In Nigerian pharmacy circle, Pharm. Lekan Asuni needs no introduction. A colossus of sort, the pharmacist is the current president, Representatives of Overseas Pharmaceutical Manufacturers (NIROPHARM). In this interview with Adebayo Folorunsho-Francis, Asuni, who was appointed managing director of GlaxoSmithKline Pharmaceuticals (Anglophone West Africa) at a relatively young age of 40, bares his mind on how NIROPHARM’s cordial relationship with all regulatory agencies is aiding its progress; why people wrongly believe the body has a rift with PMG-MAN, as well as his choice of new PSN leadership. Excerpts:

As president of NIROPHARM, how would you describe the last three years in office?

Well, the journey has been good so far. Good but laced with challenges, if I can put it that way. When we came on board, the dynamics of the operating environment had quite changed. There were newer challenges – challenges with quality of representatives who work in the industry, as well as professionalism and capacity building for people who work in the factory. We also had issues relating largely to effects of government policies on the industry; policies in terms of tariffs, drug distribution system and others. Besides that, the operating environment was becoming more and more competitive. There was need for a level playing field for everybody so that companies could conduct themselves in an ethical manner. These were some of the challenges we met on ground and we began to look into how to address them.

How did you address them?

On capacity building, we ensured that capacity building programmes were conducted for our people who work in various factories in the industry, through our sister companies abroad or through some locally organised programmes. We did this so that majority of people who work with our member companies are able to operate at the same standard. We equally extended this capacity building to the regulatory agencies because we realised that they needed support in some areas of competence and capacity. We are in a position to leverage our local range to make those things available to them. For instance, we have done a lot of capacity building with NAFDAC.

What about the challenge with quality of representatives?

Yes, On the quality of representatives’ issue, this is an area we have done some work and we’ll continue to do more. Our member companies are now engaging with Pharmacy schools to dialogue about how training of pharmacists can be such that when they graduate, they can fit into the industry and all that.

On the professional conduct, this is one nut we have not been able to crack. We are still looking at a lot of things. For instance, we are looking at how we could have a database of all staff, especially medical reps in the industry and to ensure that we do share intelligence about these staff especially when they move from one company to another. We have found out situations where they actually work for more than one company. In some cases, some have unresolved issues at Company A and jumped to Company B. But, corporately, we are looking at a sustainable framework to make this confidential information available within the group. It will serve as deterrent to those moving from one company to the other without clearing up issues from where they are coming from.

Again, for our association, membership strength has grown from what it should used to be. We have an estimated 65 corporate members from barely 30 that we had before I took over. Now, with NAFDAC, if you have to renew your product licence or do any importation, we have an agreement with NAFDAC to demand for a membership certification from us. We want to be sure that they are dealing with the right people. It has been good progress so far when you look at where we were then and where we are now. Our aspiration for the future is to be the agent of change in the industry so that we can fully realise the potential.

Have you been able to meet the objectives you set out to achieve?

One of the set objectives was to follow through on the transformation of the industry which pillars we are working on. Part of it is to be a key stakeholder, being consulted and will being visible. When it comes to the industry, we have people who are highly intellectual there. We have been able to make our contributions to all the important discussions.

Another objective we set out to achieve was collaboration with different stakeholders. We have done it with regulatory agencies and even with organisations that share certain principles and objectives with us like the anti-counterfeit coalition. We do this across and have been very collaborative.

Another objective is to ensure that when we have issues in the health sector that are of high priority, we contribute our quota and expertise. Largely we have been delivering on the objectives we set for ourselves and we will continue to build on those successes.

How has NIROPHARM been coping with the issue of funding so far?

As you know, without funding, we cannot do all the activities I enumerated. But then we must appreciate all the corporate members. They have been very committed. Majority paid their annual subscription which has been the main source of revenue for us and they equally support us through other activities like meetings and workshops, in addition to the subscription. They still go the extra mile to ensure that we don’t deplete whatever we get for subscription.

They also do “part-sponsorship” of our various activities. We cannot claim that we have that revenue base, compared to some other associations because we deal with corporate membership not individuals. I think I should use this medium to thank NAFDAC for accepting that all companies that want to register products must present NIROPHARM membership certificate. Enforcement of this will go a long way to ensure that people come to NIROPHARM to register for their membership card and present to NAFDAC whenever they want to renew their licences or register new products.

In terms of attendance, how active are your members?

They are very active. I think we have three big events that bring us together. One of them is the CEOs Forum which is a gathering for chief executives to discuss strategic issues pertaining to the industry. We extend invitations to key stakeholders that we want to have dialogue with such, as regulatory agencies, customs or federal ministry of health. They do attend because they know that it is important to reach an agreement on some strategic decisions.

Secondly, we do have bi-monthly meetings where the CEOs too could attend. But it is more directed to the level below the CEOs. What we discuss there is a lot of operational issues and that excites members because all regulatory and operation details are deliberated. People do show up at those meetings because it is something that cuts across everybody. Sometimes we bring resource people to shed more lights on some contentious issues in the industry.

The last one is our signature meeting. We call it Networking Evening because we discuss contemporary issued. We even bring people from outside the industry and have serious panel discussions. So far, I can say attendance is fairly okay.

Many pharma observers have alleged that NIROPHARM has a frosty relationship with PMG-MAN. What is your reaction?

When you talk about PMG-MAN, I don’t think we have a frosty relationship. Maybe it is just people’s perception. Even when you have children from the same father, they sometimes have different views about certain issues. What may interest you is that PMG-MAN and NIROPHARM have what you can call a symbiotic relationship. There is nobody who is into 100 per cent importation or 100 per cent local manufacture. It is to what degree you have your portfolio.

When you look at members in NIROPHARM, some are doing either contract manufacturing or they are setting up factories or even owning those factories. Maybe the importation aspect of their business is little compared to the local manufacture. They will then say “Okay, I am in PMG-MAN but I am still a member of NIROPHARM, which means they could participate in the latter. Same thing also goes for NIROPHARM. But sometimes we do have difference in opinion on some issues. That is why some people feel there is a frosty relationship. No, there is nothing like that. We work fully together and are committed to same objective.

Although there could be occasional difference in opinion, I will say that I enjoy cordial relationship with PMGMAN executives. To be clear, I am also a member of PMG-MAN. Some PMG-MAN members also belong to NIROPHARM (laughs). I don’t want to start mentioning names here. But when you go to the names on the list, you will see GSK boldly written there. On NIROPHARM, you will see their name there (laughs again).

What about NIROPHARM’s position on West African Pharmaceutical Manufacturers (WAPMA)?

Well, let me say WAPMA is just evolving and we are happy to be part it. But when it started off, the window of participation by NIROPHARM was not very clear. It was looking more like it was only meant for manufacturers within the sub-region. But I think it should be all encompassing for both manufacturers and those who import because they are a West African pharmaceutical body. Once this grey area is clear, which I believe is in progress, we will all work together in the sub-region as one. And I think that is the way it should be. If we all work together to develop the industry, instead of trying to fragment everything, everybody will benefit.

How prepared is NIROPHARM for the 2015 PSN Conference?

NIROPHARM is well prepared. We are going to be there to showcase what we stand for and make people understand what values we contribute. We do so many things that sometimes go unnoticed. Member companies are busy one way or the other doing capacity building, transferring technology and doing so many great things with federal or state government as well as corporate organisations. We need to be able to showcase all these to the larger pharmacy community. We are looking forward to it and quite excited about it.

It is another election year. What are those qualities you hope to see in the new PSN president?

I think Olumide Akintayo has tried his best. He took over from Pharm. Azubike, who equally tried his best. Whoever is coming needs to build on the momentum on which we are now. We need dynamic and pragmatic leadership. We need leadership that will be able to drive a full grounding of the profession, such that Pharmacy can now be seen and perceived as a distinct profession; a profession that is well respected within the health sector. We need a brand identity and I think whoever is coming in should be able to drive that.

Thirdly, we need a leadership that would devise strategy to be more collaborative. We need ingenious ways to manage different stakeholders within the health sector, whether they are doctors, nurses, pathologists or other members. We really need an ingenious way to collaborate and been seen as collaborative.

Fourthly, there are quite a number of policy issues about some reforms that are being initiated. I am expecting that whoever is coming in must consider the fact that people have a vision about what Pharmacy is and how it should be practised. We need a committed person that would be able to push through some of these reforms; reforms in the education curriculum; reforms in pharmacy practice, reforms in distribution system of drugs and so many others on the way. He must have the ability to focus and be able to push and drive through these whole reforms so that we are not left behind some other climes.

Health researchers across the country have unanimously submitted that except Nigerians desist from unhealthy habits and imbibe good hygiene practices, the country’s disease burden will continue to rise, rather than decline.

They also underscored the efficacy of traditional medicines, arguing that a lot of medicines developed from local medicinal plants had proved to be more efficacious in the treatment of malaria than synthetic ones.

The scholars made their submissions at the recent 6th Annual Scientific Conference of the Nigerian Institute of Medical Research (NIMR), with the theme: “Ending the communicable and non-communicable diseases divide in Nigeria”.

They noted during the conference, which was declared opened by the Delta State Governor, Dr Ifeanyi Okowa, who was ably represented by the Delta State Commissioner for Health, Dr Nicholas Azinge, that rural-dwellers’ diseases are now commonly seen in the cities, due to negligence and ignorance on the part of the citizens.

Addressing the audience, chairman of the conference, Professor Maurice Iwu, said the unique feature of non-communicable diseases is that they mainly have to do with lifestyle management, listing conditions like cancer, diabetes, hypertension and other cardiovascular diseases as health challenges brought about by people’s ways of lives. He said, “If you do not eat well and exercise regularly, you can’t be totally free from at least one of these diseases”.

In tackling the malaria burden in the country, which is one of the major diseases confronting Nigeria, the renowned scientist maintained that it is ignorance that makes most Nigeria medical doctors to   belittle locally-produced traditional medicines in the treatment of malaria.

