Medicinal plants and drugs of biological origin have a place in the treatment of chronic diseases. Drugs of biological origin, such as penicillin, morphine and senna, have been used consistently and are still in use globally in medical and pharmaceutical practices. A significant number of antimicrobial agents, such as vancomycin, griseofulvin, streptomycin, erythromycin, and gentamycin, were originally obtained from natural origin.

Stevia is a medicinal plant belonging to the botanical family Asteraceae. The leaf extracts of Stevia rebaudiana (Bertoni) contain eight potent diterpene glycosides: Stevioside, Rebaudosides A to E, Steviolbioside and Dulcoside A, which have been studied elaborately for use as sweeteners.

Three of the stevia glycosides listed above (Stevioside, Rebaudoside A, and Rebaudoside D) are well studied and recognised to be 250–300 times sweeter than sucrose. Animal studies in mammalian species, using rats, dogs and mice by researchers, have examined the pharmacological and toxicological properties of stevia glycosides. Ulbricht C, Isaac R et al, in an evidence-based systematic review, courtesy of the Natural Standard Research Collaboration, assessed the effects of stevia on two indications – hypertension and hyperglycaemia – from two long-term studies. The result showed stevia possesses hypoglycaemic and blood pressure lowering effects in mammals.

Shibata et al, have postulated that the anti-diabetic effects of stevioside may be from a suppression of glucagon secretion from the alpha cells of the pancreas. Wheeler et al (2008), have conducted human studies showing a similar but different metabolic and elimination pathways for Rebaudoside A and Stevioside. The insulin-like effects of stevia extracts in stimulating glucose uptake were demonstrated by Stone et al, using two cell types, HL-60 human leukaemia and SH-SY5Y human neuroblastoma cells. Stevia extract was found to enhance glucose uptake in both cellular lines.

In the United States, purified forms of Rebaudoside A were granted GRAS (Generally Recognised As Safe) status by the FDA and are available under low-calorie sweetener brand names as natural sugar substitutes for people living with diabetes, and for obese patients on strict diets/exercise regimen. They are also available for patients diagnosed with pre-diabetes and or metabolic syndrome.

Natural stevia leaf extracts are obtainable as diet supplements and may not be added to commercial beverages as a food additive, though current research is evaluating its potency in diabetes, obesity and hypertension. In regard to diabetes, some studies identified stevia’s trophic effects on pancreatic beta cells, insulin secretion and insulin sensitivity in rats.

Stevia is not recommended in pregnant patients, and its effect is not yet evaluated in juveniles. It is inapplicable in Type 1 diabetes since its potential effects appear connected to functional pancreatic cells. In one case report of adverse reactions, four patients who were given 500mg of stevia powder experienced symptoms of abdominal fullness, nausea, asthenia, and myalgia; but their symptoms disappeared after one week of treatment.

In vitro studies shows marked anti-inflammatory and antibacterial properties of stevia glycosides; though there have been warnings of weak mutagenic activity in laboratory animals given high doses. According to The JECFA (Joint FAO/WHO Expert Committee on Food Additives), brand name products labelled as a stevia sweetener must contain at least 95 per cent of the stevia glycoside Rebaudoside A, and the suggested acceptable daily intake(ADI) per JECFA is 0–2mg/kgbw/day of a steviol content that is equivalent to 0-6mg/kgbw/day of Rebaudoside A.

Stevia glycosides are metabolised initially in the gut to steviol (the aglycone moiety) and are excreted in the urine as steviol glucuronide. Stevia was shown to have additive antihypertensive effects with verapamil, and blood sugar lowering effects with antidiabetic drugs; therefore caution must be exercised in its use and recommendation in patients taking prescription drugs for chronic ailments.

Section 201(ff){1} of the Federal Food, Drug & Cosmetic Act permits the sale of stevia leaf extracts in the US as a diet supplement only, and not for the treatment of any manner of disease. Stevia shows promise as a potential source of important phytochemical ingredients that may serve as precursors of new drugs for diabetes in just the same way as a derivative of guanidine extracts from Galega officinalis (Goat’s rue or French lilac), Galegine, became the precursor of metformin.

