that the South has, for a long time, dominated the leadership of the Society. Efforts should be made at unification of interests, so that we can have a unified Pharmaceutical Society of Nigeria.
Is there an ideal age for a pharmacist to retire?
An active pharmacist should retire at 75 years. He needs some time to rest and reflect on his spiritual life.
As an elder in the pharmacy profession, what is your advice to young pharmacists?
My advice is simple: Be disciplined, honest; work hard and remain focused. They should adapt to professional advances in clinical pharmacy and pharmaceutical care. I believe that the future of pharmacy lies in specialisation. We should therefore de-emphasise drug trading and emphasise drug consultancy.
Young pharmacists should make themselves relevant to the socio-economic welfare of any community in which they live. As I mentioned earlier, the future of Pharmacy and pharmacists is bright, but we must be committed to the course of Pharmacy.
In a renewed bid to foster harmony and progress in the health care sector, experts have reiterated the need for cooperation and mutual understanding among the key players.
Speaking at the 1st Annual Scientific Symposium of the National Association of Pharmacists in Academia (NAPA) held at the Lagos University Teaching Hospital, Idi-Araba on 18 August, Prof. Olukemi Odukoya, dean, Faculty of Pharmacy, University of Lagos, Idi-Araba, explained that beyond serving as practice sites, health care systems and organisations are a conduit for expanding access to additional patient populations.
She stressed that to ensure effective collaboration among the various practitioners in the health industry, “the culture on both sides of partnerships must embrace individuals who dedicate their time to the pursuit of innovation.”
Focusing specifically on the relationship between pharmacists in academia and those in other sectors, Odukoya opined that since pharmacists are the most accessible health care personnel in Nigeria today, both parties should recognise where their motivations and visions lie and ensure they support each other in pursuit of the purpose of the partnership.
“Pharmacy has a rich history of advancing practice through innovation,” she said.”These innovations helped to mould Pharmacy into a patient-centred discipline recognised for its contributions to improving medication therapy outcomes. However innovations in Pharmacy have now waned. It is only the growth of academic-practice partnership that could reverse this trend and stimulate innovation among the next generation of pioneering clinical pharmacists.”
While congratulating NAPA on its 30th Pharmaceutical Education Anniversary at the University of Lagos, the dean stated that the number 30 symbolises an age when a person reaches physical and mental maturity and could therefore handle major responsibilities.
In another presentation, themed, “Collaborating with Doctors and Other Health Care Providers to Create Value,” Dr Jane Ajuluchukwu, a professor of medicine also in LUTH, hinted that studies have shown that collaboration between physicians and pharmacists can improve patients’ outcome.
While demonstrating the end result, Ajuluchukwu explained that the word “collaboration” signifies joint communication and decision-making process with a goal of satisfying the patients’ wellness and illness needs, while respecting the qualifications and abilities of each individual.
She further emphasised that this partnership should naturally bring up issues like alerting physicians to possible adverse drug reactions and discussing drug problems detected during dispensing.
The professor also noted that much as the pharmacist often turns out to be the instigator, the same cannot be said of the physician who may not see the relationship as beneficial.She was however quick to interject that younger physicians have more understanding of pharmacists’ expanding roles.
Buttressing the views of the two earlier speakers, Prof. FolaTayo, a retired professor of clinical pharmacy at the University of Lagos and pro-chancellor of Caleb University, statedthat creating value is a very appropriate topic for discussion at this critical stage in the history of our country’s health system.
“Let me congratulate the organisers of this programme for the vision. This is because, presently, our health system does not enjoy the fruits of collaboration,” he observed.
According to him, regardless of the fact that there are many constraints, ranging from inadequate funding by government to lack of passion and a display of arrogance by some practitioners, the greatest disservice healthcare providers can do to their clients is to render unacceptable service,
“What we as healthcare professionals often fail to appreciate is the fact that unto whom much is given, much is expected. Let us appreciate that it is time for change,” he emphasised.
Psalm 84:11 is an exciting and assuring verse of scripture. It says, “For the Lord God is our light and protector. He gives us grace and glory. No good thing will the Lord withhold from those who do what is right.”
Of course, this assurance only applies to those who do what is right in God’s sight. These are the righteous people. They are the people who love and obey His commandments. He says He will bless and honour them.
This promise is also supported by Job 36:11 which says, “If they obey and serve Him, they shall spend their days in prosperity, and their years in pleasures;” as well as Psalm 34:9-10, which says “O fear the Lord, ye his saints: for there is no want to them that fear him. The young lions do lack, and suffer hunger: but they that seek the Lord shall not want any good thing.”
Certainly, the prosperity and pleasures of life are rewards for those who faithfully serve and obey God. In fact, God is always searching for such people to bless.
Looking at our present society, we may be tempted to say that there are many people who sincerely serve and obey God but seem to lack the good things of life. We wonder why there is virtually nothing to show that they are special people of God. The truth is that our assessment can sometimes be wrong. The person we assume to be righteous may not actually be so in God’s eyes. We are only able to see the outside of a person, while God looks at the heart.
This tendency to hinge our judgement on appearance is, apparently, a general limitation of all mortals. Even God’s anointed prophet, Samuel, made the same mistake of looking at the physical features of Eliab, when God directed him to go anoint one of Jesse’s sons as King Saul’s successor. Samuel was so impressed with Eliab’s broad shoulders and other physical attributes that he quickly concluded that he (Eliab) was the chosen one – until God expressed His disapproval over the decision.
God has said that our thoughts are not His thoughts and our ways are not His ways. This implies that we need to think like God to understand His ways. Now, this cannot be possible without divine help. Only God can transform us from within to enable us conform to His likeness. We also need to feed on His words and allow those words to dwell richly in us before we can think like Him.
We may also sometimes wonder why some people who live in brazen disobedience and opposition to God seem to be flourishing and enjoying the good things of life. Indeed, such decadent people abound everywhere. They are full of evil devices and are involved in all sorts of shady businesses. They are the ones who call the shots and influence the economy. The truth, however, is that while they may seem to be prospering in the eyes of men, God, whose words can never fail, has said in Psalm 37:1-4, “Fret not thyself because of evildoers, neither be thou envious against the workers of iniquity. For they shall soon be cut down like the grass, and wither as the green herb. Trust in the Lord, and do good; so shalt thou dwell in the land, and verily thou shall be fed.”
God is both warning and advising us against envying wicked people who will perish with their ill-gotten wealth. This will be understood better when one considers how some seemingly green and healthy herbs slowly wither and eventually die off. In such cases, neither watering nor providing manure for them can reverse the trend.
It is also instructive to note that God’s promise of not keeping any good thing from the righteous is equally conditional. Sometimes, our definition of a good thing may not exactly be God’s perception. We all know that Rolls Royce is a very good car. Some rich Nigerians have one or more of it. But supposing I ask God to give me one Rolls Royce car today because He has said will not deny me any good thing, I am sure He would want to know my motive for wanting it. Is my desire for this good thing really justified, or is it merely to let my friends to know that I have arrived?
God does not place great things in the hands of some people because they have the tendency to misuse and monopolise such privileges. Good things are given to people for noble purposes. The purpose for which God supplies good things is not for selfish indulgence but to enable us accomplish the mission He has for us.
How we use our God-given time, talents and treasures determines whether more will be given or even the ones given would be withdrawn. Above all, we are called to devote ourselves to activities that glorify God, in order to continually receive and enjoy the good things divinely provided for us.
The federal government recently announced that, as part of measures to check the spread of the deadly Ebola Virus Disease in the country, Nigerians should henceforth bury their dead relatives in the same locality of their death. The decision, according to the Minister of State for Health, Dr Khaliru Alhassan, was taken in the best interest of the citizens. The minister added that security agencies had been instructed not to allow people bring corpses into the country or even move corpses from one state to another, until the disease is contained in the country.
For this edition of VIEWPOINT, our reporter, Adebayo Oladejo sampled the opinions of Nigerians on the decision. Their responses are presented below.
It is unnecessary
While I commend the Nigerian government, and especially the Lagos State Government, for their swift response in addressing the spread of Ebola and protecting the citizens, I think outright ban on movement of corpses is unnecessary, provided there is a death certificate stating the cause of death. That aside, the federal government should have also devised means of preventing the virus from entering the country.
Pharm. Patience Sanni
Ifo, Ogun State
Implementation should be limited to affected areas
The decision is a good one, but as we all know, it will really affect our African beliefs concerning burying our dead in foreign lands. So I’m of the opinion that the rule should be more rigid on corpses coming into the country from Ebola affectedareas. But for other unaffected areas, when a death certificate accompanies a corpse, the corpse should be allowed to move.
As at today, Ebola has been restricted to only two states, Lagos and Port Harcourt, and even in those two states, it has been well managed.So there is no cause for fear. It is also interesting to note that all the cases so far recorded are one way or the other linked to Patrick Sawyer, who brought the disease to the country, which also shows that the challenge has been well managed. So I see no reason why such action of banning movement of corpses around the country should be taken. I would rather suggest that the government makes it compulsory for the relatives of deceased persons to obtain the death certificate stating the cause of the death and that solves the problem.
Sanni Reuben O
Abuja
It’s unAfrican
Considering the current situation, the move is a good one but it’s not the best alternative because the affluent and the powerful may not comply.Or do you think anyone will disturb a convoy conveying the remains of an ex-governor or an ex-president from one place to another? It may eventually not be a balanced policy because only the masses will be left to bear the brunt.
Aside from that, it would be a disadvantage to most of our people from the East, because there is this belief that it is sacrilegiousto bury certain people outside where they hail from.In fact, there is an adage that says, “The head of a king cannot be hanged outside his kingdom.”So the fact that the directive goes contrary to our cultural belief, as Africans, meansmany may not comply.
I think what the Ministry of Health should do in this regard is to ensure there is a proper way of verifying if a deceased person actually died of EVD or not.
Odinankaru Uchenna
Oshodi, Lagos
It’s a good move by the FG
This is a welcome development and a good prevention strategy.We need to leave no stone unturned in ensuring that the ban is obeyed and respected.The man who brought the deadly virus into the country[Patrick Sawyer] contracted it from his dead sister.So the best way of preventing further spread is to bury a dead person where the person dies. In fact, to an extent, this would further reduce the rate at which people spend unnecessarily on burial ceremonies or movement of dead bodies; so the government is right on this.
However, this Ebola epidemic is another eye-opener to the age-long decadence in our health sector. It’s extremely sad to note that this significant sector of the Nigerian society has been so neglected to the extent that ordinary, but extremely important healthcare tools such as Personal Protective Equipment –gowns, googles, glovesetc–requiredfor this period are grossly inadequate and are just being ordered by most state governments at this time of medical emergency. One begins to wonder where all the budgetary allocations have ended up. So, as much as I am in support ofthe FG’s decision, I think there should be a general overhaul of our healthcare system, so that adequate staff and equipment can be provided.
The Forum for Local Government Nurses & Midwives (FOLGONM) has called on government at all levels to amend the existing policies which tend to belittle the positions of local government nurses and midwives.
The call was contained in the keynote address presented by the Head of Nursing Administration, Primary Health Care Board (Lagos), Mrs Oluwatoyin Odukoya, at a three-day annual conference and scientific workshop organised by FOLGONM.
Speaking on the topic, “The Optimum Style in Nursing Performance: Managing Patients’ Expectations in Primary Health Care Delivery Services”, Odukoya noted that the insensitivity of the government towards FOLGONM nurses had been a major challenge that must be corrected as a matter of urgency.
“Why do we always have to fight before emoluments given to nurses in other tiers are extended to us?” she queried. “The joke that our money lies in the mouth of the lion is unacceptable. If the three tiers of health services are not ours, there is no reason why we should be made to suffer for working at the grassroots.”
The leading nurse however enjoined participants at the conference to continue to demonstrate best nursing care in managing patients, not minding the several challenges besetting the profession.
She stated that nursing performance in Primary Health Care (PHC) delivery services can be measured in three ways, namely: competences, nursing-sensitive quality indicators, and measures of performance on specific task.
According to her, “competences are assessed right from when nurses are first licensed and thereafter, to ensure that nurses maintain their proficiencies and remain abreast of current issues.”
She added that, as a way of measuring quality, nurses and midwives have to account for all the dimensions of quality which are person-centeredness, safety, effectiveness, efficiency, equity, timeliness, women’s experience, clients’ experience, and satisfaction with care.
Explaining Primary Health Care, as defined by WHO and UNICEF in 1978, she said “Primary Health Care is essential health care, based on practical, scientifically sound, and socially acceptable methods and technology; universally accessible to all in the community through their full participation; at an affordable cost; and geared towards self-reliance and self-determination.”
Odukoya expatiated further on the functions of the PHCs, stating that the PHCs have shifted their emphasis on health care to the people and their needs, reinforcing and strengthening their own capacity to shape their lives. .
She also highlighted some challenges militating against optimal nursing performance such as intra-professional conflicts; inter-professional conflicts; professionally infected limitations; inferiority complexes; strike actions; in-fighting; unhealthy cadre/category supremacy; lack of trust; abuse of privileges; not wanting to take risks; divisive tendencies of mischief makers among others.
She however expressed optimism in limiting these factors, noting that they can easily be checked through continuous education from conferences, as well as Mandatory Continuous Professional Development Programme (MCPDP).
Speaking with Pharmanews at the event, the State Chairman of FOLGONM, Mrs. M. Lateef–Yusuf expressed her delight with the outcome of the group’s conferences, noting that they had always left positive impacts on nurses.
In this exclusive interview with Pharmanews, Pharm. (Mrs) Edith Uchenna Nwachukwu, founder and managing director of Audion Pharmacy Nigeria Limited, shares some of her experiences from the early days as a struggling community pharmacist to the present day as an established entrepreneur. She also discusses her contributions towards ensuring that the challenge of fake and counterfeit medicines is overcome and what others should do to effectively tackle the menace. Excerpts:
How long have you been in the practice and how did it all begin?
I have been in the practice for about 30 years now because I graduated from the University of Nigeria, Nsukka, Enugu State in June 1984, and did my internship with the Federal Medical Centre (FMC), Umuahia, Abia State. I served in Kakuri General Hospital, Kaduna State. I came to Lagos after then and someone at the PSN got me a job to work with Galaxy Pharmaceuticals. What we were doing was mainly distribution, and that was how I came into the practice.
I had a driver and an office and we went to companies to distribute to them. We used to cover areas like Bariga, Mushin, Ikeja and Agege. By the way, Idumota was not really a big name then, so I worked with Galaxy for about four years and my salary then was 1000 naira – in fact, it was around 900 naira after deducting tax (laughs).
At a time, a relative of mine in the US asked me to help him sell some drugs in Nigeria and, in doing so, I think I made a profit of about 300 naira. So I started looking for a shop with the money, having discovered that I had the skills to be a good salesperson, and I eventually got one. Incidentally, my boss had been aware of all this[intention to go into community pharmacy] because, as a child of God, I could not hide such a thing from him. He stood by me through it all and even prayed with me inside the shop I rented.
After spending the entire 300 naira in getting the shop, there was no money left to stock it; so I had to go back to God for direction and He told me to go to people I was distributing to and ask them for assistance. And as God would have it, I met some of them, especially those in Bariga and Mushin. The likes of Sabiz, Omike and the rest were my people then; so one of them called Gabiz looked at me and said he was going to give me stocks on credit that I should pay him after selling in order to get more. So I got a stock of six hundred naira from him (laugh) and that was what I started with. In fact after buying the drugs, there was no money to transport the goods. He had to made another sacrifice by helping me to bring the goods in his own car to Mende in Maryland where I opened my first pharmacy. So, Audion Pharmacy Limited started in 1989, while it was incorporated in 1990, but with lots of hard work, coupled with the grace of God, this is where we are today.
Based on your experience, how would you assess community pharmacy practice in Nigeria?
Pharmacy practice has come a long way because when I started, there were not many practising community pharmacy. There were people like Jaykay in the whole of Apapa and another one in Ikeja then. There was also Olusanya Pharmacy(though the man is late now) and Alpha Pharmacy who was just starting then. So I will say community practice has come a long way.
Many pharmacists in those days preferred to be in the industry because of the money and other benefits involved; but, to say the least, the practice has had its difficult time in the past, unlike nowadays that everybody wants to be in community practice. In those days, before setting up, you had to look for money to get a shop, register it, stock it and there was not much money in the country then and it was difficult getting a loan. So you have to struggle to raise the capital on your own.
Tell us about some of your challenges and how you were able to surmount them
The first challenge in community pharmacy practice is that of human resource management and pilfering. It’s difficult getting a trustworthy and God-fearing staff nowadays as most of them are after money and when they discover that there is no way to steal, they leave. So, it is a big challenge for us, but God has been helping me.
Another major challenge has to do with transporting of goods from one place to another – unlike in the advanced world where you could source for your goods online and they could even be transported to your pharmacy.
However the main challenge is still that of staffing. Imagine when I came back from the last ACPN conference in Ilorin, four of my staff left on the same day without any prior notice and I was helpless to the extent that I had to be at the pharmacy throughout that period before I managed to get another set of staff.
What is your view about the growing concern that newly graduating pharmacists are running away from community practice?
I have also noticed that in recent times. I think the young people of nowadays are after nothing than instant money and they are not ready to be patience about it. It’s like the inscription I read somewhere where somebody said, “God give me patience, but give it to me now.”
The challenge is impatience. Since they want to make money at all cost, they feel going into community practice may not satisfy their quest for making quick money. But community practice is not all about money-making; it’s about rendering service to humanity.
Another challenge is that of our pharmacy schools. The schools are no longer living up to expectations. Imagine a Pharmacy graduate that cannot face a patient. In fact, I take my time to correct some of them on many occasions here when I discover that the services they render are not up to expectation. But the saddest thing is that they have no patience to be trained.
Tell us about your relationship with the people of this community and the most common health conditions that bring them to your pharmacy.
I have been in this community in Ogba-Ijaiye since 1998, and I have never had a problem with any of the people. They love me and I also love them. In fact, I do to go to their homes to treat them while some of their old one soften come here sit and chat with me. Most times, they don’t leave until they discover that another set of people has arrived. In fact, there was a time May & Baker sponsored a free community typhoid vaccination programme here and they all came here to benefit from it.
Actually, the major people I deal with here are the elderly, those who get bored sitting alone and those who have nobody to talk to at home. And I take it as a duty to keep talking with them about their health and also pray with them.
The major health challenges that bring people to this place are hypertension and diabetes and the reason they come here is because they are assured of good pharmaceutical care and they feel they can talk to us. I am happy today that, at least, I’m a blessing to my community and, looking back, I am happy to be a pharmacist.
How active are you at ACPN-related activities?
I am very active at the level of the ACPN. At a time, I was made chairman, Pharmacists Day. Another time I was made a member of the planning committee for the national conference in Port Harcourt and Calabar. And, just recently, I was made chairman of the planning committee for the national conference in Ilorin.
I want others [community pharmacists] to know that if they are not there, there is no how they will know how it is being done. They should all get involved and add their quotas to the success of the profession.
How do you see the war on fake drugs and what strategy do you think can be adopted to effectively tackle the menace?
Pharmacy has come a long way and we are doing well, but it is unfortunate this war on fake drugs is proving difficult to be won because the people we are dealing with are people who want to make money by all means. But what baffles me is why we are finding it difficult to arrest those who are producing these substandard drugs. Are they not human beings and, so, can’t be arrested?
Imagine, these fake products come into the country on daily basis and pass through our borders and ports and yet we find it difficult to stop them despite the security measures in these places. What we need is total overhauling of our system. We also need to pray that God helps us.
Let me give you an example of what happen when I was at Maryland. A certain drug expired on my shelf and a boy came to my pharmacy to ask for the same drug. I told him it had expired, but he insisted that I should sell the drug to him at half price. I was amazed, but the Spirit of God told me he wanted to buy it and backdate it so he could resell it. So I went into my office, brought out a bucket of water and the products and started opening the products and pouring them into the water. That shows how bad it is in this country. I think until we all have change of mind and have the fear of God…We pharmacists should also maintain our stand and say no to stocking and selling of fake drugs.
Also, those who are non-pharmacists should also have the fear of God and accept Jesus as their Saviour (I love bringing gospel teaching into whatever I say).They should know that it is not safe to throw stones when they are in a glass house, because they can’t say who might be hit.
What is your advice to young pharmacists who are willing to come into the practice?
They should understand that ‘Rome was not built in a day.’ They should be patient and ready to learn. I told you I started with 600 naira and God, in His infinite mercies, has taken us this far and I am very sure He will do much more. So they should be calm and ready to learn. Even the Bible talks about learning; so they should be ready to learn and apply what they have learnt.
Also, they should be prudent in their spending – not that they will be thinking about cars today, house tomorrow and all that. I am worried that with the way we are going in this profession, in the next few years, there may no serious-minded pharmacists again in this country if we don’t check what these young ones are doing. They must set goals for themselves and ensure they follow such goals.
In this exclusive interview with ADEBAYO OLADEJO, Pharm. Susan Olusola Ayetoro, chairperson of Association of Lady Pharmacists (ALPs) in Kwara State, discusses the activities of lady pharmacists in the state, while also calling for stiffer penalties for drug counterfeiters in the country. Excerpts:
Tell us a bit about yourself, including your academic background
I am Pharm (Mrs) Susan Olusola Ayetoro. I am a Merit Award Winner of the Pharmaceutical Society of Nigeria, Kwara State Branch, and Fellow of the West African Postgraduate College of Pharmacists (FPCpharm).I am from Osun State. I got married to an Ondo State man. I had both my primary and secondary education in Ogbomoso and Ibadan (both in Oyo State), respectively. After that, I proceeded to the University of Ife (now Obafemi Awolowo University) Ile-Ife, Osun State, to study Pharmacy.