His words: “It is lack of confidence and ignorance that make practitioners underplay the efficacy of our traditional medicine, which are unlike the orthodox medicines which you take today and tomorrow you are alright, but next tomorrow you are down again. When you are confident about what you have, you will be proud to showcase it anywhere in the world. Normally, when you are under-developed like we are, you have setbacks, and that is what we are experiencing now”.

Stressing the need for all to cultivate hygiene habits and reside in clean environments, Iwu asserted that all normal human beings have lots of parasites living in them.

“We are actually a collection of bacteria”, he said, buttressing the need to ensure cleanliness at all times.

Prof. Iwu, who is also president of the Bio-resources Group, charged the new administration of President Buhari to reposition NIMR as the national coordinating research institute, noting that volumes of researches conducted will amount to nothing in the nation without a coordinating institute to channel the studies through the right processes for impact.

Prof. (Mrs) Olaoluwa Akinwale, director of research (Neglected Tropical Diseases) and head, Molecular Parasitology Research Laboratory, Public Health Division, while delivering her lecture series titled: “From parasites to parasites: A parasitologist’s expedition”, explained that humans are hosts to nearly 300 species of parasitic worms and over 70 species of protozoa, some derived from primates and some acquired from domestic animals.

The industrious investigator, who had travelled far and wide to gain knowledge, stated that 30 per cent of the world’s population is infected with nematode Ascaris lumbriciodes, lamenting the unusual surge in the cases of parasitic diseases such as schistosomiasis and malaria.

Describing the effects of parasitic infections on human body, she said schistosomiasis makes children urinate blood, while causing bladder cancer in adults, making it a double-edged disease.

She added that the disease is most common in water-logged and riverine areas, where people lack social amenities and highly endemic communities.

On the way forward, she said that since adequate health is a legitimate right of every Nigerian, the government must endeavour to break the social-economic inequality among the populace, a situation in which the rich are getting richer, and the poor getting poorer.

Prof. Akinwale further recommended the formulation of health policies which will address the burden of these diseases, in order to forestall further degeneration in the nation’s health care system.

She also reiterated the need for a paradigm shift in behaviour and orientation, saying Nigerians should jettison the idea that “disease cannot kill a black man”. She equally stressed the need to desist from eating unwashed foods, as well as indiscriminate urinating and defecating.

In his message to the audience, Director General of NIMR, Prof. Innocent Ujah, explained the theme of the conference, saying it was chosen to stimulate discussions and generate ideas on the communicable and non-communicable diseases burdens confronting the nation.

“This conference is intended to bring policy makers, academia, researchers and clinical experts together to deliberate, share experiences and network on how best to end the dichotomy in policy planning and implementation with regard to communicable and non-communicable diseases in the face of dwindling funding for health care and limited qualified human resource”, he said.

The DG who expressed optimism that all the objectives of the conference would be achieved, mentioned that a total of 57 abstracts were submitted; while 22 were accepted for oral presentation, 24 were accepted for poster presentation and nine were rejected

The task of revamping pharmacy education in Nigeria to make it more functional to address the societal needs and contemporary global best practices is enormous and pharmacists who are desirous of advancing their practice and improve the image of the profession must embrace the philosophy of lifelong self-directed learning, eminent pharmacist, Professor Azuka C. Oparah has said.

Prof. Oparah said this while delivering a keynote address on the topic, ‘Advancing Pharmacy Through Strategic Workforce Development in Practice Settings’, at the International Conference Centre, Abuja, during the 88th Annual National Conference of the PSN held in November.

The Professor of Clinical Pharmacy at the University of Benin (UNIBEN) urged Nigerian pharmacists to think globally and act locally, adding that the mindset that created a problem cannot be used to solve it.

He further stated that revamping pharmacy education in Nigeria requires a disruptive innovative approach and strong collaboration among the regulators to connect all the levels of the pharmacist’s training, from basic to a specialist practitioner.

This, he said, would only be possible with visionary and committed leadership occurring simultaneously along the strata.

“To bring about change within a diverse profession such as pharmacy, one needs a critical mass pull in the same direction; one needs general agreement about the best direction in which to move and defining and agreeing on this direction has been the greatest challenge,” he said.

Below is the full text of Prof. Oparah’s keynote address:

Introduction

I am grateful to the President and Members of the 88th National Conference Planning Committee of the Pharmaceutical Society of Nigeria for the honour to be keynote speaker today. The objective of this discourse is to explore how to elevate pharmacy practice in diverse settings using the tool of strategic workforce development.

Access to quality medicines and competent, capable health care professionals are fundamental aspects of any health care system. Pharmaceutical human resources should ensure the uninterrupted supply of quality medicines to the population, their management, and responsible use, as vital components in improving the health of nations (FIP Workforce Report, 2012).

Pharmacy workforce comprises pharmacists, pharmacy technicians, counter assistants, and pharmaceutical scientists. Pharmacists practice their profession in diverse settings which we have often identified the major ones as academia/research institutions, hospital, community, industry, and regulatory agencies.

Introspection into pharmacy practice in Nigeria reveals promises that have yet to be delivered. Academic pharmacists, who are producers of pharmacists seem isolated from the real world and have been described as Pharisees because they do not have opportunities to practice what they teach. Hospital pharmacy is largely focused on supply of medications with minimal patient counselling during dispensing and fragments of pharmaceutical care. Community pharmacists supply medications, with great opportunities for helping community dwellers use medications responsibly, as well as expand their frontiers to health promotion and disease-prevention, especially with an aging population.

Industrial pharmacists are experts in pharmaceutical marketing and dosage formulation. Manufacturing of active pharmaceutical ingredients and developing new remedies for emerging diseases represent huge opportunities for research and development. The regulation of pharmacy education, pharmacy practice, and pharmaceutical products makes pharmacy a profession that promises no harm to the public; when the public does not have access to safe medicines, there is a breach of trust. Pharmacists should fight circulation of fake/substandard drugs, drug faking is corruption; fake people cannot fight fake drugs.

Pharmacist workforce density

Pharmacists represent the third largest health care professional group in the world. The pharmacists-to-population ratios vary widely from less than five pharmacists per 100,000 population to as high as over 200 pharmacists per 100,000 population in some countries. The average ratio in the Western Pacific countries is about 25 times more than that of the countries in the African region and has the highest ratios compared to other regions.

The ratio is also related to the economic status of the country, with the low income countries having the lowest ratio and high income countries having the highest ratio (FIP Global Pharmacy & Migration Report, 2006). As at September 2015, 20,000 pharmacists were registered with the PCN and about 580 pharmacists have died in the past five years (PCN, 2015).

Given that some pharmacists engage in non-pharmaceutical jobs and some have migrated, Nigeria has a density of about 125 pharmacists per 100,000 population. There is inequitable distribution between urban and rural areas and even among the cities. Roughly 1,600 young pharmacists from Nigerian and overseas schools will be released yearly into the labour market as from 2015. We are heading towards a glut and fall in market price; time has come to place the cap.

Pharmacist workforce development

Pharmacist workforce development is undertaken in the following layers:

* Undergraduate training

* Internship training

* Postgraduate training (academic and professional)

* Continuing professional development

* Lifelong self-directed learning

* Mentoring

• Undergraduate training – Pharmacy education affects pharmacy practice; both the education and practice are regulated by the Pharmacists Council of Nigeria (PCN) in pursuance of the enabling act. The standards of pharmacy education are also set by the National Universities Commission (NUC). The International Federation of Pharmacists (FIP) recommends global standards for local adaptation. Pharmacy   is an international profession and training practitioners using a global template enables global workforce mobility.

Some issues regarding undergraduate training that need strategic attention are:

1. Curriculum accreditation – Both NUC and PCN undertake programme accreditation. Pharmacy faculties are required to satisfy both bodies. This process results in duplication and wasting of scarce resources. Joint accreditation between PCN and NUC is recommended for Schools of Pharmacy in Nigeria. Furthermore, so far, accreditation criteria have focused on the relevant structures, but there is now need to focus on the processes and learning outcomes as ICT makes it possible to produce good students using compact but complex structural and process models.

2. 2. Training curriculum – Over the years, we have grappled with an overloaded pharmacy curriculum that renders our students more confused than they were before they entered pharmacy schools. The curriculum also leaves our students with low self-esteem, as even the best graduating students in Pharmacy will tell you that they struggled to p

Each time we talk about curriculum review, some faculty members will vehemently defend their territories and may allow you to add a few new courses. Because we add without dropping, we end up overloading the curriculum to the extent that some undergraduate and postgraduate syllabuses are the same. We urgently need to revamp the training curriculum. In fact, I suggest a 30 per cent reduction, so as to allow the students some time to reflect and apply themselves.

The mindset we used to create problems cannot be used to solve them. Reviewing and updating pharmacy training curriculum requires courage and foresight on the part of the regulators. To this end, I wish to observe that the proposed BMAS for PharmD has confused the past with the future and needs to be revamped, so that the second error will not be greater than the first.

2. Structure of pharmacy faculties – The traditional 5- or 6- department structure is overdue for expansion to promote professional growth and development. I recall that the 2012 PSN Pharmacy Education Summit adopted three new departments: Public Health Pharmacy, Social & Administrative Pharmacy, and Agricultural & Veterinary Pharmacy.

     Furthermore, we need to pursue the creation of more directorates at practice level and rotate the headship of pharmacy departments among chief pharmacists and above, as we have in the universities, if we are to embrace innovative practice. Ironically, Pharmacy is a faculty in school but shrunk to one department in practice; that creates structural interactive dissonance.

4. 4. Doctor of Pharmacy (PharmD) degree programme – The nomenclature of entry to practics degree in pharmacy has seen an evolutionary trend from Diploma to BSc, to BPharm, to PharmD or MPh This change is accompanied with upwards review of curriculum and duration of training. Only the University of Benin was courageous to start the programme in 2000 and after 15 years, no other school has. Despite the reasons offered, these other schools need help.

