The Association of Industrial Pharmacists of Nigeria (NAIP) has called on the Nigerian government to put measures in place to ensure that essential medicines are available and affordable, saying this is a critical factor in the country’s quest for universal health coverage (UHC).
Speaking in Lagos, recently, NAIP’s National Chairman, Pharm. Ken Onuegbu, emphasised that there cannot be universal health coverage without drug availability and affordability, noting that for Nigeria to attain universal health coverage, it must first address the challenge of drug security.
According to the NAIP chairman, a country like Nigeria, where about 70 per cent of drugs are imported, cannot achieve universal health coverage, because even some of the countries it depends on are struggling to achieve same goal.
Analysing the country’s dire situation, Onuegbu said: “We are far behind now as a country on universal health coverage. The government has a lot to do to address infrastructural deficit and then create the enabling environment for industry to thrive. We have a lot of gaps. We cannot be talking of achieving universal health coverage when internally we cannot move forward.
“Take the issue of forex, for instance. In the past year or so, many drug importers in a country that is solely dependent on drug importation have not been able to import a single container because they can’t access forex. When you create such a vacuum, what happens? You simply create room for faking and adulteration of products, which is not good.
“Now when the importer eventually imports products, it comes at a very high rate. In the end, it is the final consumer that bears the burden. Whereas, to achieve universal health coverage, there must be availability, there must be affordability. These two key elements are not there right now in Nigeria. So the government needs to address the situation squarely.”
On the way forward, Onuegbu said: “Said there is a need to encourage as many companies to establish manufacturing plants here in the country. One of the things that will make it possible is to provide stable electricity. Let there be a good road networks, so that we can produce and move things from one place to another.
“If we keep running on diesel every day, availability will not be there and when there are few options, they will be very expensive. Some companies spend as much as N200 million a month to power their generators. With such a situation, we can’t achieve universal health coverage.”
He continued: “We have a lot of internal problems that we need to deal with before we can be talking about achieving universal health coverage. But as drug manufacturers, we are playing our own part. NAIP is involved in Pharma Hub and Pharma Park. We started with Ebonyi State, we have also discussed with the Gombe State government. There is a call for us to have one in Kano and Niger States.
“The essence of this hub and park is to mimic what is happening in countries like Ethiopia and have a pharmaceutical manufacturing hub where everybody can key in and leverage the individual strength of different companies, which will make costs come down to the barest minimum and ensure affordability.
“But for us to achieve the pharma hub or park, we need government support. We are not asking the government to give us money but provide infrastructure like power, road, and water, among others, that will encourage investors to invest in the initiative. Creating an enabling environment will reduce the ‘japa’ syndrome. Or why should I be going to America when there are many golden opportunities in my country?”
The NAIP chairman further described ease of doing business in Nigeria currently as frustrating.
According to him, “There are many stumbling blocks in the pharma industry. To bring some machinery into the country today, the duty you pay on it is very discouraging. The Federal Government is supposed to reduce the duty on machinery to the barest minimum, to encourage entrepreneurs to set up factories in the country.
“In some instances, some special levies are imposed on some products without considering the fact that when you impose the levies on such products, the importer, as a businessman, will do his calculation and put all the levies on the price of the products. In the end, the final consumer still bears the burden. These are some of the reasons the price of drugs is going up, especially some special ones; and it will continue to go up unless the government does something about it.”
Onuegbu equally emphasised that whatever effort that is being made today on local production of drugs must involve investment in local manufacturing of active pharmaceutical ingredients (APIs).
In his words, “If you are manufacturing drugs locally but still importing APIs, you are still importing. Egypt has about 110 million people; that is half of Nigeria’s population. But they have more than 15 API manufacturing companies. All of them were enabled or facilitated by their government.
“I am not saying the Nigerian government must invest its money in APIs; but le them create the enabling environment that will make it possible for investors to establish API plants in Nigeria. That is the way we can move forward.”
Corroborating Onuegbu’s position, the Managing Director, Neimeth International Pharmaceuticals Plc, Pharm. Valentine Okelu, stated that the pharma industry needs capital that the manufacturers will not be forced to pay back immediately but over a certain number of years. He added that, if the government cannot provide such funds directly, it can play the role of a facilitator to ensure availability.
According to Okelu, “The Nigerian government needs to see healthcare as an important aspect of national development and facilitate everything needed to make sure things work out. Government must provide the needed infrastructure and also facilitate intervention funds for the pharma industry to thrive because the sector is critical to the wellbeing of the healthcare system. Otherwise, we will not be able to get to the level where we are supposed to be.
“To build a pharma factory of an average level today, it will take, at least, two years before you can complete the set up. The cost for approval of the drawing, the GMP approval, among others, is even staggering. So you don’t find people that will just come and invest in pharma business, as it is in other businesses and this is because the return on investment is not fast. If, for instance, you invest your $2 million in a pharma manufacturing, you would have to wait for, at least, three to five years before you can begin to think of any profit from that company.
“Investment in pharma business is a social investment. Government therefore needs to facilitate an intervention fund so that people that are interested in the business can have leeway. The commercial bank cannot help out in this case because the interest for three years would have even crashed the business before the first product would come out.”
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