In a bid to produce quality graduates of high academic and moral standards, the Faculty of Pharmacy, University of Ibadan, has held the maiden edition of the White Coat/Orientation Ceremony for its students.

The programme,which took place on 29 April, at the new Faculty Auditorium, was attended by all B. Pharm. students from 100 to 500 levels.

However, the White Coat Ceremony was specifically held to welcome 200 Level students into the faculty.

In attendance at the event were Prof. Chinedum P. Babalola, dean, Faculty of Pharmacy; Prof. Oluwatoyin A. Odeku, professor and head, Department of Pharmaceutics & Industrial Pharmacy; Prof. Edith O. Ajaiyeoba, senior lecturer, Department of Pharmacognosy; Prof. Sunday O. Idowu, senior lecturer, Department of Pharmaceutical Chemistry; and Prof. Olusola Gbotosho, senior lecturer, Department of Pharmacology and Therapeutics.

Others were Buhari-Alade Akintayo, president of the Pharmaceutical Association of Nigeria Students (PANS);deputy dean of the faculty,professors, heads of departments, sub-dean undergraduate, academic, administrative and non-teaching staff of the faculty.

In her opening address, Prof. Babalola announced that the orientation programme was the first of its kind in the faculty.

According to her, Pharmacy is one of the best professions in the world and was rated by Forbes in January 2015 as the best health care profession in the USA.

She solicited the support of stakeholders,including pharmacy instructors and students, to move the faculty to even greater heights.

Prof Odeku, on her part, spoke extensively on the theme “Student Disciplinary Matters: Malpractices and Sanctions.”

She informed the students that there was a newly reconstituted Student Disciplinary Committee (SDC), headed by the vice chancellor, which had been mandated to deal with cases of indiscipline such as examination misconduct, inappropriate behaviour, membership of a secret cult on campus and other related offences.

“The SDC will also mete out sanctions such as reprimand, rustication for one, two or four semesters, depending on the gravity of the offence, and expulsion. Hence, students with disciplinary cases would be given a fair hearing and allowed to come freely and defend their cases while criminal offences shall be handed over to the police,” she stressed.

Corroborating her view, Prof. Ajaiyeoba emphasised the essence of morality in the society.

“It helps us to judge the difference between right and wrong. Morals come from home and family, friends and peers, religion and church, society and state and emotions. I advise the students to uphold a high level of personal integrity, in school, at home and within the society,” she remarked.

The highpoint of the occasion was the administration of oath of allegiance and the donning of the laboratory coats as a sign of acceptance,which was greeted with a thunderous applause by the elated students.

In her closing remarks, the dean expressed her appreciation to the speakers, guests, professors, heads of departments, sub dean undergraduate, academic, administrative and non-teaching staff of the faculty, members of the committee on student orientation, PANS and the entire students for ensuring the success of the programme.

It would be recalled that the Faculty of Pharmacy, University of Lagos (UNILAG), Idi-Araba, on 13 March, held its second edition of the same White Coat Ceremony, following the success of the maiden edition last year.

A cross-section of the “59 Champions” taking their Pharmacist Oath

    In what has turned out to be an annual celebration of excellence, the Faculty of Pharmacy, University of Ibadan, has inducted and administered oath on 59 Bachelor of Pharmacy graduands.

The 28th Induction and Oath-Taking Ceremony which was conducted for the 2013/2014 set of pharmacy graduands on 14 May 2015 at the Trenchard Hall, University of Ibadan, had in attendance, dean of the Faculty, Prof Chinedum P. Babalola, deputy vice chancellor (academics), Prof. Gbemisola Oke; deputy provost, deans of other faculties and heads of department.

Also present at the occasion were the first dean of the faculty, Emeritus Prof. A. A. Olaniyi; Pharm. Chidi Okoro, General Manager Africa – Lucozade Ribena Suntory; Pharm. N.A.E Mohammed, registrar, Pharmacist Council of Nigeria (PCN) represented bythe PCN’s Director of Education and Training, Pharm. Anthony Idoko; representatives of the Pharmaceutical Society of Nigeria (Oyo State Branch); director of pharmaceutical services; Oyo State Ministry of Health; Oyo State Hospital Management Board; PSN Board of Fellows and families of the graduating students.

In his opening remarks at the event, chairman of the occasion, Prof. I. F. Adewole, congratulated the entire members of staff, students and alumni who had worked tirelessly to ensure stability of the faculty in terms of robust quality training at both the undergraduate and postgraduate levels.

“The Faculty of Pharmacy is so dear to me because I am also part of its history,” Adewole said.”In fact, it was during my tenure as Provost, College of Medicine, that the dream of assuming a faculty stature was realised and my administration has supported the faculty in various ways.”

The celebrated don urged the inductees to be good ambassadors of the university, join the alumni association and contribute to the development of their alma mater. Adewole also admonished them to be heroes, great achievers, role models, life-long learners, and instead of making excuses, make choices that will positively transform their generation.

In her own remarks, dean of the Faculty, Prof Babalola thanked God for the conduct of the inductees, whom she tagged “The 59 Champions”.

She enjoined the inductees to continue to believe that they were the only ones who could determine the kind of career and life they wished to have.

Prof. Babalola further emphasised the need to uphold high level of discipline and integrity in all they do so as to be good ambassadors of the faculty and institution.

Delivering his keynote address, Pharm. Chidi Okoro listed a number of opportunities in the pharmaceutical sector that could make the graduands to reflect and plan ahead for a productive future.

“The pharmaceutical industry has huge headroom for expansion if you can make use of the opportunities that abound in the industry…I charge you not to get distracted in your course of adding values to the society. Otherwise how else can we explain a situation where we have about 3000 registered retail pharmacies in the country to serve a population of about 180 million Nigerians?” he said.

The former GSK (consumer) boss revealed that the current situation (economic and growth potential) in the country presented opportunities for pharmacists to contribute greatly to health care delivery in the nation.

He further advocated for better collaboration between the academia and NAFDAC,especially in the establishment of world class laboratories by NAFDAC in institutions like the University of Ibadan that would be used by NAFDAC and available for teaching and research by the faculty.

The hallmark of the occasion was the administering of the Pharmacist Oath on the graduands by the registrar, Pharmacists Council of Nigeria, followed by the presentation of provisional certificates of registration to the graduands.

In this exclusive chat with Temitope Obayendo, Dr Olugbenga Awobusuyi, a consultant nephrologist of high repute with the Lagos state Teaching Hospital (LASUTH) and an associate professor at the Lagos State University College of Medicine (LASUCOM), opens up on the prevalence of Chronic Kidney Disease (CKD) in Nigeria, implicating uncontrolled diabetes and hypertension as the major culprits. Excerpts:
Chronic Kidney Disease (CKD), also known as kidney failure, has become more rampant these days, what could be responsible for this?

The reason for the prevalence of CKD is the surge in conditions that predispose people to renal failure, which are hypertension and diabetes. Nowadays many people are coming down with uncontrolled hypertension and diabetes, thus the prevalence of CKD in our society.
There is the World Kidney Day celebration to create awareness on the disease, but there are further campaigns done by stakeholders in the hospitals during our routine clinic visits, to enlighten patients who might be at risk to come for check-ups.
Our kidneys are endowed with functional reserves, which could prevent a patient from having any symptoms years after the disease might have set in, in fact, this could delay symptoms until after 60 -70 percent of the kidney functions might have been damaged.

Before now, kidney failure used to be associated with the elderly, but it is becoming also common among the younger generation. What predisposes a youth to kidney failure?
Just as hypertension is very common, so is what is called glumerulonephritis also common. Glumerulonephritis is a situation where a patient’s body produces some substances like protein, called antibodies, which attack the kidney to destroy it. Although this condition is not common in our environment, it is a cause of renal failure. We have a lot of diabetics, habitual consumers of native medications, and the analgesics addicts, who are already down with the disease. Some infections like HIV, Hepatitis B, Sickle Cell, patients with cysts in the kidney, prostate enlargement, kidney stones, can also cause CKD. Glumerulonepheritis could be responsible for the disease in young people.

During the celebration of the 2013 World Kidney Day (WKD), President of the Nephrology Association of Nigeria (NAN), Dr Ebun Bamgboye, said 36.8 million Nigerians are suffering from kidney disease at different stages. Two years after, what do you think the statistics will look like now?

We don’t have any hard statistics on the prevalence, although the Nephrology Association of Nigeria (NAN) is taking some steps to have a renal register, though it’s still at the infant stage. Nonetheless, there are a number of studies conducted in some communities, which indicated that the prevalence is still between 17 and 21 per cent of the population.

Can you explain the stages of kidney disease, the symptoms, and at what point patients should seek medical advice?

It actually has five stages, based on what we call Glumerulo Filtrating Rate (GFR), which reflects the overall functions of the kidney. The first stage is 90 or more millimetre per minute; stage two is GFR 60-89; stage three, GFR 30-59; Stage four, GFR 15 -29 and stage five is lower than 15 GFR.
It is at stage five we do dialysis for a patient. What we generally do is to treat the underlying disease. We also consider factors that make kidney functions decline drastically, some of which are uncontrolled diabetes and hypertension. However, when the condition becomes uncontrolled, we do kidney transplant, which is very expensive.