The University of Benin model has local adaption of retaining the basic pharmaceutical sciences and terminal clinical focus. The American Educational Credential Evaluators Evaluation Report in 2009 indicated that the University of Benin (Uniben) PharmD degree is equivalent to the US PharmD degree. Therefore, holders of Uniben PharmD are currently recognised in the US and other countries. But they are begging for recognition in Nigeria because we did not speak with one voice when we should have done so, and in line with scriptural quotes, a man’s greatest enemies are members of his own household. In Luke 4:24 and Mark 6:4: Jesus said to them, “Prophets are respected everywhere except in their own home town and by their relatives and their family.”

Ghana joined the world league in 2012 when Kwame Nkrumah University of Science & Technology transited from BPharm to PharmD degree. In transiting from BPharm to PharmD, we have to accept to change the way we think and the way we act regarding pharmacy education and practice. This change entails new attitudes, new mindsets, acquisition of new knowledge and skills and most importantly, willingness to give up some of our so called traditional or conventional ways of doing things.

We must respond to change and the only way to become relevant with time is to embrace new ideas rather than sticking to our traditional comfort zones. Pharmacy is a global profession and there are changes that have occurred worldwide in response to changes in healthcare delivery systems, technology and consumer behaviour. Such changes include transition from BPharm to PharmD and moving from product-oriented practice to pharmaceutical care practice.

Nigerian Pharmacy Schools should stop offering BPharm degree that has been phased out by those who introduced pharmacy education to us. It is like sticking to your old black and white television when the colour television has become ultra-thin. I therefore call on the National Universities Commission and the Pharmacists Council of Nigeria to formally recognise the establishment of the Doctor of Pharmacy degree programme in Nigerian Pharmacy Schools, so that the training of Nigerian pharmacists will be at par with what obtains in the contemporary world.

5. 5. Pharmaceutical care education – Pharmaceutical care is the current philosophy of pharmacy practice worldwid It affects the way pharmacists think and the way they practise, irrespective of the practice-setting. Pharmaceutical care represents both a paradigm shift and disruptive innovation in health care. The pharmacist becomes a problem solver rather than a mere dispenser of medications. The overall gains include assurance of the quality of the prescribing of physicians, improving quality of life of the sick within realistic costs and maintaining the quality of life of the healthy population.

The world-wide acceptance of pharmaceutical care as the mission of the pharmacy profession is shaping pharmaceutical education and practice. As a result, pharmaceutical care was adopted as the focus of good pharmacy education (FIP 1998). Our study indicates that Nigerian pharmacists have positive attitudes towards pharmaceutical care and favour a combination of pharmaceutical care and traditional pharmacy practice; with a gradual introduction of pharmaceutical care in different practice settings (Oparah, et al., 2005)

Pharmaceutical care education in Nigeria should start with training the trainers, developing practice sites and should be student-cantered and outcome-oriented. Approaches to improve pharmaceutical care education include early introduction of pharmaceutical care in the pharmacy curriculum, use of actual patients to teach in the classroom, exposing students to shadow experience at practice sites, and use of virtual patients, especially where access to real patients is a barrier (Oparah, 2010).

Internship training

A mandatory requirement for registration of fresh pharmacists is that they undergo a period of 12-months supervised training in an approved site or split sites. For this training to be outcome-oriented, the required competences should be clearly spelt out to guide both the trainees and their preceptors.

With 17 accredited pharmacy schools and five awaiting accreditation, there is a growing number of prospective internees: 1008 (2012), 1197 (2013), and 1505 (2014) plus pharmacists trained overseas: 80 (2012), 73 (2013), 104 (2014), and 123 (2015). However, there are 208 accredited internship sites as at this review period (PCN 2015).

The implication is that most fresh pharmacy graduates will stay at home for 1-2 years before they can secure a place for internship. Nobody should expect these young professionals suffering early professional frustration to love their profession. Before we preach to them to think of what they should do for their profession, their profession should first think of what to do for them. Therefore, the PCN and PSN should actively search out and accredit more internship centres and also assist interns with placement in available centres.

Pre-registration examination

Pre-registration examination is an international practice. In Nigeria, it is necessary to guarantee the quality of entrants to pharmacy profession for the common good of the society. With the advent of several public and private schools of pharmacy, there is a wide variation in the quality of students on admission and the quality of graduates; pre-registration examination will become the final clearance house for all. Therefore, the PCN should clearly define the syllabus and guidelines for the pre-registration examination ahead of its commencement. Introduction of pre-registration examination was adopted in PCN’s Pharmacy Education Conference in 2001 and PSN’s Summit in 2012. Let us not become active members of “NATO – No Action, Talk Only” according to Prof. Fola Tayo.

Postgraduate training

Most pharmacists call themselves experts on drugs. Please note that a first degree can hardly produce an expert. Pharmacists should therefore seek further education after the pharmacy degree. The global trend in health care is for professionals to specialise; the future offers little hope for generalists.

While the schools of pharmacy can produce higher academic degrees, they are not suitable for professional degrees. This is where regional and national colleges such as the West African Postgraduate College of Pharmacists will come in to produce Fellows, who can, on appointment, function as specialists and consultants in practice settings.

Pharmacists can train and specialise as Antibiotic Pharmacists, Oncology Pharmacists, Cardiovascular & Renal Pharmacists, Nutrition Support Pharmacists, Psychiatric Pharmacists and Diabetes Educators etc. The future of hospital pharmacy practice lies in creating several areas of specialisation rather than employing everyone as just pharmacist, where there will be no distinction in the job description of different cadres of pharmacists.

Furthermore, qualifying bodies such as the West African Postgraduate College of Pharmacists only certify their Fellows. It is the duty of the professional regulator to issue licence to practice. Therefore, the PCN should develop a credentialing system for specialised pharmacists and not give everyone the same annual licence to practice as a pharmaceutical chemist.

Continuing professional development

The FIP Statement on Good Pharmacy Education Practice states that Continuing Professional Development must be a lifelong commitment for every practicing pharmacist. The concept of Continuing Professional Development (CPD) can be defined as “the responsibility of individual pharmacists for systematic maintenance, development and broadening of knowledge, skills and attitudes, to ensure continuing competence as a professional, throughout their careers” (FIP,

2000).

Continuing Professional Development is not more than participation in Continuing Education (CE) which, on its own, does not necessarily lead to positive changes in professional practice nor does it necessarily improve healthcare outcomes. CE is, however, an important part of a structured CPD programme, personalised for each pharmacist. CPD is a continuous cycle of reflection on learning needs, planning, action and evaluation. Based on identified national needs, the individual pharmacist should to learn how to draw up SMART plans (Specific, Measurable, Achievable, Realistic and Timed) for a personalised programme of CPD.

The Continuing Professional Development Process involves 5- step cyclical process of Self- Appraisal, Personal Plan, Action (Implementation), Documentation, and Evaluation. From the foregoing, it means that what we are currently doing is not CPD but it is mandatory to the extent of regulatory requirement for registration.

Lifelong self-directed Learning

In the real sense, learning whether structured or not occurs throughout lifetime and we literally die the day we stop to learn. Professionals should not only learn to maintain competence to practice but also to fit into societal expectations. In addition to professional literatures, we should read newspapers and magazines, books on leadership, entrepreneurship & resource management; politics and economics. We should listen to network news and watch football matches and also watch home videos to know the trends in our society.

Mentoring

Mentoring is a one–to-one relationship of professional development, usually between someone seeking professional progression and a more experienced practitioner. This could include someone seeking to develop a new expertise and a practitioner already active in that area (Goundrey-Smith 2011). Mentoring helps to develop confidence and skills of both the mentor and the mentee. Pharmacy profession in Nigeria will benefit from a structured mentoring scheme and I challenge the leadership of the Pharmaceutical Society of Nigeria to undertake this project.

Conclusion

The task of revamping pharmacy education in Nigeria to make it more functional to address the societal needs and contemporary global best practice is enormous. This requires a disruptive innovative approach and strong collaboration among the regulator, PCN, Faculties of Pharmacy, and the West African Postgraduate College of Pharmacists to connect all the levels of pharmacists’ training, from basic to a specialist practitioner. This will only be possible with visionary and committed leadership occurring simultaneously along the strata.

To bring about change within a diverse profession such as pharmacy, one needs a critical mass of people pulling in the same direction. Before one can get such a critical mass pulling in the same direction, one needs general agreement about the best direction in which to move and defining and agreeing on this direction has been our greatest challenge.

The mission of the profession of pharmacy is to improve public health through ensuring safe, effective, and appropriate use of medications. Contemporary pharmacy practice reflects an evolving paradigm from one in which the pharmacist primarily supervises medication distribution and counsels patients, to a more expanded and team-based clinical role providing patient-centered medication therapy management, health improvement, and disease prevention services (Webb 1995). Pharmacists should learn to make effective use pharmacy technicians to free time for their involvement in expanding roles in health care delivery.

Education stimulates change in practice. There is a shift in the pharmacy practice philosophy and education which we must embrace: from drug product to drug therapy, from pharmacy to bedside, from dispenser to caregiver, from solo to team, from knowledge to information, from as ordered to as best prescribed, and from drug distribution to pharmaceutical care; where pharmacists promote access to safe medications and their responsible use.

To become responsive, pharmacy education needs to change in three fundamental domains: the teachers should change, the curriculum should change, and mode of delivery and evaluation should change. Teachers need training and re-orientation to reflect on the purpose of pharmacy education which is to produce competent practitioners and not to give abstract knowledge. Revamping the training template entails a competency-based learning rather than compartmentalisation into pharmaceutical chemistry, pharmacology, pharmaceutics, pharmacognosy and clinical pharmacy. In my mind these departments should be structures with an integrated function; this integration further extends to biomedical & medical departments.