I had my B.Pharm (Hons) in 1986, after which I did my internship (pupil pharmacist) at Trex Chemists, Ibadan, and my NYSC programme at Children Specialist Hospital, Ministry of Health, Ilorin, Kwara State.
Since your election as ALPs chairperson in Kwara State, what changes have you brought to the association?
First, I will like to acknowledge the full support of the executives and members of the Pharmaceutical Society of Nigeria (PSN), Kwara State, for their consistent encouragement and backing. ALPs Kwara, as an interest group, has been doing its best to support PSN in all the state programmes and national conferences. There is enthusiasm and commitment of members to all ALPs programmes at the national and state levels. We are doing our best to assist the First Lady of Kwara State in her project, LEAH Charity Foundation and we go along with her anytime there is a campaign, the current one being the Cancer Awareness Programme for women in the state.
ALPs Kwara is a registered women’s group in the Ministry of Women Affairs and it also collaborates with other women professionals in the state. Most of our outreaches are usually covered by state electronic media and widely read in the local and national newspapers.
Presently, what are the major challenges facing lady pharmacists in your state?
The major challenge we are facing as ALPs in the state is funding. Most of our activities are funded by members, as God grants us the grace to do them, and we get the full support of our men in PSN Kwara State. This notwithstanding, we are moving forward and not discouraged.
In terms of membership participation, have you been getting the needed cooperation?
Membership participation is wonderful because they are always ready to come for programs and outreaches, no matter their age or status in their places of work. Our programmes are very interesting and our members are eager to make an impact in the lives of people positively. In view of this, we embark on so many programmes, such as school children deworming exercises, career talks for secondary school students, education of teenagers and youths on the implication of drug misuse and abuse, lectures on HIV/AIDS and donation of first aid boxes to secondary schools, just to mention a few.
We also collaborate with the Federation of Sickle Cell Clubs in the state, holding meetings with them and routinely donating drugs and Insecticide-treated mosquito nets. We also visit and make donations of drugs, food items and clothing to the children reception centre of the Ministry of Social Welfare, children with special needs and prison inmates.
What would you say about the campaign against fake drugs in the country?
It is disheartening that most of the medicines counterfeited are those used for the treatment of life-threatening conditions and have high public health impact. These include antimalarial drugs, antibiotics, antihypertensive and antiretroviral drugs. Selling or distributing fake drugs is a health-related crime, which poses a great threat to public health and the economy of the nation; therefore, pharmacists should be involved in the campaign against it.
In Kwara State, the Pharmaceutical Inspection Committee of the PSN has been collaborating with the government’s taskforce on fake and counterfeit drugs. They do regular inspection of premises and refer serious cases to NAFDAC for necessary action. NAFDAC also does routine post-marketing surveillance and mops up substandard/fake or counterfeit medicines displayed.
However, innovation and the use of cutting-edge technology, in combination with regulatory measures, have improved detection of fake drugs. Such innovations include the Mobile Authentication Service (MAS), which is free, easy, simple, available anywhere there is a mobile network and places the power to detect counterfeit products in the hands of the consumers.
Additionally, public enlightenment, through the print and electronic media, has been sustained in the campaign against fake drugs. Pharmacovigilance has been helpful also.
Many people have canvassed for stiffer penalties for drug counterfeiters. What’s your take on this?
It is a crime against humanity for anyone to knowingly procure and distribute fake or counterfeit drugs that can be detrimental to people’s health in the quest for profit making. In fact, the consequences of fake drugs also include loss of money on the part of the consumers because whatever money invested in buying fake drugs is a loss. Many pharmaceutical companies are also deprived of their profits, due to the unjust competition from counterfeiters, which may result in the collapse of some of the companies. In view of these, stiffer penalties should truly be meted out to drug counterfeiters.
What are those things you hope to achieve before the end of your tenure as ALPs chairperson?
By the grace of God, some of the important projects I hope to embark on before the end of my tenure as chairperson include: Mass enlightenment on the pharmacy profession among secondary school students in Kwara State. The programme aims at educating the students more on what the pharmacy profession represents and its importance.
I also hope to increase membership participation in all our meetings and programmes.
What is your advice to young pharmacists who are willing to come into the practice?
The young ones out there should know that our top priority in pharmacy profession is not money making, but saving lives. We, pharmacists, are men of honour and we tread that path always. So the thinking of adding value to people’s lives should be the most paramount in their minds. We also need to take the issue of fake drugs seriously. All hands must be on deck to tackle and curtail this menace of fake drugs in our society, at all cost.
Leadership and management of health care systems are increasingly receiving attention from countries and international organisations. In 2007, while acknowledging that the achievement of the Millennium Development Goals would generally require additional international resources, the Secretary General of the United Nations stressed that leadership and management were key to using these resources effectively to achieve measurable results.
Good leaders set the strategic vision and mobilise efforts towards its realisation; good managers ensure effective organisation and utilisation of resources to achieve results and meet aims. However, the challenge for many countries (both developed and developing) is how to provide this much needed leadership and management within resource constraints and peculiar country contexts.
In 2003, Kane and Turnbull proposed a framework for managing health systems which argued that most health systems were managed care entities and, thus, could be successfully managed by employing managed care tools such as:
Managing cost (managing insurance risk, provider and supplier prices and utilisation of services)
Managing care (developing and managing community-wide practice guidelines, care pathways, case management processes, and disease management across the continuum of care)
Managing health (development and management of population-based interventions and pooling/shifting resources among health and other sectors).
They, however, emphasised that the success of these tools depend on some features of a country’s health system which include:
Level of system funding
Structure of provider market
Proportion of population covered by health insurance
Information and communication system infrastructure
Consumer expectations
Socio-political values
While all of the managed care tools may not apply in all the systems in the overall health system of a country like Nigeria, they do provide a useful basis for analysing the leadership and management of health systems generally.
Overview of health insurance
Health insurance is insurance against the risk of incurring medical expenses among individuals. According to the Health Insurance Association of America, health insurance is defined as “coverage that provides for the payments of benefits as a result of sickness or injury. It includes insurance for losses from accident, medical expense, disability, or accidental death and dismemberment”
By estimating the overall risk of health care and health system expenses, among a targeted group, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to ensure that money is available to pay for the health care benefits specified in the insurance agreement.
In Nigeria, subscribers to health insurance mostly pay a premium, whereas in the UK and in many other European countries, funding is from payroll tax.The benefit is administered by a central organisation such as a government agency, private business, or not-for-profit entity.
Types of health insurance
1) Social Health Insurance
2) Community-Based Health Insurance
3) Private Health Insurance
Social Health Insurance (SHI)
SHI is a method of health financing where contributions for health services are collected from workers, self-employed people, enterprises and the government. Collections through SHI are often mandatory and backed by a legal act.
Contributions under SHI are usually based on the average expected cost of health service use by the entire insured group and not by that of an individual or sub-group; in other words, it is community rated. Here, the nation decides on what to collect based on what it would need to provide care for her citizens. The NHS in the United Kingdom is a good example.
Studies indicate that about 60 countries all over the world are using SHI as the predominant method for raising money for health services.27 countries have achieved universal coverage for their populations through this method.
In recent times, multilateral and bilateral organisations, such as the WHO, World Bank, and the German Agency for Technical Cooperation, have been promoting social health insurance as an alternative way to mobilise additional funds for the health system especially in developing countries. They suggest that SHI is a suitable alternative when low-income countries do not have adequate tax revenues to fund health care of reasonable quality for everybody.
Here, the target is to utilise public funds to subsidise premiums for health services,thereby shifting public subsidies from supply side to the demand side to improve efficiency and quality of health services. In fact, the World Health Assembly adopted a resolution recommending SHI as an effective strategy for financing health systems. In SHI, the premiums of the poorest can be cross subsidised by government or the local community.
The problem of adverse selection – where low risk people drop out – can be countered by trying to make insurance cover universal. However, some of the other problems of private insurance, notably moral hazard (explained below), will remain.
Community-Based Health Insurance (CBHI)
CBHI is a non-profit health insurance programme for a cohesive group of households/individuals or occupation-based groups, formed on the basis of the ethics of mutual aid and collective pooling of health risks, in which members take part in its management
CBHI has, in recent times, been advocated as a complementary method for mobilising funds for the health system especially in low-income countries. However, evaluations by the World Bank, the International Labour Organisation and others conclude that in low-income settings, CBHI schemes make only modest contributions to overall coverage and only as a complement to other formal schemes.
Studies indicate that coverage with CBHI rarely exceeds 10 per cent of the population because voluntary contributions of poor people are usually insufficient to make it viable.
Some experts, however, argue that in situations where government taxation is weak, formal mechanisms for social protection for vulnerable populations absent, and government oversight of the informal sector lacking, community health financing provides the first step towards improved financial protection against the cost of illness and improved access to priority health services.
Private Health Insurance
This is health Insurance cover provided to individuals or groups based on an assessment of the risks they carry.It differs from social health insurance because it is usually voluntary, can be very expensive and is usually not equitable. Private health care insurance confronts various problems, notably moral hazard and adverse selection.
Moral hazard is a change in behaviour towards an insurable event as a consequence of being insured. Here, the insured could become more careless or visit the clinic more often because he has been insured.
Adverse selection, on the other hand, occurs when a potential subscriber decides he is healthy enough, hence, needs not pay the amount of premium the insurer believes he should pay. Both scenarios would result in market failure.
Overview of health financing in Nigeria
Health care sector funding in Nigeria is primarily sourced from government (federal, stateand local) revenues, private sources (households and firms), and donoragencies.
Between 1998 and 2002, total health expenditure in Nigeria was US$2121 million. This corresponds to a Total Health Expenditure (THE) per capita of US$17 and 4.9 per cent of GDP. Disaggregation of this data indicates that government sources accounted for 20.6 per cent of THE, with the federal government, state governments and local governments expending 12.4 per cent, 6.2 per cent, and 2 per cent respectively.
Private sources accounted for an average of 69.1 per cent of THE; with households accounting for 64.2 per cent; firms,
4.9 per cent, and donor agencies, 10.3 per cent.
Comparatively, the total government expenditure on health as proportion of GDP is lower than that of some poorer African countries such as Rwanda, Kenya, Zambia (6.2 per cent), Tanzania and Malawi. Without considering the efficiency of fund deployment, the average THE per capita of US$ 17 is far lower than the $34 per capita that is estimated to be the cost for providing a minimum package of health intervention by the WHO commission on macroeconomics and health. This suggests that the Nigeria health sector is underfunded.
The National Health Insurance Scheme (NHIS)
The Nigerian NHIS was established in 1999 by Act 35 of the Federal Republic of Nigeria with the overall goal of enhancing access to quality and affordable health care to all Nigerian citizens. It became operational in 2005 and targets universal coverage of all Nigerians by 2015. The Scheme comprises schemes that cover formal sector workers, the urban self-employed, families and individuals in rural areas; children under five years of age, disabled persons and prison inmates.
Formal sector programme
The formal sector programme is expected to be mandatory for firms employing ten or more workers and covers workers of the federal, state and local governments; organised private sector; and military personnel.
Employees are required to contribute 5 per cent of their basic salary, which is matched by 10 per cent by the employer. Membership covers the contributor, spouse and a maximum of four biological dependants. The benefit package for the scheme is enshrined in the NHIS Act and covers basic out and in-patient care, including maternity care and basic surgery.
Basic eye and dental care are covered while expensive and complex medical and surgical care is excluded. Cover for HIV/AIDS is limited to treatment for opportunistic infections.Contributors may enjoy more benefits on payment of an additional premium.
Service provision
Services are provided through a network of registered private and public health providers.Providers are paid fixed monthly capitations for primary care services, fee-for-service for secondary care and per diem for in-patient care. Beneficiaries are expected to choose one health care provider who provides primary care services and coordinates health care across the secondary and tertiary levels
Administration
Administration of the NHIS is effected through the National Health Insurance Scheme, Health Maintenance Organisations (HMO) and Health Care Providers (HCP).
NHIS is the regulator for the Scheme (private sector programme) and is responsible for registering HMOs and HCPs; issuing appropriate guidelines for the scheme; approving format of contracts proposed by the health maintenance organisations for all health care providers; determining, after negotiation, capitation and other payments due to HCPs, by the HMOs.
HMOs and HCPs
The HMOs are private or public limited liability companies established solely for the Scheme. They are responsible for the collection of contributions from eligible employers and voluntary contributors; payment of HCPs; and establishing quality assurance systems for the HCPs. The relationship between HMOs, the scheme and HCPs is formalised through contracts. Each HMO is expected to market itself to registered subscribers in competition with other HMOs.
HCPS are public and private providers of health care services and include primary, secondary and tertiary care providers, pharmacies, laboratories and diagnostic centres.
Primary Care Providers (PCPs) serve as gatekeepers to the scheme and coordinate access to the secondary and tertiary levels of care on behalf of the beneficiary.
PCPs are paid a fixed capitation fee per beneficiary per month for primary care services. Secondary and tertiary care providers are paid on a fee-for-services basis based on NHIS approved tariffs for drugs, diagnostic investigations and specific procedures. In-patient stay is covered under the capitation up to a maximum of 15 cumulative days in a year and thereafter the beneficiary pays.
Progress so far
The Scheme commenced on 6 June, 2005 and services started in September 2005. 77 HMOs, 5949 HCPs, 24 banks, 5 insurance companies and 3 insurance brokers have been registered.
Four schemes have been launched, namely – Formal Sector Social Health Insurance Programme; Tertiary Institutions Social Health Insurance Programme; Community-Based Social Health Insurance Programme; and the Voluntary Contributors Social Health Insurance Programme.
About five million persons are reported to have been registered in the Scheme representing just about three per cent of the population.
Opportunities
Nigeria has a large population of over 160 million people with a growing economy at over 6per cent GDP and a relatively stable democracy. There is a strong political will especially at the federal level and a very huge out-of-pocket expenditure. These present a good environment for health facility growth and expansion for managed care provision.
Challenges
Nigeria has a very large informal sector – over 70per cent of the population; hence these are not covered in the formal sector scheme which accounts for the majority of subscribers.
Poverty also poses a serious challenge as over 60per centof Nigerians live on less than one dollar/day; though the relatively large out-of-pocket expenditure by individuals would also have contributed to these poverty rates.
There is a relatively low awareness of the operations of the Scheme even among care givers, coupled with a perceived poor quality of care.
The prevailing weak provider network has also posed limitations on access to care.
More importantly, the voluntary nature of the Scheme has limited access to a larger resource pool which could lead to increased efficiency. Also, weak support from state governments has not been helpful.
Way forward
The Scheme should be made mandatory and awareness increased. Provider networks should be strengthened especially at the primary care level. Also health should be placed on the executive list and alternatives sources of funding found for the Scheme, e.g. Sin tax, Sales tax etc. This is needed considering the high level of poverty.
References
Ashley, Allan and Jayen B. Patel: The Impact of Leadership Characteristics on Corporate Performance. International Journal of Value-Based Management 16:211-222, 2003.
Tubbs, Stewart L., and Eric Schultz: “Leadership Competencies: Can They Be Learned? The Business Review, Cambridge. 3(2)7-12, Summer 2005.
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Malaria has been a major threat in Africa, ravaging most of its population. According to recent figures from the World Health Organisation (WHO), about 3.4 billion people – half of the world’s population – are at risk of malaria. In 2012, there were about 207 million malaria cases (with an uncertainty range of 135 million to 287 million) and an estimated 627,000 malaria deaths (with an uncertainty range of 473,000 to 789,000). While increased prevention and control measures have led to a reduction in malaria mortality rates by 42 per cent globally, since 2000, and by 49 per cent in the WHO African Region.
Worried by the surge in malaria cases in Nigeria, the Federal Ministry of Health had launched various programmes, including the Roll Back Malaria campaign and other programmes aimed at controlling the disease in the country.
While deaths from malaria in Nigeria, as at 2010, were the highest recorded worldwide, the National Malaria Control Strategic Plan shifted the set date for the achievement of its redefined goals to 2013. One of the goals was that by the end of 2013, at least 80 per cent of patients attending any health facility would get appropriate testing and treatment for malaria, according to national guidelines.
Though the population of Nigerians who eventually received the planned treatment for malaria was not up to the projected percentage, many infected individuals actually got some treatment. However the war against is far from being won.
Facts about the disease
Malaria is a potentially fatal mosquito-borne parasitic disease that kills an estimated 655,000 people, mostly children, worldwide each year. It is transmitted through the bites of infectious female Anopheles mosquitoes. Only female mosquitoes bite, and when feeding, they can pick up malaria parasites from an infected person. After a development cycle in the mosquito lasting from seven to ten days, the mosquito becomes infectious and transfers malaria into the next human host, when feeding.
Malaria is probably the only infection that can be treated in just three days but still kills millions every year. Without prompt and appropriate treatment, malaria may become a medical emergency by rapidly progressing to complications and death. Malaria can also aggravate certain pre-existing illnesses and may even prove fatal for patients with end stage organ disease.
Malaria causes periodic fever, anaemia, and low birth weight. It can be particularly fatal in children under five years of age and pregnant women. Nigeria has the world’s largest malaria burden, containing nearly one-third of the cases in Africa. Nearly all Nigerians (97 per cent) are at risk of contracting the disease and half of the population will have at least one malaria attack per year. Malaria is also the leading cause of clinic attendance and absenteeism in Nigeria.
Malaria is caused by protozoan parasites called Plasmodia, belonging to the parasitic phylum Apicomplexa. More than 200 species of the genus Plasmodium (=plasma + eidos, form) have been identified that are parasitic to reptiles, birds and mammals. Four Plasmodium species have been well known to cause human malaria, namely, P. falciparum, P. vivax, P. ovale, and P. malariae. A fifth one, P. knowlesi, has been recently documented to cause human infections in many countries of Southeast Asia. Very rare cases of malaria have been reported due to other species such as Plasmodium brasilianum, Plasmodium cynomolgi, Plasmodium cynomolgi bastianellii, Plasmodium inui, Plasmodium rhodiani, Plasmodium schwetzi, Plasmodium semiovale, Plasmodium simium and Plasmodium eylesi. All malaria parasites infecting humans probably jumped from the great apes (in case of P. knowlesi, macaques) to man.
It is very important to remember that malaria is not a simple disease of fever, chills and rigors. In fact, in a malarious area, it can present with such varied and dramatic manifestations that malaria may have to be considered as a differential diagnosis for almost all the clinical problems! Malaria is a great imitator and trickster, particularly in areas where it is endemic.
All the clinical features of malaria are caused by the erythrocytic schizogony in the blood. The growing parasite progressively consumes and degrades intracellular proteins, principally haemoglobin, resulting in formation of the ‘malarial pigment’ and haemolysis of the infected red cell. This also alters the transport properties of the red cell membrane, and the red cell becomes more spherical and less deformable. The rupture of red blood cells by merozoites releases certain factors and toxins (such as red cell membrane lipid, glycosyl phosphatidyl inositol anchor of a parasite membrane protein), which could directly induce the release of cytokines such as TNF and interleukin-1 from macrophages, resulting in chills and high grade fever. This occurs once in 48 hours, corresponding to the erythrocytic cycle.
In the initial stages of the illness, this classical pattern may not be seen because there could be multiple groups (broods) of the parasite developing at different times, and as the disease progresses, these broods synchronise and the classical pattern of alternate day fever is established.
It has been observed that in primary attack of malaria, the symptoms may appear with lesser degree of parasitemia or even with submicroscopic parasitemia. However, in subsequent attacks and relapses, a much higher degree of parasitemia is needed for onset of symptoms. Further, there may be great individual variations with regard to the degree of parasitemia required to induce the symptoms.
Stages and symptoms of malaria development
The first symptoms of malaria after the pre-patent period (period between inoculation and symptoms, the time when the sporozoites undergo schizogony in the liver) are called the primary attack. It is usually atypical and may resemble any febrile illness. As the disease gets established, the patient starts getting relapse of symptoms at regular intervals of 48-72 hours.
The primary attack may spontaneously abort in some patients and the patient may suffer from relapses of the clinical illness periodically after eight to ten days, owing to the persisting blood forms of the parasite. These are called short term relapses (recrudescences). Some patients will get long term relapses after a gap of 20-60 days or more and these are due to the reactivation of the hypnozoites in the liver in case of vivax and ovale malaria. In falciparum and malariae infections, recrudescences can occur, due to persistent infection in the blood.
While most of the clinical manifestations of malaria are caused by the malarial infection per se, high grade fever, as well as the side effects of anti malarial therapy, can also contribute to the clinical manifestations. All these may act in unison, further confusing the picture. In some cases, secondary infections like pneumonia or urinary tract infection can add to the woes. All these facts should always be kept in mind.
Typical features of malaria
The characteristic, textbook picture of malarial illness is not commonly seen. It includes three stages, namely: the cold stage, the hot stage and the sweating stage. The febrile episode starts with shaking chills, usually at mid-day between 11am to 12 noon, and this lasts from 15 minutes to one hour (the cold stage), followed by high grade fever, even reaching above 1060 F, which lasts two to six hours (the hot stage). This is followed by profuse sweating and the fever gradually subsides over two to four hours.
These typical features are seen after the infection gets established for about a week. The febrile paroxysms are usually accompanied by headaches, vomiting, delirium, anxiety and restlessness. These are, as a rule, transient and disappear with normalisation of the temperature.
In vivax malaria, this typical pattern of fever recurs once every 48 hours and this is called benign tertian malaria. Similar pattern may be seen in ovale malaria too (ovale tertian malaria). In falciparum infection (malignant tertian malaria), this pattern may not be seen often and the paroxysms tend to be more frequent (sub-tertian). In P. malariae infection, the relapses occur once every 72 hours and it is called quartan malaria.