Is it possible to treat the disease if detected earlier?
It is one of the messages we are trying to pass across to the populace – that chronic kidney disease is preventable, and many of the causes are treatable. If patients are diagnosed early enough, their diabetes and hypertension can be well managed to prevent renal failure. This could be done by slowing down the deterioration rate of the kidney, thereby ensuring adequate management of the underlying conditions. Patients must always ensure they meet their doctors at the right time, as well as take their medications as prescribed. If this is done, there are chances that the rate of death associated with kidney failure will be reduced.
For everybody to understand the symptoms of the disease, there is need to know the functions of the kidney. The kidney actually excretes water and other waste products from the body; secondly it regulates the internal environment, by making the system conducive for the internal organs e.g., the electrolytes; and thirdly, it regulates blood pressure. It is also responsible for the production of a very active form of Vitamin D, which makes our bones strong. It produces another substance called erytopoietin which stimulates our bones to be stronger.
Thus, once a kidney start failing in carrying out these functions, then it’s a symptom of an ailment. For instance, when a patient cannot eliminate the water he/she takes in, through sweat and urine, when he finds it difficult to pass out excreta, then there will be an accumulation of waste products in the body, which is an indication of kidney failure.
What we usually tell people during awareness campaign is that they should always check their urine; once it’s foamy, it’s an indication of protein in the urine, which is a symptom of CKD. Diabetics need to be more conscious about their health, because it’s a condition that has more tendencies to damage the kidney. Once these symptoms are detected, patients need to visit the hospital for screening. It’s also worthy of note, that the initial medical tests are not expensive. Urine test costs around N500, while blood screening is around N1000.

How many forms of kidney failure exist?
There are two forms of kidney failure, acute and chronic. Acute kidney failure could occur within an hour or two, due to severe infections, loss of blood through childbirth, severe diarrhoea and cholera – but the system normalises itself few hours later. Diarrhoea and cholera patients could be predisposed to this condition. At times, they lose consciousness and may even convulse. However chronic kidney disease is our focus of discussion.

With your involvement in medical practice so far, can you estimate the cost of a successful kidney transplant?
A kidney transplant goes for about N5 million to N6 million. All over the world, I’m not sure many patients can afford that. However, in most cases where they can access the facility, the government usually pays for the chunk of the fee.

How many nephrology experts do we have in the country?
The ratio of nephrologists in Nigeria to patients is about 150,000 to about 40 million patients.

Can it be said that people without diabetes or hypertension are not at risk of CKD?
Yes, they are not at risk, but if they have a family history of CKD, diabetes or hypertension, they should be going for check at least once a year. Especially if they are above 40 years, regular check up is important.

Considering the state of our health care facilities, is there any hope for Nigeria in overcoming CKD?
It depends on the will of the government of the day. If there is political will in the provision of local facilities, building of good facilities, provision of manpower, and monitoring of the administrative section for effectiveness, then cases of CKD would be drastically reduced.

What is your advice to Nigerians as regards kidney diseases and their general health conditions?
They should always participate in medical screening exercises. Hypertensives and diabetics should keep their appointments with their health care givers and also ensure they meet qualified doctors, not roadside quacks.

Regent of Akure Kingdom, Princess (Dr) Adetutu Adesida, and Ondo State Commissioner for Health, Dr Dayo Adeyanju have urged the federal government to step up its war against fake drugs in the country, saying the menace had caused more deaths than the dreaded Boko Haram group and could wreak even more havoc, except drastic measures were taken.

The duo disclosed this at the Palace of the Deji of Akure land, where Princess Adesida received members of the Association of the Community Pharmacists of Nigeria (ACPN), led by their national chairman, Pharm. (Alh) Olufemi Ismail Adebayo who visited the palace to receive the royal blessing of the monarch as the ACPN kick-started its”Walk Against Counterfeit Drugs”campaigned, as part of activities for the 34thAnnual National Conference which was held in Akure, Ondo State recently.
Addressing the visitors, Princess Adesida, who holds a PhD in Pharmacy, implored the federal government to emulate the government of Ondo State, under the leadership of Dr, Olusegun Mimiko, whom, she disclosed, had taken giant strides in the fight against fake and counterfeit drugs by procuring a Trustcan machine to test the genuiness of drugs being sold in the state.
According to her, any nation that cares for the lives and safety of its citizens will never take the issue of fake and adulterated drugs lightly.
“We all know the dangers fake and counterfeit drugs portend for the health of the citizens and as such, serious campaigns, through the media, electronic and print, must be used so that more people could be aware and well-informed about the dangers it poses to their health.”
Also advising the Nigerian populace, the regent said, “I want to implore our citizens as well to desist from buying drugs anyhow and anywhere as drugs are too dangerous to be taken anyhow; therefore they should ensure they get their drugs from approved places across the state. The campaign will not end here as all my chiefs here present will as well take the message back to their people and with that, everybody, especially our ageing mothers and fathers, will be aware of it.”
Speaking in the same vein, the state’s Commissioner for Health, Dr Dayo Adeyanju, disclosed that aside the procurement of a Trustscan machine to test the originality of drugs being sold across the state, government had also set up a task force which comprising officials of the Ministry of Health, the National Agency for Food and Drug Administration and Control (NAFDAC) and security agencies, to inspect drugs being sold in the state.
He added that with the use of the scanning machine, officials from the ministry and other agencies would be able to know the genuineness of drugs put up for sale in stores, adding that any stores found selling fake drugs would be blacklisted and the findings of the inspection team would be made public so as to serve as a deterrent to others who may be nursing the idea of starting such illicitbusiness.
The Commissioner, while highlighting the harmful effects of fake drugs, noted that the danger was much more than the effects of dreaded diseases like HIV/AIDS, cancer and malaria combined.
“It is funny when you see people taking drugs for same ailment over and over and the ailment refuses to go and they assume the ailment has spiritual connection, not knowing that it is actually as a result of fake drugs. It is therefore pertinent that we fight this scourge now before it kills us all,” Adeyanju said.
While thanking the association on behalf of the king of Akure Kingdom, High Chief M.A Adebayo, who was referred to as “Akure Warlord” appreciated the health commissioner for creating an enabling environment for the ACPN to hold its conference and for his effortsin the fight against fake and counterfeit drugs in the state.
“The influx of fake and substandard drugs has done a lot of havoc to our healthcare sector in this state and the entire nation; therefore the decision to organise this ‘walk’ in order to sensitise our people and create awareness is a welcome development and we are happy about it. We therefore assure you of our maximum support, while we enjoin you not to hesitate to ask us for anything that will ensure smooth running of your programme because its importance to the lives of our people,” Adebayo stated.
In his response, ACPNnational chairman, Pharm. (Alh) Olufemi Ismail Adebayo, appreciated the state government for its efforts at ensuring the state was rid of fake and substandard drugs. He also thanked the regent of Akure for sharing the passion of the association, regarding the theme for the ‘walk’.
“I want to assure your majesty and entire people of this state that and my members and I will not rest on our oars until the war against fake and counterfeit drugs is won.I therefore enjoin members of the public to cooperate with the association by reporting matters relating to the issue of fake and counterfeit medicine to the appropriate authorities, while patronising only authorised pharmacies for their drugs,” Adebayo stated.

The Pharmaceutical Society of Nigeria (PSN) has appealed to the newly elected government of President Muhammadu Buhari to appoint a pharmacist as next minister of health.

In a communiqué signed by its president, Pharm. Olumide Akintayo, the society argued that such appointment had eluded its members for several years under various administrations.
“The norm now is to appoint seasoned administrators and managers with cognate experience to run modern day health care. With benefits of insight, we assure relevant decision-makers that we have a preponderance of such persons in the pharmacy profession.
This development is coming on the heels of speculations that a technocrat or a health professional with medical background could emerge as the next minister to pilot the affairs of the health sector. The last time a pharmacist rose close to a similar position was during the short-lived interim government of Ernest Shonekan when Prince Julius Adelusi-Adeluyi (incumbent president of Nigeria Academy of Pharmacy) was made the minister of health and human resources,” the statement said.
The PSN further stressed that the marginalisation suffered by pharmacists is not limited to the ministerial level but equally affects other areas, such as the National Health Insurance Scheme (NHIS), the Consolidated Health Salary Scale (CONHESS) and the amendment bill to correct the obnoxious decree 10 of 1985.
“In the spirit of broad spectrum of reforms, the PSN recalls the monumental injustice meted out to its teeming members in Nigeria’s version of a social insurance scheme. For over 5 years now, the NHIS encourages unlawful payment mechanisms dubbed global capitation, while HMOs also capitate secondary and tertiary facilities which outrightly disrupts the equilibrium of the health system,” the PSN stated.
The Akintayo-led society demanded a well-defined welfare package for health workers, which redresses controversies that have led to recurrent and perennial strike actions.
According to the PSN communiqué, some of the recurrent welfare issues the society considers relevant include:implementation of the circular on promotion of its members from CONHESS 14 to 15, as directors, which places premium on the need to sanction defaulting hospital managements; specific steps to be taken by head of service of the federation to ensure expedited issuance of an enabling circular authorising consultancy cadre for health professionals that have adhered to due process to be vested with consultancy status.
“We want payment of arrears of specialist allowances to qualified hospital-based health professionals with effect from January 1, 2010, to be ensured with further delay. Flowing from those two earlier requests, the PSN strongly demands that the federal ministry of health must come up with a circular on residency programmes for all health professionals in Nigeria” it emphasised.
Aside from calling for immediate and full payment of arrears accruing from skipping of CONHESS 10 which remain outstanding since 2010, the society said it was high time an amendment bill was sponsored to correct, once and for all, the litany of contentious provisions in the obnoxious decree 10 of 1985 (CAP U15 463) LFN 2004 which formalises marginalisation of all health workers by doctors in the country.