Based on the global competences for pharmacists, the competence pyramid (Miller 1990) of knowing it, knowing how to do it, showing how to do it, and doing it will expect the pharmacist to acquire competences in pharmaceutical care, public health, management, and production/quality assurance of medicines. The new approach to student-centered teaching indicates active learning, problem solving, communication skills and teamwork; evaluation then assesses the outcomes of specific competence objectives.

Finally, pharmacists who want to advance their practice should embrace the philosophy of lifelong self-directed learning. We must think globally and act locally; the mindset that created a problem cannot be used to solve it. The pharmacist of tomorrow is one with specialised knowledge and skill to solve society’s problems. As long as mankind takes medications, there will always be a future for the pharmacist. A former US President, JFK Kennedy in a speech in 1962 described “the pharmacist as an indispensable link in the chain of national health protection and promotion. If we did not have the pharmacist, it would be necessary to invent him.”

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63-67.

Oparah AC (2010). Barriers to the implementation of pharmaceutical care In: Essentials of

Pharmaceutical Care; Lagos Cybex Publications 155-167.

Oparah AC, Eferakeya AE (2005). Attitudes of Nigerian Pharmacists towards pharmaceutical care. Pharmacy World and Science; 27 (3): 208 – 214.

Webb E. Prescribing medications: Changing the Paradigm for a Changing Health Care

System Am J Health-Syst Pharm. 1995;52:1693–5.

Why pharmacists should embrace lifelong learning – Prof. Oparah

The task of revamping pharmacy education in Nigeria to make it more functional to address the societal needs and contemporary global best practices is enormous and pharmacists who are desirous of advancing their practice and improve the image of the profession must embrace the philosophy of lifelong self-directed learning, eminent pharmacist, Professor Azuka C. Oparah has said.

Prof. Oparah said this while delivering a keynote address on the topic, ‘Advancing Pharmacy Through Strategic Workforce Development in Practice Settings’, at the International Conference Centre, Abuja, during the 88th Annual National Conference of the PSN held in November.

The Professor of Clinical Pharmacy at the University of Benin (UNIBEN) urged Nigerian pharmacists to think globally and act locally, adding that the mindset that created a problem cannot be used to solve it.

He further stated that revamping pharmacy education in Nigeria requires a disruptive innovative approach and strong collaboration among the regulators to connect all the levels of the pharmacist’s training, from basic to a specialist practitioner.

This, he said, would only be possible with visionary and committed leadership occurring simultaneously along the strata.

“To bring about change within a diverse profession such as pharmacy, one needs a critical mass pull in the same direction; one needs general agreement about the best direction in which to move and defining and agreeing on this direction has been the greatest challenge,” he said.

Below is the full text of Prof. Oparah’s keynote address:

Introduction

I am grateful to the President and Members of the 88th National Conference Planning Committee of the Pharmaceutical Society of Nigeria for the honour to be keynote speaker today. The objective of this discourse is to explore how to elevate pharmacy practice in diverse settings using the tool of strategic workforce development.

Access to quality medicines and competent, capable health care professionals are fundamental aspects of any health care system. Pharmaceutical human resources should ensure the uninterrupted supply of quality medicines to the population, their management, and responsible use, as vital components in improving the health of nations (FIP Workforce Report, 2012).

Pharmacy workforce comprises pharmacists, pharmacy technicians, counter assistants, and pharmaceutical scientists. Pharmacists practice their profession in diverse settings which we have often identified the major ones as academia/research institutions, hospital, community, industry, and regulatory agencies.

Introspection into pharmacy practice in Nigeria reveals promises that have yet to be delivered. Academic pharmacists, who are producers of pharmacists seem isolated from the real world and have been described as Pharisees because they do not have opportunities to practice what they teach. Hospital pharmacy is largely focused on supply of medications with minimal patient counselling during dispensing and fragments of pharmaceutical care. Community pharmacists supply medications, with great opportunities for helping community dwellers use medications responsibly, as well as expand their frontiers to health promotion and disease-prevention, especially with an aging population.

Industrial pharmacists are experts in pharmaceutical marketing and dosage formulation. Manufacturing of active pharmaceutical ingredients and developing new remedies for emerging diseases represent huge opportunities for research and development. The regulation of pharmacy education, pharmacy practice, and pharmaceutical products makes pharmacy a profession that promises no harm to the public; when the public does not have access to safe medicines, there is a breach of trust. Pharmacists should fight circulation of fake/substandard drugs, drug faking is corruption; fake people cannot fight fake drugs.

Pharmacist workforce density

Pharmacists represent the third largest health care professional group in the world. The pharmacists-to-population ratios vary widely from less than five pharmacists per 100,000 population to as high as over 200 pharmacists per 100,000 population in some countries. The average ratio in the Western Pacific countries is about 25 times more than that of the countries in the African region and has the highest ratios compared to other regions.

The ratio is also related to the economic status of the country, with the low income countries having the lowest ratio and high income countries having the highest ratio (FIP Global Pharmacy & Migration Report, 2006). As at September 2015, 20,000 pharmacists were registered with the PCN and about 580 pharmacists have died in the past five years (PCN, 2015).

Given that some pharmacists engage in non-pharmaceutical jobs and some have migrated, Nigeria has a density of about 125 pharmacists per 100,000 population. There is inequitable distribution between urban and rural areas and even among the cities. Roughly 1,600 young pharmacists from Nigerian and overseas schools will be released yearly into the labour market as from 2015. We are heading towards a glut and fall in market price; time has come to place the cap.

Pharmacist workforce development

Pharmacist workforce development is undertaken in the following layers:

* Undergraduate training

* Internship training

* Postgraduate training (academic and professional)

* Continuing professional development

* Lifelong self-directed learning

* Mentoring

• Undergraduate training – Pharmacy education affects pharmacy practice; both the education and practice are regulated by the Pharmacists Council of Nigeria (PCN) in pursuance of the enabling act. The standards of pharmacy education are also set by the National Universities Commission (NUC). The International Federation of Pharmacists (FIP) recommends global standards for local adaptation. Pharmacy   is an international profession and training practitioners using a global template enables global workforce mobility.

Some issues regarding undergraduate training that need strategic attention are:

1. Curriculum accreditation – Both NUC and PCN undertake programme accreditation. Pharmacy faculties are required to satisfy both bodies. This process results in duplication and wasting of scarce resources. Joint accreditation between PCN and NUC is recommended for Schools of Pharmacy in Nigeria. Furthermore, so far, accreditation criteria have focused on the relevant structures, but there is now need to focus on the processes and learning outcomes as ICT makes it possible to produce good students using compact but complex structural and process models.

2. 2. Training curriculum – Over the years, we have grappled with an overloaded pharmacy curriculum that renders our students more confused than they were before they entered pharmacy schools. The curriculum also leaves our students with low self-esteem, as even the best graduating students in Pharmacy will tell you that they struggled to p

Each time we talk about curriculum review, some faculty members will vehemently defend their territories and may allow you to add a few new courses. Because we add without dropping, we end up overloading the curriculum to the extent that some undergraduate and postgraduate syllabuses are the same. We urgently need to revamp the training curriculum. In fact, I suggest a 30 per cent reduction, so as to allow the students some time to reflect and apply themselves.

The mindset we used to create problems cannot be used to solve them. Reviewing and updating pharmacy training curriculum requires courage and foresight on the part of the regulators. To this end, I wish to observe that the proposed BMAS for PharmD has confused the past with the future and needs to be revamped, so that the second error will not be greater than the first.

2. Structure of pharmacy faculties – The traditional 5- or 6- department structure is overdue for expansion to promote professional growth and development. I recall that the 2012 PSN Pharmacy Education Summit adopted three new departments: Public Health Pharmacy, Social & Administrative Pharmacy, and Agricultural & Veterinary Pharmacy.

     Furthermore, we need to pursue the creation of more directorates at practice level and rotate the headship of pharmacy departments among chief pharmacists and above, as we have in the universities, if we are to embrace innovative practice. Ironically, Pharmacy is a faculty in school but shrunk to one department in practice; that creates structural interactive dissonance.

4. 4. Doctor of Pharmacy (PharmD) degree programme – The nomenclature of entry to practics degree in pharmacy has seen an evolutionary trend from Diploma to BSc, to BPharm, to PharmD or MPh This change is accompanied with upwards review of curriculum and duration of training. Only the University of Benin was courageous to start the programme in 2000 and after 15 years, no other school has. Despite the reasons offered, these other schools need help.

The University of Benin model has local adaption of retaining the basic pharmaceutical sciences and terminal clinical focus. The American Educational Credential Evaluators Evaluation Report in 2009 indicated that the University of Benin (Uniben) PharmD degree is equivalent to the US PharmD degree. Therefore, holders of Uniben PharmD are currently recognised in the US and other countries. But they are begging for recognition in Nigeria because we did not speak with one voice when we should have done so, and in line with scriptural quotes, a man’s greatest enemies are members of his own household. In Luke 4:24 and Mark 6:4: Jesus said to them, “Prophets are respected everywhere except in their own home town and by their relatives and their family.”

Ghana joined the world league in 2012 when Kwame Nkrumah University of Science & Technology transited from BPharm to PharmD degree. In transiting from BPharm to PharmD, we have to accept to change the way we think and the way we act regarding pharmacy education and practice. This change entails new attitudes, new mindsets, acquisition of new knowledge and skills and most importantly, willingness to give up some of our so called traditional or conventional ways of doing things.

We must respond to change and the only way to become relevant with time is to embrace new ideas rather than sticking to our traditional comfort zones. Pharmacy is a global profession and there are changes that have occurred worldwide in response to changes in healthcare delivery systems, technology and consumer behaviour. Such changes include transition from BPharm to PharmD and moving from product-oriented practice to pharmaceutical care practice.

Nigerian Pharmacy Schools should stop offering BPharm degree that has been phased out by those who introduced pharmacy education to us. It is like sticking to your old black and white television when the colour television has become ultra-thin. I therefore call on the National Universities Commission and the Pharmacists Council of Nigeria to formally recognise the establishment of the Doctor of Pharmacy degree programme in Nigerian Pharmacy Schools, so that the training of Nigerian pharmacists will be at par with what obtains in the contemporary world.