Oluwole Williams wrote from Glenside, Pennsylvania, USA

REFERENCES

• Ulbritch, C; Isaac, R; Milkin, T; Poole, EA; Rusie, E. et al.(April 2010). “An evidenced-based systematic review of stevia by the Natural Standard Research Collaboration”. Cardiovascular Hematol Agents Med Chem 8(2): 113 – 127. PMID 20370653.
• Joint FAO/WHO Expert Committee on food additives, sixty-ninth Meeting. World Health Organisation 4 July 2008.
• FDA GRAS notification database; Stevia search in FDA GRAS Database.
• Misra, H; Soni M; Silawat, N; Mehta, D; Mehta, B.K; “Antidiabetic activity of medium-polar extract from the leaves of stevia rebaudiana Bet(Bertoni) on alloxan-induced diabetic rats” Pharm Bioallied Sci. 3(2): 242 – 8.
• “Diabetic Supplement Health and Education Act of 1994”. FDA.gov. 2011.
• Koyama, E.et al. “In vitro metabolism of the glycosidic sweeteners in stevia mixture and enzymatically modified stevia in human intestinal microflora. “Food and Chemical Toxicology 41”.3(2003) 359 – 374.
• Kujur, R.S; Singh, V; Ram, M; Yadava, N.H; Singh, K.K; Kumari, S; and Roy, B.K. Antidiabetic activity and phytochemical screening of crude extract of stevia rebaudiana in alloxan-induced diabetic rats. Pharmacognosy Res. 2010 Jul – Aug; 2(4): 258 – 263 PMC3141138.
• Shibata H, Sawa Y, Oka T, Sonoke S, Kim, K.K, Yoshioka M. Steviol and steviol glycosides: glucosyl tranferase activities in stevia rebadiana Bertoni – purification and partial characterization. Arch Biochem Biophys. 1995; 321(2): 390 – 396.
• Chen TH, Chen SC, Chan P et al. Mechanism of the hypoglycemic effect of stevioside, a glycoside of stevia rebaudiana. Planta Med.2005; 71(2): 108 – 113.
• Wheeler A, Bioleau AC, Winkler PC, Compton JC, Prakash I et al. Pharmacokinetics of rebaudoside A and stevioside after single dose in healthy men. Food Chem Toxicology, 2008:04.041.
• Gregersen S, Jeppensen PB, Holst JJ, Hermansen K. Antihyperglycemic effects of stevioside in type 2 diabetic subjects. Metabolism.2004; 53:73-6.
• Melis, M.S. et al. “Effect of calcium and verapamil on renal function of rats during treatment with stevioside” : J. Etnopharmacol. 1991; 33(3): 257-62.

In this insightful article, the International Pharmaceutical Federation (FIP) gives hospital pharmacists a preview of what to expect at this year’s World Congress of Pharmacy and Pharmaceutical Sciences.

The World Health Organisation estimates that each year some 16 million people die prematurely —before the age of 70 —from non-communicable diseases (NCDs). These include heart and lung diseases, stroke, cancer and diabetes. The effective use of medicines figures prominently among the “best-buy” options to reduce the death toll. This is a thread that links many of the sessions at the International Pharmaceutical Federation’s 75th world pharmacy congress and is a topic of particular interest to hospital pharmacists.

Building blocks

Evidence-based practice and medication review are two of the building blocks of effective medicines use and a number of speakers will address different aspects of these topics. One session is devoted to reviewing the definition and relevance of evidence-based practice, the gaps between current practice and evidence-based use of medicines, and the limits. Medication reviews are undertaken in all areas of clinical practice and, in recent years, guidelines and algorithms have been developed to help pharmacists deliver consistent, high-quality reviews.

Best practice examples from all over the world will demonstrate different methods for medication review, software solutions and documentation together with the evidence for effectiveness. A related session will show how “information mastery” is essential for the delivery of evidence-based practice. Speakers will explain how this differs from critical appraisal skills and provide a hands-on demonstration of the use of high quality information mastery resources.

Revolutionary developments

Another aspect of effective medicines use is personalised dosing—something that is critical for high-potency drugs and vulnerable groups, such as paediatric or geriatric patients. Speakers will describe how, for some drugs, doses can be matched to the patient’s unique genetic make-up —an approach that is predicted to increase the safety and efficacy of drug treatment.

But this is not the only revolutionary development in drug treatment. The way we give medicines is advancing far beyond the tablet and the injection and participants will hear about new formulation concepts. Experts will describe how individualised oral therapy can be given using a solid dosage pen and how printing technology can be used to produce personalised dosage forms.