Diagnosis of malaria
Diagnosis of malaria involves identification of malaria parasite or its antigens/products in the blood of the patient. Although this seems simple, the efficacy of the diagnosis is subject to many factors. The different forms of the four malaria species; the different stages of erythrocytic schizogony; the endemicity of different species; the population movements; the inter-relation between the levels of transmission, immunity, parasitemia, and the symptoms; the problems of recurrent malaria, drug resistance, persisting viable or non-viable parasitemia, and sequestration of the parasites in the deeper tissues; and the use of chemoprophylaxis or even presumptive treatment on the basis of clinical diagnosis can all have a bearing on the identification and interpretation of malaria parasitemia on a diagnostic test.
The diagnosis of malaria is confirmed by blood tests and can be divided into microscopic and non-microscopic tests.
Microscopic tests
These include:
Peripheral smear study
Quantitative Buffy Coat (QBC) test
Peripheral smear study
Light microscopy of thick and thin stained blood smears remains the standard method for diagnosing malaria. It involves collection of a blood smear, its staining with Romanowsky stains and examination of the Red Blood Cells for intracellular malarial parasites. Thick smears are 20–40 times more sensitive than thin smears for screening of Plasmodium parasites, with a detection limit of 10–50 trophozoites/ìl. Thin smears allow one to identify malaria species (including the diagnosis of mixed infections), quantify parasitemia, and assess for the presence of schizonts, gametocytes, and malarial pigment in neutrophils and monocytes. The diagnostic accuracy relies on the quality of the blood smear and experience of laboratory personnel.
Before reporting a negative result, at least 200 oil immersion visual fields at a magnification of 1000× should be examined on both thick and thin smears, which have a sensitivity of 90 per cent. The level of parasitemia may be expressed either as a percentage of parasitised erythrocytes or as the number of parasites per microlitre of blood.
In nonfalciparum malaria, parasitemia rarely exceeds two per cent, whereas it can be considerably higher (>50 per cent) in falciparum malaria. In nonimmune individuals, hyperparasitemia (>5 per cent parasitemia or >250,000 parasites/ìl) is generally associated with severe disease.
In falciparum malaria, parasitised erythrocytes may be sequestered in tissue capillaries resulting in a falsely low parasite count in the peripheral blood (‘visible’ parasitemia). In such instances, the developmental stages of the parasite seen on blood smear may help to assess disease severity better than parasite count alone. The presence of more mature parasite forms (>20 per cent of parasites as late trophozoites and schizonts) and of more than 5 per cent of neutrophils containing malarial pigment indicates more advanced disease and a worse prognosis. One negative blood smear makes the diagnosis of malaria very unlikely (especially the severe form); however, smears should be repeated every six to 12 hours for 48 hours if malaria is still suspected.
The smear can be prepared from blood collected by venipuncture, finger prick and ear lobe stab. In obstetric practice, cord blood and placental impression smears can be used. In fatal cases, post-mortem smears of cerebral grey matter obtained by needle necropsy through the foramen magnum, superior orbital fissure, ethmoid sinus via the nose or through fontanelle in young children can be used.
Sometimes no parasites can be found in peripheral blood smears from patients with malaria, even in severe infections. This may be explained by partial antimalarial treatment or by sequestration of parasitised cells in deep vascular beds. In these cases, parasites, or malarial pigment may be found in the bone marrow aspirates. Presence of malarial pigment in circulating neutrophils and monocytes may also suggest the possibility of malaria.
Non-microscopic tests
Several attempts have been made to take the malaria diagnosis out of the realm of the microscope and the microscopist. Important advances have been made in diagnostic testing, including fluorescence microscopy of parasite nuclei stained with acridine orange, rapid dipstick immunoassay, and Polymerase Chain Reaction assays.
These tests involve identification of the parasitic antigen or the antiplasmodial antibodies or the parasitic metabolic products. Nucleic acid probes and immunofluorescence for the detection of Plasmodia within the erythrocytes; gel diffusion, counter-immunoelectrophoresis, radio immunoassay, and enzyme immunoassay for malaria antigens in the body fluids; and hemagglutination test, indirect immunofluorescence, enzyme immunoassay, immunochromatography, and Western blotting for anti-plasmodial antibodies in the serum have all been developed. These tests have found some limited applications in research, retrograde confirmation of malaria, investigation of cryptic malaria, transfusion blood screening, and investigation of transfusion acquired infections.
Rapid Diagnostic Tests (RDTs) detect species-specific circulating parasite antigens targeting either the histidine-rich protein-2 of P. falciparum or a parasite-specific lactate dehydrogenase. Although the dipstick tests may enhance diagnostic speed, microscopic examination remains mandatory in patients with suspected malaria, because occasionally these dipstick tests are negative in patients with high parasitemia, and their sensitivity below 100 parasites/ìl is low. Tests based on polymerase chain reaction for species-specific Plasmodium genome are more sensitive and specific than are other tests, detecting as few as 10 parasites/ìl blood. Antibody detection has no value in the diagnosis of acute malaria. It is mainly used for epidemiologic studies.
Therefore, the simplest and surest test is the time-honoured peripheral smear study for malarial parasites. None of the other newer tests have surpassed the ‘gold standard’ peripheral smear study.
Malaria prevention
Mosquito control is an important component of malaria control strategy, although elimination of malaria in an area does not require the elimination of all Anopheles mosquitoes. In North America and Europe for example, although the vector Anopheles mosquitoes are still present, the parasite has been eliminated. Socio-economic improvements (e.g., houses with screened windows, air conditioning) combined with vector reduction efforts and effective treatments have led to the elimination of malaria without the complete elimination of the vectors.
On the other hand, controlling these highly adapted, flying and hiding vectors is indeed a formidable task. Development of resistance to insecticides has compounded the problem. Ban on non-biodegradable and non-eco-friendly insecticides like DDT also may have contributed to the resurgence of malaria.
Mosquito control measures
The following are the steps in mosquito control:
Discourage egg laying
Prevent development of eggs into larvae and adults
Kill the adult mosquitoes
Do not allow adult mosquitoes into places of human dwelling
Prevent mosquitoes from biting human beings and deny blood meal
Treatment of Malaria
The effectiveness of early diagnosis and prompt treatment, as the principal technical components of the global strategy to control malaria, is highly dependent on the efficacy, safety, availability, affordability and acceptability of antimalarial drugs. The effective antimalarial therapy not only reduces the mortality and morbidity of malaria, but also reduces the risk of resistance to antimalarial drugs. Therefore, antimalaria chemotherapy is the KEYSTONE of malaria control efforts.
On the other hand, not many new drugs have been developed to tackle malaria. Of the 1223 new drugs registered between 1975 and 1996, only three were antimalarials! Hence the need for a national antimalaria treatment policy.
Antimalarial drugs can be classified according to antimalarial activity and structure.
Classification according to antimalarial activity
Tissue schizonticides for causal prophylaxis: These drugs act on the primary tissue forms of the plasmodia which, after growth within the liver, initiate the erythrocytic stage. By blocking this stage, further development of the infection can be theoretically prevented. Pyrimethamine and Primaquine have this activity. However since it is impossible to predict the infection before clinical symptoms begin, this mode of therapy is more theoretical than practical.
Tissue schizonticides for preventing relapse: These drugs act on the hypnozoites of P. vivax and P. ovale in the liver that cause relapse of symptoms on reactivation. Primaquine is the prototype drug; pyrimethamine also has such activity.
Blood schizonticides: These drugs act on the blood forms of the parasite and thereby terminate clinical attacks of malaria. These are the most important drugs in anti malarial chemotherapy. These include chloroquine, quinine, mefloquine, halofantrine, pyrimethamine, sulfadoxine, sulfones, tetracyclines etc.
Gametocytocides: These drugs destroy the sexual forms of the parasite in the blood and thereby prevent transmission of the infection to the mosquito. Chloroquine and quinine have gametocytocidal activity against P. vivax and P. malariae, but not against P. falciparum. Primaquine has gametocytocidal activity against all plasmodia, including P. falciparum.
Sporontocides: These drugs prevent the development of oocysts in the mosquito and thus ablate the transmission. Primaquine and chloroguanide have this action.
Essentially, therefore, treatment of malaria would include a blood schizonticide, a gametocytocide and a tissue schizonticide (in case of P. vivax and P. ovale). A combination of chloroquine and primaquine is thus needed in all cases of malaria.
Folate synthesis inhibitors: Type 1 – competitive inhibitors of dihydropteroate synthase – sulphones, sulphonamides; Type 2 – inhibit dihydrofolate reductase – biguanides like proguanil and chloroproguanil; diaminopyrimidine like pyrimethamine
Report compiled by Temitope Obayendo with additional information from: World Health Organisation, Africa; Malaria site; Annals of African Medicine and The Nigeria Voice
The Medical and Dental Council of Nigeria (MDCN) has called for the transfer of students of the Oba Okunade Sijuade College of Health Sciences, Igbinedion University, Okada, Edo State, to other schools.
This follows the suspension of academic activities and the subsequent ban on admission of fresh students in the college.
In a press release issued at the end of its 3rd plenary meeting, held at the council house in Kaura District, Abuja, recently, Dr Abdulmumini Ibrahim, registrar of the council, disclosed that the MDCN had directed the institution to transfer all the existing students to other accredited medical schools.
“The decision is to help the students complete their programmes as they will no longer be allowed to participate in the council’s assessment examination. This resolution supersedes the MDCN’s advertisement on the list of medical schools recently published in the dailies,” he said.
According to him, the suspension placed on Oba Okunade Sijuade College of Health Sciences will last until all the identified inadequacies are corrected and the college is ready to resume the training of medical students.
L-R: Dr Abdulmumini Ibrahim, registrar MDCN; Professor J. C. Azubuike of Medical and Dental Council of Nigeria (MDCN) and Professor Eugene Okpere of Nigeria Universities Commission (NUC), during a recent event
It would be recalled that the news of the college’s suspension was announced to the public by Dr Ibrahim in April during the induction of 395 medical doctors and dentists in Abuja. The medical doctor told newsmen that MDCN revoked the accreditation of the medical school for failing to meet the required standards.
In another development, the MDCN has also reiterated its guidelines on registration of expatriate medical and dental doctors who are expected to complete their registration with the council before they are allowed to undertake any clinical duty in Nigeria.
“We cannot do this alone. Therefore we are using this opportunity to appeal to the chief executive of each state and other stakeholders to join the MDCN to enforce this regulation,” it noted.
L-R: Pharm. NAE Mohammed, registrar, Pharmacists Council of Nigeria (PCN) and Fellow, NIM; Pharm. (Dr) UNO Uwaga, president and chairman of council, Nigerian Institute of Management (NIM) and Pharm. (Sir) Ifeanyi Atueyi, managing director, Pharmanews Ltd and Fellow, NIM during the Awards, Fellows & Spouses’ Day Luncheon, organised by NIM and held at Muson Centre, Lagos, recently.
Managing Director of Pharmanews Limited, Pharm. (Sir) Ifeanyi Atueyi, and Registrar, Pharmacists Council of Nigeria (PCN), Pharm. N.A.E. Mohammed, were among 48 eminent Nigerians who recently became Fellows of the Nigerian Institute of Management (NIM).
The memorable NIM Fellowship investiture ceremony tagged: “Awards, Fellows & Spouses’ Day Luncheon”, was held 28 August, at the Shell Hall, Muson Centre, Onikan, Lagos.
In his welcome address at the occasion, Pharm. (Dr) Nelson U. O. Uwaga, president and chairman of NIM, congratulated the new Fellows, joining the 709 existing ones, for being found worthy of the highest professional membership grade of the Institute.
Uwaga stated that the tradition which started in February 1963, when the first three Fellows of the Institute were inducted, is a great honour and privilege, adding that the Institute guards its Fellowship jealously and is always meticulous in applying criteria for the upgrade.
This, he hinted, accounts for the meagre number of Fellows of the Institute, out of a total individual membership strength of over 200,000.
The NIM boss urged the new Fellows not to be contented with just adding the designation, FNIM, to their names but to see it as a call to higher service to the Institute, the management profession, and the nation as a whole.
While presenting the NIM Fellowship plaque and certificate to Pharm. Atueyi at the occasion, Dr Uwaga commended the Pharmanewspublisher for his contributions to pharmaceutical journalism in Nigeria.
Also speaking at the event, Mr Akinbayo A. Adenubi, FNIM, chairman of P + F Ventures Limited, noted that the NIM Fellows’ Information Booklet places a big burden on Fellows, as they are expected to play critical roles in the Institute’s strategic goals of being a prime driver of management values, management standards and management professionalism.
Speaking on the topic “Random Thoughts on NIM and its Fellows”, which he modified to “NIM (Chartered) Fellows: Debtors and Creditors to the Institute,” Adenubi said Fellows should also contribute their talents, time and treasures towards generating desirable ideals that will impact on the Nigerian society, adding that Fellows as senior members of professional management should challenge themselves and participate actively in the affairs of the Institute at all strata of its informal structure.
The highlight of the occasion was the conferment of awards to some NIM members and the presentation of plaques and certificates to new Fellows
Against the backdrop of meeting the Millennium Development Goals (MDGs) target of reducing child mortality rates by a third in 2015, which is less than four months from now, there are indications that Nigeria is far from reaching the goal, as the country ranks the second largest contributor to the under-five and maternal mortality rates in the world, according to UNICEF.
Although analyses of trends show that the country is making relative progress in reducing infant and under-five mortality rates, the pace is still too significantly slow to achieve the MDG of reducing child mortality by a third by 2015.
Maternal mortality, according to the World Health Organisation (WHO), “is the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes.”
Infant mortality, on the other hand, refers to the death of infants and children under the age of five. In 2011, 6.9 million children under five reportedly died down from 7.6 million in 2010, 8.1 million in 2009 and 12.4 million in 1990. Global statistics on the challenge reveal that child mortality is more prevalent in the sub-Saharan Africa with about half of child deaths being recorded there.
Lending its voice to that of UNICEF, the Nigeria Human Rights Commission (NHRC) recently hinted that Nigeria was one of the countries in the world with high maternal and infant death rates with a ratio of 545-630 per 100,000 live births, or 75 per 1,000 live births on the infant mortality index, according to the United Nations, UN.
According to the UNICEF statement, “Every single day, Nigeria loses about 2,300 under-five year olds and 145 women of childbearing age; this makes the country the second largest contributor to the under–five and maternal mortality rate in the world.”
Relevant questions
The question that should arise from the facts and figures presented so far is, having received the charge to achieve these maternal and infant MDG goals for the past 14 years, what has kept Nigeria lagging behind in meeting the 2015 deadline? Or more specifically, one should be compelled to ask stakeholders in the country, “Whose responsibility it is to reduce the alarming rate of maternal and child mortality to the barest minimum?”
The most relevant group of persons to answer the first question are those at the helms of affairs of both federal and state ministries of health, because they are accountable for all the funds released into the ministries for this singular purpose. In fact, it is an open secret that, so far, several international agencies have donated large chunk of dollars to Nigeria for the reduction of mortality in this area; yet Nigeria still ranks the second largest contributor to maternal and child mortality rate globally.
The other question raised about the commitment of practitioners in the health care industry to this cause is also very crucial. If all stakeholders had taken it as a priority to decisively tackle the challenge of infant and maternal mortality, we should be basking in the euphoria of successful accomplishment by now. Observations, however, clearly suggest that most members of the health care team have left the responsibility to doctors and nurses. Only when a case becomes complicated and menacing do others start making frantic efforts to make their services count.
Rational steps
Now that it is evident that we may not meet the MDGs deadline, should we discontinue the quest to achieve the laudable goals, while countless infants and their poor mothers succumb to the cold hands of death? The obvious answer is no – we mustn’t throw the baby away with the bathwater. Rather, we should be thinking of what steps to take to accelerate our pace.
We may borrow a leaf from the strategic partnership between the Nigeria Human Rights Commission (NHRC) and the White Ribbon Alliance for Safe Motherhood in Nigeria (WRAN), which was engendered by the need to protect the rights of mothers in Nigeria. In a recent conference organised by the partners, a Memorandum of Understanding was drafted to spell out a working relationship for the implementation of respectful maternity care in Nigeria. They called it the “Respectful Maternity Care Charter”.
The challenge here is, if human rights organisations could form a partnership on issues relating to maternal and child health care in Nigeria, then health care practitioners cannot be excused in any way for not doing even more, having sworn to commit themselves to the task of saving lives.
Removing barriers
Barriers to progress also have to be dislodged if we expect to fulfil our mission in good time. A technical partner of the Lagos State Civil Society Partnership (LACSOP), Mrs Dede Kadiri, after surveying the environments of some Primary Health Centres (PHCs) in Lagos, said, “We were able to assess 30 PHCs in 2013 and found out four critical issues, firstly, postpartum haemorrhage; out of the 30 PHCs we went to, we found out that almost all of them were unable to handle postpartum haemorrhage. And most times, they don’t have equipment and ambulances for referral processes to send patients to the general hospital for attention.
“Secondly, to generate power supply, most PHCs still make use of candles and lanterns in the labour room; and thirdly, the attitudes of staff are resenting people off to use other alternatives such as private hospitals and traditional birth attendants. Finally, the problem of water supply and dirty boreholes are still very conspicuous.”
Also, a recent report by the Lagos State Chairman of the Society of Gynaecology and Obstetrics of Nigeria Dr Oluwarotimi Akinola, stated that the major causes of high maternal mortality rates in Nigeria are haemorrhage, infection, hypertensive disorder of pregnancy, obstructed labour and anaemia. He added that any efforts by the government to reduce maternal mortality rates in the country must address the root cause of delays in seeking health care, accessing it and receiving help at any centre.
There are also other barriers that are specific to rural areas as identified by stakeholders. Delivering a paper recently at an event organised by the National Council of Women Societies of Nigeria (NCWS), Hajiya Khadijat Mustapha Giwa of the FCT Health Department said the problems include lack of proximity of health care posts to people at the grassroots, non-functional health centres, unqualified health care personnel and illiteracy among the target groups which make them to resort to traditional birth attendants (TBAs).
Remedial strategies
There is no gainsaying the fact that the coverage and quality of health care services in Nigeria have continued to fail women and children. Presently, less than 20 per cent of health facilities offer emergency obstetric care and only 35 per cent of deliveries are attended by skilled birth attendants.
To remedy the current situation, experts have suggested that maternal health conditions can only be improved by a three-stage programme, namely:
Child spacing by self-determination of periods between the childbirths
Professional care during pregnancy and childbirth
Timely access to hospitals where complications can be treated by Caesarean cut.
It is also necessary to add that stakeholders must collaborate to form workable partnerships, with the objectives of implementing this programme, as well as providing conducive social and infrastructural environments for the improvement of the health of both mother and child.
It was a great moment at the Muson Centre, Lagos, as leading stakeholders and notable personalities in the health sector converged in Lagos on 11 September, 2014 to felicitate with the management of May & Baker Nigeria Plc., at an event organised to celebrate the company’s 70th anniversary.
Among the dignitaries who graced the colourful dinner were Prof. Onyebuchi Chukwu, minister of health; Mrs Olufunsho Amosun, first lady of Ogun State; Lt-General Theophilus Danjuma, chairman, May &Baker Plc.; Pharm. Nnamdi Okafor, managing director, May and Baker Plc.; Pharm. (Mrs) Vera Nwanze, head of Novartis Pharma (Nigeria & Ghana); Pharm. Lekan Asuni, managing director of GlaxoSmithKline (Pharma) Nigeria; David Dankaro, former chairman of May & Baker; and Prof. Ibiyemi Olatunji-Bello, deputy vice chancellor of Lagos State University (LASU) representing the first lady of Lagos State; and Pharm. Kayode Aiyegbajeje, chairman, Lagos branch of Nigerian Association of Hospital and Administration Pharmacists (NAHAP).
L-R: Prof. Onyebuchi Chukwu, minister of health; Lt-General Theophilus Danjuma, chairman of the company, and his wife, Senator Daisy Danjuma, at the May & Baker 70th Anniversary dinner.
May &Baker MD, Pharm. Nnamdi Okafor, disclosed that the company was celebrating the milestone for three reasons.
“First reason is that 70 is a landmark age that deserves to be celebrated. Second, May& Baker has during the long years saved the lives of millions of Nigerians through its quality and efficacious medicines. The last reason is because this is the moment M&B has turned full circle – moving from a distributor of products imported from its principals to a local manufacturer of quality medicines for the Nigerian market,” he said.
Buttressing the MD’s notion, Lt-General Danjuma disclosed that, within the last 70 years, many companies had collapsed due to the harsh operating environment but May&Baker had been fortunate to survive it all.
He also revealed the secret of the company’s success over the years.
“We built trust and confidence through quality products offering and a commitment to saving lives,” he said. “What we are celebrating today is the story of a great corporate legend that did not only introduce western medicine into Nigeria but equally has for seven decades been consistent in providing quality drugs that have saved millions.”
The chairman equally commended the efforts of the government through the Federal Ministry of Health and the National Agency for Food Drugs Administration and Control (NAFDAC) in assisting growth in the pharmaceutical industry.
He however noted that government needed to do more in the area of promoting private sector capacity building, as well as technological development to handle critical diseases like cancer and HIV/AIDS, and to produce vaccines for preventable health disorder.
“That way, companies can become relevant in combating epidemics such as Ebola Virus Disease (EVD),” he stressed.
Minister of Health, Prof. Chukwu said the federal government was delighted to note the giant and pioneering strides May&Baker had made in the development of the nation’s pharma sector since inception.