Christ is the Spirit of love, which is the abiding and indwelling reality in man. In this principle of love, all knowledge, intelligence, and wisdom are contained, and until a man realises it as the one vital reality of his being, he does not fully comprehend the Christ. Such glorious realisation is the crown of evolution, the supreme aim of existence. Its attainment is complete salvation, emancipation from all error, ignorance, and sin.
When Jesus said, “Without Me ye can do nothing,” he spoke not of His perishable form, but of the universal Spirit of love of which His conduct was a perfect manifestation; and this utterance of His is the statement of a simple truth; for the works of man are vain and worthless when they are done for personal ends, and he himself remains a perishable being, immersed in darkness and fearing death, so long as he lives in his personal gratifications.
Man is of the substance of love; this he may realise if he will relinquish the impure, personal elements which he had hitherto been blindly following, and will fly to the impersonal realities of the Christ Spirit; and these realities are purity, humanity, compassion, wisdom, love.
Every precept of Jesus demands the unconditional sacrifice of some selfish, personal element before it can be carried out. Man cannot know the real whilst he clings to the unreal; he cannot do the work of Truth whilst he clings to error. Whilst a man cherishes lust, hatred, pride, vanity, self-indulgence, covetousness, he can do nothing, for the works of all these sinful elements are unreal and perishable. Only when he takes refuge in the Spirit of love within, and becomes patient, gentle, pure, pitiful, and forgiving, does he work the works of righteousness and bear the fruits of life.
The vine is not a vine without its branches, and even then it is not complete until those branches bear fruit. Love is not complete until it is lived by man; until it is fully understood by him and manifested in his conduct. A man can only consciously ally himself to the vine of love by deserting all strife and hatred and condemnation and impurity and pride and self-seeking, and by thinking only loving thoughts and doing loving deeds. By so doing, he awakens within him the divine nature which he had heretofore been crucifying and denying.
Every time a man gives way to anger, impatience, greed, pride, vanity, or any form of personal selfishness, he denies the Christ, he shuts himself out from love. And thus only does one deny Christ, and not by refusing to adopt a formulated creed.
Christ is known only to him who by constant striving has converted himself from a sinful to a pure being, who by noble, moral effort has succeeded in relinquishing that perishable self which is the source of all suffering and sorrow and unrest, and has become rational, gentle, peaceful, loving, and pure.

Culled from MIND IS THE MASTER by JAMES ALLEN

Godwin is a sales representative for Richmond Pharmaceuticals in Jos, Plateau State. His primary assignment is the marketing of the company’s brand of paracetamol syrup. While supplying retail outlets on a Monday morning, he comes across Daily Need Pharmacy on CBN Road. On getting into the pharmacy, he is warmly received by Aisha, the sales attendant. Godwin introduces the product, informing her that the drug is very effective and in high demand. He offers her a carton to sell on a trial basis. Aisha inspects the medication and considers putting it up for sale in the pharmacy. Eventually, she agrees to sell. She explains that her boss is out of town till the weekend. She would try to sell the product as long as her boss approves of it.

On Thursday, Godwin calls Daily Need Pharmacy. He is pleased to hear that four bottles of the syrup have been sold. The following Monday, he arrives at the pharmacy with an invoice for one carton of paracetamol syrup. Unfortunately, Aisha has bad news for him. Her boss had returned over the weekend. He saw the product and decided against selling it. The unsold bottles have been packed to be returned. Considering that the drugs are already being sold, Godwin suggests that they sell the rest and pay for the carton afterwards. From a legal perspective, what are the effects of the terms of this transaction?

In every business transaction with a valid contract, it is necessary to determine the measure of obligations committed by each party. This can only be done by identifying the terms and the importance of each one. The terms of a contract will vary in weight, from the fundamental terms (the most important), to the conditions and the warranties. The nature of the term of a contract will determine the liability of the party committed to it and the consequences of a breach.

The legal issues to be considered in this situation are:

1. The distinction between a contractual term and a mere representation.
2. The nature and effect of terms of a contract.
3. The incidence of collateral contracts.

While negotiating an agreement leading to the conclusion of a contract, parties may communicate certain things aimed at securing the other person’s commitment. If a dispute on a term of contract arises, it may become necessary to determine whether the issue involved was a ‘contractual term’ or a ‘mere representation’. This is because, in the case of a breach of a term of the contract, the aggrieved party can sue and receive a remedy in damages or in both damages and cancellation of the contract (depending on the seriousness of the breach). On the other hand, should the issue involved be a mere representation, the remedies available may be little or none at all.

The case of Shawel v. Reade established the principle that if the person who made the statement had special knowledge or skill, as compared to the other party, then the statement is taken to be a term of the contract. In our scenario above, during the presentation of the paracetamol syrup, Godwin asserted that the medication was “very effective and in high demand”. This would rightly be taken as expert information, inducing the other party to rely on it.

Having seen that the obligations in a contract are not of equal significance, it is understandable that the consequence of a breach of terms will vary. For this reason, a distinction should be made between a warranty, a condition and a fundamental term. Section 11(1)(b) of the Sale of Goods Act 1893 defined a condition as a stipulation in a contract of sale, the breach of which may give rise to a right to treat the contract as repudiated (or right to damages), and a warranty as a stipulation, the breach of which may give rise to a claim for damages but not to a right to reject the goods and treat the contract as repudiated.

Going by this definition, a term of contract which gives a party the right to cancel is a condition. Thus, an agreement which is premised on the occurrence of a specific factor is one subjected to a condition precedent. That agreement is not binding until the specific factor has occurred. In our case with Godwin and Daily Need Pharmacy, there was an agreement to sell the product on the condition of the approval of the boss. This situation is similar to the facts of Pym v. Campbell. In that case, an agreement by the defendant to buy the plaintiff’s invention was made subject to the approval of an engineer. It was held that there was no binding agreement until that approval was obtained.

Finally, some statements by a party may not qualify as terms of the contract but are still relevant to the incidence of it. These will come under the doctrine of collateral contracts. The rule established in the City & Westminster case is this: if a person makes a statement or promise which is intended to induce the other party to enter into a contract, then if that party makes a commitment on reliance on that promise, the person who made the promise will be held bound by it. The statement or promise is regarded as part of a preliminary or collateral contract.

In view of this, it should be noted that Aisha received a carton of paracetamol syrup from Godwin to sell “on a trial basis”. This trial basis was the premise on which she entered into the transaction in the first place. That means that the attempt to sell the product was simply a test which could be cancelled in the event of any vitiating factor.

Principles and cases are drawn from Sagay: Nigerian Law of Contract

Former President of the Pharmaceutical Society of Nigeria (PSN) and current President of the African Pharmaceutical Forum (APF), Pharm. (Sir) Anthony Akhimien, has called on community pharmacists to do more with their skills and training as professionals, urging them to delegate the daily routines of prescription filling and counting of tablets to their support staff.

Akhimien, a Fellow of the PSN, gave the charge while delivering his keynotes address at the 34thAnnual National Conference of the Association of Community Pharmacists of Nigeria (ACPN), recently held in Akure, Ondo State.

He noted that, globally, task-shifting is the order of the day in the health care industry, adding that pharmacy technicians can be supervised to handle most of the pharmacist’s routine, so that the pharmacist can concentrate on pharmaceutical care, using his deep knowledge and skills in clinical pharmacy.

The APF president further disclosed that the National Health Insurance Scheme (NHIS), which kicked off about 10 years ago became moribund, largely due to poor implementation. He therefore urged the ACPN to reflect, return to the drawing board and engage relevant authorities in other to bring back community pharmacists into the scheme.

“We have a primary duty to protect the enrollee by guaranteeing the quality of drugs produced and dispensed to Nigerians who are in the scheme,” hestated.

Akhimien also observed that community pharmacists could be valuable assets in the management of chronic diseases in the neighbourhood, as the treatment of such diseases often requires long term use of medicine.

“Also, community pharmacists should advocate for inclusion in the provision of health screening for chronic diseases as diabetes, hypertension, cancer and others; counsel patients on appropriate use of medicines; advocate for lifestyles changes that prevent a chronic disease; and improve outcomes of drug therapy”, Akhimien said.

The former PSN president also bemoaned the attitude of community pharmacists in the country towards veterinary medicine, noting that this leads to loss of potential income.

In his words, “In this part of the world, community pharmacist shy away from stocking and dispensing of veterinary products; yet there is a growing need for veterinary products.A section of the pharmacy can be allocated to veterinary pharmaceutical products, such as mineral supplements, antiseptic, milking ointments, hoof softeners, flea and tick repellants, etc. This can improve the economic fortunes of community pharmacy practitioners,especially those in urban dwellings.”

The veteran pharmacist also encouraged community pharmacists to participate in government health programmes, adding that such could be achieved by working closely with other health care providers.

“Pharmacists should sharpen their skills and knowledge by attending short time certificate courses as approved by International bodies like USAID, PEFAR, WAPCP, WHO etc,” he said.

Explore new frontiers, Akhimien urges community pharmacists

By Adebayo Oladejo

Akhimien equally tasked community pharmacists to explore herbal medicine, adding that this would boost the image of the profession and the economic value of the individual.

“I am one of the proponents that herbal medicines are the future of pharmacy practice as evidences abound that where orthodox drugs fail, herbal remedies have taken over and done very well. These products are not cheap but our clients search and go for them. It is also economically viable to engage in them. ACPN can also invite a Director of NAFDAC and the Herbal Medicine Department of the Federal Ministry of Health to offer training to members that are interested,” he counseled.

Poised to reduce the alarming rates of mortality and excruciating pains in people living with sickle cell, medical doctors with specialty in Sickle Cell Disease (SCD) have suggested bone marrow transplantation, good nutrition, mandatory screening policy, comprehensive and holistic management as life saving measures for sickle cell sufferers.

The experts, who converged at the National Sickle Cell Centre, Lagos, on June 19, 2015 to commemorate the World Sickle Cell Day, took turn to advise the patients on best options available for the management of the disorder, and possible means of staying healthy.

Fielding questions from journalist, Dr Adediran Adewumi, consultant dermatologist, Lagos State University Teaching Hospital, said sickle cell is an unwanted guest in Africa, which was brought about by genetic mutation, and it has done a lot of damage to Africans.