5. 5. Pharmaceutical care education – Pharmaceutical care is the current philosophy of pharmacy practice worldwid It affects the way pharmacists think and the way they practise, irrespective of the practice-setting. Pharmaceutical care represents both a paradigm shift and disruptive innovation in health care. The pharmacist becomes a problem solver rather than a mere dispenser of medications. The overall gains include assurance of the quality of the prescribing of physicians, improving quality of life of the sick within realistic costs and maintaining the quality of life of the healthy population.

The world-wide acceptance of pharmaceutical care as the mission of the pharmacy profession is shaping pharmaceutical education and practice. As a result, pharmaceutical care was adopted as the focus of good pharmacy education (FIP 1998). Our study indicates that Nigerian pharmacists have positive attitudes towards pharmaceutical care and favour a combination of pharmaceutical care and traditional pharmacy practice; with a gradual introduction of pharmaceutical care in different practice settings (Oparah, et al., 2005)

Pharmaceutical care education in Nigeria should start with training the trainers, developing practice sites and should be student-cantered and outcome-oriented. Approaches to improve pharmaceutical care education include early introduction of pharmaceutical care in the pharmacy curriculum, use of actual patients to teach in the classroom, exposing students to shadow experience at practice sites, and use of virtual patients, especially where access to real patients is a barrier (Oparah, 2010).

Internship training

A mandatory requirement for registration of fresh pharmacists is that they undergo a period of 12-months supervised training in an approved site or split sites. For this training to be outcome-oriented, the required competences should be clearly spelt out to guide both the trainees and their preceptors.

With 17 accredited pharmacy schools and five awaiting accreditation, there is a growing number of prospective internees: 1008 (2012), 1197 (2013), and 1505 (2014) plus pharmacists trained overseas: 80 (2012), 73 (2013), 104 (2014), and 123 (2015). However, there are 208 accredited internship sites as at this review period (PCN 2015).

The implication is that most fresh pharmacy graduates will stay at home for 1-2 years before they can secure a place for internship. Nobody should expect these young professionals suffering early professional frustration to love their profession. Before we preach to them to think of what they should do for their profession, their profession should first think of what to do for them. Therefore, the PCN and PSN should actively search out and accredit more internship centres and also assist interns with placement in available centres.

Pre-registration examination

Pre-registration examination is an international practice. In Nigeria, it is necessary to guarantee the quality of entrants to pharmacy profession for the common good of the society. With the advent of several public and private schools of pharmacy, there is a wide variation in the quality of students on admission and the quality of graduates; pre-registration examination will become the final clearance house for all. Therefore, the PCN should clearly define the syllabus and guidelines for the pre-registration examination ahead of its commencement. Introduction of pre-registration examination was adopted in PCN’s Pharmacy Education Conference in 2001 and PSN’s Summit in 2012. Let us not become active members of “NATO – No Action, Talk Only” according to Prof. Fola Tayo.

Postgraduate training

Most pharmacists call themselves experts on drugs. Please note that a first degree can hardly produce an expert. Pharmacists should therefore seek further education after the pharmacy degree. The global trend in health care is for professionals to specialise; the future offers little hope for generalists.

While the schools of pharmacy can produce higher academic degrees, they are not suitable for professional degrees. This is where regional and national colleges such as the West African Postgraduate College of Pharmacists will come in to produce Fellows, who can, on appointment, function as specialists and consultants in practice settings.

Pharmacists can train and specialise as Antibiotic Pharmacists, Oncology Pharmacists, Cardiovascular & Renal Pharmacists, Nutrition Support Pharmacists, Psychiatric Pharmacists and Diabetes Educators etc. The future of hospital pharmacy practice lies in creating several areas of specialisation rather than employing everyone as just pharmacist, where there will be no distinction in the job description of different cadres of pharmacists.

Furthermore, qualifying bodies such as the West African Postgraduate College of Pharmacists only certify their Fellows. It is the duty of the professional regulator to issue licence to practice. Therefore, the PCN should develop a credentialing system for specialised pharmacists and not give everyone the same annual licence to practice as a pharmaceutical chemist.

Continuing professional development

The FIP Statement on Good Pharmacy Education Practice states that Continuing Professional Development must be a lifelong commitment for every practicing pharmacist. The concept of Continuing Professional Development (CPD) can be defined as “the responsibility of individual pharmacists for systematic maintenance, development and broadening of knowledge, skills and attitudes, to ensure continuing competence as a professional, throughout their careers” (FIP,

2000).

Continuing Professional Development is not more than participation in Continuing Education (CE) which, on its own, does not necessarily lead to positive changes in professional practice nor does it necessarily improve healthcare outcomes. CE is, however, an important part of a structured CPD programme, personalised for each pharmacist. CPD is a continuous cycle of reflection on learning needs, planning, action and evaluation. Based on identified national needs, the individual pharmacist should to learn how to draw up SMART plans (Specific, Measurable, Achievable, Realistic and Timed) for a personalised programme of CPD.

The Continuing Professional Development Process involves 5- step cyclical process of Self- Appraisal, Personal Plan, Action (Implementation), Documentation, and Evaluation. From the foregoing, it means that what we are currently doing is not CPD but it is mandatory to the extent of regulatory requirement for registration.

Lifelong self-directed Learning

In the real sense, learning whether structured or not occurs throughout lifetime and we literally die the day we stop to learn. Professionals should not only learn to maintain competence to practice but also to fit into societal expectations. In addition to professional literatures, we should read newspapers and magazines, books on leadership, entrepreneurship & resource management; politics and economics. We should listen to network news and watch football matches and also watch home videos to know the trends in our society.

Mentoring

Mentoring is a one–to-one relationship of professional development, usually between someone seeking professional progression and a more experienced practitioner. This could include someone seeking to develop a new expertise and a practitioner already active in that area (Goundrey-Smith 2011). Mentoring helps to develop confidence and skills of both the mentor and the mentee. Pharmacy profession in Nigeria will benefit from a structured mentoring scheme and I challenge the leadership of the Pharmaceutical Society of Nigeria to undertake this project.

Conclusion

The task of revamping pharmacy education in Nigeria to make it more functional to address the societal needs and contemporary global best practice is enormous. This requires a disruptive innovative approach and strong collaboration among the regulator, PCN, Faculties of Pharmacy, and the West African Postgraduate College of Pharmacists to connect all the levels of pharmacists’ training, from basic to a specialist practitioner. This will only be possible with visionary and committed leadership occurring simultaneously along the strata.

To bring about change within a diverse profession such as pharmacy, one needs a critical mass of people pulling in the same direction. Before one can get such a critical mass pulling in the same direction, one needs general agreement about the best direction in which to move and defining and agreeing on this direction has been our greatest challenge.

The mission of the profession of pharmacy is to improve public health through ensuring safe, effective, and appropriate use of medications. Contemporary pharmacy practice reflects an evolving paradigm from one in which the pharmacist primarily supervises medication distribution and counsels patients, to a more expanded and team-based clinical role providing patient-centered medication therapy management, health improvement, and disease prevention services (Webb 1995). Pharmacists should learn to make effective use pharmacy technicians to free time for their involvement in expanding roles in health care delivery.

Education stimulates change in practice. There is a shift in the pharmacy practice philosophy and education which we must embrace: from drug product to drug therapy, from pharmacy to bedside, from dispenser to caregiver, from solo to team, from knowledge to information, from as ordered to as best prescribed, and from drug distribution to pharmaceutical care; where pharmacists promote access to safe medications and their responsible use.

To become responsive, pharmacy education needs to change in three fundamental domains: the teachers should change, the curriculum should change, and mode of delivery and evaluation should change. Teachers need training and re-orientation to reflect on the purpose of pharmacy education which is to produce competent practitioners and not to give abstract knowledge. Revamping the training template entails a competency-based learning rather than compartmentalisation into pharmaceutical chemistry, pharmacology, pharmaceutics, pharmacognosy and clinical pharmacy. In my mind these departments should be structures with an integrated function; this integration further extends to biomedical & medical departments.

Based on the global competences for pharmacists, the competence pyramid (Miller 1990) of knowing it, knowing how to do it, showing how to do it, and doing it will expect the pharmacist to acquire competences in pharmaceutical care, public health, management, and production/quality assurance of medicines. The new approach to student-centered teaching indicates active learning, problem solving, communication skills and teamwork; evaluation then assesses the outcomes of specific competence objectives.

Finally, pharmacists who want to advance their practice should embrace the philosophy of lifelong self-directed learning. We must think globally and act locally; the mindset that created a problem cannot be used to solve it. The pharmacist of tomorrow is one with specialised knowledge and skill to solve society’s problems. As long as mankind takes medications, there will always be a future for the pharmacist. A former US President, JFK Kennedy in a speech in 1962 described “the pharmacist as an indispensable link in the chain of national health protection and promotion. If we did not have the pharmacist, it would be necessary to invent him.”

REFERENCES

Akubue PI, Adenika FB (2001) Eds. Pharmacy Education in Nigeria; Proceedings of the Pharmacy

Curriculum Conference Organized by the Pharmacists Council of Nigeria.

International Pharmaceutical Federation (FIP). Statement on Good Pharmacy Education

Practice, 1998

International Pharmaceutical Federation (FIP) Global Pharmacy & Migration Report 2006

International Pharmaceutical Federation (FIP) Global Pharmacy Workforce Report 2012

International Pharmaceutical Federation (FIP) Policy Statement on Good Pharmacy Education

Practice, Vienna 2000

Goundrey-Smith S (2011). How to ensure effective mentoring. Available at www.pjonline.com

Accessed 17/03/2015

Miller GE. The Assessment of Clinical Skills/Competence/Performance; Acad Med (1990); 65 (9):

63-67.

Oparah AC (2010). Barriers to the implementation of pharmaceutical care In: Essentials of

Pharmaceutical Care; Lagos Cybex Publications 155-167.

