To many, Pharm Chika Agughasi, managing director, Carrot-Top Drugs, seems like a taciturn fellow. But when the former image maker of the Pharmaceutical Society of Nigeria (PSN) decides to loosen up a bit, he talks tough! In this interview with Adebayo Folorunsho-Francis, the pharmacist takes a swipe at the excesses of patent medicine dealers, perennial problem of quackery and present NAFDAC regime. Below is the excerpt:
As a one-time spokesman of the PSN, we observe you are no longer as active and vibrant as you used to be. How will you respond to that?
Basically, we have served. I have served in PSN and ACPN, both at the state and national levels. It is only proper to leave the place for others to showcase their own abilities. But, by and large, we are still working in the background giving our support. For instance, I still anchored half of the programmes at the last PSN conference. So, we are still there. But other people have to offer their own bit too.
You also do not seem to take keen interest in contesting executive posts in any arm of the PSN. Why?
There are many ways to serve, even in the profession, not necessarily in executive positions. For some of us who have the capacity, the profession needs us more at the national political arena, and not just where we can move to. That is where I am playing currently. I vied for the House of Representatives at the last general election, it didn’t sail through. I have not given up yet; I am still hanging in there. I am of the belief that this will position me better to contribute my own quota at the national arena, than being recycled year in, year out in the pharmaceutical sector. Like I said earlier, other people should be given equal opportunity to try out their hands at different executive positions. But, as for me, I have moved on to other higher calling.
You run a community pharmacy and have been around a long while, what can you identify as challenges and problems plaguing the community pharmacy practice in Nigeria?
The challenges are many. Generally, community pharmacy practice is over-regulated. Those of us who have subjected ourselves to be regulated are not, in any way, better for it. But I think one of the major issues is that of the unhealthy competition, both from charlatans and sometimes even from colleagues, where you find that you are not able to mark-up appropriately, to cover your overheads and make enough profit. You will expect a pharmacist to stick around all day or even employ a pharmacist to work in the company. In theory, the practice should be profitable enough to be able to cater for that overhead and pay the pharmacist handsomely. But in reality, you will find that it is very difficult to mark-up appropriately in most locations. Secondly, stocking of products is another issue. However, that is getting better with pharmacists now coming into the distribution network and pharmacist-owned wholesale shops springing up here and there. That said, it is still a challenge. Thirdly, personnel training is a very big issue in running a community practice. This is particularly so because the calibre of personnel that we are able to employ are not the very high earning ones, not graduates most times, sometimes just school leavers. And these are people that are most difficult to motivate. Try, as you can, they have shown that training them sometimes can be an issue. That is also a challenge. Fourthly, epileptic power too has been a major challenge to community practice. Reason being the ambience you require, for instance, you need your refrigerator and air conditioner to be working. In the absence of public power, you need to resort to your own alternative power, which can be quite expensive. In fact, most kinds of generators we are able to run may not carry some of the appliances we need to run in a standard pharmacy. So, it was an issue. I used ‘WAS’ because I noticed it is getting better. Another mind-boggling thing is the fact that community pharmacists generally receive zero allocation in most localities from hospitals around them. It should not be. You know, in other climes, outfits of this nature normally rely on filling prescription. But you can be sure most pharmacies can run from day-to-day, week-to-week, month-to-month without filling a single prescription. That should not be so. There are quite a number of challenges, but these are some that readily come to mind.
In a renewed bid to curb incidence of drug abuse, the Pharmacists Council of Nigeria (PCN) has warned patent medicine dealers in the country to desist from selling prescription or ethical drugs. Do you support this position?
Of course, in fact, what I should be saying is that, apart from backing it, the Pharmaceutical Inspectorate Committee (PIC) should be clearly barking and start biting strongly. I mean, patent medicine dealers have absolutely no business going near ethical drugs. Because they know next to nothing concerning the things they should have had education before they are dispensed. So, basically, they have no business whatsoever anywhere near ethical products. I very much strongly support the move to comply with the statutory directive.
Do you actually think patent medicine dealers can do without selling ethical drugs, knowing full well that is where they make their money?
That is why, again, like a decaying tooth, there is the need for it to be completely uprooted. It is heart-warming already. The policy statement is that patent medicine stores are no longer registerable in urban centres. They can only be registered in rural areas. There is the need to continuously weed up this issue. It is quite difficult to get these medicine dealers to do the right thing. Because, like you rightly pointed out, much as they know what the rule says, they will never comply. There are categories of drugs they should not carry. You find some of them converting their cabin shops to mini clinics. They even go as far as administering injections; some can even put infusions for people in that place. You see them mixing all manners of things; you will see somebody come in and say I have this, I have that. You will see so-called medicine dealers mixing four different brands of paracetamol. The patient could have pain and he is giving four different analgesics, probably doing the same thing but coming with different names. There are just so many things they do and are not ready to comply.
How have you been coping with the perennial problem of quackery and counterfeiting?
From my own practice, basically, what has definitely helped us is that we have been careful with our sourcing. As I mentioned, we now have pharmacist-owned wholesalers. Incidentally, I have the privilege of being part of the ownership of a wholesale store – Pharmforte to be precise. So, currently I source most of my supplies from there and a few items that I am not able to get from Pharmforte, I will get from a nearby pharmacist-owned shop, which is Nemitt, and the rest. This is because these pharmacist-owned shops go through the right channel and take the pain to ensure their supplies come from either the companies or their accredited representatives or distributors. The case of counterfeit medicines has been drastically reduced to the barest minimum. I have encountered that issue in a very long time and that is because I source my supplies from these places.
Do you think NAFDAC is doing enough to sustain the war against counterfeiting?
No. Incidentally, I feel that the current leadership of NAFDAC is not maintaining the tempo of the campaign the immediate past director general (Dora Akunyili) has started. The tempo has really come down. I think there is a lot of lip service going on, their attitude has deteriorated in most departments in NAFDAC, which is exactly what we have been crying about. We have strong personalities in very little institutions. One could not imagine that things could deteriorate this far, in such a short period of time. So, I think there is a lot NAFDAC needs to do.
Carrot-Top Drugs seems to have built a niche for itself in the area of fertility solution, within a short time. How did you do it and why do you take fertility issue (for both men and women) as priority?
Well, we are focusing, as you said, on fertility solution and awareness care. It is an area in which I have passion. Secondly, it is a lot easier to play in a small area and make some impact than to be Jack of all trades and master of none. But I think the driving force is the fact that I have passion in this area. It is an area that generates a lot of interest for me, as a person, and that is what I have brought to bear. And so far so good, it has been quite rewarding, in the sense that we are making very remarkable impact. We have impacted on a number of lives. There are so many who have called to express their gratitude for what our products have been able to do for them. Nothing gives more joy than seeing the satisfaction that we are able to give people. We are able to restore joy to childless couples. So, it has been quite rewarding and very interesting. That is how it has been, really!