“All these can be attributed to the ingenious of the leadership of the company which has continued to ensure safe, efficacious and quality drugs,” he said.
Chukwu acknowledged that it was the vital role played by May&Baker and other indigenous companies that made government give support for WHO prequalification, patronage of local pharma companies in line with provision of Procurement Act 2007, facilitation of access to cheap funds, approval of the national health bill, as well as the national drug distribution policy.
Applauding the feat attained by May&Baker, Pharm. Vera Nwanze described it as significant and laudable milestone.
“As a young pharmacist then, May & Baker was one of the few foremost pharmaceutical companies around,” she recalled. “I am glad the legacy is sustained especially here in Nigeria where we know companies come and go. It has lived up to his slogan of “Strong & Reliable.”
Sharing same view, Pharm. Kayode Aiyegbajeje of NAHAP, said, “This is what 70 years of celebration should look like. It is quite good. May&Baker has been there before I was born. In fact, I grew up to know that M&B was not even a drug but a brand. I work in hospital pharmacy and can tell what the majority of the patient needs are. Over the years, May & Baker has since diversified from vaccine to other areas and has continued to be consistent and focused.”
In his own view, Pharm. Asuni of GlaxoSmithKline noted that it was expected that 70th anniversary should mean so much to a company like May&Baker.
“It shows the company has gone through transformation and it calls for celebration,” he said.
As part of efforts to reduce maternal mortality in the country, traditional birth attendants (TBA) have been charged to encourage pregnant women in their communities to go for regular antenatal check-ups, as well as patronise only registered health facilities for their deliveries.
The call was recently made by the Vice President of Livewell Initiative, Pharm. (Mrs) Bisi Bright, while speaking at the sensitisation programme for the Faith Based and Traditional Birth Attendants, Ikosi/Isheri Local Council Development area, as part of activities marking the 2014 Association of Lady Pharmacists (ALPs), Lagos State Chapter, Day.
Bright, who was a guest speaker at the event, held at the Ikosi/Ketu LGA Primary School, Ketu, explained that the TBA should realise that they were free to practise, for as long as they were aware of their limits and willing to work with the qualified health officials.
She added, by way of example, that a traditional birth attendant had no business attending to a woman that had undergone caesarean section, adding that “a woman that is hypertensive, a woman that has never given birth and a woman that has had more than five pregnancies are high risk patients and should be attended to by an expert.”
According to the Livewell VP, about145 women die in Nigeria daily, due to pregnancy-related complications. She therefore urged the TBA toen roll for further professional training, which would enhance their effectiveness and competitiveness.
Earlier in her welcome address at the event, Pharm. (Mrs) Modupe Ologunagba, chairperson of ALPs, Lagos, hinted that the reason for the annual “ALPs Day” was to create additional avenue for acquainting the public with the vital roles of lady pharmacists in healthcare delivery and social developmental work, adding that the group was delighted to celebrate the 2014 edition with the grassroots maternal caregivers in Kosofe Local Government of Lagos State.
Ologunagba also noted that the reason for picking out the traditional care givers was based on ALPs concern and desire for improvement in the country’s health indices, especially as regards maternal and child mortality.
“The current global trend in healthcare practice is collaboration and it is in this regard that we seek to promote this trend through the invitation of other stakeholders such as female medical doctors, community pharmacists, medical laboratory scientists, community health volunteers and others in the health care delivery system to the sensitisation programme,” Ologunagba said, adding that “it is our desire that this programme will initiate a change in health care practices in Kosofe Local Government Area and Lagos State, in general.”
While speaking with journalists after the event, Chairman of TBA, Ikosi/Isheri LCDA, Alhaji Rasheed Shodehinde,said the ultimate facilitator of safe delivery is God, noting that both traditional care givers and medical practitioners were mere instruments in his hand.
“What we usually do at our own end whenever we are faced with any complicated case is that we pray to God and we do everything humanly possible to save the lives of the mother and child,” he said.
The veteran traditional birth attendant also noted that the traditional care givers possess some vital skills and experiences that medical doctors may imbibe.
“Imagine if the placenta of the baby comes first and there is severe bleeding, they [medical doctors] will quickly resort to surgery, but all this would have been monitored from the beginning by the traditional birth attendant; however in severe cases, we also refer to the hospital for operation, but that will not be the first option,” he said.
Shodehinde further stated that one of the biggest challenges facing the association was unhealthy competition and discrimination from some medical practitioners.
Association of Lady Pharmacists (ALPs), Lagos State Chapter members and Traditional Birth Attendants, Kosofe Local Government Unit, at the ALPs Day of the Pharmacy Week, held at Ikosi Ketu Primary School, Ketu, Lagos.
Foremost lawyer, Barrister Ebun-Olu Adegboruwa, has called on the Pharmacists Council of Nigeria (PCN) to initiate an amendment process of Act 91 of 1992, which established it as a regulatory body for all pharmaceutical activities in the country.
Adegboruwa said this was necessary to accommodate pharmacists’ rights as well as other employment terms.
The legal icon, who made the submission while addressing members of the Nigerian Association of Hospital and Administrative Pharmacists (NAHAP) Lagos State Chapter, during the NAHAP Day held recently, stressed the need for the council to collate and establish a set of rights for practitioners in the industry.
He maintained that it was the responsibility of the PCN to state the conditions of employment of pharmacists beyond what is stated in sections 11 and 12 of the Act.
“It is not enough to practise and make money, but the environment of the practice must guarantee the safety and retirement benefits of practitioners”, Adegboruwa said.
He also suggested that a more meaningful and precise definition of a pharmacist should be included in the amendment as this would further help to rid the profession of quacks.
Speaking on the topic, “Emerging Global Trends in Patients Care: The Rights of Stakeholders”, the barrister highlighted the rights of pharmacists to include right to protection, insurance, confidentiality, association, job security, refusal, among others.
Citing the example of First Foundation Hospital, where some Ebola caregivers lost their lives in the course of duty, Adegboruwa explained that recent trends in the health care system have made it crucial for practitioners to have these rights established, adding that the level of protection must be commensurate with the risk of the environment.
The legal practitioner also spoke on patients’ rights, including the right to be treated in a dignified and friendly manner; right to effective communication in preferred language; right to cultural value; right to privacy; right to system of information of data; right to accommodation of religion; right to participate in decision about care; right to refuse care and leave the facility contrary to management decision; right to know names of practitioners in the health facility; and right to explanation for bill to services rendered.
He however decried the Nigerian situation where there is no legislation guaranteeing the enforcement of the rights of patients, thereby leaving patients at the mercy of doctors and health care givers.
“Of what essence are patients’ rights without the laws to enforce them?” he queried, while calling on the legislative arms of the government to consider working towards the establishment of patients’ rights in Nigeria.
He also called on pharmacists to always educate their patients properly on every issue, in order for them to be exempted from any eventuality that may arise from the treatment given.
Chairman of NAHAP (Lagos), Pharm. Kayode Aiyegbajeje, earlier noted that the association was doing its best to keep its members abreast fn trends in pharmaceutical care. He said the association also played a major role in sensitising the public on the prevention of Ebola Virus Disease (EVD) through health campaigns and distributed large quantities of hand sanitisers to the people at Yaba bus-stop.
SNNLive spoke with Bassam Damaj, President & CEO of Innovus Prescription drugs, Inc. (OTCQB: INNV) on the Aegis Capital Corp. Healthcare & Expertise Convention 2014 in Las Vegas, NV.
“Health care in Nigeria is changing. Our present challenges call for new ways of thinking. There is great need for visionary leaders to transform our health care organisations and to deliver outstanding products and services within our unique environment. At Pharmanews Centre for Health Care Management Development, our goal is simple – to help you prepare for the future.”
Sir Ifeanyi Atueyi – MD, Pharmanews Limited
The above statement constitutes our mission and drive at the Pharmanews Centre for Health Care Management Development. It is our business and passion to contribute significantly to the development of the health care sector in Nigeria.
Target Participants:Pharmacy Technicians
Date: Tuesday 18 – Wednesday 19 November, 2014
Time: 9:00am – 4:00pm
Venue: Pharmanews Training Centre
8, Akinwunmi Street, Mende, Maryland, Lagos.
Course Contents:
Essentials of Patient Care and Pharmacy Logistics.
Effective Communication Skills and Collaborative Practices in Care Delivery.
Self-management and understanding the Health Care Team Dynamics.
Fundamentals of Supply Chain Management and ICT Integration.
Course Objectives:
At the end of the workshop, participants will be able to:
Understand the importance of patient care and best practices for achieving effective planning and distribution of pharmaceuticals.
Develop effective communication skills and proper attitude required for effective collaboration with other health care personnel.
Work purposefully within a team to achieve common objectives and learn how best to manage self for optimum effectiveness.
Understand the principles guiding sustainable supply chain management protocols.
Integrate ICT in supply chain management for optimum performance.
Registration:
₦45,000 per participant on or before 18 October, 2014.
Group discounts: 3 – 5 participants: 10%, 6 and above participants: 15%
Cancellation:For cancellation of registration fee, 90% of the fee will be refunded, if cancelled at least seven (7) days to the workshop and this information communicated to us by sms or email, using: pharmanews@yahoo.com. There will be no refund if cancelled thereafter.
Method of Payment:
Participants should pay into Pharmanews Ltd account in Zenith Bank Plc (A/c No. 1010701673) or Access Bank Plc (A/c No. 0035976695) and send their full names and bank deposit slip numbers by sms or email to Pharmanews Ltd.
In the business of health care, understanding oneself and developing the perceptive and analytical skills required to relate with the work team and with customers are essential requirements for success.
We have designed this unique course with such considerations in mind.
We hereby invite you to attend or nominate participants for our one-dayBody Language Course for Managers and Sales Representatives.
To be delivered by one of Nigeria’s foremost body language specialists, this course promises to increase your team’s capacity to produce outstanding market results.
Please find below the necessary details.
Target Participants:Managers and Sales Personnel in the pharmaceutical and health care sector
Date: Saturday, 22 November, 2014
Time: 09.30 am – 4.30 pm
Venue: Pharmanews Training Centre, 8, Akinwunmi Street, Mende, Maryland, Lagos
Course Contents:
You and Your Corporate Personal Brand: The Brain, Colours and Brands
Understanding Impressions and Expressions
Developing Good Listening Habits
Common Mistakes Medical Reps Make
Body Language Essentials
Handwriting Analysis: A Reliable Tool in Psychoanalysis
Assessment Tasks
Learning Objectives:
At the end of the workshop, participants will be able to:
Have a better understanding of self in relation to their corporate brand.
Understand the basic principles that undergird personal impressions and expressions.
Adopt effective listening skills as a tool for improved client and work team relationships.
Identify and ameliorate common sales and marketing errors that occur with customer management.
Understand common body gestures and enhance capacity for deductions.
Develop the essential skills for handwriting analysis and its application in psychoanalysis.
Registration fee:₦30,000 per participant.
(Fee covers tea break, lunch, workshop materials and certificates ONLY)
Group discounts: 3 – 5 participants: 10%; 6 and above participants: 15%
Method of Payment:
Participants should pay into Pharmanews Ltd account inZenith Bank Plc (A/c No. 1010701673) or Access Bank Plc (A/c No.0035976695) and send their full names and bank deposit slip numbers by sms or email to Pharmanews Ltd. Payments can also be made at the training venue.
Last July, I was in Dubai for an international workshop on Health Care Financing and Innovation. The workshop, which was organised by Pharmanews in collaboration with Aster DM Healthcare, was attended by medical doctors, pharmacists and nurses.
From the analysis of the evaluation forms and comments of the participants, the workshop was very rewarding. The visit to the Aster DM facilities and the city tour made the event memorable.
Two key messages of the workshop were teamwork among the health care personnel and commitment to the welfare of the patient. Health care personnel generally were urged to respect, serve, help, encourage and exercise patience with the patient. We were challenged to learn from the service industry that does everything to provide good service to the customers or consumers.
However, one major obstacle to such admirable and patient-centered kind of care was identified as ego – the feeling of superiority and self-importance, which results in poor services to the patient. Today’s health care, as the workshop facilitators observed, demands capacity development and continuous training of personnel. Effective hospitals can no longer be managed by doctors alone. As the hospital grows, there is a need for hospital administrators, pharmacists, business managers, accountants, technologists and so on.
That aside, it was also noted that medical procedures are certainly getting more and more sophisticated; more new and complicated drugs are being developed to tackle old and emerging diseases. Hospitals are increasingly depending on sophisticated machines for their services. This implies that employment of personnel may be reducing with time. According to Rajiv Sehgal, the chief information officer for Aster DM, 85 per cent of the work of doctors will be done by machines in future.
On our way back from Dubai, I had some time at the airport, and as usual, visited bookshops. This time, one of the books I bought was “Live Life Like Never Before” by Shukla Datta. I started reading the book at the departure hall. In the process, I came across a touching story that I would like to reproduce here.
One day, a doctor entered the hospital in a hurry after being called for an urgent surgery involving a boy. He immediately went to the changing room, got ready, and went to the surgical block. He found the boy’s father restlessly walking in the hall, waiting for the doctor. On seeing doctor, the father yelled, “Why did you come so late? Don’t you know that my son’s life is in danger? Don’t you have any sense of responsibility?”
The doctor smiled and said, “I am sorry, I wasn’t in the hospital. I came as fast as I could, after receiving the call. And now, I want you to calm down, so that I can do my work.”
“Calm down?”the man asked angrily. “What if your son was facing life and death right now? If your son dies right now what would you do?”
The doctor replied with a gentle smile on his face, “I will quote from the Bible: ‘From dust we came and to dust we return.’ Doctors can’t prolong lives. Go and mediate for your son’s life; we will do our best by God’s grace.”
“Giving advice when we aren’t concerned is so easy,” mumbled the father.
The surgery took a long time, after which the doctor came out happy. “Thank goodness! Your son is saved,” he said. And without waiting for the father’s reply, he left the place as hurriedly as he came.
Minutes later, the father went to the nurse attending to the boy and asked “Why is the doctor so arrogant? He didn’t even wait, so that I could ask about my son’s condition.”
The nurse could not check her tears. Her voice was choked. She struggled for some time and then said, “His son died yesterday in a traffic accident. He was at the funeral when we called for him for your son’s surgery. And now that he saved your son’s life, he left running to finish his son’s burial.”
I do not know whether this is a true story or not, but I am sure it is not a Nigerian story. Nigeria is not a place where a patient can have the courage to yell at the doctor for coming late to work. A patient may not even be bold enough to ask for the name of the medicine prescribed for him. No patient can challenge his doctor, who is the almighty in the hospital. No doctor can be so humble as to apologise to his patient for coming late. And, definitely, no doctor in Nigeria can be so committed to his patients as to leave the burial of his own son, to rush to the hospital on call, to save another man’s son.
As I write this, doctors in government service have been on strike for several weeks, demanding improved conditions of service, while many people suffer and die for lack of medical services. The incessant attacks by Boko Haram and the Ebola outbreak are not even enough reasons to soften their hearts to save some lives.
Now, indeed, is the time to rethink the manner of care we provide in the light of the calling we claim to have received.
On the trip back to Nigeria from the Pharmanews workshop on Health Care Innovation and Financing which held in Dubai, UAE, I was able to read the greater part of the book, Entrepreneurial Spirits by Dr Poly I. Emenike. The book tells a simple story of the audacity, courage and faith of a young man who demanded something a whole lot better than what life had offered him. Today, we all know of Neros Pharmaceuticals, one of the fruits of his quest.
I mentioned that we were returning from the United Arab Emirates – another story of audacity. The UAE has successfully executed a miracle to say the least. The city of Dubai is simply beyond belief, considering the territory – an Arab nation in the desert. Dubai has successfully transformed itself into a leading global city. In a recent article by Forbes magazine, the city was ranked 7th among the world’s “necessary cities”. The report listed the most influential cities, with London and New York coming first and second respectively.
The men that conceptualised the city of Dubai and, indeed, the master plan of the UAE were simply too audacious. Today, tourists from Nigeria account for a major percentage of the shopping activities in the many malls of Dubai.
Although Dubai’s economy was historically built on the oil industry, the emirate’s western-style model of business drives its economy, with the main revenues now coming from tourism, aviation, real estate, and financial services. Only 7 per cent of its revenue comes from oil. A whopping 86 per cent of its residents are foreigners and the city boasts of the largest international airport in the world.
Aster DM Healthcare, our workshop partner, is another inspiring story of audacity. Dr Azad Moopen rose up one day, after many years of managing a single hospital, and decided to build a multinational healthcare conglomerate. Today, his firm has over 100 pharmacy outlets, 10 tertiary hospitals, 44 medical centres and more than 10,000 employees, with operations in India, the Philippines and seven other countries in the Middle East.
The concept of strategy as stretch
In a 2003 article in the Harvard Business Review (HBR), Gary Hamel and C.K. Prahalad introduced the Strategic Discipline of Stretch. Strategic stretch, simply stated, is the incongruence between organisational resources and organisational aspirations.
Strategic stretch occurs when the little Davids of the society decide to take on mighty Goliaths. It happens when we overlook our limitations and take on seemingly impossible tasks as Dr Poly Emenike, Dr Morpen and the UAE have done respectively. The result is that we begin to see things which we would not have seen otherwise.
In his book, The Business Angel as a Missionary, Prof Pat Utomi shared some of his many exploits as a teacher, businessman and politician – the audacity of his hopes and the enormity of his aspirations amidst the limitation of resources. Though he is not the founder of the Lagos Business School, he has contributed a lot to its development. Today, Pan Africa University (formerly Lagos Business School) is West Africa’s leading business school and has produced several leading business executives in Nigeria. What’s more, unknown to many, the university was born out of the aspirations of a group within the Catholic Church – just one very aspiring group!
The deduction from the HBR article is that the reason a David would always take out a Goliath is that, most times, the Goliath no longer has stretch. The Goliaths have succeeded and are now operating within the realms of their capacities. Unwittingly, they have placed a cap on the options they could consider, become less daring and innovative. This is almost a natural phenomenon – a full stomach and pride could stifle desire; and some things can only come from persistent desire.
The nature of our desires
The above suggests to me that when money, rather than the achievement of some definite objectives, becomes the sole object of our desires, we could also come to the position where we lose our strategic stretch.
In Nigeria, it is fairly easy to get satisfied once you are doing better than your colleagues. Hence, for strategic stretch to be sustained, we must be built on something other than just money, something more immaterial – though money is still a good source of stretch.
Strategic stretch and leverage
To illustrate the point of strategic stretch, consider a nascent pharmaceutical firm X, with very lean resources but with the dream of becoming Africa’s leading product development and manufacturing firm. Assume that this firm believes in the possibility of this aspiration and is really working towards achieving same, the following would be clear on observing the activities of the management at X, compared to that of another firm Y (the current largest firm in the industry).
Though the aspirations of firm X is about the same as that of firm Y, the stretch on the management of X would be greater than that on Y.
What Y would take as a given, X would consider more carefully. X would be humble and hungry – learns more, networks more, and is more willing to borrow others’ ideas and capacities.
X would find the best option (in terms of efficiency and effectiveness) if it exists simply because it has no other choice.
X could persevere in a given direction that has long-term benefits but short-term appeal to gain market share, seeing that it would be naïve to take on Y in areas where Y is strongest.
Y could find it difficult to change fast as it could have other vested interests that would favour the status quo.
X would be more focused in the application of itsenergy and resources.
X would be more daring and quicker in evaluating new knowledge and possibilities.
For its team, X would look for believers and not just employees. It would employ other compensation packages to retain good talents.
X could actually fail – but it is below already!
X would complement and balance its resources more. In X, you won’t find the sales department quarrelling for productions, for example. The firm is too small and fraternal to have such squabbles. They are more like a team – united by one purpose. Company Y could have specialists in every field but X would have more of generalists – people who think in systems. For example, at Aster DM Healthcare, the doctors managing the hospitals are more businessmen than doctors – they simply understand the business of healthcare.
Essentially, at X, leveraging is a lifestyle, that is, making the most of the available resources – of materials, money and men.
Salient clarification
The emphasis here is not that small companies do better. There are no inherent benefits in being small; a small company with a sub-par aspiration would do worse. The difference is in the level of motivation which can exist even in large firms. Thus, it is wise to say that the job of management is to create this stretch.
In the light of the ever-changing competitive landscape, it is evident that these differences in motivation and, consequently, in strategies explains why that there would always be newcomers to displace old legends; especially when the legends actually begin to see themselves as legends. These analogies form my conviction that Nigeria could become a mega power if it so desires, likewise for any young firm out there.
Our aspirations need be far greater than our resources, or we may not be able to see the invisible. This larger-than-life aspirations are, most times, God-given and could attract some jeers, but this, dear reader, is our greatest asset.
It is only this strategic stretch that will help us question our assumptions, seek cheaper options, lose old habits, become better managers, and deliver the much-needed results with few resources.
The source of stretch
How do we create stretch? How do we make a health care system administrator desire to develop a health care system that caters for over 170 million persons in a cost-effective manner? How do we make such a person move in a particular direction when some indicators point to the futility of that course of action? How do we help the person persist till he or she finds the strategy that will work?
This is one thing business schools don’t teach but it is valid none-the-less. Faith is the currency of strategic stretch. People who will be the David of tomorrow must be told to be comfortable believing in the impossible – to get used to it. We may not agree with you, but you must agree with yourself.
Stretch is created when a leader wakes up and tells the team that he has a dream – a fresh big dream. It needs not be financial; for example, yours could be to build a university network that would be able to produce a 50,000 student population per annum, or to lead a research facility that others could look up to when the next epidemic like Ebola crops up.