Oparah AC, Eferakeya AE (2005). Attitudes of Nigerian Pharmacists towards pharmaceutical care. Pharmacy World and Science; 27 (3): 208 – 214.

Webb E. Prescribing medications: Changing the Paradigm for a Changing Health Care

System Am J Health-Syst Pharm. 1995;52:1693–5.

It was a grand event in Lagos as West Africa’s foremost journal, Pharmanews, along with nine other broadcast and print media, bagged different categories of awards for contributing to the advancement of the Nigerian health sector.

The colourful ceremony which took place at R & A City Hotel, Ikeja, on 19 November, had several health professionals, guests and programme sponsors in attendance.

Speaking at the event, Prince Ifeanyi Dike, one of the organisers, praised the recipients of the award saying that they justified it.

“The essence of the Health Media Award is to recognise and honour those who have been in the vanguard of projecting the health sector. This is why we took our time picking the media and personalities whose efforts are felt from both print and broadcast media,” he stressed.

Butressing his view, Dr Bamidele Oshalusi, consultant neurologist, Olabisi Onabanjo University Teaching Hospital noted that no one could deny the fact that information released to the public from the recipients over the years had not only been reliable, but also life-saving.

While congratulating the awardees, Vivian Dunu, executive chairman of Maydon Pharma, announced that the company was glad to be a part of the occasion.

“In health, we need the support of everybody. The unfortunate incident of Ebola breakout last year showed that we can indeed succeed if we agree to come together. The focus should always be on the patient,” she urged.

Recipients of the 2015 edition of Media Health Awards were Sir Ifeanyi Atueyi (Publisher, Pharmanews), Cordelia Okpei (Health edition on AM Life, Metro FM), Dr Wale Adeboje (Doctor’s Puzzle, Cool FM), Franca Osakwe (Health Column, National Mirror Newspaper), Mary Alale-Yusuf (Health Matters, Channels TV), Funmi Akingbade (Time-Out, Galaxy TV), Habibah Basanya (Health Issue, TVC), Olushola Ogundipe (Health editor, Vanguard Newspaper), Jibeh Ologeh (R-Wells Media) and Funmi Myk-Adeniran (Loyin Ladun, NTA).

Among the dignitaries at the event were Chief Donatus Dunu, chairman of Maydon Pharmaceuticals; Dr Akin Erinosho, director of disease control, Lagos State Ministry of Health; Rajeev Rajan, territory head (West Africa) Narayana Health; Chief Emeka Okafor, managing director of All American Products Limited; and Oluwatoyin Olajide, chief operating officer, Air Peace Airline.

For the vision and mission of the Nigeria Academy of Pharmacists (NAPharm) to be fully realised in the country, the war against drug abuse, especially among the youth population, must be won by pharmacists in collaboration with other regulatory bodies, former Head of State, General Yakubu Gowon (rtd) and immediate past chairman of the Independent National Electoral Commission (INEC), Prof. Attahiru Jega, have said.

Gowon, who is an honorary Fellow of NAPharm, and Jega, a guest at the Investiture and Award Night of NAPharm, held at the Sheraton Hotels and Towers, on 27 October, 2015, also stressed the need for pharmacists to intensify efforts in curbing the circulation of substandard drugs in the country.

Prof. Jega, who was given the first NAPharm Lifetime Achievement award, for his   immeasurable service to his fatherland, decried the upsurge in indiscriminate use of prescription drugs among young people, which has led to the death of thousands.

He noted how the misuse of ethical drugs has become trendy among youths, noting that political thugs and party vanguards are getting hooked on codeine, among other opioid pain medications that are strictly prescription drugs in other countries.

In his words: “I urge the academy and the pharmaceutical profession to pay attention to the way and manner in which prescription drugs are being sold over the counter. This is doing a lot of damage to our youths, in particular, because some of these drugs are addictive.

“Many youths, young men and women, regrettably, can just walk into a patent medicine store or pharmacy and buy these over-the-counter drugs, as many bottles as they wish, and many of them have now become addicted to them. This is causing problems in many parts of the country. I know that it is a very serious problem in the part of the country that I come from.

“So, I believe that having been given this award, it also gives me the opportunity to urge leading and respected pharmacists, whether industrial or professors, to begin to pay attention to ethical issues related to selling drugs over-the-counter, because the damage this is doing to our youths is really going to be massive and needs to be addressed appropriately.”

Commending the new inductees of NAPharm. for having run a good race to reach the zenith of their profession, General Gowon reminded them that to whom much is given, much is required, adding that the critical area of their intervention is overcoming counterfeit drugs in the nation.

Gowon, who recalled the achievements of the late former NAFDAC DG, prof. Dora Akunyili, in combating the menace of fake drugs, stated that though the agency continues to sustain the tempo after her demise, more still needs to be done.

He said practitioners must rededicate themselves to the fight against fake and substandard products all around the country, noting that, while the situation is not peculiar to Nigeria, NAFDAC’s relentless efforts over the years is yet to succeed “as perpetrators are more determined and very much in the unfortunate business.”

The high point of the event was the decoration of the new Fellows, among whom were Professor of Pharmacognosy, University of Lagos (UNILAG), Olukemi Odukoya; Senator of the Federal Republic of Nigeria, Matthew Urhoghide; Professor of Pharmacokinetics/Pharmaceutical Chemistry, Chinedum Peace Babalola; Dr Evans Chidomere; Professor of Pharmaceutical Technology & Industrial Pharmacy, Amarauche Chukwu; Pharm. Ngozi Chu-Madu and Pharm. Olakunle Ekundayo.

Also inducted were: Professor Joshua Eniojukan, Professor Mbang Nyong Femi-Oyewo, Professor Isa Marte Hussaini, Professor Jacob Adegboyega Kolawole, Professor Udoma Mendie, Professor Nelson Ochepe, Professor Abiodun Ogundaini, Professor Tiwalade Olugbade, Professor Philip Olurinola and Professor Grace Onawunmi.                       Others were: Sir Nnamdi Obi, Pharm. Nnamdi Nathan Okafor, Pharm. Ikechukwu Ugwu John, Professor Anthony Obiosa Onyekweli, and Professor Cyril Odianose Usifoh.

Earlier on, President of the Academy, Prince Julius Adelusi-Adeluyi, explained how fortunate the Academy was, in bringing together bright minds whose education and experience would be jointly and severally shared while they remained Fellows of NAPharm.

The president further highlighted the objectives of the Academy, stating that it would provide a platform to influence national and state policies which would enable the fulfilment of the vision, mission, rights and obligations of Pharmacy.

He therefore urged all pharmacists to perform their roles in the society, saying it is their duty to ensure that things get better, not bitter with Pharmacy.

As a means of extending her philanthropic gestures to children, with the aim of improving Children’s Health Care in Okija, Anambra State, the OBIJACKSON GROUP OF COMPANIES has commissioned a world class Children Hospital (OBIJACKSON CHILDREN HOSPITAL) heavily equipped with the state-of -the -arts facilities

The official commissioning, which was held at the weekend, took place at the OBIJACKSON CHILDREN HOSPITAL centre, 2 Madonna Road in Okija L.G.A of Anambra State, with facilities to cater for the health care needs of over 2000 children. This event was organized by the famous Recherché Events & Gift

In line with the company’s vision to provide products with high quality and safety standards, Pfizer Consumer Healthcare has launched two new ranges of multivitamins and minerals.

The official products unveiling took place during the opening ceremony of the 88^th Pharmaceutical Society of Nigeria’s (PSN) annual conference which held on November 10, 2015 at the International Conference Centre, Abuja.

While addressing newsmen, Sue Cartwright, Pfizer’s marketing manager (Southern & West Africa) explained that Centrum range of multivitamins is scientifically formulated to help fill nutritional gaps in diets, enhance multiple health benefits to help unlock energy, strengthen immunity as well as support healthy eyes and brain development.

She further highlighted that the products are tailored to different ages and lifestyle; children, women, men, pregnant women and adults over 50 years. Keeping in mind that dietary supplements are not intended to diagnose, cure or prevent any disease but rather help consumers attain the recommended dietary allowance.

“Although we are treating our entry as a launch, Centrum is already available in the country via informal means (suitcase trade, temporary import permits). We have been in the market since 1968 and over these years, a lot of science and technology have gone into it.

“Centrum is the most clinically studied multivitamin brand with over 100,000 patient years of exposure in clinical studies in the world,” she said.

During a presentation on the second product, Caltrate, Cartwright disclosed that it is equally a scientifically formulated calcium supplement for adults and the elderly to support calcium and vitamin D deficiencies as well as assists in osteoporosis treatment.

“It is the World’s No.1 selling calcium supplement with vitamin D for calcium absorption, helping to support strong and healthy bones.

On her assessment of the Nigerian pharmaceutical market, the Pfizer marketing manager declared that it seems like a complex one because of the huge presence of drugs.

“But I think it is very exciting. There are a lot of variants coming in. Secondly I must admit that working with Nigerian pharmacists too is quite exciting. However we are positive about the huge opportunities awaiting us,” she noted.

On measures taken to avert counterfeiting of Centrum and Caltrate, Cartwright announced that both Pfizer and WWCVL teams are working closely with NAFDAC on the possibility of introducing the Mobile Authentication Service (MAS) technology.

She was also quick to point out that since the products are imported into the country directly from abroad, there is no reported case of counterfeit yet.

“However we have got people on the ground to assess the problem better. We (Pfizer team and WWCVL management) will be working together with Nigerian healthcare workers – doctors, pharmacists, nurses and we will be going directly to the consumers through newspapers, radio, television and digital media,” she concluded.

In a related development, Zikhona Spelman, a qualified South African dietician also addressed pharmacists on the role of nutritional supplements in the new millennium.

“It is pertinent to note that people are not eating the way they are supposed to. Besides, the nutritional value of food has changed over time. This is where nutritional value comes in. However such supplements are not meant to replace your normal meal,” she stressed.