His words: “To get rid of this disease, bone marrow transplantation is the sure way out. Also, if our government could make sickle cell screening policy mandatory from secondary schools through to intending couples level , the spread of the disease can also be curbed. Another alternative is for our government to adopt the European policy with a deadline of transforming our sickle cell patients to normal patients through bone marrow transplantation”.

Another specialist on strokes in SCD, Professor A. A. Akinsulie asserted that comprehensive and holistic management from birth will go a long way in cutting down on SCD crisis. He said the implication of this is that a mother must know a child’s genotype from birth, in order for proper care to takeoff from birth. “Preventive health care like the provision of folic acid, good nutrition and proper hydration, will put the children in steady state. If by the age of two, a child with the tendency to develop stroke is monitored with a Transcranial Doppler (TCD), then such stroke can be preventable.

The representative of Lagos State Ministry of Health, Dr. Eniola Erinoso intimated the participants on the activities of the state government in giving succour to people living with SCD, stating that the government has recognised the plight of this group of people and has provided free medical treatment for children under 12 years with the condition, describing it as the most prevalent period of the disease in children.

“We have finalised the treatment guideline for the management of Sickle Cell Disorders and machinery has also been put in place towards developing a comprehensive state policy on Hemoglobinopathies. A key component of this policy would be support for enlightenment activities at all levels with particular emphasis on young persons who are yet to be committed in marriage to their partners”, he stated.

By Adebayo Folorunsho-Francis

Against all odds, representatives of the Obafemi Awolowo University (OAU), Ile Ife, have won the grand prize at the 2015 edition of the Sir Ifeanyi Atueyi Debate Competition.

The contest which took place at the Banquet Hall of the University of Benin (UNIBEN) on 8 July, 2015 was part of activities lined up by the Pharmaceutical Association of Nigeria Students (PANS) to celebrate the Annual Pharmacy Health Week.

Debating on two topical issues – “Should Nigeria Practice Free Education?” and “Should Euthanasia be Legalised in Nigeria?” academic gladiators from both OAU and UNIBEN metaphorically went for each other’s jugular in a bid to garner maximum points through their arguments.

While representatives of UNIBEN claimed that education could not be completely free, citing the huge budget earmarked annually for the educational sector, the OAU team maintained that it was indeed possible, considering the near-100 per cent literacy model of countries like Korea and Sweden.

Team UNIBEN however countered the argument with the claim that the countries cited succeeded simply because of their moderate population figures.

“Now imagine Nigeria with a huge population of approximately 177 million to contemplate the idea of offering free education. Where is that done?” the team asked rhetorically.

On legalisation of euthanasia in Nigeria, Team OAU canvassed that Nigeria was not ripe for such “obnoxious act of ‘mercy killing.’” One of the contestants cited the remarkable case of Karen Quinlan of the United States who survived after she had been removed from mechanical ventilation and even went on to live nine more years in vegetative state before her eventual death in 1985.

Team UNIBEN however countered the notion, pointing out that their opponent (OAU) was not putting peculiar cases, such as those suffering from cerebral cancer, into consideration.

“When dying patients cry out for euthanasia, they know the reason for it. After all, don’t we humans clamour for analgesics and opium in the face of excruciating pains? How then can you justify the need for patients with terminal diseases to go through a lifetime pain? It is totally uncalled for!” the team argued.

At the end of the debate. Team OAU was announced winner.

Announcing the result, the panel of judges, comprising Dr Patrick Osarenmwinda Igbinaduwa, head of department, Pharmaceutical Chemistry, Faculty of Pharmacy, UNIBEN; Barrister Theodora Ewah, administrative assistant, UNIBEN; and Barrister Omoduwa Osaduwa, administrative assistant, UNIBEN, said that they considered a number of factors, which included number of points garnered, manner of presentation, dress code and composure, to arrive at their final decision.

In the same debate category, Ojelabi Jesujoba, who led the OAU delegation, was declared the best speaker.

In the essay writing category, Ezekiel Efeobhokhan, a 400 level pharmacy student in UNIBEN emerged winner, with his article, “Performance Enhancing Drugs: Is it Justifiable In Sports & Academics?”

Praising the contestants and the organisers for their outstanding contributions, Pharm (Sir) Ifeanyi Atueyi, managing director of Pharmanews Limited, said he was particularly impressed with the institution that won the debate contest, given the fact that OAU was his alma mater.

Remarking on the essence of the annual event, which is hosted in his honour, the Pharmanews boss said it was necessary to understand that great men and women do not become successful or prominent overnight, noting that so many hurdles and challenges must have been surmounted along the way.

“There will always be obstruction and challenges. It will get to a point where you might start wondering why those things are happening to you. But know that God is with you even with those challenges.

“I am where I am today because God has destined it. Pharmanews might look like an accident, but I assure you that it is not,” he remarked.

Reminiscing on how the journal was birthed in May 1979, Atueyi narrated the story of how he was compelled to abandon employment to pursue his dream.

“As you go on with your programme, some of you are finishing; let nobody tell you that you cannot be the person you hope to be. Let God decide that for you,” he counselled.

The quest to have a well-ordered drug distribution system in Nigeria through the implementation of the new National Drug Distribution Guidelines (NDDGs) has received a big boost as Pharm. Olumide Akintayo, president of Pharmaceutical Society of Nigeria (PSN) and other eminent pharmacists have backed the 30 June implementation commencement date.

The pharmacists spoke at the official launch of Ultra Logistics Company (ULCO), a Mega Drug Distribution Centre (MDDC), promoted by the PSN, held recently at MAN Centre, Ikeja, Lagos.
Speaking with Pharmanews in an interview at the event, Pharm. Akintayo noted that the MDDC was a product of direct consultation between the federal government, through the Federal Ministry of Health, and the PSN, alongside its various appendages, including the technical groups and the strategic platforms like PMG-MAN, APIN and NIROPHARM.
He disclosed that the PSN had urged the FG to keep to the implementation date,adding that there would be a ministerial press briefing in June to announce the commencement of the policy.
The PSN president, who was the chief host at the event, in his opening remarks, noted that one of the underlying principles behind PSN promoting ULCO is to have pharmacy solution to pharmaceutical problems, especially that of drug distribution.
He noted that ULCO was set up to protect the interest of pharmacy practice and the general public in the implementation of the NDDGs, adding that, in recognition of the value-based principle of the pharmacy profession, the company would operate as a commercial organisation with social enterprise ethos, while growing the investment of shareholders.
The PSN helmsman explained that ULCO will aim to achieve three main objectives, namely, effective and efficient pharma supply management; distribution of safe, efficacious, effective and affordable drugs of good quality; and access to affordable pharma products to the public.
Pharm. Akintayo noted that the Nigerian pharmaceutical market is presently confronted with key challenges which include: fragmented and chaotic nature of drug distribution network; limited advancement in regulatory reforms; poor healthcare infrastructure; limited spending power of citizen; policy inconsistency; poor storage of drugs, leading to deterioration of active ingredients; reliance on imported pharmaceuticals; as well as limited market data, asoperators do not have real time data on quantities of drugs sold, where, when, by who and to whom.
He stated further that if the industry gets drug distribution right, the role of pharmacists will be clearer and there will be better professionalised detailing and less of selling, adding that the desire to see this come to fruition prompted the PSN to play a fundamental role in putting together the 2011 NDDGs.
Pharmacists, he said, must be in charge of ensuring that there is a model of practice in drug distribution, which other players must follow, stressing that, it is part of the responsibility of pharmacists to create confidence in the drug distribution system and ensure the safety and efficacy of drugs.

ULCO, Akintayo said, would be part of providing solution that will ensure an elimination of the current unprofessional practice in drug distribution, as the centre will provide an opportunity to change how drugs are distributed, while also serving as a platform for wealth creation for the pharmacy profession.
While urging pharmacists and pharmacy institutions to see the company as an initiative for financial empowerment, the PSN helmsman hinted that ULCO’s aspiration is to be the market leader in ensuring the Nigerian public get good and quality drugs at reasonable prices.
In his presentation at the occasion, the managing director of ULCO, Dr Lolu Ojo, said that the company was established to provide an opportunity for practitioners to be part of the positive changes that would reposition and boost the Nigerian pharmaceutical industry.
ULCO, Lolu Ojo said, has a mission to emerge as the preferred MDDC and ensure that drugs that are available are affordable and of good quality.
He added that ULCO will establish physical presence in Lagos with zonal hubs in each of the geopolitical zones, so as to meet up with its operational and regulatory requirements.
The ULCO MD stated that the company will focus on densely populated urban areas with large scale wholesalers to maximise business cost of distribution.
He also noted that ULCO will seek competitive advantage by offering highly diverse products at competitive pricing, noting that pricing remains the strongest key buyer value in the Nigerian market.
Chairman of the occasion, Dr Dere Awosika, in her closing remarks, urged all pharmacists to support the ULCO and the new NDDGs, stating that with the support of everybody, the company would succeed and the NDDGs would be effective.

Managing Director of the HealthPlus Group, Pharm. Bukky George, has charged community pharmacists to regularly evaluate their business success to ensure better performance and profitability.

She gave the charge at the 2nd Annual Alumni Lecture of the Faculty of Pharmacy, University of Lagos (UNILAG), which took place at the main auditorium of the institution in Akoka, on 3 March, 2015.

Speaking at the event, which also coincided with the institution’s 30th anniversary of pharmacy education, Pharm. George said she had observed over the years that most pharmacists were laid-back and not willing to take risk in their businesses.

“As an entrepreneur, pharmacists must ever be willing to take risk,” she urged.

While advisingthe 2013/2014 graduating students present at the lecture, the HealthPlus boss recalled that from the inception of her business, her mission was to be Nigeria’s first integrated pharmacy, a dream that eventually materialised.