Also, individuals who no longer have the stretch should rather be in management positions and not in leadership positions. A leader should have stretch; maintaining the status quo is simply not good enough.
Stretch as risk
Stretch is not irrationality; it only looks so in the beginning, until you find that strategy that will work. For Dr Moopen, it was all about understanding and implementing venture-financing and resource management. For Dr Poly Emenike, it was the idea of importing Artesunate from Vietnam. For the United Arab Emirates, it was their blossoming tourism industry, airports, skyscrapers and the brand of being the ultimate business destination. (Note: the Dubai International Airport accounts for about 250,000 jobs and 28 per cent of the country’s GDP).
These individuals, organisations and nations used the resources at their disposal to connect to a strategy that works. Stretch is risky when we don’t spend the time to build the required knowledgebase and when the needed collaborations are not identified and built-upon.
Generally, risk reduces as knowledge grows; and as knowledge grows, one’s capacity to advance grows with it.
Strategic stretch and leverage
To illustrate the point of strategic stretch, consider a nascent pharmaceutical firm X, with very lean resources but with the dream of becoming Africa’s leading product development and manufacturing firm. Assume that this firm believes in the possibility of this aspiration and is really working towards achieving same, the following would be clear on observing the activities of the management at X, compared to that of another firm Y (the current largest firm in the industry).
Though the aspirations of firm X is about the same as that of firm Y, the stretch on the management of X would be greater than that on Y.
What Y would take as a given, X would consider more carefully. X would be humble and hungry – learns more, networks more, and is more willing to borrow others’ ideas and capacities.
X would find the best option (in terms of efficiency and effectiveness) if it exists simply because it has no other choice.
X could persevere in a given direction that has long-term benefits but short-term appeal to gain market share, seeing that it would be naïve to take on Y in areas where Y is strongest.
Y could find it difficult to change fast as it could have other vested interests that would favour the status quo.
X would be more focused in the application of its energy and resources.
X would be more daring and quicker in evaluating new knowledge and possibilities.
For its team, X would look for believers and not just employees. It would employ other compensation packages to retain good talents.
X could actually fail – but it is below already!
X would complement and balance its resources more. In X, you won’t find the sales department quarrelling for productions, for example. The firm is too small and fraternal to have such squabbles. They are more like a team – united by one purpose. Company Y could have specialists in every field but X would have more of generalists – people who think in systems. For example, at Aster DM Healthcare, the doctors managing the hospitals are more businessmen than doctors – they simply understand the business of healthcare.
Essentially, at X, leveraging is a lifestyle, that is, making the most of the available resources – of materials, money and men.
Salient clarification
The emphasis here is not that small companies do better. There are no inherent benefits in being small; a small company with a sub-par aspiration would do worse. The difference is in the level of motivation which can exist even in large firms. Thus, it is wise to say that the job of management is to create this stretch.
In the light of the ever-changing competitive landscape, it is evident that these differences in motivation and, consequently, in strategies explains why that there would always be newcomers to displace old legends; especially when the legends actually begin to see themselves as legends. These analogies form my conviction that Nigeria could become a mega power if it so desires, likewise for any young firm out there.
Our aspirations need be far greater than our resources, or we may not be able to see the invisible. This larger-than-life aspirations are, most times, God-given and could attract some jeers, but this, dear reader, is our greatest asset.
It is only this strategic stretch that will help us question our assumptions, seek cheaper options, lose old habits, become better managers, and deliver the much-needed results with few resources.
The source of stretch
How do we create stretch? How do we make a health care system administrator desire to develop a health care system that caters for over 170 million persons in a cost-effective manner? How do we make such a person move in a particular direction when some indicators point to the futility of that course of action? How do we help the person persist till he or she finds the strategy that will work?
This is one thing business schools don’t teach but it is valid none-the-less. Faith is the currency of strategic stretch. People who will be the David of tomorrow must be told to be comfortable believing in the impossible – to get used to it. We may not agree with you, but you must agree with yourself.
Stretch is created when a leader wakes up and tells the team that he has a dream – a fresh big dream. It needs not be financial; for example, yours could be to build a university network that would be able to produce a 50,000 student population per annum, or to lead a research facility that others could look up to when the next epidemic like Ebola crops up.
Also, individuals who no longer have the stretch should rather be in management positions and not in leadership positions. A leader should have stretch; maintaining the status quo is simply not good enough.
Stretch as risk
Stretch is not irrationality; it only looks so in the beginning, until you find that strategy that will work. For Dr Moopen, it was all about understanding and implementing venture-financing and resource management. For Dr Poly Emenike, it was the idea of importing Artesunate from Vietnam. For the United Arab Emirates, it was their blossoming tourism industry, airports, skyscrapers and the brand of being the ultimate business destination. (Note: the Dubai International Airport accounts for about 250,000 jobs and 28 per cent of the country’s GDP).
These individuals, organisations and nations used the resources at their disposal to connect to a strategy that works. Stretch is risky when we don’t spend the time to build the required knowledgebase and when the needed collaborations are not identified and built-upon.
Generally, risk reduces as knowledge grows; and as knowledge grows, one’s capacity to advance grows with it.
Mrs Olatunde Olushola is the chairman, National Association of Nigerian Nurses and Midwives (NANNM), Lagos State branch. In this exclusive chat with Temitope Obayendo, the versatile and dedicated chief nursing officer offers deep insights into the various issues surrounding nursing practice in the country. She also stresses the need for private hospital managements to employ professional nurses, in order to give qualitative care to patients. Excerpts:
What informed your choice of nursing as a profession?
I was motivated to choose nursing as a career, after the visit of the mother of one of my classmates in secondary school to her daughter during school hours. Her uniform, carriage, comportment and everything about her motivated me so much that I enquired about her and discovered she was a nurse; so I chose my science subjects.
My passion for nursing increased when I realised how much influence I could make in restoring wellness to people who are sick and make them smile again. I feel fulfilled after every thought of a sick patient regaining their health.
Also, as a holder of Bachelor of Nursing Science (BNSc) degree, I rose to the rank of a chief nursing officer and head nurse of Isolo LCDA. I served as a two-term chairman of NANNM, Agege Local Government Unit, before assuming the post of chairman, Forum for Local Government Nurses and Midwives (FOLGONM), from August 2008 to October 2011, when I assumed the position of NANNM chairman, Lagos State Council.
Are there some new skills developed for nurses to reduce infants’ morbidity and maternal mortality?
Yes, there are new skills. The advent of anti-shock garment, use of misoprostol for the control of Post-Partum Haemorrhage (PPH), training and retraining of nurses in life saving skills, obstetric care, handling of emergency cases, prompt referral of cases from primary to secondary level and two-way referral system, provision of well-equipped ambulances, etc. cannot be over-emphasised.
Also, the newly approved law of six months maternity leave for women and two weeks for men [in Lagos State] will definitely have a positive effect on maternal morbidity and mortality rate.
Is there any relationship between midwives and traditional birth attendants (TBAs) and where are they missing it?
There is a relationship between them because the duo are involved in taking deliveries; but the type and level of training, as well as method of practice, speak a lot of difference.
While the government is trying hard to modify and regulate the practice of the TBAs, trained and experienced midwives should be in charge of their activities and control their services. Midwifery is a delicate service that only a registered midwife is allowed to perform and it should be accorded that great respect. Many lives are lost every day, unknown to the government because of inadequate data, zero reporting and under-reporting of cases.
The TBAs are missing it in the area of non-regulation of their practices and inadequate reporting of maternal death.
Now that there are calls for orthodox practice to accommodate herbal medicines, is it possible for midwives to train traditional birth attendants?
No. Training of midwives can only be received in a registered school of midwifery. Anybody wanting to be a midwife should attend the school of midwifery, be registered and licensed to practice by the Nursing and Midwifery council of Nigeria, otherwise, they are referred to as quacks in the nursing profession.
Midwives are not trained to train others, but to practise and render their services as midwives in the maternity wards. Midwifery training is exclusively left for the school of midwifery to handle.
It has been discovered that majority of nurses in private hospitals are quacks, whereas registered nurses working there do all sorts of jobs. What is the association’s reaction to this?
Trained nurses are no quacks, and quacks are not trained nurses. Some private-owned hospitals believe that a shortcut to obtaining nursing services is by training quacks, who are used to murder patients in the disguise of providing nursing services. In addition, some of them cannot afford the salary of trained nurses, while some exploit the bad economy and high unemployment rate. Unfortunately, this is done at the expense of the patient’s life!
I therefore appeal to their consciences to employ trained nurses and midwives to render qualitative health care to the patients. This will elevate their hospital standard and increase the flow of patients. No amount of millions or pounds sterling can bring back a lost life.
We strongly plead with the federal and state governments to employ new nurses as the older ones retire, in order to reduce untimely death and improve the quality of life of nurses in Nigeria.
What are the challenges of nursing practice in Lagos and Nigeria as a whole, and how can they be solved?
The challenges facing the nursing profession are enormous. On the priority list is shortage of nurses and midwives throughout the federation. Secondly, inadequate recognition of the nursing profession, coupled with the inability of the majority of people, especially the lower socio-economic class, to differentiate between a trained nurse and a quack (anybody in white uniform is erroneously referred to as a nurse).
Thirdly, ignorance about who a trained nurse is and what nursing, as a profession, entails especially by some medical doctors. With reference to the insulting statement made by the president of NMA, Dr Obembe, that his used gloves could only be disposed of by a nurse, otherwise his licence would be seized – if a medical doctor of that status could display such high level of ignorance against another profession to the whole world through the media, then one wonders the species of doctors being produced in this country. Most of them travel abroad to humbly undergo nursing training, to be relevant in the health sector over there. They are trained by experienced nurses in the wards; but after that they disregard and rubbish them. This is highly unethical.
As the Lagos NANNM chairman, what is your goal for all nurses in Lagos before the expiration of your tenure?
My goal is to ensure that the services rendered by nurses and midwives in Lagos State are qualitative, life-changing, standard-proven and full of recognition, both in the public and private sectors; to ensure that nurses put in their best at all times and the nursing image is highly competitive with the international standard.
I know that, very soon, we shall attain these heights by God’s grace.
In this interview with Adebayo Folorunsho-Francis, former PSN Chairman, Sir (Pharm.) Charles U. Obowutakes a cursory look at the dynamism of the Nigerian pharmaceutical industry, its impact on the health sector and how he became a distinguished civil servant. Excerpts:
Tell us about yourself, especially your early days
I attended St Patrick’s College, Calabar from 1947 to 1951 after my elementary education at Government School, Kumba, in Cameroun. I passed the Senior Cambridge School Certificate in grade I and the London matriculation exams in 1951. In 1953, I travelled overseas to study. I studied at Kings College, University of London and the School of Pharmacy, Sunderland.
Tell us about your work experience
On my return to Nigeria in 1962, my first appointment was in the Ministry of Health as a manufacturing pharmacist, at the Federal Manufacturing Laboratory Yaba, under Mrs Nylander. Under the headship of Lady Nylander, my humble self, and Pharm. Sylvester Onwuka (later Dr Onwuka) set up the framework for the first indigenous manufacturing outfit in Lagos. Pfizer & Burroughs Wellcome had already started manufacturing in the country. We produced various tablets, intravenous drips, and chloroquine injections. These were supplied to government hospitals for use.
In retrospect, can you confidently say studying Pharmacy was a good decision?
The pharmacy profession is very satisfying. There is power in the role of the pharmacist. I saw myself as being the pivot to the wellness of the nation. Without the pharmacist, medicines and drugs which are tools in the hands of the physician and other professional health workers would not be made or prepared safely. It was both challenging and fulfilling working in the manufacturing lab.
What about your subsequent engagements
On leaving government work, I joined the private sector. I was recruited by Kingsway Chemists Limited as trainee manager in Lagos. Later I was transferred to Benin as branch manager.
When the civil war broke out, I was moved to the Aba branch of Kingsway Chemists Limited. After the war, I joined Shell Petroleum Development Company as senior pharmacist in Shell Hospital, Port Harcourt.
Before my services to Shell came to an end, I was moved to the Department of Public Affairs where I became Head, Government and Public Affairs, from 1985 to 1987. (I will reveal the rationale for this movement later). I finally retired from Shell in 1987 and set up Uchem Pharmacy Limited in Port Harcourt. In 2013, I decided it was time to put down the mortar and pestle. It is my belief that for every activity in life there is a time for retirement from active engagement.
Going by your wealth of experience in Pharmacy, how many platforms were you privileged to use?
The platforms from which I operated as a pharmacist include: government, private sector, hospital (Shell) and community pharmacy practice. These platforms provided for me rich pathways to some more non-pharmaceutical engagements.
For example, in 1975, the Rivers State Government appointed me as Chairman, PABOD Supplies Limited. In 1976, I was appointed member of Justice Allagoa Commission of Inquiry into Rivers State-owned companies, boards and parastatals. I did these jobs alongside my work at Shell Hospital.
Reports have it that you were in Gen. Muhammed Buhari’s cabinet. How true is this?
Yes, it is true. In 1983, I was invited to join Rivers State cabinet after the Buhari military coup. Shortly after that, I served as Commissioner for Commerce and Industry. Later, I was moved to the ministry of Information, Welfare, Tourism, Sports and Arts and Culture as commissioner.
In all, I served as commissioner in Rivers State from 1983 to 1985.
Is that all?
No. I had two other engagements with the Rivers State Government. Between 1994 and 1998, I was appointed Chairman of the Governing Council of the Rivers State Polytechnic, Bori. This was at the height of the Ogoni crisis. It is on record that I was the first Chairman of Council that completed the four-year tenure. Others before me (four of them) were removed before the end of their tenures.
The return of civilian rule in 1999 saw the beginning of the existence of the free medical service programme in Rivers State. I was the first chairman of that body from 1999 to 2004. The last three appointments were challenging, exciting and rewarding in terms of inputs and execution. They, in no small measure, fulfilled my yearning to do something to improve the education and health indices of our beloved country.
How active were you in PSN-related activities?
I served as PSN chairman in Rivers State on two occasions (1981-1984; 1988-1992). I was instrumental to the formation and inauguration of the Rivers State branch of the Association of Community Pharmacists (ACPN) in 1987, of which I was the first chairman (1987-1994). I was a member of NEC (1992-1994). I received the Fellowship award of the PSN in 1994. I was conferred with the knighthood of the order of St Christopher in 1995.
What was the profession like in your day compared to today’s practice?
The volume of medicaments produced today for treatment of ailments has been tremendous. This has changed the face of pharmacy practice. Hospital pharmacy has changed from dispensing and compounding to providing medicines to patients in a safe effective way. Hospital practice has become patient-oriented. This has given rise to clinical pharmacy as a specialisation. The emphasis now is on pharmaceutical care in pharmacy profession.
When I was in Shell Hospital, doctors, pharmacists and nurses took part in ward rounds. Retail pharmacy is now community-oriented; accordingly, the Association of Community Practice Pharmacy (ACPN) has become a technical group.
Manufacturing companies have increased more than ten-fold in the country. Academic pharmacy has more than quadrupled. Many universities now have faculties of Pharmacy. Consequently, the annual output of pharmacists has grown in leaps and bounds. Thus the content of Pharmacy and quantity of pharmacists has increased tremendously. But it is arguable whether this explosion translates to higher ethics and devotion to Pharmacy by the new breed of pharmacists.
What are the challenges facing pharmacy practice in Nigeria and how can they be surmounted?
Pharmacy nowadays has been so commercialised that standards have taken a dip. Today, the counterfeiting of drugs and the evils of “Register and Go” by the new breeds have become a thorn in the flesh.
How best do you think the issue of fake drugs and counterfeit medicine can be curbed?
One of the greatest challenges facing pharmacy practice in Nigeria is the issue of fake and counterfeit drugs. Counterfeiting of drugs is lethal, causing the death of many people.
Faking in general is global, leading to losses for authentic drug manufacturers. Counterfeiters have a worldwide network. To counter this evil, regulatory agencies must be involved, namely NAFDAC and SON (Standards Organisation of Nigeria), as well as customs and the consumers themselves. Consumers are also stakeholders and must work hand-in-hand with the regulators.
One of the duties of the regulators is to raise the awareness level of the consumers. The policy framework of the regulators should be constantly revised. There should be appropriate deterrent for offenders. Judges and anti-counterfeit agents should be strengthened. Culprits should be given speedy trials in our law courts. Those involved in arrest, investigation and prosecution should do their work honestly, and without delay.
What is your view about the annual PSN conferences?
PSN national conferences are good. They present opportunities to meet old colleagues. They provide for people in the same profession to deliberate and analyse issues of common interest.
I have enjoyed past conferences, although I must apologise for not attending one for some time now.
Over the years, is there any PSN president who left a lasting impression on you?
Past PSN presidents have been good. They represent young men who are anxious and ready to give leadership and their time in order to make the profession first among equals. There is no reason why the current PSN president should do less.
Of the past PSN presidents, I would rank Prof. Ogunlana high, especially as I was member of NEC during his tenure. He is a man of clarity and I think he is nimble and precise in thought, word and deed.
If you were not to be a pharmacist, what other profession would you have opted for?
Any other profession is the answer. As you might have deduced, my training and education fits me into any profession or duty but Pharmacy is my number one.
What advice do you have for young pharmacists?
In my day you were not allowed to practise until you had worked for at least three years after qualification under a qualified pharmacist. Nowadays it is not so. Young pharmacists are advised to be patient and learn the “trade” as the lives of innocent souls are at stake.
Editor’s note: The next few editions of the Pharmanews Health Care Leadership Series will focus on selected presentations made at the just concluded Pharmanews -Aster DM Healthcare workshop on Health Care Innovation and Financing. The workshop held from 19 to 23 July, 2014 in Dubai, United Arab Emirates.
Below is the introductory material prepared by the lead discussant, Dr Femi Olaleye.
Across the nation, doctors and all cadres of healthcare workers are asking for better conditions of service, including more money for themselves and for improved service delivery. With these demands come counter-claims by the government, coupled with aggressive and intimidating attacks on the leadership of the medical professional bodies and associations, all with the aim to maintain the status quo.
In fact, the Lagos State Government, in a vain attempt to win public sympathy during the last doctor’s strike in Lagos State after negotiations broke down with the striking doctors, claimed the “unreasonable demands” of the doctors would bankrupt government if their demands were to be granted. Meanwhile, while the squabbles continue, the sick continue to die due to lack of decent and affordable health care.
From the primary health centres (PHCs) controlled by the local governments to the general, state, specialist, and state university teaching hospitals owned and operated by state governments, to the federal medical centres, national hospitals, and federal university teaching hospitals that are heavily subsidised by the federal government, the story is the same – corruption and negligence leading to low quality of care and outcomes, and crumbling infrastructure. Indeed, the Nigerian public healthcare system is gravely ill, just like the patients it is meant to take care of.
However, the cure for this malaise will not come from some miracle antidote, or some ‘imported’ idea from the Western or more industrialised economies. The cure must and will come from new ideas, and pragmatic, home-grown, realistic and sustained approach to finding long-term solutions to the issues affecting healthcare delivery in Africa’s most populous nation.
One can pardon sceptics for giving up on the ability of the government to listen, much less, implementing some of the ideas that entrepreneurial clinicians and public health specialists may want to initiate. In fact, a former NMA President (2007) Dr Olukayode Akinlade, was quoted as saying that ‘’Funding healthcare is like throwing money in a bottomless pit. The more money you put in, the more it requires. It is not only a political problem; it also has financial and moral dimensions.”
I make bold to say he may just be right. There needs to be a major paradigm shift in how healthcare financing is done in Nigeria if we are to stop the rot in the system.
Blunder of the government
Really, the firmly-held belief in most quarters is that government brought all these troubles onto itself. It is hard for anyone to be surprised at the level of rot in the public healthcare system, especially when one has had the opportunity to take a look at the administration and operation of public healthcare facilities in Nigeria.
One thing all public health care facilities in Nigeria have in common is that they are all heavily-subsidised by all tiers of government – year in, year out – without any discernible(not even commensurate) improvement in the quality and range of care. Another thing they have in common is that the subsidy they all enjoy is currently misapplied on the supply side, thereby continuing to feed the culture of corruption, which has been institutionalised in the civil service; and while several administrations over the years have taken steps to correct the same anomaly in other sectors such as telecoms, oil and gas, and even banking, nothing has been done to date to correct this gross misapplication of healthcare funds.
This misapplication of resources has also had the consequence of saddling government with the responsibility of paying the salaries of the army of doctors, nurses, and other healthcare workers employed directly by local, state and federal government. And so, the vicious cycle continues with each succeeding administration!
Blueprint from experts
In 2007, the IFC (International Financial Corporation), a member of the World Bank Group, released a report, titled, “The Business of Healthcare in Africa”. In it, they argued that there were five main imperatives in healthcare delivery, namely:
Developing mechanisms for creating and enforcing quality standards for health services and medical product manufacturing and distribution.
Including as many of the population as possible in risk pooling programmes.
Channelling a portion of public and donor funds through the private health sector.
Enacting local regulations that are more encouraging of a private health care sector.
Improving access to capital, including by increasing the ability of local financial institutions to support private health care enterprises.
The big question is, can any government hospital in Nigeria, as currently constituted, achieve any of these milestones? Are they ready to shift from tradition and embrace innovative reforms?
Basis of reform
All over the world, it is no longer feasible for any country, rich or poor, to provide all needed health services to its entire population. The reason for this is the extraordinary increases in health care costs throughout the world, and the very real budgetary limitations that all countries face.
There are many reasons why health care costs have risen so dramatically. Among the most important are:
Changes in the population – in almost every country, the population has become older and more urban, leading to an increased demand for high cost tertiary care health services. As the population ages, their health care needs and costs increase.