The dietician further harped on the need for multivitamins, specifically the ones with B Complex, to be taken in the morning.

According to her, they are meant to extract energy from food.

“You need energy during the day hence the need to take them in the morning. Otherwise the purpose of taking it either in the evening or any other time would be defeated.

But calcium is totally a different case. It has big molecular structure which can interfere with absorption and other nutrients. This is why serious physicians canvass that you take multivitamin in the morning and calcium in the evening,” she said.

Pfizer is one of the world’s premier pharmaceutical companies, committed to applying science and global resources to improve health and well-being at every stage of life.

It has its operating affiliate office in Nigeria with two of the world’s leading multivitamins and minerals – Centrum and Caltrate (both approved by NAFDAC).

In attendance at the official launch were Uloaku Atueyi, brand manager (Nigeria); Deepak Kanwar, WWCVL sales manager; Pharm. Bruno Nwankwo, chairman, Pharmacists Council of Nigeria (PCN); Pharm. Lere Baale, director of Business School of Netherlands; Mazi Sam Ohuabunwa, former Neimeth Pharmaceuticals Plc CEO and Pharm. Ade Popoola, chairman, PSN Board of Fellows.

Others were Rukiyat Odekunle, director of Procurement, Federal Ministry of Health; Pharm. Ifeanyi Atueyi, managing director of Pharmanews Limited; Pharm. Lawrence Anyafulu, a PSN Fellow; Pharm. Ike Onyechi, managing director of Alpha Pharmacy; directors of pharmaceutical services and other relevant stakeholders.

Pfizer Consumer Healthcare recently launched its new range of multivitamins and minerals in line with the company’s vision to provide products with high quality and safety standards. The event took place at the 88^th Pharmaceutical Society of Nigeria Annual Conference held in Abuja.

Centrum, Complete from A to Zinc^TM is scientifically formulated to help fill nutritional gaps in diets, enhance multiple health benefits to help unlock energy, strengthen immunity, support healthy eyes and brain development etc. The range offers products with vitamins and minerals tailored to different ages and lifestyle; children, women, men, pregnant women and adults over 50 years. Keeping in mind that dietary supplements are not intended to diagnose, cure or prevent any disease but rather help consumers attain the recommended dietary allowance.

Speaking at the launch, the Marketing Manager, Pfizer Consumer Healthcare, Sue Cartwright, said, ‘’we have brought a range of five different variants into Nigeria which are all NAFDAC approved’’. Explaining the science behind the products, Cartwright said: ‘’since 1978, a lot of science and development have been put in place. We have clinically tested all of our products and we have done numerous studies using centrum globally. More than a hundred thousand years of clinical studies exist; so we can prove our products are excellent’’.

Caltrate is a scientifically formulated calcium supplement for adults and the elderly to support calcium and vitamin D deficiencies; it also assists in osteoporosis treatment. It is the World’s No.1 selling calcium supplement with vitamin D for calcium absorption, helping to support strong and healthy bones.

Pfizer Consumer Healthcare has its operating affiliate office in Nigeria with two of the world’s leading multivitamins and minerals – Centrum® and Caltrate® approved by NAFDAC.

Pfizer is one of the world’s premier pharmaceutical companies, committed to applying science and global resources to improve health and well-being at every stage of life.

Sugarcane juice or ganne ka ras as it is known in Hindi is a popular drink in India especially in summers. India is one of the leading producers of sugar cane in the world. It is one of the healthiest drinks giving lot of natural energy to the body. Sugarcane juice is rich in zinc, chromium, cobalt, magnesium, calcium, phosphorous, potassium and copper. It contains Vitamins A, C, B1, and B2, B5 and B6 and iron. Besides this it has antioxidants, proteins soluble fiber and phytonutrient.

Sugarcane is also an important member of the grass family. It contains sucrose and is filled with various other nutrients that aids in good health.  Mentioned below are few health benefits of sugarcane juice.

Health Benefits:

• Sugarcane juice has all the required vitamins and minerals that provide precious health benefits for the person suffering from various diseases.
• Drinking sugarcane juice instead of artificial and aerated drinks helps to improve the health of a person.
• The juice of sugarcane helps in treating the burning sensation while passing urine, prostatitis, kidney stones, STD (sexually transmitted disease), and urinary tract infections
• Sugarcane juice reduces the bad cholesterol level in the body and has natural sugar. It helps in eliminating toxins from the body by cleansing, improving metabolism and detoxifying the body. This aids in gradual weight loss especially if taken regularly with lime juice or coconut water.
• It is found to be beneficial for pregnant women because of its contents of iron and folates. These contents enhance the hemoglobin level in pregnant women. It also prevents the unborn baby from variety of birth defects.
• The antioxidant property of sugar cane juice makes the skin soft, fair, supple and healthy. It also helps in delaying the signs of aging on the skin.
• Sugarcane contains natural sugar which has low glycemic index that prevents steep rise in blood glucose levels and so can be taken as a substitute of aerated drinks by diabetics. However people with Type-2 diabetes should consume it in moderation after consulting the doctor.
• Studies show that sugarcane is effective in fighting against cancer especially breast and prostate cancer.
• Sugarcane juice boosts protein levels in the body which is helpful in maintaining the health of the kidney.
• The antioxidants in sugar cane juice help in fighting against infections and boosting the immune system of the body. It also protects liver the liver against infections and helps in keeping the bilirubin levels in control.
• It is helpful in preventing stomach infection and is considered a good digestive aid due to the presence of potassium. It is also useful in treating constipation.
• Studies show that sugarcane juice helps in protecting tooth decay and bad breath because of its high mineral content.
• Sugarcane juice contains all the nutrients that are required for strong shiny nails. It naturally strengthens the nails and prevents them from becoming brittle and discolored.
• Sugarcane juice has been found to be good for people suffering from febrile disorders. Febrile disorders are responsible for causing fevers, which can result in a great amount of protein loss from the body. These can lead to seizures especially in infants and children. Liberal consumption of sugar cane juice provides the necessary protein.

• Sugarcane is beneficial for healthy skin. It helps to fight acne, reduce blemishes, prevent ageing and keeps the skin hydrated. A mask or scrub of sugarcane juice is beneficial for the skin.

• Sugarcane juice is good for the hair and helps in the proper growth of the hair and also prevents hair fall.
• Sugarcane is beneficial for micturition, caused by high acidity, along with gonorrhea, cystitisne phritisanden larged prostate.
• Sugarcane Juice is the best remedy for sore throat, freezing and flu.

• Sugarcane juice is naturally sweet. It doesn’t need any added sugar to make it sweet and hence is very beneficial for ones health. Diabetics can thus enjoy it without being concerned about soaring body-fluid sugar levels (those with type 2 diabetes should still have restricted sugarcane juice).
• It’s recommended for those suffering from fever, which results in protein loss from the body. Consumption of sugarcane juice supplies the body with protein throughout febrile disorders. It also brings down high body temperatures and helps one to recuperate from unwanted illness.

• It’s a perfect thirst quencher and cooling drink during summers. It keeps the body hydrated.

• Regular intake of sugarcane juice extract strengthens the stomach, kidneys, heart, eyes, mind and sex organs.

In the last edition, Pharmacist Adebayo lost his contract to provide drugs and supplies to the Benue State University for their Sports Festival. The products he ordered from Freddy Pharmaceuticals arrived late, and he received no compensation, because he had signed a receipt issued to him, which contained an exclusion clause.

Subsequently, the Benue State University Hospital decides to do business with Freddy Pharmaceuticals and contacts the distributor for their requirements. Three cartons of Emzoron® (a blood tonic) are ordered and paid for. A driver is sent by the hospital to collect the products and he is made to sign the receipt, which has certain terms written on it.

On arrival at the hospital, it is discovered that the drugs delivered are not the blood tonic required but rather Emzolyn®, a cough syrup produced by the same company. The hospital pharmacist immediately calls Freddy Pharmaceuticals and demands a refund of payments made.

The distributor, however, contends with him, claiming protection under an exclusion clause contained in the receipt.   According to Mr Freddy, the document expressly stated that “goods sold in good condition are not returnable and the supplier will not be liable for refunds.” In his contention, this document was signed by the driver, on collection of the goods, and so the hospital is bound by the terms. In this transaction, what is the legal position of the parties?

It has been established that parties to a contract are free to limit or exclude obligations arising from their transaction. These exclusion clauses or limiting terms are often written in a receipt, ticket, form or notice, which the buyer may or may not have read. There are various rules regarding issues of the transaction and they usually favour the seller, when the exclusion clause is written in a document, which is signed by the buyer.

The situation above involves the following legal issues:

1. The validity of an exclusion clause in the case of a breach of contract.
2. The effect of an exclusion clause when there is a fundamental breach.

From the case of Parker v. South Eastern Railway Company, it is understood that if the person receiving a document knew that there was a writing on it, and realised that the writing contained conditions, then he is bound by those conditions.

In this situation, the goods were received by the driver on behalf of the hospital. Apparently, the distributor, Freddy Pharmaceuticals, ensured that the receipt was signed by the driver, to avert any liability arising from the transaction. Interestingly, the previous delivery involving Pharmacist Adebayo arrived too late for the purpose of the products, but the distributor was covered by the excluding terms because Adebayo had signed the receipt (containing the terms) even though he had not realised that there was anything written on it.

It thereby follows that, even in the case of a breach, a party to a contract may protect himself, with the insertion of an exclusion clause, to limit any liability.   However, the weight of the term that is breached must be considered. There is a difference between a condition, in a contract, and a fundamental term. In the words of Justice Delvin, “a fundamental term is something which underlies the whole contract so that, if not complied with, the performance becomes totally different from that which the contract contemplates.”

In view of this, where there is a breach by one party to the degree that what is delivered is essentially different from the requirement of the transaction, the party in breach cannot claim to have performed the contract. As Lord Abinger stated in the case of Chanter v. Hopkins: “If a man offers to buy peas of another, and he sends him beans, he does not perform his contract; the contract is to sell peas and if he sends him anything else in their stead, it is a non-performance of it.”