According to her, Healthplus commenced operation 15 years ago in a modest18-square-metre room in Ikeja GRA, with just three staff, adding that, since then, the business had progressively grown to include40 branches nationwide.

“This is why I said that you need to evaluate the success of your business from time-to-time. Being a leader is beyond just opening a store and sitting there. We all have entrepreneurial spirit and skills within us,” she said.

George, who was once a staff of GlaxoSmithKline, equally encouraged young community pharmacists to seek mentoring.

“As young pharmacists, you must learn to look at the big picture. Everything you need to know about life, you don’t know yet. Graduating from school is just a step into preparing you for the journey ahead,” she stressed.

The pharmacist-turned-entrepreneur also called for professionalism on the part of the graduating students, adding that a professional pharmacist is mature, dresses appropriately, comes to work with a good attitude, is always willing to learn, gives appropriate feedback and is a team player.

Quoting the FIP description of a professional pharmacist, George said that such pharmacist is a 7-star pharmacist who is a communicator, manager, leader and teacher.

“I believe that is what you all are. If there is anything I learnt from my role models (Aliko Dangote and Richard Branson), it is to do big things at all time. That has always been my mantra,” she said.

While emphasising the need for careful thinking and planning before venturing into the world of entrepreneurship, the retail mogul also charged the students to be confident and inquisitive.

“You need to be bold and speak as you would like to be remembered. One of your lecturers, Pharm Tosin Adeyemi, once interned with HealthPlus after his graduation. He was bold, brash and quite inquisitive, always asking questions.That is the hallmark of a good pharmacist. I encourage you to do the same wherever you find yourself,” she admonished.

Sharing Pharm. George’s optimism, Pharm. Remi Adeseun, chairman of Rodot Nigeria Limited charged the graduating students to be emboldened and empowered by their history,rather being than being enslaved by it.

“The skill-set you have acquired in the course of your training can also be deployed to create and share value in other fields such as telecommunication, sales and marketing, retail banking and management education services,” he said.

Adeseun urged the young scholars to hold on to their dreams as there would be challenges on their way to becoming outstanding pharmacists.

Sharing his personal experience, the Rodot chairman said, “Competition is in my nature. That is why it was easy for me to seek a career in pharmaceutical sales and marketing. After my internship in community pharmacy and national youth service in the hospital, I knew my future professional happiness lay in deploying the clinical pharmacy knowledge I had acquired from the university to help healthcare workers give their patients the best treatment choices using my products from my Sandoz to Novartis to Janssen-Cilag days.”

Dignitaries at the event included Prof. Olukemi Odukoya, dean, Faculty of Pharmacy, University of Lagos; Pharm. Wale Oyenuga, managing director, Evans Therapeutics and Prof. Fola Tayo, pro-chancellor and chairman of council, Caleb University.

Others were Dr Ayodele Ogunleye, chairman, UNILAG Alumni Association, Dr Arinola Joda, PSN assistant secretary, Pharm. Ike Onyechi, managing director of Alpha Pharmacy and Prof. Cecilia Igwilo, Director, Foundation Programme Unilag

According to Dr Odukoya, the lecture was intended to bring prominent and successful alumni to the campus to share their wisdom and experience with the faculty.

“Lecturers are also chosen amongst the alumni who have repeatedly proven themselves with tremendous achievements at the highest levels in their respective fields. In this way, both the students and faculty benefits in terms of alumni support and overall exposure,” she said.

Chairman of the Pharmacists Council of Nigeria (PCN) Pharm. Bruno Nwankwo has said that, to consistently meet the drug needs of Nigerians, patent medicine stores are indispensable .

Speaking at the three-day education summit organised by the Nigeria Academy of Pharmacy (NAPharm.) in collaboration with the Pharmaceutical Society of Nigeria and the PCN which held at the University of Lagos Guest House and Conference Centre, Akoka on 22 April, Nwankwo explained that such sub-cadre was essential to support pharmacists in the onerous task of meeting their obligations to the community.

He added that his stance was “not so much out of love for the vendors but out of concern for the council’s responsibility to the nation.”

The PCN boss further remarked that while he was aware that many pharmacists would be repulsed by his seeming endorsement, especially considering his office as the chairman of the PCN, there was no denying that patent medicine dealers were indispensable in the present circumstances.

“Current statistics show that only about 25 per cent of our 774 local government areas have a pharmacist; yet their residents need basic medicines,” Nwankwo noted.

He said rather than denounce patent medicine dealers, pharmacists must “come up with an appropriate training model for them and then go on to recruit, train, relocate and regulate them to provide the intended limited services in the rural and remote places where pharmacists cannot presently serve.”

He also added that “our profession has a responsibility to provide medicines and medical supplies to the entire population of Nigeria. Unfortunately, we are not doing so. WHO guidelines in this area require countries to have a pharmacist to population of 1 to 2,300 persons. In Nigeria, we presently have about 19,000 pharmacists for a population of 168 million people – a far cry from the ideal.”

Pharm. Nwankwo’s pronouncement echoes a similar call made by Dr Moyosore Adejumo, Director of Pharmaceutical Services in Lagos State Ministry of Health, recently.

Speaking at The Panel, an annual entrepreneurial summit for young pharmacists organised by Shyne and Cloe Consulting, Adejumo had declared that it was wrong for people, especially pharmacists, to victimise patent medicine dealers over their role in the health sector.

“Let me categorically say that patent medicine dealers equally have their right. We register them especially to in areas where pharmacists are in short supply or don’t exist at all. For instance, we need them in remote places like Badagry, Ikorodu and environs,” Adejumo said.

To justify her statement, the Lagos DPS explained that a team of inspectors once visited a community called “Cele Village” in Ikeja and was shocked to discover there was no single pharmacy in sight.

“Should we leave such areas to suffer? I don’t think so. What’s fair is fair! If you (pharmacists) don’t want them, we admonish you to move to those areas and cover up the lapses. Because one thing I can tell you is that they are recognised by the Pharmacists Council of Nigeria (PCN) and the DPS in Lagos State for as long as they comply within the ambiance of the law,” she noted.

Dr Adejumo, however, conceded that only the PCN had a final say on the issue. Accordingly, with the present thumbs-up coming from the PCN chairman, the contentious issue appears to have been laid to rest.

In a similar vein, Pharm. Azubike Okwor, immediate past president of the PSN, has also called for the incorporation of pharmacy technicians into the society, saying that the world was facing a chronic shortage of trained health workers.

During his presentation at the academy summit, he remarked that the WHO statistics had shown that there was a global health workforce deficit of more than four million, adding that countries with lower economic indicators such as those in Africa tend to have relatively fewer pharmacists and pharmacy technicians.

As a way out, he recommended to the summit that task-shifting, the process of delegating assignments to less-specialised health workers should be implemented alongside other strategies that had been designed to increase the total number of health workers in all cadres.

“Pharmacy technicians are a vital part of the pharmacy team working under the direct supervision of pharmacists. However, a relatively small percentage of graduating technicians are registered with the PCN,” he observed.

Okwor further canvassed protection and fairer treatment of technicians by pharmacists.

“With sufficient supervision and support, technicians can be assigned more roles to enable pharmacists concentrate on more patient-centred roles. I also urge the PCN to ensure that there is ‘One Register, One Entry Point and One Standard for Technicians,” he proffered.

The distinguished pharmacist who has been officially recognised as the first African Fellow of the International Pharmaceutical Federation (FIP) charged community pharmacies to engage the services of pharmacy technicians to relieve them of the daily stress, stressing that task-shifting could provide a platform for the incorporation of the technicians’ services into the pharmacy team efforts in health care delivery.

“The PSN should understudy other professional associations and how they relate with their technicians with a view to incorporating pharmacy technicians into our society,” he suggested.

For the record, the summit organised by NAPharm. marked its first formal programme since inauguration at a ceremony chaired by former Head of State, General Yakubu Gowon (rtd.) GCFR, in June 2014.

The summit was created to provide the necessary window for the pharmacy profession to look outwards with a duty to society, with the purpose of working with other members of the health professional team in order to create a larger health system that would deliver on quality health for Nigerians including diagnostic, preventive, curative and rehabilitative health care.

In attendance at the summit were Prince Julius Adelusi-Adeluyi, former minister of health and president of NAPharm; Prof. Rahamon Bello, vice chancellor, University of Lagos; Prof. (Mrs) Cecilia Igwilo, chairman of the NAPharm.’s Education Committee; Prof. Fola Tayo, NAPharm’s general secretary; Pharm. Olumide Akintayo, PSN president and Pharm. N.A.E. Mohammed, PCN registrar.

Others were Sir Ifeanyi Atueyi, vice president of the Academy; Dr Teresa Pounds, assistant dean for Clinical Pharmacy Education of Mercer University College of Pharmacy & Health Sciences, USA; Dr Bugewa Apampa, director of pharmacy, University of Sussex, United Kingdom; Prof. Chinedu Babalola, FPSN, FAS (dean, Faculty of Pharmacy, University of Ibadan) and Prof. Augustine Okhamafe, FPSN (Former dean, Faculty of Pharmacy, University of Benin).