Changes in disease patterns – Twenty five years ago, most diseases were acute, often infectious, and people suffering from these diseases were either cured or died. Today, most diseases are chronic, and patients with chronic diseases, such as diabetes, asthma and heart failure, are on expensive medicines for all their lives. Even diseases such as cancer which were once acute are now chronic, and patients can live with cancers in remission for five, ten, 20 years, or longer. The cost of treating chronic diseases is much greater than treating acute disease.
Improvements in treatments – In the last decade, new treatments and new diagnostic techniques have made very real and very expensive contributions to health. Treatments for cancer, burns, and neurological disease have saved lives and improved the quality of life for millions of people, but they have also dramatically increased the costs of health care.
As Nigeria is not exempted from this reality, it is therefore time to reform the way healthcare is financed in the country. We cannot continue planning and delivering healthcare the same way we have been doing for the past five decades.
For example, between 2009 and 2010, it is on record that the Lagos State Government spent over N38 billion on healthcare. Over 40 per cent or about N15.4b went to salaries, over 51 per cent or over N20b went to capital expenditure and over 8 per cent or about N3.2b on overhead. The next obvious question is, where are the deliverables from the over N20b healthcare CAPEX between 2009 and 2010? The remaining 35 states of the federation also have similar planning and spending pattern.
Bringing in health insurance and HMOs
When the health reform agenda of the administration of former president,OlusegunObasanjo,commenced, the FG decided to adopt an employer-based private insurance model to pool healthcare risks. Almost 10 years after the programme started, the NHIS only covers less than 7 per cent of Nigerians. This is not surprising, because when you look back at the histories of countries that have attempted to reform healthcare, it has never been an easy task.
However, it is also surprising when one considers the capabilities that have been unleashed by information technology, and with these, the ability to leap frog into the new healthcare economy. While the wisdom of implementing an employer-based health insurance scheme in a country with unofficial unemployment rate of over 50 per cent can forever be questioned, our objective is truly to find and offer a way forward by seeking to understand global healthcare financing models, challenges and opportunities for innovative ideas.
An alternative health care financing option – one of the ways that government can achieve leverage – is to enter into joint venture agreements with private investors or NGOs with social investment funds. The joint venture company will then own and operate the government hospitals. The private sector/NGO brings in equipment, capital and expertise and also provides funding and expertise towards creating a State Community Health Insurance Program, which will essentially be the anchor revenue source for the hospital(s) being managed by the joint venture. The government, on its part, provides the facility and commits to appropriating a certain percentage of the state budget into a State Health Insurance Trust Fund, which will fund the Community Health Insurance Scheme (CHIS).
CHIS makes it possible for subscribers to access healthcare at a government hospital, without the need to pay out of pocket. CHIS, apart from providing services to the elderly and indigent, can also be heavily marketed to the almost 93 per cent of Nigerians currently not covered under NHIS. People will be encouraged to subscribe through their various groups – Community Development Association, Okada Riders Association, Union of Road Transport Workers, and other self-employed groups. Because the groups guarantee a larger risk pool, the premiums could actually be as low as N6, 000 per annum for basic coverage.
An additional advantage is that because the group bears responsibility for premium collection, subscribers can even pay month to month, with less likelihood for defaults and a guaranteed platform for conflict resolution if/when they arise.
This model does not privatise government hospitals, as they will remain public. The model may actually lower costs for the hospitals, some of which they can pass to their consumers through lower prices.
Some of the advantages for government are that responsibility for staff salary will be transferred to the joint venture owners. Thus, government is relieved of this burden. It also relieves government of the burden of capital expenditure, because all CAPEX will be planned for and borne by the joint venture.
When the healthcare market in Nigeria is organised thus, its potential to generate millions of jobs directly and indirectly will also be enormous.
Bonding for progress
It is to be expected that relief from increasing costs will come from efficient improvements occasioned by partnerships. Unfortunately, although some efficiency and improvements can be expected, the experience of most developed countries is that the increasing costs associated with technology improvements and shifts in the population are of a much greater order of magnitude than any savings that can be achieved.
Additionally, there are other troubling lessons to be learnt from the experience of the richer countries in cost control and partnerships. One of these is that, as medical costs continue to increase, no one, not even the wealthy, will be able to afford the full costs of care; thus, better mechanisms for risk-sharing are needed and, inevitably, the government will become a major player and often a major funder of health care for the wealthy as well as the poor.
For this reason, governments have a very strong motivation to become more active players in defining the structure of the overall health system, public and private, and how the entire sector will allocate resources and manage costs. For this approach to be successful, partnerships will therefore become even more important, not only as a source of efficiency, but also in terms of strategic planning so that both the private and public sector can benefit from the advances in health technology without becoming victims of the financial chaos that has tarnished the health care system in most western countries.
Bridging the competency gap
There is also a critical need for capacity building in human resource management in the health sector. HR challenges – understaffing, lack of trained staff, lack of staff satisfaction, poor working conditions, and staff grievances – are severely limiting the capacity of health care organisations and professionals to meet the needs of their populations.
These are complex issues that, if neglected, contribute directly to lower standards of performance, increased turnover, higher levels of staff vacancies, constraints on health service delivery and thus poor health outcomes.
In summary, governments at all levels in Nigeria need to learn how to effectively leverage their limited resources to achieve acceptable outcomes, especially in healthcare, and the time-tested way of achieving this is to move healthcare spending away from the supply side to the demand side.
This will allow government to begin gradual withdrawal from the business of providing healthcare, making room for professionals in the field to come in and act as service providers. Non-governmental organisations, too, have a role to play in this inevitable transition.
Dr Femi Olaleye is the MD/CEO of Optimal Healthcare Limited, Lagos
Health care professionals met and synergized at the recently held Pharmanews international workshop in collaboration with Aster DM Healthcare, Dubai, on Health Care Financing and Innovation, in Dubai. It was an eventful outing with participants from across board of the health care and pharmaceutical industry. Dr Femi Olaleye also played a vital role as the lead discussant during the syndicate session.
Below are some of the pictures taken during the workshop.
Pharmanews International Workshop, Dubai
Photo Gallery
Participants at the workshop, with Sir Ifeanyi Atueyi.
A group photograph of participants, the Pharmanews team, and the Medcare team during a tour around the Medcare facility
Other participants in a group photograph with Sir Ifeanyi Atueyi.
Dr Femi Olaleye, the lead discussant, during the syndicate session.
in line with the World Health Organisation’s seven-star concept of modern pharmacy practice, the Pharmacists Council of Nigeria (PCN) has renewed its commitment to institutionalising the concept of Good Pharmacy Practice (GPP) in the country.
The newly appointed registrar of the council, Pharm. N.A.E Mohammed, disclosed this at the annual general meeting of the Pharmaceutical Manufacturers Group of Manufacturers Association of Nigeria (PMG-MAN), held recently at the Indoor Hall, MAN House, Ikeja, Lagos.
The registrar, who was the guest of honour at the event and was represented by Pharm. Amaka Okafor, director of the Inspection and Monitoring unit of PCN, Lagos, further disclosed that in his quest to move pharmacy practice from where it is to an enviable position, he has prepared a four-point agenda, which will serve as his vision for the practice.
According to him, part of the agenda is repositioning of the registry for effective service delivery by inculcating a new mind-set and advancing new ideas, arguments and processes.
“We will aim to create a veritable platform for the merging of the private sector market culture concept of high focus on clients’ needs, productivity, clients’ satisfaction, competitiveness and result-oriented activities, with the clan culture of the public service sector that focuses on collaboration and teamwork,” he said.
Mohammed further disclosed that his repositioning agenda would involve creating IT-driven pharmacy regulation procedures, as well as partnering with stakeholders capable of speeding pharmaceutical practices and processes.
Such stakeholders, according to him, include the likes of pharmaceutical industries, academia, relevant ministries, the Nigeria Customs Service, the Central Bank of Nigeria (CBN) and selected international agencies.
“We will also encourage transformation of career professionals into intellectual practitioners,” he stated, “and this will come in the area of redesigning, restructuring and strengthening of the Mandatory Continuing Professional Development (MCPD) programme. In this regard, we are looking at e-learning as the driving force in the MCPD Programme”.
While unveiling the PCN’s vision for uplifting the pharmaceutical sector of the country, Pharm. Mohammed equally assured that the recently approved National Drug Distribution Guidelines, which would become operational by 30June, 2015, would be vigorously implemented through the Mega Drug Distribution Centres and the State Drug Distribution Centres, stressing that this would eliminate illegal operators in the industry and also lessen the problem of fake and counterfeit products, while ultimately ensuring increased capacity utilisation for local manufacturers.
“Also, we intend to collaborate in facility upgrade to enhance compliance with standards. This will involve reviewing our inspection checklist, especially the Good Manufacturing Practice (GMP) and Good Pharmacy Practice (GPP), to have a more robust impact on the industry, in line with international standards,” he said.
While commending the efforts of PMG-MAN in encouraging and facilitating the World Health Organisations Good Manufacturing Practice approval for some local industries, the registrar congratulated Swiss Pharma Nigeria Limited for emerging the first WHO-GMP compliant company in the country.
There was widespread excitement at the Indoor Hall of the Manufacturers Association of Nigeria (MAN) Complex, venue of the Annual General Meeting (AGM) of the Pharmaceutical Manufacturers Group of the Manufacturers Association of Nigeria (PMG-MAN), as Pharm. Simon Okey Akpa, managing director, SKG Pharma Limited, was announced new chairman of PMG-MAN.
The event, which had Pharm. N.A.E Mohammed, the newly appointed registrar of the Pharmacists Council of Nigeria (PCN) as guest of honour, was also witnessed by notable personalities in the pharmaceutical manufacturing sector, including Chief Bunmi Olaopa, immediate past chairman of PMG-MAN; Dr Steve Onya of Chi Pharmaceuticals; Dr Fidelis Ayebae of Fidson Healthcare; Mr Nnamdi Okafor of May &Baker Nigeria; Mr Emma Ekunno of Neimeth International Pharmaceuticals Plc; Mr V. Verghese of Jawa International; Mr Abbas Sambo of Swiss Pharma Nigeria; and Chief (Mrs) Lamide Adegbenro of Topway Pharma.
In his acceptance speech, Pharm. Okey Akpa expressed his appreciation to God, as well as members of the group, for their support and confidence in him.
Speaking on behalf of all the newly appointed members of the executive, Akapa said, “We consider it a privilege to serve PMG-MAN and there is no doubt in our minds that our group being the strongest and the foremost stakeholder in the pharma industry has been made possible as a result of the hard and dedicated work of our past leaders; and it is our intention to sustain the legacy that has been laid by them.
“A lot has been achieved by our past leaders in this industry but we believe there is more to be done. So, it is our intention in this new management committee to look at all the challenges confronting the industry and to find ways through which we can surmount them. In doing so, we shall employ our areas of expertise, starting from upholding the principles of Good Manufacturing Practice, which is the hallmark of our industry, and following it to the highest standard that is possible. The new executive committee will also ensure that we continue with the tempo and spirit of the outgoing leadership.”
Speaking further, the SKG Pharma boss urged his fellow executives to imbibe the spirit of selflessness which, according to him, is the only way the Nigerian pharma sector can develop and become one of the best in Africa and the world, at large.
“I am convinced that Nigeria, as a country, has the potential to lead the rest of Africa in pharmaceutical manufacturing, but we need a very conducive environment to do that and it is our duty to create that environment. So I, as the chairman, with the help of my wonderful team and with the help of God, will be committed to the mission and vision of this group, while we seek your cooperation and prayers, so that, together, we can take PMG-MAN to greater heights,” he said.
Earlier in his handover speech, Chief Bunmi Olaopa noted that the mandate, which the PMG-MAN bestowed upon him four years ago, had afforded him the opportunity to be of service to the pharmaceutical industry and the pharmacy profession as a whole.
He also used the opportunity to urge the new leadership of the group to continue to consolidate the efforts of the outgoing administration in promoting innovation, ethical practices and healthy partnership with all stakeholders, relevant regulatory agencies and international associations.
“PMG-MAN has consistently upheld the tenets of Good Manufacturing Practice as the cornerstone of the industry, and promoted the culture which ensures documented proofs that correct procedures are consistently followed, every time a product is made, while recommending that self-regulation and good manufacturing practice audits, capacity building and good manufacturing practice workshops be sustained,” said Olaopa.
While appreciating the sacrifices of the members of the outgoing management committee and their respective companies for the progress recorded during his administration, Chief Olaopa called on the new management to ensure that the biennial Pharma Expo which, according to him, had enhanced the image of the country and created a platform for exchange between pharmaceutical manufacturers and business partners worldwide, was sustained. He also recommended that the PMG-MAN Building project be prioritised, saying the group deserved a befitting secretariat and training centre.
In his speech, Dr Fidelis Ayebae, managing director of Fidson Healthcare Plc., expressed confidence in the leadership ability of Pharm. Akpa, adding that the new chairman was one of the committed and capable senior pharmacists left in the industry.
Dr Ayebae further noted that Akpa’s experience and success as the MD of SKG Pharma was an added advantage and would assist him in paddling the canoe of the group.
“Aside coming in as a new chairman, his ideas and support were instrumental to the success of the outgoing administration; now that he is at the helm of affairs, there is no doubt that he will, as well, bring those ideas to the fore of his administration,” Ayebae enthused.
Other members of the newly elected executive committee of the PMG-MAN include: Pharm. Emma Ekunno, 1st vice chairman; Mr V. Verghese, 2nd vice chairman; Pharm. Abiola Adebayo, Treasurer; Pharm. Abbas Sambo, financial secretary; Pharm. (Mrs) Nkeiru Okoro, assistant financial secretary; Prince Degun Agboade, publicity secretary; and Chief (Mrs) Lamide Adegbenro, auditor.
Others are Dr Fidelis Ayebae, Pharm. Olakunle Ekundayo, Mr Julius Ajufo, Mr S.D Ashwin, Pharm. Steve Onya and Pharm. Nnamdi Okafor; all ex officio members.
Members of the newly elected executive committee of PMG-MAN with the outgoing chairman, Chief Bunmi Olaopa (sixth from left) and Pharm. (Mrs) Amaka Okafor, who represented the Registrar, PCN, at the end of the annual general meeting of the group held in Lagos recently.
Leadership, as described by Wikipedia, is “a process of social influence in which one person can enlist the aid and support of others in the accomplishment of a common task.” The same source also defines leadership as “organising a group of people to achieve a common goal.”
The emphasis here is on the achievement of the common goal. The common goal itself can be expanded to mean the aggregate of aspirations, expectations and direction shared by a set of individuals, groups, systems, organisations, and nations. It is for the achievement of the common goal that we all seek good leadership in our country, clubs, societies and individual organisations. We crave for leaders who will bring out the best in us. We seek visionary leadership that can see beyond the limitations of today. We seek leadership that can organise and deploy the available human and material resources for the benefit of all.
All great leaders have something unique about them. From the oldest of times, people have been led by efficient and progressive leaders. Such men and women have been responsible for ushering their people into a new and more modern world, as we now know of it. In recent history, we have some of the greatest leaders like Mahatma Gandhi, who led his Indian compatriots to independence in 1947; George Washington, founding father of the United States of America and leader of the American Revolution. He was a true visionary whose vision has endured for more than 200 years. There are others like Abraham Lincoln, Winston Churchill, Mao Zedong, Fidel Castro, and so on. What made these leaders great were their foresight, vision, strategic planning and ability to lead people to success.
Our dilemma
Nigeria, as a country, has remained underdeveloped due to paucity of good leadership. Virtually everything that we used to know and described as good in the past two to three decades is now comatose. Public education has become a travesty of what it used to be and only people who cannot afford the private sector alternatives send their children to public schools. Transportation has become a nightmare. No particular unit has escaped the pervasive rot: air, road and sea.
No particular sector of the economy is really thriving. The euphoria of the breakthrough in the telecom sector has given way to despondence, due to poor network service. We can go on and on to bemoan the sorry state of our nation, due to bad leadership now and in the past.
The health sector of the Nigerian economy is in doldrums. The health indices are among the worst in the world. The Millennium Development Goal for the health sector is more or less a mirage and may not be achieved, just like the Vision 2010 fantasy and the dead slogan, “Health for All by the year 2000”!
Our hospitals are crowded and grossly underfunded. A visit to any of the General Hospitals in Lagos will reveal the unmet needs of the population. You will see huge crowds waiting for long hours to get health care services. You will see health care professionals stressed to the bone and struggling to meet the need of the crowd in a most unfavourable environment. There is really very little to cheer about and the level of discontent (and disconnect) remains, understandably, very high. The net effect is what we see in our daily lives: avoidable morbidity and mortality, low morale among health care staff, migration of qualified personnel to other climes, etc.
Our diagnosis
We are in this sorry state because of poor leadership at all levels of administrative set up: federal, state, ministry and hospital. Our collective destiny has been grossly mismanaged and the shared aspirations and expectations have become forlorn. We have become so disoriented that absurdity has taken over our health sector.
How else can you explain the unending acrimony and the cut-throat competition among the various cadres of the health care workers? I have been following the agitation of the doctors, vis-à-vis the groaning of the other health care counterparts: pharmacists, nurses, and the rest. So many times, the hospital system has been brought to its knees, as a result of strikes which come in quick succession. For several weeks now, docotors have been on strike and there seems to be no end in sight. Much of their 24-point demand borders on the wellbeing of the other health care workers, which, if granted, will only mean the beginning of another round of strikes.
I have read the many arguments for and against the demands of the doctors and I have come to the conclusion that this crisis can be attributed to the failure of leadership, on the part of the doctors. The doctors have failed, over the years, to mobilise and effectively deploy the available health care human resources for the growth and development of the sector. There has been too much emphasis on ‘me’ or sectional interest, which has subsequently bred mistrust among the different cadres of health care workers. It is always about the doctors: that doctors must be this; doctors must be that, etc. It has never been about the common good or about the patient.
If, truly, health care service delivery is a team work, then where can we situate the health of the team in the demands of the doctors? Can the hospital system really work with the doctors alone? I have engaged many senior doctors in discussions on how to find a middle ground in this unending sector crisis. Indeed, the doctor occupies such a unique position to be regarded as the leader of the health care team and I am not sure there is much opposition to this position. The major issue is what type of leadership the doctors have given to the health sector now or in the past.
Now, there cannot be leaders without followers. If the doctors are the leaders, who are the followers? What are our commonly defined and accepted goals? Followership is not something you can decree into existence. It needs a fertile ground to germinate and grow, based on achievement of common goals. The doctors’ attitude has been to force everyone to be followers in an environment where one depends on the other to get things done. This attitude has never worked and never will. It will be nothing but slavery and no one will accept to be a slave in his father’s vineyard.
Our decision
This contribution has been long in coming because I do not want it to be seen or regarded as a doctor-bashing note from an aggrieved pharmacist. Rather, I want us to have a consideration that is fresh and solution seeking. The angle of consideration, so far, is myopic and so narrow that it leaves virtually no room for peace to prevail. The fierce argument that only doctors have the knowledge and experience to lead can only bring an equally vitriolic rhetoric from concerned parties, as we have witnessed in the past few months. It will be a hard sell for a party to agree to a position of permanent slavery in the hospital system. Even the accountants, the engineers and the administrators are complaining. What offence have they committed for seeking a career in the hospital system?
It is only in the hospital system that pharmacists find career growth and aspirations difficult to attain. At a time, in the history of the Nigerian telecommunication sector, the positions of chief marketing officer and chief sales officers of a major network were occupied by pharmacists!
No one is born a medical doctor. You go to school to study and acquire the knowledge and skills to practise, just like every other professional. I speak for myself and my colleagues who had very sound foundations at the secondary school level and could have proceeded to qualify for any profession of their choice. I could have been a rocket scientist, if it had been the will of God for me. I have some of my secondary school classmates who are now doctors as witnesses. Therefore, let us bury this superiority/inferiority argument permanently. Let us now begin to discuss common goals and how to achieve them.
To the doctors, I want to appeal for a change of attitude and a shifting of position. The current push will not favour anybody. It will breed eternal enmity between professionals and stunt the growth of the sector. The doctors need to demonstrate leadership, which is greatly in demand at this critical stage. I cannot follow you when you have continually denigrated my profession and demonstrate open hatred for everything that I represent. My natural response will be resentment and that is what you are getting now from the other health care professionals. That was what gave birth to JOHESU.
Dear Doctor, there are stages in life: dependence, independence and interdependence. The true growth comes when we are interdependent. Let us think about this. Let us expand the space to accommodate diverse interests and opinions. Let us create a hospital system that is free of discrimination of every kind. Let us create an atmosphere and environment which will allow every individual to develop his or her potential and be the best he or she can be. Let us plan for the future. A future where the next breakthrough drugs will be from Nigeria; where the next innovative surgical procedure will be from Nigeria; where infant/maternal mortality rate will be one in a million; where Nigeria will be the ideal place to be born.
This is the common goal and it will take an unbiased and focused leadership to take us there. God bless Nigeria.
Contrary to the widespread assumption that scientific research institutes in Nigeria are lackadaisical towards tackling the recent outbreak of the Ebola Virus Disease (EVD) in the country, Director General of the National Institute of Pharmaceutical Research and Development (NIPRD), Professor K.S. Gamaniel, has revealed, in a recent chat withPharmanews, that the institute was actively implementing efforts to provide the specific facilities needed to develop a viable local cure for the deadly disease.
Prof. Gamaniel, who noted that Nigeria had the human resources and intellectual capability to develop its own vaccine for the treatment and prevention of the Ebola virus, also revealed that the institute had entered into partnership with other relevant bodies, including the Lagos University Teaching Hospital (LUTH), Oxford University, and Innovative Biotech USA, for research and development of therapeutic agents, including vaccines that will help in preventing the disease.
