Coronavirus Outbreak, Another Wake-up Call for Drug Security – Lolu Ojo

pharmacy

Pharm. (Dr) Obalolu Ojo is the managing director/CEO, Merit Healthcare Limited. In this exclusive interview with Pharmanews in his office in Lagos, Ojo, a former national chairman of Association of Industrial Pharmacists of Nigeria (NAIP) and incumbent chairman of the PSN Committee on Research, Documentation and Industrial Liaison, examines the impacts of the outbreak of coronavirus on the pharmaceutical industry and the lessons the Nigerian nation should learn from it. He also reveals what his committee has been doing since inauguration, as well as his thoughts on other burning pharmacy issues. Excerpts:

As the chairman of the PSN Committee on Research, Documentation and Industrial Liaison, what do you consider as the most fundamental challenge facing the pharmaceutical industry and how can the challenge be surmounted?

Since your question started from that PSN committee, let me first use this opportunity to appreciate the PSN president, Mazi Sam Ohuabunwa, for setting up the committee.  Having that committee is a result of good thinking, I must say. And the president summarised the work of the committee in one sentence.  He said he wants the committee to provide an intellectual basis for PSN advocacy. That is, he wants the committee to look indepth at all issues pertaining to Pharmacy and provide an intellectual basis for whatever is the advocacy the PSN will be making.

And that is what we have been trying to do. We have handled some cases. We handled the Pharmaceutical Technology Bill, which was a bill they were pushing to split Pharmacy into sub-categories.

We had to look into what was happening in other climes, the complaints of the group and other things.  At the end of the day, we were able to give the PSN president some basis for what we needed to do.  I thank God that that bill was killed at the National Assembly.

We have also worked on online pharmacy. Without any particular regulation right now, the entire online space is filled with pharmaceuticals that are being offered for sale.  We did a webinar that involved about 1000 pharmacies. More than 1000 pharmacies registered for the webinar, although not all of them were able to participate eventually.  For the webinar, we had an expert from India who shared experience on the situation in India and advised us on what we needed to do.

What we eventually agreed on is that we are having a big challenge handling the physical medicines, not to now talk of the ones online. However we can’t close our eyes and pretend as if nothing is happening online.  We spoke to a lot of people. We spoke to the managing director of Jumia and other stakeholders.

We are still on it and our position is that it is better if we take control of the process now, not for anything, but to protect the people. This is because a lot of fake products are being sold online. This has been documented in so many countries. It was confirmed in a number of researches that online transactions actually enables the sale of fake products, including pharmaceuticals and vaccines.

I have some evidence to confirm this. It happened in the so-called advanced countries, despite all their sophisticated processes of preventing such.

We are having problem with the physical medicines which are sold like ordinary commodities on our roads. What do you think will happen when it is now so liberalised that you can buy it online anytime? It will be a big challenge and we cannot afford to keep our focus out of that.

However, the most important intervention the committee has made so far is in the manufacturing sector.  The question we are asking is how can we ascertain the real percentage of what we are importing as pharmaceuticals and what we are producing locally. Because the percentage being bandied is actually not based on fact. They are saying that we are importing 80 per cent of what weare consuming locally. This is not based on fact.

Even the 20 per cent that is said to be manufactured locally, what percentage of the manufacturing inputs are sourced in Nigeria?  Apart from water, what else is used in pharmaceutical manufacturing sector that is produced in Nigeria?  We had a summit on this issue and a lot of people came and made presentations. We had speakers from the Central Bank of Nigeria (CBN), Federal Ministry of Health (FMOH), raw materials manufacturers and other stakeholders.

Unfortunately the pace of progress has been very slow, but certainly we need to and should be able to address that challenge.  I have my hands full but I’m happy we have colleagues that are assisting us with pushing to get things done.

However, to answer your question on what is the most fundamental challenge of the pharma industry, I will answer by telling you that the challenges are legion.  They are so hydra-headed and multidimensional. Sometimes you begin to ask yourself if this nation really wants pharmaceutical manufacturing industries and the pharma sectors as a whole.  There is nothing that is not stacked against the sector. Even the simple process of clearing what you need at the port is so difficult.

This affects not just manufacturers of pharmaceuticals but also importers of finished medicines.  You will go through hell just to clear things at the Apapa port.  Eventually, when it is cleared and you want to get the container out of the port, you will face another trouble. It costs about 2 thousand dollars to ship a container from India to Nigeria. It however will cost you more than one thousand dollars to move the same container from Apapa to Isolo.  This is not a story. Yesterday, I paid 400 thousand naira to move my container from Apapa to my office here in Isolo.  If there is no traffic, driving from Apapa to Isolo here should not take more than 10 minutes. That is the distance that will cost you more than 1000 dollars to transport a container. It is crazy.

Other challenges facing the pharma sector are that of power, which cannot be overemphasised, as it is central to all manufacturing activities. Patronage is also fundamental all over the world. Today, in Nigeria, the government is the biggest spender and we need to ask how much they are spending on the sector and how they are spending it.  Even when you supply drugs to government, to get paid is difficult. Government is the highest debtor to this industry. We are working on the statistics, but if we put it together, it will run into billions of naira owed to this industry by government.

When I say government, I’m not saying federal government. I’m saying FMOH, all the state agencies, all the teaching hospitals, all the Federal Medical Centres, all the state hospitals and other government parastatals. The debt is huge and it is killing the industry. It bothers me because it is this same government that will come to your office and lock it up for not paying one tax or the other. The same government owing you. It is difficult to see the logic behind government’s action sometimes.

However, we shall not run away or give up because if we do, we know the charlatans are ready to take over and they won’t care what happens to Nigerians.  We care about the patient that is why we are not giving up.  It is also because we know anybody can be a patient anytime.

The outbreak of coronavirus aptly named COVID-19 by WHO is said to have put Nigeria in a difficult situation, as it relates to medicines availability, because we depend on China and India for our pharmaceutical raw materials and finished pharmaceutical products, what can we do about his precarious situation?

Unfortunately in this situation, there are no quick fixes. If there are no raw materials, you just have to get them and you can’t start today to produce the raw materials you need. It is a process.  We import everything we need for pharmaceutical manufacturing, despite the fact that we have opportunity to produce some of them locally.  We have been saying this for a very long time, Nigeria needs to look inward. I just hope that perhaps when things like this coronavirus outbreak happen, it will make us to pay attention to the things that are important and serious.

The things that are serious are life, food and medicines. These are important matters that serious nations don’t joke with.  We have been saying that drug availability is a national security issue.  That was the theme of the PSN Conference in 2017.  Medicines availability for Nigerians has to be seen as a serious security issue. The nation cannot afford to continue to depend on other nations for it.

200 million people require medicines and about 80 per cent of that these are imported. Now, coronavirus is blocking importation of medicines from China as China is the source of raw materials for the whole world. Even India where we go to buy our finished pharmaceutical products buy raw materials from China. The implication is that this problem in China is a big problem for the whole world. Even the USA get its inputs from China. That country, China is a big player in raw materials and is indeed the second largest economy in the world after USA.

Certainly, except the COVID-19 is quickly contained, we are going to see the effect, not just on pharmaceuticals but on other sectors of our economy.  However, the issue of pharmaceuticals is particularly serious because we are so helpless, since we depend on importation for our finished medicines and even the 20 per cent that we say is manufactured locally depends on importation for the raw materials to produce.  I just hope that this incident will make the government to listen and act on what is important henceforth.