Atrial fibrillation (Afib) is a disorder of heart rhythm, also known as an arrhythmia. It is now an increasingly common disease, particularly in elderly persons of over 60 years of age. There are approximately 160,000 new incidences of Afib annually in the United States alone, each patient requiring proper care and management to prevent the occurrence of a stroke due to circulating blood clots.
People with Afib may be on medication treatments to stabilise/normalise their heart’s electrical conduction; or they may be surgically treated by the placement of a pacemaker device.
Among those that may suffer an Afib are people suffering from hyperactive thyroid glands, those with diseases of the heart’s mitral valve, and those with genetically induced malformations of the heart’s musculature. These patients will require a well co-ordinated counselling and treatment programme for better understanding of their ailment and for survival.
Some symptoms of an atrial fibrillation are: chest pain, palpitations, syncope and or fainting spells due to an heart failure. The irregular heartbeats and misfiring of electrical impulses seen in Afib may lead to pooling of blood, stasis and clot formation in the upper chamber of the heart. The clots formed may dislodge and travel through the blood vessels into the brain causing an occlusion and stroke.
Prevention of a stroke, management of Afib and treatment compliance, especially for oral anticoagulants is critical to the management of patients living with atrial fibrillation. Warfarin is an important oral anticoagulant that is commonly used in Afib, and its role as an anticoagulant is discussed comprehensively in this action plan. Aspirin, an antiplatelet is also used for its efficacy in preventing clot formation.

What drugs are used in Afib?
Your prescriber may recommended different kinds of medications in the management of your condition, depending on the diagnosis and perceived origin of the atrial fibrillation. Examples of these medications are listed below:
• Anticoagulants: Warfarin, Enoxaparin, Heparin.
• Antiplatelets: Aspirin, Clopidrogel, Cilostazol, and Dabigatran.
• Beta-blockers: Sotalol.
• Antiarrhythmics: Quinidine, Procainamide, Flecainide, Propafenone, Disopyramide, and others, Amiodarone, Dronaderone, Dofetilide ,Ibutilide.
• Calcium channel blockers: Verapamil and Diltiazem.
• Digoxin.

Warfarin as an oral anticoagulant in atrial fibrillation
The use of warfarin in the management and prevention of complications of Afib is discussed here in detail because it is the most widely used oral anticoagulant agent for the prevention of strokes in Afib patients. Other than the need for monitoring of its effectiveness with an INR or PT Time test, warfarin is efficacious, cheap and tolerable in most patients with Afib.
Warfarin is superior to aspirin or clopidrogel, whether both agents are used singly or combined. It is preferred over dabigatran because it’s hepatically metabolised and can be used in patients with renal failure. The starting doses of warfarin in most cases are: 5MG in the elderly, 7.5MG in obese patients or 2.5MG in patients with very lean body mass.
Warfarin’s effect may take up to seven days to manifest, therefore most patients are first given heparin or low-molecular weight heparins (LMWH) together with oral warfarin if patient can be orally dosed. Most hospitals in the US do have standard warfarin dosing protocols for initiation therapy and for maintenance based on the patient’s Lab values of the INR and comorbid conditions.
Warfarin education and treatment counselling is an essential component of pharmaceutical care for patients who require continuous anticoagulant therapy in atrial fibrillation management. Following admission for an acute episode of Afib, and subsequent patient stabilisation and effective resolution of blood clots (if any) with LMWH or heparin infusion, the patient is initiated on warfarin for a continuous anticoagulation therapy.
Warfarin doses have to be taken daily and continuously for a life time in most Afib patients. The patient, if active, and family members or care-givers are educated appropriately by the clinical pharmacists on duty on the anticipated side-effects, adverse drug reactions, precautions, food-drug interactions and herb-drug interactions of warfarin.

How warfarin works in preventing complications of Afib
Warfarin works by inhibiting a liver enzyme known as vitamin K epoxide reductase(VKOR) which converts natural vitamin K to the active form for the production of clotting factors (II, VII, IX and X). In this way, warfarin helps reduce the chances of blood clot formation, reducing the risks of a stroke in atrial fibrillation. It also slows the production of certain proteins: Proteins C, S and Z which are called anticoagulant proteins.
Warfarin doses must be taken daily to be effective in the prevention of clots in Afib. If doses are missed or skipped, the effectiveness is compromised. If warfarin doses are doubled, the risks of bleeds from the nose, gums, skin cuts and other body cavities are increased. Warfarin’s effect may be reduced or increased by some other drugs that a physician or dentist prescribes. The effect of warfarin is increased by drugs such as: Aspirin, Clopidrogel, Dabigatran, Cilostazol.
Some pain relief drugs used in arthritis may increase your risks of bleeding with warfarin, examples are: Naproxen, Ibuprofen, Nabumetone, Ketorolac, Diclofenac, Sulindac and Indomethacin. Inform your dentist appropriately that you are a warfarin patient. Use of certain steroids, orally or topically, may also increase your chances of skin bruises and bleeds with warfarin. Drugs or medications that interfere with warfarin metabolism or elimination from the body may equally prolong its effects and adverse reactions. These include: metronidazole, co-trimoxazole such as Batrim or Septra brands and their generic equivalents, as well as some medications used for high lipids- rosuvastatin, atorvastatin and simvastatin.

What’s the duration of warfarin treatment?
Oral doses of warfarin prescribed by a doctor or clinical pharmacist must be taken regularly and consistently as instructed, to prevent unfavourable circumstances and complications of Afib. Clinic visits need to be adhered to, so the doctor’s office may check the effectiveness of warfarin through the INR (International Normalised Ratio) Test, or by the PT (Prothrombin Time) Test.

Side-effects of warfarin use
These include skin bruises, purple-toes syndrome, gum bleeds, stomach upsets, nausea, taste alterations, chills, numbness, muscle weakness, dizziness etc. Inform your physician or pharmacist immediately if you notice or experience any of the following:
*Bruises, Gum bleeds, or Bright-red colour stools.
*Head injuries from falls
*Unusual dizzy-spells, fainting, light-headedness or extreme weakness.
*Pregnancy, excessive period bleeds or blood in urine.
*Bright-Red or coffee-brown coloured stools.

Monitoring of warfarin effects
The effectiveness of warfarin is measured at clinic visits by the test known as the International Normalised Ratio (INR). The INR is a standardised test used in monitoring whether warfarin levels in the blood are maintained and normal for the prevention of blood clots.
In Afib patients, an INR goal of 2.0–3.0 is the target. INR values of less than 1.8 has been shown to double the risk of a stroke.

General goals of treatment in atrial fibrillation
(a) To reduce rapid heart rate
(b) To effect a control of irregular heartbeat or tachycardia
(c) To use an anticoagulant for stroke prevention
(d) To get the patient into normal heart rhythm.

References
1. Lopes RD, Crowley MJ, Shah BR et al, Stroke Prevention In Atrial Fibrillation(Internet); Agency For Healthcare Research and Quality(US); 2013 Aug. Report No. 13-EHC113-EF
2. Stuart J et al; Dabigatran versus Warfarin in Patients with Atrial Fibrillation. N Engl J Med 2009, 361: 1139 – 1151, September 17, 2009.
3. Mant J, Hobbs FD, Fletcher K, Roalfe A, Fitzmaurice D; Warfarin versus aspirin for Stroke Prevention in an elderly population with atrial fibrillation – The Lancet vol. 370, Issue 9586; 11 – 17, August 2007.

“Things may come to those who wait, but only the things left by those who hustle” – Abraham Lincoln

The world doesn’t pay you for what you know; it pays you for what you do. There’s an enduring axiom of success that says, “The universe rewards action.” Yet, as simple and as true as this principle is, it’s surprising how many people get bogged down in analysing, planning, and organising when what they really need to do is take action.

When you take action, you trigger all kinds of things that will inevitably carry you to success. You let those around you know that you are serious in your intention. People wake up and start paying attention. People with similar goals become aligned with you. You begin to learn things from your experience that cannot be learnt from listening to others or from reading books. You begin to get feedback about how to do it better, more efficiently, and more quickly. Things that once seemed confusing begin to become clear. Things that once appeared difficult begin to be easier. You begin to attract others who will support and encourage you. All manner of good things begin to flow in your direction once you begin to take action.

Talk is cheap

Over the years of teaching and coaching people in my company and in my seminars, I have found that the one thing that seems to separate winners from losers more than anything else is that winners take action. They simply get up and do what has to be done. Once they have developed a plan, they start. They get into motion. Even if they don’t start perfectly, they learn from their mistakes, make the necessary corrections, and keep taking action, all the time building momentum, until they finally produce the result they set out to produce…or something even better than they conceived of when they started.

To demonstrate the power of taking action in my seminars, I hold up a $100 bill and ask, “Who wants this $100 bill?” Invariably, most of the people in the audience will raise their hands. Some will wave their hands vigorously back and forth; some will even shout out “I want it” or “I’ll take it” or “give it to me.” But I just stand there calmly holding out the bill until they get it. Eventually, someone jumps out of her seat, rushes to the font of the room, and takes the bill from my hand.

After the person sits down – now $100 richer for his efforts – I ask the audience, “What did this person do that no one else in the room did? She got off her butt and took action. She did what was necessary to get the money. And that is exactly what you must do if you want to succeed in life. You must take action, and, in most cases, the sooner the better.”

I then ask, “How many of you thought about getting up and just coming and taking the money but stopped yourselves?” I then ask them to remember what they told themselves that stopped them from getting up.The usual answers are

“I didn’t want to look like I wanted or needed it that badly.”

“I wasn’t sure if you would really give it to me.”

“I was too far back in the room.”

“Other people need it more than I do.”

“I didn’t want to look greedy.”

“I was afraid I might be doing something wrong and then people would judge me or laugh at me.”

“I was waiting for further instructions.”

I then point out that whatever things they said to stop themselves are the same things that they say to stop themselves in the rest of their lives.

One of the universal truths in life is “How you do anything is how you do everything.” If you are cautions here, you are probably cautious everywhere. If you hold yourself back for fear of looking foolish here, you probably hold yourself back for fear of looking foolish elsewhere. You have to identify those patterns and break through them. It’s time to stop holding yourself back and just go for the gold.