Integrated safety

Safety is now seen as an integral aspect of medicines use. In a session devoted to pharmacy in Germany, Dr Torsten Hoppe-Tichy, chief pharmacist, University Hospital of Heidelberg, will describe how pharmacists are playing a key role in the development of the medication safety system in German hospitals. “There are many good examples where pharmacists have taken the lead, for example, in tackling vincristine and methotrexate dosing errors and look-alike, sound-alike drug names. As a result there is now a national plan for patient safety,” he says.

Human impacts

In what promises to be a thought-provoking session on human impacts on medicines use, speakers will explore a variety of important issues. Yolanda Robles, executive vice president of the Philippine Pharmacy Association, explains: “It is in the hospital setting where admissions and negative consequences related to non-adherence by patients to medication regimens are encountered.In addressing this problem, more focus has been given by healthprofessionals to motivating patients through standard patient education and counselling (based on disease and drug information), and the use of compliance aids. While these methods have their documented benefits, there is less knowledge and understanding of medication adherence relating to human beliefs, including religiosity and spirituality.”

Professor Robles has studied the relationship between medication and the depth of belief in Christian religious doctrines in the Philippines, for example. “The data from the study may be helpful in designing counselling interventions for patients with religious belief-related health adherence problems,” she says. Participants will also hear how the study has provided data on religious and spiritual beliefs that patients may not openly discuss with health professionals during their hospital stay.

In the same session,Dr PernilleDam, an R&D consultant at Pharmakon, Denmark, will talk about new technologies for tracking compliance and administration. The impact of pharmacogenomics and the balance between patient autonomy and acting in the patient’s best interests will also be discussed during the session.

Workforce evolution

The changing role of the hospital pharmacist and rapid developments in pharmaceutical technology raise many issues for workforce training and development. How the FIP Global Competency Framework supports the FIP Basel statements —a set of 75 consensus statements developed by an international group, which describe the preferred vision for hospital pharmacy— is also on the agenda. Speakers will use practical examples and case studies to show a variety of approaches that are being used to develop competency and advanced practice.

For instance, Catherine Duggan, director of professional development and support, Royal Pharmaceutical Society, will describe how the UK is developing a “royal college” approach to professional recognition, following the medical model.“Healthcare providers now need to provide evidence that their staff have the qualifications, competence, skills and experience to safely provide patient care,” Dr Duggan explains.

Participants can also hear about an e-learning project for French-speaking, low-income countries. Started in 2013, it aims to foster the development of local experts in hospital pharmacy. Pascal Bonnabry, chief pharmacist at the University Hospital of Geneva,explains: “In many low-income countries, access to affordable high-quality drugs is a problem and so is [ensuring] safe and appropriate use of drugs. There are significant gaps both in the training of professionals in this specialised area and in the organisation of hospital pharmaceutical services — and patient care suffers as a result.” His hospital has had a long-standing collaboration with the Faculty of Medicine, Pharmacy and Dentistry at the University of Bamako, Mali, providing valuable insights into the problems and possible solutions.

“The e-learning platform that we have developed provides free, internet-based training at undergraduate and postgraduate levels”, Professor Bonnabry says.

Remuneration

Remuneration is a critical element of any job and can be an important incentive. Around the world, there is a wide diversity of models for the payment of hospital and community pharmacy services, some based on margins, while others are fees for services or capitation. FIP has conducted an international survey on remuneration in both community and hospital pharmacy and Dr Jacqueline Surugue, immediate past president of FIP’s Hospital Pharmacy Section, will describe the findings related to hospital pharmacy.

When and where?

The World Congress of Pharmacy and Pharmaceutical Sciences will take place from 29 September to 3 October in Düsseldorf, Germany.It offers 230 hours of sessions given by 220 experts from 40 different countries and includes many leading hospital pharmacists, clearly demonstrating the breadth and depth of innovative hospital pharmacy services worldwide. Make this a date in your diary.