He further disclosed that an internal call for research proposals was made in the institute on Friday 15 August for Research Fellows to come up with innovative research plans, including those responding to the urgent national health emergency on EVD.
Speaking on the experimental anti-Ebola drug, ZMapp, Prof. Gamaniel stated that the drug was the result of a scientific collaboration between companies in both the US and Canada, as well as the governments of both countries, adding that while the drug’s components and manufacturing processes might be replicable, it would be illegal to do so, due to issues of intellectual property rights.
He noted that, if Nigeria, or any other country in the world, would like to produce the same drug for its use, permission must be sought and obtained through a formal licence or agreement.
The NIPRD helmsman however assured that the federal government had concluded plans to locally commence research for treatment of the disease, adding that already, the FG had set-up the Treatment Research Group for the Ebola National Response, while the relevant research Institutions were collaborators in the initiative.
Below is the full text of the interview:
As the DG of NIPRD, what are the steps taken by the institute in searching for relevant plants to prevent and cure the Ebola Virus Disease (EVD)?
The National institute for Pharmaceutical Research and Development (NIPRD) carries out research and development (R&D) activities routinely on medicinal plants and products, as part of its official mandates. These R&D activities include the screening of medicinal plants with demonstrable immunogenic and antiviral properties. The Department of Medicinal Plant Research and Traditional Medicine (MPR&TM) has been specifically commissioned to carry out this task through its team of researchers. As at today, up to 15 of such medicinal plants have been so identified and work is on-going to ascertain their immunogenic and antiviral activities.
Efforts are now being intensified to provide the specific facilities required for screening and working with the deadly Ebola virus in the institute and to identify competent collaborators on this assignment. Meanwhile, an internal call for research proposals was made in the institute on Friday 15 August for Research Fellows to come up with innovative research plans, including those responding to this urgent National Health Emergency on EVD.
A species of tobacco has been recognised as one of the active components in the production of ZMapp, the experimental drug for curing EVD. Is this species of tobacco available in Nigeria?
Tobacco is Nicotiana tabacum and it is found in Nigeria. But the strain used for the cultivation of the antibodies used for ZMapp might not be found here. We should know that tobacco plant is notpart of the recipe for ZMapp; the plant was only used as carrier to multiply the artificial antibodies which was later extracted from the plant to make the recipe for the treatment.
The artificial antibodies used in the ZMapp treatment were created from a particular tobacco-plant strain found in Australia. The plants were genetically modified to serve as an ideal medium to grow the massive amounts of the antibodies needed for the treatment. The antibodies were then harvested and ground into the green mix used in the serum doses. Charles Arntzen, a plant biotechnology expert at Arizona State University, said that the appropriate viral genes for the antibodies that the scientists want are fused to the tobacco genes, infecting the tobacco with the virus. The plant produces antibodies that are subsequently separated from the plant when it is ground up.
What would it cost to embark on similar research in Nigeria?
Even if we know what was used to make the ZMapp, we cannot go ahead to produce such because of issues of intellectual property rights. If Nigeria or any other country in the world would like to produce the same ZMapp for its own use, permission has to be sought and obtained through a formal licence or agreement signed to that effect by both parties, irrespective of whether the receiving party has the capacity to produce the product on its own.
I must point out however that Nigeria has the human resources and intellectual capability to develop its own vaccine for treatment and prevention of Ebola virus. The institute, in collaboration with other relevant bodies, have started putting in place plans to commence research in the area of treatment and vaccine for prevention of EVD.
ZMapp™ is the result of a scientific collaboration between Mapp Biopharmaceutical, Inc. and LeafBio (San Diego, CA), Defyrus Inc. (Toronto, Canada), the U.S. Government and the Public Health Agency of Canada (PHAC). ZMapp™ is composed of three “humanised” monoclonal antibodies manufactured in plants, specifically Nicotiana tabacum. It is an optimised cocktail combining the best components of MB-003 (Mapp) and ZMAb (Defyrus/PHAC). ZMapp™ was first identified as a drug candidate in January 2014 and has not yet been evaluated for safety in humans.
EVD has been with us in Africa for a while now. Is NIPRD collaborating with any international research institute to tackle the infection?
Yes, NIPRD has initiated collaboration with the Lagos University Teaching Hospital (LUTH), Oxford University, and Innovative Biotech USA for research and development of therapeutic agents including vaccines.
Since health facilities and staff stand the highest risk of being infected, how can they detect an Ebola patient before admission? And if detected, should they admit or reject the patient?
The essence of our collaboration with institutions like LUTH is to work with experts like Prof. Omilabu, who is a renowned virologist, with sufficient experience to handle victims of the EVD. Patients with EVD shall be isolated and workers shall wear personal protective equipment before getting near the infected persons. No patent will be rejected, as this will be unethical and inhuman, but all handlers will be adequately trained to handle patients safely.
Aside from the routine preventive measures, is there any other comment you would like to add?
The Ebola viral infection has a 90 per cent fatality rate and, so far, there is no cure. It is imperative that hard and unusual decisions would be inevitable in order to save lives. Particularly for drug treatments, the use of experimental drugs may be necessary.
This certainly is not the best of news for local drug manufacturers as Nigeria’s pharmaceutical imports have been forecast to reach $789 million by 2018, thereby widening the country’s pharmaceutical trade deficit from the $475 million it posted in 2013.
Addressing a gathering of foreign investors, pharmacists and other health practitioners during the Nigeria-Pakistan Pharma Investment Forum (NIPIF 2014), Mr Farouk Gumel, a PwC West Africa adviser, who was the keynote speaker at the forum, explained that the $789 million projected import mark clearly represents a 10.4 per cent rise from what was recorded in 2013.
During his presentation on “Investment Opportunities in the Pharmaceutical Sector – Nigeria/Pakistan”, Gumel disclosed that despite the gloomy prediction, imports still remain key to meeting growing local demand for medicines in the country.
The keynote speaker also took a swipe at the Nigeria’s critically low levels of human and infrastructure resources for health care, adding that while no reliable data exists, various estimates have put the amounts so far spent on medical tourism abroad over the years at between $500 million and $800 million.
“Some of the top medical tourist destinations observed over the years include India, Europe, the United States and the Persian Gulf. In fact, the Indian High Commission estimated that 47 per cent of Nigerians who visited India in 2012 did so to seek medical attention, spending $260m on treatment – about $15,000 per medical tourist,” he said.
According to the PwC West Africa adviser, a research conducted by the International Medical Travel Journal had it that the major medical conditions most Nigerians often travelled abroad for include brain surgery, open heart surgery, eye treatment, renal transplants, cancer and cosmetic surgery.
“What this simply means is that opportunities exist for investors to take advantage of, especially in the gap noticeable in the health and pharmaceutical sector in Africa’s largest economy,” he opined.
Gumel buttressed his view by saying that although there were over 130 pharmaceutical companies in Nigeria, only nine were listed on the stock exchange.
“These pharma firms include Neimeth, Neros, Emzor, May & Baker Nigeria, Fidson, Drugfield, Nigerian German Chemical Plc (NGC), Novartis and GSK. Also, some of the common drugs they produce are anti-malarials, vaccines and antiretroviral (ARV), antibiotics, anti-helminthics, oncology drugs and diabetic drugs,” he noted.
The speaker was however quick to laud the efforts so far made by NAFDAC to sanitise and standardise the pharmaceutical industry. Gumel declared that, among other things, NAFDAC now inspects factories anywhere in the world before it registers or renews the registration of their products; mandates all pharmaceutical companies to imprint unique numbers on drugs; requires compulsory pre-shipment information from all importers before the arrival of their products, and collaborates with the NHIS (National Health Insurance Scheme) to combat drugs counterfeiting and the illegal sale of prescription drugs.
“Not only that, I am aware they are collaborating with the Pharmacists Council of Nigeria (PCN) to close pharmaceutical companies involved with illegal and fake drugs, as well as launching of a Mobile Authentication Service (MAS) to check the authenticity of pharmaceutical products. These efforts are quite remarkable,” he stated.
The presentation also highlighted some of the features Nigeria and Pakistan had in common such as population size, health expenditure in the budgets of both countries and size of pharmaceutical companies on both sides.
“Also, Nigeria and Pakistan have similar disease burden with a significant proportion of deaths attributable to communicable diseases, with malaria, diarrhoea and dysentery being common ailments,” he observed.
In his conclusion, Gumel said that the bilateral trade between Nigerian and Pakistan had since peaked and reached the incredible mark of $56 million.
“In my opinion, I think the Pakistani pharmaceutical Industry is expected to post steady growth into the near future, while the Nigerian pharmaceutical Industry is expected to grow at a faster rate until 2020,” he stressed.
No fewer than 50 investors from Pakistan attended the forum, as well as two investors each from Jordan, the United Arab Emirates (UAE) and Ghana, confirming reports that Pakistani companies are indeed eager to make an inroad into the Nigerian pharmaceutical industry.
Tributes flowed endlessly for the late former Minister of Information and Communications and erstwhile Director General of the National Agency for Food and Drug Administration and Control (NAFDAC), Prof. Dora Nkem Akunyili, as the Association of Lady Pharmacists, Lagos State chapter, paid a condolence visit to the current Director General of NAFDAC, Dr Paul Orhii, at his office in Oshodi, Lagos, recently.
Prof. (Mrs) Dora Nkem Akunyili, who died in an Indian hospital on 7 June, after a battle with cancer, assumed office in April 2001 as Director General of NAFDAC.She was an internationally acclaimed pharmacist and pharmacologist.
Chairperson of ALPs, Pharm. (Mrs) Modupe Ologunagba, Sstated that the visit was to enable members of the association sign the condolence register prepared for the late pharmacist, as well as to deliver their condolence letter to Dr Orhii.
Ologunagba described Akunyili as a patriotic, dedicated and hardworking person, adding that she was also a woman of integrity and a role model to the lady pharmacists.
“She was a Nigerian that everybody loved and a national hero,” she said.”Her antecedent in the practice portrayed the motto and objective of our association because in ALPs, we strive towards professional excellence and she actually conveyed excellence in her activities and work.”
The Lagos ALPs boss further suggested that a day be set aside as a public holiday, especially for those in the health sector, in Akunyili’s honour.
“I think Prof. Dora Akunyili, being a national symbol, should be immortalised in Anambra State, where she hailed from, and in her professional circle, by dedicating a day in her honour to celebrate her and her contributions to the issue of drug distribution and her fight against drug counterfeiting in Nigeria. It will also serve as a way of mentoring others to also follow her footsteps,” She stated.
Corroborating Ologunagba’s view, a prominent member of the association, Pharm. Oluwafunke Adepegba of Funket Nigeria Limited, said there was nothing wrong in dedicating a day in Akunyili’s honour as this would promote the virtues of courage, commitment and dedication, which the late luminary exemplified.
“Late Prof. Dora Akunyili was a very bold person and her boldness was part of the reasons that made her successful as the Director General of NAFDAC because there were lots of big obstacles that could have prevented her from being successful; but she was able to overcome the so-called obstacles and, today, her works still speak for her,” said Adepegba.
While receiving the group and their letter of condolence, Dr Paul Orhii, who was represented by the NAFDAC Director of Narcotics and Controlled Substances, Pharm. (Alh.) Hashim Ubale Yusufu, appreciated ALPs for finding time to condole the agency on the loss of the pharmacy icon, while adding that the agency was taking solace in the fact that the former DG had gone to rest with her creator.
While apologising for his unavoidable absence, Dr Orhii affirmed that Akunyili’s demise was a major blow to NAFDAC and the entire nation.
“Of course, we are really grieved because Prof. Dora is so dear to us. She was a hardworking woman who has the love of this country at heart; and she was that type of person that would tell you her mind and what she felt without fear or favour.She is a great loss to us in NAFDAC and of course the entire nation,”he said.
ZMapp, a combination of three humanised monoclonal antibodies, has recently dominated the headlines as the only available treatment for the dreaded Ebola Virus Disease (EVD). The drug is one of the arsenals in the medical kit of the United States’ National Institute of Health that also include DNA vaccines and patents of the Ebola virus itself.
Produced under contract by Mapp Laboratories, ZMapp represents a wonderful demonstration of the power of effective partnerships between public research organisations and the private industry. A study of the efforts made by the US government shows a strong degree of long–term cohesive thrust between different organisations that include the National Institute of Health (NIH), Centres for Disease Control and Prevention (CDC), the United States Army Medical Research Institute of Infectious Diseases (USMRIID), the Canadian government and a host of private pharmaceutical firms.
Apparently, each member of the partnering group had been preparing for a time like this and the outbreak was simply an opportunity to evaluate their degree of preparedness. The United States, in particular, had reasons to take Ebola seriously. One is that there are no known cures for EVD, as the rapid onset of symptoms does not allow the host immune system to develop sufficient antibody for boosting immunity. Another more important reason is that the Ebola virus constitutes a potential biological weapon. If this was a war, the United States was ready; Nigeria, on the other hand, could have been wiped out.
We wish to note that it is the same United States Army that made significant contributions in the search for Ebola vaccines and treatments that sponsored some of the massive research efforts undertaken by Prof. Maurice Iwu in 1985. The United States government, also, through the NIH, sponsored a similar project at the National Institute for Pharmaceutical Research and Development (NIPRD) that centred on multi-drug resistant tuberculosis.
No doubt, a host of other Nigerian research grants are sponsored by international governments working in tandem with the local industry and we know that the terms of the intellectual property rights sharing is always in favour of the one paying the bill, being the one seeing the bigger picture. The inference is that great nations are built on strong ideas and structures. It is great institutions, public and private, that comprise these structures. A pivotal responsibility of leadership is to fashion out modalities for the smooth operation of these structures as they seek to address national prerogatives.
It is our belief that the Nigerian health care landscape is wanting in both effective ideas and structures. There is no consistency between our professed long-term objectives and a commitment to the development of the requisite structures.The impasse between the government, medical doctors and other health care professionals is one of the clear indicators that we are yet to even arrive at what constitutes our long-term objectives and how we hope to achieve them.
At the onset of the President Obama administration, his commitment to a national health care agenda and the manner in which it was executed was unmistakable. In the case of Nigeria, however, there is apparently yet to be ownership of the health care agenda. Someone might even argue that there is no agenda yet, at least a compelling one
The Ebola crisis, therefore, is a wake-up call. It tells us that there are consequences, grave consequences for our ineptitude. It reminds us that, without a strong national spirit in our quest for development, we will always be at the mercy of other nations even for things we could have resolved ourselves.
The resounding message we get from the National Institute for Pharmaceutical Research and Development is that Nigeria indeed has the capacity to develop a serum similar to ZMapp and we in no way question the capacity of its leadership. Our worry is that a nation like ours with an already diminished elite human resource base need not lose heroes like Dr Ameyo Adadevoh, before we arise to our capabilities.
Health care is an integrated system; it can only be built on strong ideas and strong institutions by individuals who have a system view and a long-term commitment to noble objectives.
Prof. Emmanuel Chinedum Ibezim has been announced new dean of the Faculty of Pharmaceutical Sciences, University of Nigeria, Nsukka.
Born on 16 January, 1964, Ibezim had his M.Pharm (1987-1988) and PhD in Physical Pharmaceutics (1990-1995) from the University of Nigeria, Nsukka.
The don started out as a pupil pharmacist with the General Hospital, Owerri in Imo State (1985-1986) before switching to Chanpharm in Jos as superintendent pharmacist.
His last engagement before his latest appointment was professor in the same institution from 2006. His appointment took effect from 1 August and will last for two years.
“Health care in Nigeria is changing. Our present challenges call for new ways of thinking. There is great need for visionary leaders to transform our health care organisations and to deliver outstanding products and services within our unique environment. At Pharmanews Centre for Health Care Management Development, our goal is simple – to help you prepare for the future.”
Sir Ifeanyi Atueyi – MD, Pharmanews Limited
The above statement constitutes our mission and drive at the Pharmanews Centre for Health Care Management Development. It is our business and passion to contribute significantly to the development of the health care sector in Nigeria.
We wish to invite you to participate in our forthcoming transformative health care management workshop. This workshop is designed to help health care personnel achieve an effective synergy between the right strategies, structures, knowledge base and attitude required to drive service improvements in the health care sector.
Target Participants:
Doctors, Pharmacists, Nurses, Medical Laboratory Scientists and other Clinical, Administrative, Management and Technical personnel in the health care system.
Date:Tuesday 2 – Thursday 4 December, 2014
Time: 8:00am – 4:00pm
Venue: Pharmanews Training Centre,
8, Akinwunmi Street, Mende, Maryland, Lagos
Course Contents:
Management and Team Development
Organisational Structures and Change Management
Quality Measurement and Management
Essentials of Health Care Research Management
Health Care Financing in Nigeria
Stress Management
Syndicate Sessions
Learning Objectives:
At the end of the workshop, participants will be able to:
Understand Clinical Leadership and the management concept of Work Teams and Team Development.
Understand the relationships between organisational strategies, structures and essential elements of change management.
Master basic organisational planning and evaluation tools for total quality management in a health care setting.
Develop the necessary skills and attitude required to lead clinical research projects.
Understand the essentials of health care financing in developing and developed nations, with special focus on the Nigerian health care sector.
Learn how to effectively manage stress and stress related disorders at work and in other settings.
Topic Case
Our training approach in addition to traditional lectures emphasizes the use of relevant case studies to stimulate learning and development. Participants are involved in syndicate sessions where they collaborate with colleagues to develop practical and relevant interventions from the taught material.
Registration Fee: ₦70,000 before 2nd November, 2014. Afterwards, ₦75,000.
The proposed training cost covers tea break, lunch, workshop materials and certificates ONLY.
Group Discounts: 3 – 5 participants: 10%, 6 and above participants: 15%
Cancellation:For cancellation of registration, 90% of the fee will be refunded, if cancelled at least seven days to the workshop and this information communicated to us by sms or email to Pharmanews Ltd. Online payments can also be made via our website at www.pharmanewsonline.com
Method of Payment:
Participants should pay into Pharmanews Ltd account in Zenith Bank Plc (A/c No. 1010701673) or Access Bank Plc (A/c No. 0035976695) and send their full names and bank deposit slip numbers by sms or email to Pharmanews Ltd. Payments can also be made at the training venue.
Managing Director of Optimal Healthcare Limited, Dr Femi Olaleye, has declared that it has become a difficult task for individuals to build and run hospitals successfully in Nigeria.
Addressing participants at a three-day workshop on “Effective Leadership In Health Care Delivery” held at Pharmanews Training Centre, Maryland, Lagos on 20 May, 2014, the medical doctor explained that operating hospitals in Nigeria today comes with several challenges.
“You have to consider the rent, staff salary (which includes payment for security guards to secure your property), change of equipment from time to time, and of course, fuel to power your generator, in the absence of steady electricity supply,” he stressed.
Speaking further, Olaleye revealed that in most developed countries like the United Kingdom, medical equipment is not owned by the government or hospital managements.
“The medical equipment you see around in those hospitals, including beds, is leased. Unlike most Nigerian hospitals that wait for government to buy new equipment to replace old or outdated ones, the ones abroad are replaced immediately more sophisticated ones hit the market, with no extra cost as part of the lease arrangement,” he noted.
Olaleye further emphasised the indispensability of Public-Private Partnership (PPP) in running effective and profitable hospitals.
“We cannot afford to leave everything for government because those at the helm of affairs cannot do it alone,” he canvassed.
The medical doctor however cautioned that entering into partnership with any organisation or individual demands specification of roles for each partner, as well as documentation of agreements.
“Even if you cannot afford a lawyer, ensure whatever you discuss and agree upon is put in ‘black and white’ to make it legal,” he counselled.
In attendance at the workshop were doctors, pharmacists, nurses, medical lab scientists and other clinical, administrative and technical personnel in the health care system.
Cadila Prescribed drugs Ethiopia PLC (CPEL) is a three way partnership between Cadila Prescribed drugs Restricted PLC of India and Almeta Impex PLC. CPEL is likely one of the few giant state-of-the-art prescribed drugs manufacturing vegetation within the Ethiopia.
“The intention of this joint-venture is to make a outstanding distinction within the lives of the Ethiopian folks by offering them with healthcare options of the very best high quality at reasonably priced costs and a assured provide, thus carving a definite identification in any respect ranges”
It was recently reported in the media that the federal government was working towards enacting a law that would make it mandatory for intending couples to go for the Human Immuno-Deficiency Virus (HIV) test before being allowed to wed in churches and mosques.
The move, it was reported, was part of measures to curb the spread of the deadly virus in the country. In this edition of Viewpoint, our reporter, Oladejo Adebayo, went out to ask the opinions of people on the purported scheme. Their reactions are presented below.
FG should bring back our girls first
I think the problem with the federal government is that of misplaced priority. There are so many pressing challenges facing the nation and the government can’t find a solution to any of them; yet they keep coming out with a series of unnecessary laws that are not beneficial to the people.
Come to think of it, is that the real thing bothering us in this country? There are lots of things that need to be done. How far have we gone with the issue of insecurity of lives and properties? What has the federal government done about the abducted Chibok Girls that have been in captivity for more than three months? Can’t they do something about the incessant bombing and kidnapping that has turned the country to a ‘no go’ area for visitors and investors? I think the federal government should mind their business and leave the intending couples alone.
Again, I think the issue of HIV/AIDS is being overhyped in this part of the world because it is not really a major threat like that – unlike so many other diseases that we do not even care about.
Another reason I do not support the plan has to do with the issue of stigmatisation. How do we handle the challenge of stigmatisation that is bound to ensue, if the status of people living with HIV is exposed? So, I think the move should not be made compulsory; rather it should be for those who are interested in it.