Culled from How to Get from Where You Are to Where You Want to Be by Jack Canfield

Man’s essential being is inward, invisible, spiritual, and as such it derives its life, its strength, from within, not from without. Outward things are channels through which its energies are expended, but for renewal it must fall back on the inward silence.
As the body cannot thrive on empty husks, neither can the spirit be sustained on empty pleasures. If not regularly fed, the body loses its vitality, and, pained with hunger and thirst, cries out for food and drink. It is the same with the spirit: it must be regularly nourished in solitude on pure and holy thoughts or it will lose its freshness and strength, and will at last cry out in its painful and utter starvation.
The pure life of the spirit cannot be found, but is lost, in the life of the senses. The lower desires are ever clamorous for more, and they afford no rest. The outward world of pleasure, personal contact, and noisy activities is a sphere of wear and tear which necessitates the counterbalancing effect of solitude. Just as the body requires rest for the recuperation of its forces, so the spirit requires solitude for the renewal of its energies.
Solitude is as indispensable to man’s spiritual welfare as sleep is to his bodily well-being; and pure thought, or meditation, which is evoked in solitude, is to the spirit what activity is to the body. As the body breaks down when deprived of the needful rest and sleep, so do the spirits of men break down, being deprived of the necessary silence and solitude.
Man, as a spiritual being, cannot be maintained in strength, uprightness, and peace except he periodically withdraws himself from the outer world of perishable things and reach inwardly toward the abiding and imperishable realities. The consolations of the creeds are derived from the solitude which those creeds enforce. The regular observance of the ceremonies of formal religion, attended, as they are, with concentrated silence and freedom from worldly distractions, compels men to do unconsciously that which they have not yet learnt to do consciously – namely to concentrate the mind periodically on the inward silence, and meditate, though very briefly, on high and holy things.
In solitude a man gathers strength to meet the difficulties and temptations of life, knowledge to understand and conquer them, and wisdom to transcend them. As a building is preserved and sustained by virtue of the foundation which is hidden and unobserved, so a man is maintained perpetually in strength and peace by virtue of his lonely hour of intense thought which no eye beholds.
It is in solitude only that a man can be truly revealed to himself, that he can come to understand his real nature, with all its powers and possibilities. The voice of the spirit is not heard in the hubbub of the world and amid the clamours of conflicting desires. There can be no spiritual growth without solitude.

Culled from MIND IS THE MASTER by JAMES ALLEN

Man’s essential being is inward, invisible, spiritual, and as such it derives its life, its strength, from within, not from without. Outward things are channels through which its energies are expended, but for renewal it must fall back on the inward silence.
As the body cannot thrive on empty husks, neither can the spirit be sustained on empty pleasures. If not regularly fed, the body loses its vitality, and, pained with hunger and thirst, cries out for food and drink. It is the same with the spirit: it must be regularly nourished in solitude on pure and holy thoughts or it will lose its freshness and strength, and will at last cry out in its painful and utter starvation.
The pure life of the spirit cannot be found, but is lost, in the life of the senses. The lower desires are ever clamorous for more, and they afford no rest. The outward world of pleasure, personal contact, and noisy activities is a sphere of wear and tear which necessitates the counterbalancing effect of solitude. Just as the body requires rest for the recuperation of its forces, so the spirit requires solitude for the renewal of its energies.
Solitude is as indispensable to man’s spiritual welfare as sleep is to his bodily well-being; and pure thought, or meditation, which is evoked in solitude, is to the spirit what activity is to the body. As the body breaks down when deprived of the needful rest and sleep, so do the spirits of men break down, being deprived of the necessary silence and solitude.
Man, as a spiritual being, cannot be maintained in strength, uprightness, and peace except he periodically withdraws himself from the outer world of perishable things and reach inwardly toward the abiding and imperishable realities. The consolations of the creeds are derived from the solitude which those creeds enforce. The regular observance of the ceremonies of formal religion, attended, as they are, with concentrated silence and freedom from worldly distractions, compels men to do unconsciously that which they have not yet learnt to do consciously – namely to concentrate the mind periodically on the inward silence, and meditate, though very briefly, on high and holy things.
In solitude a man gathers strength to meet the difficulties and temptations of life, knowledge to understand and conquer them, and wisdom to transcend them. As a building is preserved and sustained by virtue of the foundation which is hidden and unobserved, so a man is maintained perpetually in strength and peace by virtue of his lonely hour of intense thought which no eye beholds.
It is in solitude only that a man can be truly revealed to himself, that he can come to understand his real nature, with all its powers and possibilities. The voice of the spirit is not heard in the hubbub of the world and amid the clamours of conflicting desires. There can be no spiritual growth without solitude.

Culled from MIND IS THE MASTER by JAMES ALLEN

African Pharmaceutical Forum (APF), a subgroup of the International Pharmaceutical Federation (FIP), has officially unveiled its website for the use of all pharmacists across the globe.

The event which was held at the Pharmacy House in Anthony, Lagos, was graced by dignitaries like Sir Anthony Akhimien, APF president; Pharm. Azubike Okwor, former president of the Pharmaceutical Society of Nigeria (PSN); Pharm. Olumide Akintayo, PSN president, represented by the PSN secretary, Pharm. Gbolagade Iyiola; Ms Margaret O. Olele, corporate affairs/health & value director, Pfizer; and representatives of the various arms of the PSN.

While addressing the audience, the APF president, who revealed that the launch of the website was a dream comes true, noted that the project was made possible by the sponsorship of Pfizer Global.

Sir Akhimien disclosed that since the APF was established ten years ago, it had been difficult to create such a platform due to logistical and financial challenges.

“Since I became the president two years ago, it had been one of my goals to get a website for the region and I’m happy because it’s a dream come true,” said Akhimien.

The APF helmsman, who described the website as a robust, multilingual and professional site, said the establishment of the platform would bring an end to the language and payment barriers the Forum had encountered in the past, as members can now easily pay their dues without difficulty.

He further expressed optimism in APF members’ utilisation of the website, as each country would be expected to regularly update information on its activities, which should spur up a sort of competition among all member states.

Also speaking at the event, Pfizer’s corporate affairs/health & value director, Ms Olele, said Pfizer chose to sponsor the website because it was important to have a platform to galvanise groups of professionals together towards a common goal.

“The world is becoming a global village, and people need to know about best practices in their country, and neighbouring countries, in order to utilise available opportunities,” Olele said.

She explained that the existence of a viable platform that pulled different groups of pharmacists from different countries together to speak with one voice, learn and improve themselves, was indispensable at such a time as this, adding that the website could also serve as an educational educational platform for pharmacists to be updated on recent developments in the profession.

The Pfizer’s spokesperson also noted that the website would enable members leverage on social media networking, where they could share information on the website on social media, whereby creating global connection with other pharmacists .

While assuring that Pfizer would continue to support the APF, Olele added that it was part of the company’s obligations to teach the Forum’s executives how to sustain the website through generation of revenues.

“Pfizer delights in CSR because it is our belief that when society is getting better, it will definitely impact positively on the people. That’s why we are also on the vanguard to see how we can assist the communities and people enjoy good life. We look at different areas to help drive people, knowing that if we create a better world, life becomes sweet to the people”, Olele stated.

Also speaking, Pharm. (Mrs) Amaka Okafor, who represented the PCN registrar at the occasion, expressed the Council’s willingness to support APF on both institutional and individual levels.

She also appreciated the Forum’s president for the laudable initiative, adding that the website would facilitate easy payment, through the e-payment channel thereby ameliorating the challenges of the past.

A consultant physician and endocrinologist in the College of Medicine, University of Lagos, has revealed that contrary to the widespread belief that diabetes mellitus affects only adults, the condition also affects children but is often misdiagnosed.
Speaking with Pharmanews in an exclusive interview, Dr Ifedayo Adeola Odeniyi, a Fellow of the American College of Endocrinology and honorary consultant endocrinologist for the Lagos University Teaching Hospital, Idi Araba, noted that while Type 2 diabetes sometimes occurs, the Type 1 variant is the commonest type seen in children.
According to him, the onset of diabetes can be noticed at any stage after the neonatal period, but it is most common in childhood and adolescence. He added that the usual cause of the ailment is absolute deficiency of insulin.
On the symptoms of the condition, Odeniyi said the major ones are weight loss, excessive passage of urine, bedwetting, excessive thirst and tiredness (not wanting to work or play). He stated also that children could suffer from a severe complication of diabetes mellitus, called diabetic ketoacidosis, which may lead to shock, coma and eventually death.
“Diabetes in children is often misdiagnosed as some other condition,” says Odeniyi.“For example, it is often misdiagnosed as pneumonia or asthma, which manifests through laboured breathing; as appendicitis or gastroenteritis, which manifests through abdominal pain and vomiting; and as a serious infection as malaria, typhoid, HIV/AIDS, tuberculosis, meningitis etc. It could also manifest as urinary tract infection or as malnutrition, through weight loss and tiredness.”
While blaming the recent upsurge in the number of people living with diabetes on lifestyle and environmental factors, the diabetetologist however disclosed that those with a family history of diabetes mellitus are more vulnerable to the condition.
“The International Diabetes Federation (IDF) puts the prevalence of diabetes in Nigeria at 4.64 per cent as at 2014 and this is projected to increased to 5.47 per cent by 2035. There is also increase awareness of diabetes mellitus by the populace and the health care practitioners. This has led to more people being diagnosed as having diabetes mellitus. However, according to statistics from the IDF, 50 per cent of people with diabetes mellitus are still not diagnosed,”Odeniyi said.
The specialist also listed factors that lead to complications in diabetes to include poor education about the disease, non-compliance with medications, lack of finance to get right medications, lack of motivation on the part of the patients and lack of knowledge in managing the patient on the part of the medical practitioner.
The don however advised the government to further assist in enhancing diabetes care and management in the country by improving on the education, training and support of health professionals He said such initiative will boost their capacity to identify diabetes early and treat it cost-effectively, while also developing innovative ways of extending the geographical reach of health services to improve access to care and education for people with diabetes, especially those in low and middle-income classes.
“Government should also ensure that essential care (which includes risk assessment and early diagnosis), essential low-cost medicines, treatments and self-care education appropriate to people’s needs are made available. They must ensure that the safest and most proven medicines are purchased at the lowest possible prices, while they strive to improve drug distribution systems to ensure continuity in the availability of essential diabetes medicines”, Odeniyi said.