Source:www.fip.org/dusseldorf2015/media

There is no striking a cheap bargain with prosperity. It must be purchased, not only with intelligent labour, but with moral force. As the bubble cannot endure, so the fraud cannot prosper. He makes a feverish spurt in the acquirement of money, and then collapses. Nothing is ever gained, ever can be gained, by fraud. It is but wrested for a time, to be again returned with heavy interest. But fraud is not confined to the unscrupulous swindler. All who are getting, or trying to get, money without giving an equivalent are practicing fraud, whether they know it or not. Men who are anxiously scheming how to get money without working for it, are frauds, and mentally they are closely allied to the thief and swindler under whose influence they come, sooner or later, and who deprives them of their capital. What is a thief but a man who carries to its logical extreme the desire to possess without giving a just return – that is, unlawfully? The man that courts prosperity must, in all his transactions, whether material or mental, study how to give a just return for that which he receives. This is the great fundamental principle in all sound commerce, while in spiritual things it becomes the doing to others that which we would have them do to us, and applied to the forces of the universe, it is scientifically stated in the formula, “Action and reaction are equal.”

Human life is reciprocal, not rapacious, and the man who regards all others as his legitimate prey will soon find himself stranded in the desert of ruin, far away from the path of prosperity. He is too far behind in the process of evolution to cope successfully with honest men. The fittest, the best, always survive, and he, being the worst, cannot therefore continue. His end, unless he change in time, is sure – it is the jail, the filthy hovel, or the place of the deserted outcast. His efforts are destructive, and not constructive, and he thereby destroys himself.

It was Carlyle who, referring to Mohammed being then universally regarded by Christians as an impostor, exclaimed, “An imposter found a religion! An imposter couldn’t build a brick house!” An imposter, a liar, a cheat – the man of dishonesty – cannot build, as he had neither tools nor material with which to build. He can no more build up a business, a character, a career, a success, than he can found a religion or build a brick house. He not only does not build, but all his energies are bent on undermining what others have built, but this being impossible, he undermines himself.

Without integrity, energy and economy will at last fail, but aided by integrity, their strength will be greatly augmented. There is not an occasion in life which the moral factor does not play an important part. Sterling integrity tells wherever it is, and stamps its hall-mark on all transactions; and it does this because of its wonderful coherence and consistency, and its invincible strength. For the man of integrity is in line with the fixed laws of things – not only with the fundamental principles on which human society rests, but with the laws which hold the vast universe together. Who shall set these at naught? Who then shall undermine the man of unblemished integrity? He is like a strong tree whose roots are fed by perennial springs, and which no tempest can lay low.

To be complete and strong, integrity must embrace the whole man, and extend to all the details of his life; and it must be so thorough and permanent as to withstand all temptations to swerve into compromise. To fail in one point is to fail in all, and to admit, under stress, a compromise with falsehood, howsoever necessary and insignificant it may appear, is to throw down the shield of integrity, and to stand exposed to the onslaughts of evil.

The man who works as carefully and conscientiously when his employer is away as when his eye is upon him, will not long remain in an inferior position. Such integrity in duty, in performing the details of his work, will quickly lead him into the fertile regions of prosperity.

The shirker, on the other hand, he who does not scruple to neglect his work when his employer is not about – thereby robbing his employer of the time and labour for which he is paid – will quickly come to the barren region of unemployment, and will look in vain for needful labour.

Culled from MIND IS THE MASTER by JAMES ALLEN

It should be 755 to 760 words

With a view to increasing the participation of students in the publication, the National Health Magazine creates a new column for letters and contributions from university students. As an incentive, writers of any article published will receive the sum of N20,000.

Oliver, a pharmacy student in Benin, has a school assignment which is required to be published in a health journal. He sends his write-up to the National Health Magazine. Fortunately, his contribution is selected and published along with articles of some other students. Oliver proceeds to the offices of the magazine to receive his remuneration. On meeting with the editor, he is informed that the magazine has accepted more entries than was budgeted for. He is offered N10,000, instead, as compensation. Oliver accepts the sum of money and signs with the accounts department for the collection.

After one week, the money from the magazine is exhausted. Oliver wants more. He writes a letter to the editor of the National Health Magazine, demanding for the payment of N10,000, being the balance of his remuneration. The editor replies him stating that: (1) Oliver’s write-up was of no real value to the magazine in the first place; (2) He already had a duty to publish his school assignment and so his contribution was merely in fulfillment of that duty; and (3) He accepted the sum of N10,000 offered and was paid in good faith.

In view of this, what are the legal rights of Oliver and the liabilities of the National Health Magazine?

It has been established that a contract between two parties requires an exchange. This may involve money, a product, a service or a promise to perform a certain action. The term ‘consideration’ refers to that which is exchanged. For a party to be able to enforce a contract, he or she must have furnished some consideration in support of it. This consideration must have some value in the eye of the law.