– Titilope Balogun (Akure, Ondo State)
It’s a good move
I think the federal government is right on this one. The HIV/AIDS burden globally is worrisome and something drastic should be done to reduce its spread. Majority of people still do not believe that HIV/AIDS is incurable; while some have been brainwashed to think that the HIV campaign is just a strategy by the World Health Organisation to discourage the rate at which people engage in sexual intercourse. So, this is a good move and I am sure it will guard against the spread of the virus.
However, this step must be followed up with intensive awareness programme by the various health organisations, as this will go a long way in reducing the menace. The awareness programme should cover the stigmatisation aspect, so as to avoid people living with the disease dying as a result of depression and shame. The reason most people are afraid to go for HIV/AIDS test or counselling is due to the way people perceive things like that in our society. It is so bad to the extent that once people know that you are an HIV patient, they see you as an outcast, and that alone kills faster than the disease itself. So the government should do something about it. In my own opinion, the plan is good and should be passed into law without hindrance.
Olutunde Fisayo
Lambe, Ogun State
Test should not be compulsory
Have we not seen couples who were not HIV positive before they got married but became positive after marriage, due to some reasons? I think the federal government should analyse policies before making them public.
We are living in a society where sanctity of marriage is no longer respected and extra-marital affairs are now rampant. Why can’t the federal government start tackling it from that angle? What if the couples refuse to do official marriage, won’t they still raise children after paying the dowry? I think Nigerians need policies that have direct, positive impacts on the masses and not all these borrowed laws from the western world. As much as I would have loved the law because it would enable intending couples to know their status, Nigeria is not yet ripe for this type of thing.
Besides, I don’t support the mandatory aspect of it because marriage is a union between two people who have agreed to come together, to love each other and to care for each other. So, the issue of HIV testing before marriage is a secondary thing. Also, I don’t see any reason HIV should be an issue before marriage because healthcare has gone beyond that. It is possible for couples who are infected to lead normal lives and still give birth to healthy children.
In my opinion, it is a right step but with a wrong approach because it should not be made compulsory.
– Oyeniran Kemi
Berger, Lagos
No big deal, some churches do it already
I don’t think there is any big deal about the law because some churches have been doing it for years. For example, in my own church, anybody getting married must present the results for HIV, blood group and genotype tests. So, if the federal government is starting the same thing, it is a welcome development.
My only fear is that the law may not work properly in this country because the government may not be able to enforce it, especially in the rural areas. It is also possible for couples to forge results and present such, in order to get approval.
Moreover, I think the solution to the increasing rate of HIV/AIDS in the country is not mandating intended couples to get tested; rather, the government should embark on awareness and enlightenment programme for the people. Many people only get to hear about HIV/AIDS on radio and television but do not really believe it is real. So, the government and other organisations that have one or two things to do with theHIV/AIDS campaign should be pragmatic in their activities by organising series of awareness and enlightenment programmes on the disease.
On 1 July, medical doctors under the aegis of the Nigerian Medical Association (NMA) commenced, once again, another indefinite strike action. Dr Kayode Obembe, the NMA president, who announced the commencement of the strike said the decision followed the expiration of a two-week ultimatum the association, gave the government on its 24-point demand. He said the NMA was taking the decision to save the health care system from anarchy that was palpably imminent.
Some of the major issues the NMA hinged its strike on include reserving the position of chief medical director to only medical directors, appointment of Surgeon General of the Federation, passage of the National Health Bill and provision of adequate security for doctors. The doctors are also asking for an increase in duty, hazard and specialist allowances, as well as budget for residency training programme.
Since the NMA commenced its strike, which crippled health services in public hospitals throughout the country, there has been a barrage of arguments from different quarters on the timing and propriety or otherwise of the strike action. While the Trade Union Congress (TUC) faulted the strike, describing it as selfish, anti-people, ego-driven and provocative, the Medical and Dental Consultants Association of Nigeria (MDCAN), relying on the judgment of the National Industrial Court, which stopped the federal government from implementing the agreement it had earlier reached with the Joint Health Sector Union, opted out of the strike. The MDCAN urged its members nationwide to ignore the strike and continue to provide services to patients.
It is our view that while the NMA can justifiably make demands it believes will help improve the health sector, as well as the lives of its members, it could do so with adequate and conscientious consideration for the stability of the entire health sector and the well-being of Nigerians, as a whole. Members of the association must acknowledge and embrace the equally important roles being played by other members of the health team, when making demands. A situation where the NMA goes on strike, not just to seek its interests but to also compel the government to disregard the legitimate demands of other health workers is, to say the least, deplorable.
The NMA is expected to be at the frontline of promoting industrial harmony and team spirit in the health sector, not vehemently fanning embers of discord. The association should be less strident in turf protection in a multidisciplinary sector like health, where the ultimate goal (providing optimal health care services to patients) is dependent on the efforts of so many healthcare professionals, all playing crucial and beneficial roles.
Perhaps, the most worrisome reason why many stakeholders think this strike action is one too many is that it is occurring at such a time when the country is battling serious challenges resulting in heightened need for the services of NMA members. Aside from the millions of Nigerians, who, even in normal times, struggle to access health care for various dire health conditions, many Nigerians are now ending up in hospitals in critical conditions, as a result of terrorist attacks that have recently become rampant in the country. One would expect that at such a trying time as this, all health care professionals, NMA members inclusive, should be more concerned about saving the lives of Nigerians.
While we urge the NMA to be more circumspect before embarking on costly strike actions that could lead to avoidable loss of lives, we also call on the federal government to once and for all be decisive in resolving the numerous contentious issues resulting in incessant strike actions in the nations’ health sector.
It is also necessary to have a comprehensive review of the laws regulating industrial action in the health sector. The present provision, which allows health workers to proceed on an indefinite strike action after a 21-day statutory notice, is inappropriate. The statutory notice period should be reviewed upwards to a minimum of three months. We believe that whatever issue leading to such notice could be and indeed should be resolved within the recommended period and thus halt the trend of health professionals abandoning work.
These constant, catastrophic and, yet, preventable strikes have, over the years, resulted in the untimely death of many Nigerians. Several patients have also been maimed and scarred for life as a result of complications they suffered because health workers abandoned work. This trend is unacceptable and must stop.
Hurray! Another season of corn (maize) is here again. But even more thrilling is the recent revelation that the antioxidants and other nutrients found in corn are effective in fighting cancerous cells and preventing many other heart diseases.
According to studies carried out at Cornell University and published in the Journal of Nutritional Biochemistry, corn is a rich source of a phenolic compound called ferulic acid, an anti-carcinogenic agent that has been shown to be effective in fighting the tumours which lead to breast cancer, as well as liver cancer. Anthocyanins, found in purple corn, also act as scavengers and eliminators of cancer-causing free radicals.
Corn is one of the most extensively cultivated cereal crops on earth. More corn is produced, by weight, than any other grain, and almost every country on earth cultivates corn commercially for a variety of uses.
As a staple food in most homes in Nigeria, corn is identified with different local names. The Igbos call it “oka,” “azizi”, “oyikpa” or “akpe” (depending on dialectical variations); the Hausas called it “masara”; the Yorubas call it “agbado”; while the Efik call it”ibikpot”. Corn is also considered a staple crop globally, as many people rely on it as a primary source of nutrition.
In addition to playing a major role in the human diet, corn is also used as livestock fodder. Corn is processed to make an assortment of products, ranging from high fructose corn syrup to biofuels, all of which play important roles in human society. Oddly enough, corn is at the forefront of the green revolution with by products like compostable containers and biofuel, while simultaneously being used as a controversial food additive in the form of corn syrup and other derivatives.
Domesticated corn grows to a height of eight feet (2.5 meters). It is typically planted in rows, to make it easy to harvest the female ears once they mature. The crop is also surprisingly vulnerable to pests and drought, given its global importance as a food source.
In a recent interview, Professor Henrietta Ene-Obong, a nutritionist in the Department of Biochemistry, Faculty of Medical Science, University of Calabar, noted that cornis a food that is very versatile and is consumed by all in one form or the other, irrespective of age, gender or socio-economic status.
Prof. Ene-Obong, who had carried out a supplementary experiment on corn, to determine its protein quality when combined with a legume known as the African yam bean (Sphenostylisstenocarpa) or “igirigi”, “ezama”, “okpodudu”, “akpaka” as known in some Nigerian languages, said the result confirmed earlier studies that when legumes and cereals are combined appropriately, their amino acid profile wouldrise almost to the level of the reference protein (milk/egg), indicating that such meal can support growth in children and adults.
Countering the popular notion that 90 per cent of the food is made up of carbohydrate, the erudite don noted that corn is a good source of fibre, especially when eaten whole.
“The yellow corn is a good source of carotene, which is a precursor of vitamin A, as well as an antioxidant. The carbohydrate content of dried corn is about 64 per cent, while that of corn in the fresh or boiled form is about 25 per cent,” she said.
To obtain the best nutritional value of the food, Ene Obong recommended that it should be eaten along with other foods,such as legumes and vegetables.
In a separate chat with a UNICEF nutrition consultant, Mrs Abigail Ishaya Nyam from
Adamawa State, she corroborated the points mentioned by Prof. Ene Obong and also added that most of the fibre in corn is insoluble.
“Insoluble fibre adds bulk to stool and may help prevent constipation. It also helps rid your body of toxins faster, as well as lower cholesterol”.
Continuing, she said, “Like other vegetables, Corn can help fight against cell-damaging free radicals, and may decrease the risk of heart diseases, cancer and other diseases. The antioxidants found in corn include carotenoids, vitamin C and vitamin E. Vitamin C is an important antioxidant and also necessary for the synthesis of collagen. It provides all of the B vitamins except vitamin B-12, thiamine, riboflavin, niacin, vitamin B-6 and folate. Collectively, these B-complex vitamins help you form red blood cells and support your metabolism.”
Still on the benefits of corn, Nyam noted that the American Optometric Association reports that lutein and zeaxanthinfound in corn may help protect from developing chronic eye diseases, such as macular degeneration and cataracts.
Nutritional contents of corn
One large ear of cooked yellow corn contains almost 4 grams of protein, 3.5 grams of dietary fibre, around 30 grams of carbohydrates, 1.5 grams of fat, 3.6 grams of sugar, around 100 grams of water, no cholesterol, and amounts to 126 calories.
The kernels of corn are what hold the majority of corn’s nutrients, and are the most commonly consumed parts of the vegetable. The kernels can come in multiple colours, depending on where the corn is grown and what species or variety they happen to be. Another genetic variant, called sweet corn, has more sugar and less starch in the nutritive material.
Corn not only provides the necessary calories for healthy, daily metabolism, but is also a rich source of vitamins A, B, E and many minerals. Its high fibre content ensures that it plays a significant role in the prevention of digestive ailments like constipation and haemorrhoids, as well as colorectal cancer. The antioxidants present in corn also act as anti-carcinogenic agents and prevent Alzheimer’s disease.
Below is more corn nutrition facts and information about the vitamin and mineral content in one large ear of yellow corn, which is cooked without salt.
Corn nutritional information – vitamins
Vitamin amount per 100 gram
Vitamin A310 IU
Vitamin B1 (thiamine0.254 mg
Vitamin B2 (riboflavin)0.085 mg
Vitamin B60.071 mg
Vitamin C7.3 mg
Vitamin E0.11 mg
Vitamin K0.5 mcg
Vitamin E0.11 mg
Niacin1.9 mg
Folate54 mcg
Corn nutritional value – minerals
Amount per 100 grams
Potassium250 mg
Phosphorus 90 mg
Magnesium 37 mg
Calcium 4 mg
Zinc 0.72 mg
Iron 0.52 mg
Selenium 0.2 mg
Pantothenic Ac1.036 mg
Apart from the above listed minerals, traces of manganese and copper are also found in corn.
Specific health benefits of corn
Corn provides many health benefits due to the presence of quality nutrients within it. Besides being a delicious addition to any meal, it is also rich in phytochemicals, and it provides protection against a number of chronic diseases. Some of the well-researched and widespread health benefits of corn are listed below.
Prevents breast and liver cancers: Corn is a rich source of a phenolic compound called ferulic acid, an anti-carcinogenic agent that has been shown to be effective in fighting the tumours which lead to breast cancer, as well as liver cancer.
Reduces risk of haemorrhoids and colorectal cancer: The fibre content of one cup of corn amounts to 18.4 per cent of the daily recommended amount. This aids in alleviating digestive problems such as constipation and haemorrhoids, as well as lowering the risk of colon cancer, due to corn being a whole-grain. Fibre has long been promoted as a way to reduce colon risk, but insufficient and conflicting data exists for fibre’s relationship with preventing cancer, although whole-grain consumption, on the whole, has been proven to reduce that risk. Fibre helps to bulk up bowel movements, which stimulates peristaltic motion and even stimulates the production of gastric juice and bile. It can also add bulk to overly loose stools, which can reduce the chances of Irritable Bowel Syndrome (IBS) and diarrhoea.
Reduce the risk of diabetes and heart diseases: Recent clinical studies in Japan, published in the Biochemical and Biophysical Research Communications journalhave shown that purple corn (Zea mays L.) could be a great ally in the fight against diabetes and obesity. Anthocyanin is what gives colour to purple corn.Corn is low in cholesterol and fat content. Cereal or whole grains are great sources of vitamins and minerals, magnesium, fibre and complex carbohydrates. The fibre in whole grains helps to prevent the risk of heart diseases and diabetes, and all its nutrients boost the immune system.
Rich source of vitamins: Corn is rich in vitamin B constituents, especially Thiamin and Niacin. Thiamin is essential for maintaining nerve health and cognitive function. Niacin deficiency leads to Pellagra, a disease characterised by diarrhoea, dementia and dermatitis, that is commonly observed in malnourished individuals. Corn is also a good source of Pantothenic acid, which is an essential vitamin for carbohydrate, protein, and lipid metabolism in the body. Deficiency of folic acid in pregnant women can lead to the birth of underweight infants and may also result in neural tube defects in new-borns. Corn provides a large percentage of the daily folate requirement, while the kernels of corn are rich in vitamin E, a natural antioxidant that is essential for growth and protection of the body from illness and disease.
Provides necessary minerals: Corn contains abundant minerals which positively benefit the body in a number of ways. Phosphorous, along with magnesium, manganese, zinc, iron and copper are found in all varieties of corn. It also contains trace minerals like selenium, which are difficult to find in most normal diets. Phosphorous is essential for regulating normal growth, bone health and optimal kidney functioning. Magnesium is necessary for maintaining a normal heart rate and for increasing bone strength.
Protecting your heart: According to researchers, corn oil has been shown to have an anti-atherogenic effect on cholesterol levels, thus reducing the risk of various cardiovascular diseases. Corn oil, particularly, is the best way to increase heart health, and this is derived from the fact that corn is close to an optimal fatty acid combination. This allows omega-3 fatty acids to strip away the damaging “bad” cholesterol and replace them at the binding sites. This will reduce the chances of arteries becoming clogged, will reduce blood pressure, and decrease the change of heart attack and stroke.
Prevents anaemia: The vitamin B12 and folic acid present in corn prevent anaemia caused by a deficiency of these vitamins. Corn also has a significant level of iron, which is one of the essential minerals needed to form new red blood cells; a deficiency in iron is one of the main causes of anaemia as well.
Lowers LDL cholesterol: According to the Journal of Nutritional Biochemistry, consumption of corn husk oil lowers plasma LDL cholesterol by reducing cholesterol absorption in the body. As mentioned earlier, this reduction of LDL cholesterol does not mean a reduction in HDL cholesterol, which is considered “good cholesterol” and can have a variety of beneficial effects on the body, including the reduction of heart disease, prevention of atherosclerosis, and a general scavenger of free radicals throughout the body.
Vitamin A content: Yellow corn is a rich source of beta-carotene, which forms vitamin A in the body and is essential for the maintenance of good vision and skin. Beta-carotene is a great source of vitaminA because it is converted within the body, but only in the amounts that the body requires. Vitamin A can be toxic, if too much is consumed, so deriving vitamin A through beta-carotene transformation is ideal. Vitamin A will also benefit the health of skin and mucus membranes, as well as boosting the immune system.The amount of beta-carotene in the body that is not converted into vitamin A acts as a very strong antioxidant, like all carotenoids, and can combat terrible diseases like cancer and heart disease. That being said, smokers need to be careful about their beta-carotene content, because smokers with high beta-carotene levels are more likely to contract lung cancer, while non-smokers with high beta-carotene content are less likely to contract lung cancer.
Rich source of calories: Corn is a rich source of calories. The calorific content of corn is 342 calories per 100 grams, which is among the highest for cereals. It is why corn is often turned to for quick weight gain, and combined with the ease and flexibility of growing conditions for corn, the high calorie content makes it vital for the survival of dozens of agriculture-based nations.
Controls diabetes and hypertension: In recent decades, the world has seemed to suffer from an epidemic of diabetes. Although the exact mechanism for this cannot be pinpointed, it is generally assumed to relate to nutrition. Eating more organic fruits and vegetables, like corn, has been thought to be a return to an older style of diet, and it has been linked to reduced signs of diabetes. Studies have shown that the consumption of corn kernels assists in the management of non-insulin dependent diabetes mellitus (NIDDM) and is effective against hypertension,due to the presence of phenolic photochemical in whole corn. Photochemical can regulate the absorption and release of insulin in the body, which can reduce the chance of spikes and drops for diabetic patients and help them maintain a more normal lifestyle.
References:
Journal of Nutritional Biochemistry, organicfacts.net; seedguides.info
The newly established Phamatex Industries Limited has expressed its commitment to getting the World Health Organisation (WHO) Good Manufacturing Practice (GMP) prequalification approval for its products, as it commenced local manufacturing at its state-of-the-art factory in Amuwo Odofin, Lagos.
Chairman/CEO of the company, Prince Christopher Nebe, made the disclosure while receiving the Pharmanews team led by the Managing Director, Pharm. (Sir) IfeanyiAtueyi, which visited the new factory recently.
Speaking with Pharmanews in an interview after a tour of the factory, Nebe revealed that the watchword of the company was to consistently ensure quality in all its processes and to manufacture only high quality products of international standard, adding that from inception, quality assurance was the guiding principle, as the company procured machines and equipment for the factory.
“Quality was the only thing we considered,” he said.” We did not compromise on quality. We have set up a standard laboratory for the factory because we know that laboratory is the police of the factory…We procured all our equipment from the best companies around the world. We have been relating very well with NAFDAC and getting the agency’s approval for our products. We are committed to producing products of international standard and that is why we are going for WHO GMP prequalification.”
Prince Nebe also commended the Director General ofNAFDAC, Dr. Paul Orhii, for the immense cooperation and support granted the company so far. DrOrhii, he said, had visited the factory and was impressed with what he saw. He added that the NAFDAC DG had also introduced Phamatex to WHO officials and that the company had started liaising with the global health body, even though WHO was yet to officially visit its factory.
The Phamatex boss also urged the federal government to support Nigerians going into local manufacturing, saying they were the ones contributing to the growth of the economy.
He disclosed that even though Phamatex factory was yet to commence production, the company had employed many Nigerians and had been paying them salaries for over two years.
“It is not easy to go into pharma manufacturing,” he stated.”You have to follow the process or else you will get it wrong. The process is what I call ‘start before you start.’ This means that you have to employ people to start doing things from the scratch and it takes time for them to get the process running.”
Nebe also bemoaned the fact that manufacturing industries in Nigeria have to individually generate power to run their factories, due to epileptic power supply from the national power holding firm, adding that his company had to make a huge initial investment for alternative source of power at the commencement of its operation.
Prince Nebe further disclosed that even though Phamatex started out to concentrate on local pharmaceutical manufacturing, the company, which debuted as an exclusive agent to Hovid Berhad (the leading pharmaceutical manufacturing company in Malaysia) in 1990, would continue its good relationship with Hovid in Nigeria by marketing its products, as it had done over the years.
Director General of the National Agency for Food, Drug Administration and Control (NAFDAC), Dr Paul Orhii, has expressed satisfaction with the on-going collaboration between the agency and the Association of Community Pharmacists of Nigeria (ACPN).
He stated that the move was beginning to produce the desired effect.
Dr. Orhii made the assertion while delivering his goodwill message at the 33rd annual national conference of the ACPN, held in Ilorin, Kwara State, recently.
The NAFDAC DG, who was represented by the agency’s coordinator for Kwara State, Mrs Juliana Bolaji Abayomi, expressed satisfaction with the theme of the conference, “Evolving Best Practice in Community Pharmacy,” saying it recognised the importance of the mainstreaming excellence in service delivery in all spheres of national life, especially in the health sector.
He further disclosed that NAFDAC had adopted a multi-layered approach in the fight against substandard, spurious, falsely-labelled, falsified and counterfeit medical products.
“The multi-layered intervention includes, but not limited to, massive awareness campaign, stakeholders collaboration and deployment of cutting-edge technologies,” he said, adding that “I am happy that the collaboration towards drugs quality monitoring between NAFDAC and ACPN is being strengthened and beginning to yield desired results, in terms of much needed support and cooperation.”
Orhii also noted that the key feature of the agency’s action plan in widening access of Nigerians to good quality medicines and wholesome foods is strengthened by the use of the Mobile Authentication Service (MAS) and other anti-counterfeiting mechanisms, while assuring that the challenges associated with MAS were already being discussed by all stakeholders.
“It is our collective responsibility, as professionals in the expert handling of medicines, to continuously monitor the quality of medicines in the market place, to minimise morbidity and mortality. This will also improve public confidence in our supply chain system,” he said.