In this case, even though a document with an exclusion clause was signed, it is unarguable that the product delivered was not Emzoron®, the blood tonic required by the hospital, but Emzolyn®, a cough syrup.

The case of Adel Boshalli v. Allied Commercial Exporters Ltd., a contract for the supply of cloth from London to Lagos, throws more light on this. In that transaction, the shipping sample was found very much inferior, in quality, to the sample which formed the basis of the agreement. In their defence, the suppliers tried to rely on an exemption clause in the following terms: “For goods not of United Kingdom origin, we cannot undertake any guarantee or admit any claims beyond such as are admitted by and recovered by the Manufacturers.”

Reversing the decision of the Nigerian Federal Supreme Court, the Privy Council held that the clause did not avail the respondents any protection: “An exemption clause can only avail a party if he is carrying out the contract in its essential respects. A breach which goes to the root of contract disentitles a party from relying on an exemption clause”.

From the foregoing, it is generally held that, though parties have the use of excluding terms in defining their transactions, a party guilty of a fundamental breach of contract cannot avoid liability by relying on such terms. The consequences of such a breach result in the right of the injured party to repudiate the contract and claim damages.

Considering that the products supplied were clearly different from those that were ordered, Benue State University Hospital is entitled to cancel the contract and receive a refund. Freddy Pharmaceuticals cannot be protected by exclusion clauses. In the words of Lord Denning, the distributor “is not allowed to use them as a cover for misconduct or indifference or to enable him to turn a blind eye to his obligations.”

Principles and cases are from Sagay: Nigerian Law of Contract

President of the Nigeria Academy of Pharmacy, (NAPharm), Prince Julius Adelusi-Adeluyi, has said that for the present government to boast a vibrant and thriving health care sector, it is imperative for the in-coming health minister to imbibe the culture of teamwork as well as transmit such to all members of the health care team.

This was made known during the press conference organised to announce the forthcoming investiture of new Fellows of the Academy, also charged the in-coming health minister on the need to increase the national health budget to the required WHO standard which is 15 per cent of the national budget.

Adelusi-Adeluyi who was ably represented by the Vice President of NAPharm, Pharm (Sir) Ifeanyi Atueyi, lamented the recurrent inadequate budgetary allocation to the health sector, noting that Nigeria had never given up to 10 per cent allocation to health, much less 15 per cent. This constitutes a major setback in the subdivision, he said.

He therefore urged the would-be health minister to focus on the two key areas of harmony and funding, for the nation’s health care delivery system to compete favourably with those of developed climes.

The Assistant General Secretary of NAPharm, Sir Anthony Akhimien, explained the criteria for the selection of the 22 new Fellows of the Academy out of about 20,000 pharmacists in the country. He noted that the selected pharmacists had distinguished themselves in their different areas of practice.

“Many of them are lecturers who have imparted thousands of students in pharmacy schools, as well as those in the community, industry, and drug importation, who have contributed immensely to the growth of the profession,” he said.

He however admitted that the present number of pharmacists available in the country was inadequate to meet the need of the over 170 million Nigerians, urging all universities in the country to establish schools of pharmacy, while the existing schools should expand their capacity in order to train sufficient pharmacists to meet the health care needs of the citizens.

On the essence of the investiture of new Fellows of the Academy to Nigerians, Pharm. Isreal Ade Popoola, chairman, Board of Fellows (BoF) PSN and Fellow of NAPharm, stated that NAPharm Fellows had been playing great roles in conflict and crisis resolution in the health sector, citing the instance of when the president of NAPharm led a delegation to meet with the committee set up by former President Goodluck Jonathan to resolve cases of unhealthy rivalry and acrimony in the health sector.

He said the committee which was headed by Yayale Ahmed received the delegation while they offered the chairman their ideas on how to move the sector forward.

He, however, expressed fears over the continuation of the committee in the new administration, adding that there should be room for continuity

Other Fellows present at the briefing were, Pharm. Paul Enebeli, chairman, Committee of Investiture of New Fellows; Pharm (Sir) Ike Onyechi, treasurer of NAPharm, and Nigerian chairman, West Africa Postgraduate College of Pharmacists (WAPCP); Pharm. Lere Baale, director, Business School Netherlands; and Pharm. Remi Adeseun, NAPharm Fellow and CEO Rodot Group.

Leaders in the health care sector have admitted that health researchers in the country are not performing up to expectations, resulting in many Nigerians becoming casualties rather than survivors of health challenges.

The experts, who blamed their failings on lack of necessary facilities and conducive working environment, said they were often incapacitated despite their willingness to provide quality care.

Speaking at the official commissioning of the Biomedical Training and Cancer Research Centre by the Nigerian Institute of Medical Research (NIMR) in conjunction with Sysmex Partec, the Pioneer Chairperson of National Action Committee on AIDS (NACA), Professor Ibironke Akinsete lamented how cancer care facilities continued to depreciate in the country, despite the fact that about 250,000 Nigerians are diagnosed with the disease every year.

Akinsete who was the chairperson of the occasion noted the current deplorable conditions of various clinical centres in the country, adding that such centres with limited infrastructure in terms of laboratories, bio-repositories and database, coupled with inadequate finance and personnel have hampered African and Nigerian scientists from conducting rigorous evidence-based research.                  She therefore urged all stakeholders in the sector to squarely tackle the besetting challenges.

“I sincerely think this is the time for us as players to do a holistic appraisal of ourselves in the health sector, find out what exactly has gone wrong with us, where we have really missed it and then honestly find lasting solutions to how we really should move the health sector from where we are comatose to where we truly should be”, she said.

Director General of the Nigerian Institute of Medical Research (NIMR), Professor Innocent Ujah, also corroborated the view of Akinsete, noting that the bane of scientific research in the country was lack of professional tools.

“What I can say is that we are not doing enough. We are not doing enough not because we don’t have the knowledge, but because we don’t have the facilities, the tools are not there”, he stated.

He challenged stakeholders in the health sector, governments and private institutions to respond to the huge infrastructural needs in research institutions and invest in this segment of the sector.

The NIMR boss, who expressed his delight over the official launching of the new cancer researcher centre, said the inclusion of the centre to the existing ones would facilitate easy access to cancer care as the centre would focus more on cancer of the breast in women, and prostate cancer for men.

The professor, who called for the creation of more public-private partnership in the health sector, noted that there was still need for the establishment of study institutes for the examination of the liver, kidney, and other vital organs of the body.

A glass of warm lemon or lime water first thing in the morning is surprisingly helpful in several ways. This Yogic or Ayurvedic ritual was primarily for stimulating digestion and eliminating ama, the Ayurvedic term for toxic slime that builds up in the gastro-intestinal or GI tract. This ritual has even more health benefits.

The ten reasons you need warm lemon juice

1. The warm lemon water helps purify and stimulate the liver. Lemon/lime water liquefies bile      while inhibiting excess bile flow.
2. Warm lemon/lime water aids digestion. Its atomic composition is similar to saliva and the hydrochloric acid of digestive juices.
3. The liver produces more enzymes from lemon/lime water than any other food, according to A.F. Beddoe, author of Biological Ionization as Applied to Human Nutrition.
4. The lemon/lime water helps bowels eliminate naturally and easily.
5. Lemons and limes are high in potassium. Potassium is an important mineral that works with sodium for smooth electrical transmission in the brain and nervous system. Depression, anxiety, fogginess, and forgetfulness can often be traced to low potassium blood levels. That same nervous system needs potassium to assure steady signals to the heart. So your heart health is improved from the lemon water’s potassium.
6. Calcium and magnesium are plentiful in good ratio to each other in lemon/lime water. Magnesium is important for heart health and calcium prevents rickets.
7. Lemon/lime water can help lower blood pressure.
8. Lemon/lime water has an alkalizing effect in the body as it is buffered. Even if you drink it just before any meal, it will help your body maintain a higher pH than if you didn’t drink it. The higher or more alkaline your pH, the more your inner terrain is resistant to minor and major disease.
9. Helps dilute uric acid, which if it accumulates it creates arthritic pain or gout.
10. Helps reduce phlegm in the body.

Towards the global celebration of Polio eradication, as October 24 of every year is set aside for enlightenment campaign on the disease to further curb the spread, the World Health Organization (WHO) is set to formally pronounce the delisting of Nigeria as a polio endemic country before President Muhammadu Buhari.

In expressing the great importance attached to the event, which is scheduled for the State House next Monday, the country will be hosting the Director-General of WHO, Dr. Margaret Chan, who will be represented by WHO Regional Director for Africa, Dr. Matshidiso R. Moeti.

According to the Permanent Secretary, Federal Ministry of Health, Mr. Linus Awute, in an interview with P.M, he said that the Regional Director will meet with Mr. President to formally announce to the Government of Nigeria the WHO’s decision to remove Nigeria from the list of Polio endemic countries, as a recognition of the immediate achievement of Nigeria in stopping the transmission of the Wild Polio Virus for a period of fourteen months, which has exceeded WHO’s target for interruption.

The Regional Director, Dr. Moeti, is also expected to emphasize to policy makers and major stakeholders, that despite tremendous progress in Nigeria, complacency is not a luxury at the disposal of the Government and partners until the gains of this great feat is sustained for two years to be able to achieve the certification of Nigeria as a Polio-free nation by 2017.

In order to boost population immunity of children between the ages of zero to five years, as well as achieve eradication status in 2017, Nigeria will continue to vaccinate children, irrespective of their previous immunization status.

It will be recalled that on 25 September 2015, WHO declared Nigeria Polio free, which implies that polio is no longer endemic in Nigeria, and this is the first time that Nigeria has interrupted transmission of wild poliovirus, bringing the country and the African region closer than ever to being certified polio-free.

Presently, only two countries -Pakistan and Afghanistan, are still battling with the polio virus.