The legal issues to be considered in this case are:

1. The determination of something of value.
2. The performance of an existing duty.
3. The variation of a contract.
4. Composition with creditors.

The sufficiency of consideration means that what is provided by a party in a contract must be ascertainable, useful or meaningful; otherwise it will be regarded as insufficient. Judicial declarations support the notion that consideration does not have to be something of economic benefit. In the view of the legal scholar, J. C. Smith, “all that is necessary is that the defendant should, expressly or impliedly, ask for something in return for his promise, an act or promise by the offeree. If he gets what he asks for, then the promise is given for a consideration.”

With regard to Oliver’s contribution to the magazine, it is the view of the editor that his write-up added no value to the publication. However, in the case of De la Bere v. Pearson, the question arose whether a letter from a reader was sufficient consideration to a newspaper. It was held that there was consideration, as such publications had a tendency to increase the circulation of the newspaper. Considering that the National Health Magazine created the coloumn to reach more students, it is apparent that the involvement of a student, like Oliver, constituted something of value.

Subsequently, there is the question of the performance of a duty that one is already bound to fulfil. From the case of Collins v. Godefroy, it is established that a party cannot enforce a promise made to him in return for his performance of a public duty. On the other hand, Oliver’s commitment was to a school assignment, which he was not bound by law to fulfil. Rather, this was a duty to a third party (his lecturer).   In the New Zealand Shipping Case, it was declared that “an agreement to do an act which the promisor is under an existing obligation to a third party to do, may well amount to valid consideration.”

A major point of contention is the variation of the magazine contract to pay a student writer N10,000 in lieu of the advertised sum of N20,000. It is the position of the editor that since Oliver accepted the arrangement, the magazine is no longer liable to pay the balance. On the contrary, the authourity for this is Pinnel’s Case, where a creditor accepted to be paid a lower sum and later sued for the outstanding amount. The court held that the payment of a lesser sum could not discharge a debtor from the obligation to pay the full amount of debt.

The basis of this judgement is clear. For this new arrangement to be tenable, there must be some new form of consideration from the debtor. The magazine should have given something in compensation for the difference, otherwise the promise by the creditor to accept less money would not be enforceable.

Finally, in the settlement of debts, there is a concept known as composition with creditors. This is a situation where one debtor has multiple creditors and an arrangement is jointly made with all the parties to accept a lower sum in order to offset the debts simultaneously. In Wood v. Roberts, it was held that such an agreement is binding on all of them and none can subsequently sue for the balance of his debt. If the magazine had made a joint agreement with all the student writers, the arrangement would have been binding.

In conclusion, Oliver is entitled to the outstanding sum of N10,000. The National Health Magazine is liable for the full sum advertised.

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

The Association of Industrial Pharmacists of Nigeria (NAIP) has reiterated its commitment to charting the way forward for the pharmaceutical sector by helping pharmacists manage the impacts of government’s macroeconomic policies on the pharmaceutical industry.

The national chairman of the association Pharm. (Prince) ’Gbenga Falabi, disclosed this while making his opening remarks at the first 2015 NAIP bimonthly general meeting/lecture, held at the Lagos Chamber of Commerce & Industry (LCCI), Alausa, Ikeja, Lagos, recently.

According to the NAIP helmsman, the quest of the association to help surmount the numerous challenges facing the pharmaceutical sector prompted the decision of NAIP to bring Dr Akin Ogunbiyi, a distinguished business coach, to speak to members at the event.

In his presentation, Dr Ogunbiyi, who is the group managing director of Mutual Benefit Assurance Plc, observed that the pharmaceutical industry is faced with a number of challenges, including drug counterfeiting, unfavourable macroeconomic policies, unlicensed/unqualified pharmaceutical practitioners and limited spending power of citizens.

The guest speaker also listed poor infrastructure, inadequate and inefficient financing, high registration fees for imports, as well as the absence of meaningful patent legislation, as part of the challenges.

Ogunbiyi, however, noted that despite the challenges, opportunities still abound in the industry due to the growing demography, export opportunities in the ECOWAS region, efforts of NAFDAC to reduce counterfeiting and the renewed interest of the government in the healthcare system.

The Mutual Benefit Assurance helmsman lamented that despite the importance of the pharmaceutical sector to healthcare and general development of the country, the sector had not been well positioned.

He flayed the inability of operators in the industry to be entrepreneurial, their aversion for risk and their inability to attract private investors to the sector.