Mr Emmanuel Tarfa addressing a section of participants at the workshop

A business consultant, Mr Emmanuel Tarfa, has stated that for there to be a meaningful boost in health care financing in Nigeria, there is need to re-orientate health entrepreneurs on new and progressive methods of business management.

Tarfa, who was addressing a group of health practitioners on the topic, “Health care Entrepreneurship: Business Financing and Cash Management”, in a recent workshop organised by Pharmanews Limited in Lagos, highlighted some reasons health-related businesses encounter difficulties in accessing loans. These, according to him, include: too many bad examples, poor communication of business pitches, key-man risk, lack of business traction, among several others.
Explaining business financing, the business expert said it is a means of sourcing capital to fund a business start-up, operation or expansion, which could be done through debt or equity, depending on which seems handier at the specific time.
To achieve the goal of funding their businesses, the consultant counselled practitioners to build a team of people who have faith in their visions and who can lend support at any time to the business. He equally advised them to acquire knowledge and skills in their area of concentration, as well as get professional assistance in drawing up clear-cut business plans.
“Raising money is a difficult task and sometimes a very long process. You must be patient with your prospects and display that calmness always”, Tarfa explained.
The workshop facilitator also urged health entrepreneurs to always resolve a fundamental issue of whether a loan is needed or not before embarking on the acquisition of such fund. This, he said would help to forestall future challenges.
“Cogent indications that a business needs funding include: one, when you have identified a clear opportunity and have the business case to back it up, especially for start-ups; and two, when an existing business cannot meet demands and when a business is undercapitalised and could acquire more market share, if given more money”, Tarfa stated.
On the necessity of a solid business plan, Tarfa noted that the idea, concept or actual business must have a clear value proposition, a target audience and a clear connection between the entity and audience.
According to the expert, other prerequisites in establishing and managing an enterprise effectively include: “knowing the difference between the market and industry and determining intricacies of both; identification of size, growth, structure, consumer trends; having a detailed list of risks and plans on how to deal with such threats; as well as knowledge of capital requirement (the projection of financial statement – income, cash flow and balance sheet).”
Tarfa equally dwelt on the issue of cash management, defining it as a broad area of finance involving the collection, handling, and usage of cash. He explained that businesses could keep cash for speculative or compensation motives.
Clarifying further, he said that by speculative motive, an enterprise may want to take advantage of an opportunity, outside the normal course of business; while compensation motive involves compensating banks for providing certain services or loans.
He added that whatever may be the reason for a business to be in possession of cash, it must maintain a minimum balance of cash at the bank which it cannot readily use.

Lifeline Chemicals Limited has just moved to its new corporate office in Victoria Island, Lagos. Bose, a younger sister of the Managing Director, is invited to serve meals at the office cafeteria daily. She is issued a letter, requesting for her services for one year, starting from October 2009. The letter contains an “honour clause” stating that the arrangement “shall not be attended by any legal relationship or the subject of litigation, but all such transactions are binding in honour only.” The desired menu for each month, from October to December, is sent to Bose and she provides the meals according to the order.

In the month of November, plans are made for an End-of-Year & Christmas Party. It is suggested that professional caterers should be hired for this event. The Managing Director accepts the suggestion. He informs his sister that she will not be needed to cater for the End-of-Year event. He also lets her know that her services to the company may not be required subsequently.

Bose is saddened by this development. She has already invested in foodstuff towards fulfilling the orders. She intends to make a case to protect her interests. However, she is told by a friend that her rights are not enforceable because she is doing business with her brother. What is the legal position of Bose with the company?

A valid contract, which is enforceable in a court of law, must have an offer, an acceptance and some form of consideration from each party. It is however agreed that there is a fourth element required to be present in any contract. This is the intention of both parties to enter into legal relations. For a contract to be enforceable, it must be clear that the parties consented to enter into legal obligations and accepted to be bound by them.

The present case covers the following legal issues:

1. The place of domestic and social engagements.
2. The effect of the “honour clause” in contracts.
3. The nature of divisible contracts.

From as far back as 1919, the case of Balfour v. Balfour, established the position that contractual intention is absent in domestic and social engagements. Parties to such an agreement cannot sue each other on it. This rule has been applied especially in family relationships like that of a husband and wife or between a parent and child. In Jones v. Padavatton, a mother promised to make monthly payments to her daughter and provide accommodation in return for the daughter’s promise to study Law. After a bitter quarrel between the two, the mother revoked her promise and evicted the daughter. It was held by the Court of Appeal that the agreements to pay the daughter a monthly allowance and permit her possession of the house were not binding because they were not meant to create legal relations.

However, this rule may not apply in certain situations. For example, where family members are not living in harmony and their relationship has degenerated to the level of mutual hostility, an agreement between them would be binding. Also, where the performance of a domestic or social engagement involves great sacrifices on the part of one or both parties, the absence of contractual intention may be rebutted. In the case of Parker v. Clark, a man and his wife sold their house to move in and share expenses with his uncle. The agreement was held to be binding because of the drastic and irrevocable steps they had taken.

The case of Bose catering for Lifeline Chemicals involves a commercial agreement to provide services over a period of time. The fact that the business is done with the company classifies it as a commercial transaction. In law, there is a presumption of contractual intention in commercial agreements. However, a party may plead the absence of contractual intention where the agreement itself contains a clause expressly excluding the intention to enter into legal relations.

Indeed, it is not uncommon for provisions in a contract, as in the letter from Lifeline Chemicals, to absolve the parties of any legal liabilities arising from the business. In Buko v. Nigerian Pools Company, the Supreme Court expressed its views on the “honour clause” as follows: “the intention was to ensure that the relationship between the parties was to be that of honour, in other words, a gentleman’s agreement rather than to create a legal relationship.”

Thus, it would seem that the provision of catering services is a commercial transaction, which should be binding on the parties. Nevertheless, provisions have been made to exclude legal liabilities by the insertion of an “honour clause” in the original letter of offer. This means that, even though the services of Bose have been engaged for a period of one year, Lifeline Chemicals is at liberty to disengage without any liability.

It must be noted that this transaction involves what is known as a divisible contract. This is a situation with a major contract clearly divisible into smaller units. For example, a contract may be entered into for the supply of goods over a period of time. Every time a specific order is placed, it is a smaller contract in the major one. In Bose’s case, she had a major contract to provide meals for a period of one year. Subsequently, specific menus were given for October to December. Each order placed was a contract by itself. From the judicial decision in Rose & Frank’s Case, we see that the parties in a divisible contract are legally obligated to orders made before the termination of the contract.

In conclusion, Lifeline Chemicals is liable for the orders made to Bose for the months of October to December, before her services were disengaged.

Principles and cases are drawn from Sagay: Nigerian Law of Contract

Worried by the dismal health conditions of the poor in Nigeria, Pharm (Mrs) Bisi Bright, CEO of LiveWell Initiative (LWI), has called for immediate intervention from all stakeholders to prevent escalation of morbidity and mortality rates in the country.

Pharm. Bright made the call while speaking at a workshop organised by Pharmanews Limited, with the theme, “Health Care Entrepreneurship Workshop.”
The consultant clinical pharmacist and public health manager highlighted the poor health indices observed in the country to include 608 maternal mortality in every 100,000 births, compared to Ghana’s 409 and South Africa’s 237; high under-five and infants mortality; low life expectancy at birth; low adult literacy; low birth weight; non-conformity of many nursing mothers to exclusive breastfeeding, malnutrition and stunted growth among many others.
She attributed the disturbing statistics to inadequate health education, arguing that if majority of Nigerians were adequately furnished with health information, there would be drastic reduction in mortality rates in the country.
“Health literacy can be achieved through the informal sector, where it can be well organised with its own structure and hierarchies, which can be realised by reaching out in harmony to the community leaders, health care practitioners within the community, government officials, and government at all levels’’, Pharm. Bright pointed out.
Addressing the participants on the topic, “Elements of the emerging wellness industry”, Pharm. Bright explained the concept of wellness as being not merely the absence of disease but a complete state of physical, mental, social, emotional and psychological fitness.
While admitting that not all deaths are preceded by disease, the LWI boss emphasised that wellness promotion activities are designed to maximise the health of the community dwellers, while disease prevention is utilised to minimise the risk of disease and premature death.
Analysing the current state of the Nigerian health care system, she recommended better options of health care management for best outcomes. She noted that instead of exhibiting a nonchalant attitude towards health until there is an emergency or a life-changing diagnosis, there should informed choices, as well as informed decision-making.
She equally noted that in place of peer referral system and self-medication, there should be pharmaceutical care, promotive health care and public health care. She suggested that out of pocket health care spending be replaced with effective ‘pooling’ of health care services through microfinancing or health insurance, while individual is health responsibility must shift to collective responsibility, where individuals, communities, governments, employers and policy makers are all stakeholders.
Citing Burnside and Dollar (2000)’s submission as stated in The American Economic Review, Pharm. Bright stated the need for officials in the health sector to utilise internal and external funds judiciously for the benefit of the masses, as well as establish functional institutions and policies, adding that anything short of this would keep up the status quo.
“Not all aid is intended to generate economic growth,” she said. “Some aid is intended for humanitarian purposes; some may simply improve the standard of living of people in developing countries. The impact of aid on GDP growth is positive and significant in developing countries with sound institutions and economic policies, while aid has less or no significant impact in countries with “poor” institutions and policies.”