Preferring the way forward, Ogunbiyi urged operators to improve entrepreneurship, arguing that the current training in pharmaceutical sciences does not adequately prepare registered pharmacists for the business of pharmacy, adding that there was need for re-training of pharmacists as business managers.

He further advocated the development of the local chemical industry to reduce dependency on imported Active Pharmaceutical Ingredients (APIs), while also suggesting active participation of pharmacists in politics to shape the policies affecting the industry.

The guest speaker also urged pharmacists to invest in research and development, as well as getting the WHO GMP certification. He equally urged all pharmacists to work together in cooperation and be creative in initiating innovative strategies to make the system better.

Pharm. Okey Akpa, the chairman of the occasion, while making his remarks, said the guest speaker had challenged pharmacists to strive to continue to make a difference. He however, noted that the current environment is a challenge, noting that everywhere an industry had grown, policies must be improved.

While noting that there was enterprise in the industry, he argued that political will was critical to getting things right, lamenting that there was no enabling environment for Pharmacy to thrive.

He further urged pharmacists to begin to look into partnership. “We must begin to come together. We cannot run singularly and expect to make progress,” he said.

Also speaking at the event, Pharm. (Sir) Nnamdi Obi, managing director/CEO, Embassy Pharmaceuticals& Chemicals Limited, equally lamented the environmental problem.

He noted that pharmacists were not bereft of ideas nor incompetent on how to get things done but were operating in a very difficult environment.

Hehowever urged pharmacists not to relent on their efforts to get things right in spite of the environmental challenges, adding that pharmacists couldmake a huge difference in the industry. “We are the ones that will be the architect of our fortune and/or misfortune,” he said.

The Pharmacists Council of Nigeria (PCN) has admonished young pharmacists in the country to avoid practice that could tarnish the image of the pharmaceutical profession.

 Shun unethical practices, PCN urges graduating  pharmacists – As UNILAG Pharmacy Faculty inducts 138.

Speaking at the induction and oath-taking ceremony for 138 graduands of the Faculty of Pharmacy, University of Lagos, Akoka, on 5 March 2015, PCN registrar, Pharm. N.A.E Mohammed, charged the newly robed pharmacists to distinguish themselves from those who had gate-crashed their way into the profession.

Stressing that the intruders’ primary concern is making money at all cost, Mohammed noted that this was the bedrock of fake drugs in Nigeria.

“As young professionals, please ensure you do the right thing,” he urged the graduands.“If you are caught in a desperate attempt to use your licence in unethical practice, you will be in trouble.”

While explaining the danger of compromising one’s integrity in the profession, the PCN registrar spontaneously asked how many of the graduands understood the meaning of ‘Register and Go’. Scores of hands went up in response, to the admiration of the registrar.

Mohammed also congratulated the parents of the graduands for encouraging them to complete the first phase of pharmacy training, saying that the second phase is the mandatory one-year internship training programme under the supervision of a registered pharmacist in an accredited internship training facility.

“What I see in many of you are personalities that are looking for unforgettable adventures. The Nigerian health care delivery arena is full of untapped opportunities that are wrapped in countless but surmountable challenges,” Mohammed told the young graduates.

The PCN chief executive officer further observed that brain drain had orchestrated shortage of pharmacists, as many had migrated to other countries in search of better remunerations, state-of-the-art facilities and conducive working environment.

He added that even within the country, pharmacists were walking away from the health sector to other more attractive sectors such as telecommunication and petroleum.

“I am happy to note that most of them are coming back to their first love – Pharmacy. As you can see, Pharmacy is not boring because you will forever be learning about new people, organisations, places and methods of doing things…the PCN is aware of the challenges posed to pharmacists by the dynamics of the practice, tech advancement, increasing disease burdens, adverse drug reactions, drug interactions, drug resistance among others,” he said.

Congratulating the graduands, Prof. Olukemi Odukoya, dean of the faculty, explained that the occasion was not only meant to reflect on the past, but to prepare for the future.

“You will be faced with so many obstacles but with these challenges come opportunities for leadership and innovation. As pharmacy profession continues to evolve, remember the oath and commitment to patient care,” she said.

The dean also charged the newly inducted pharmacists to remember that their strength as pharmacists lay in their being experts in the safe and effective use of medicines and their potential contribution and integration into health and social care teams.

According to her, the profession of pharmacy is currently in a dynamic era, as it attempts to transform the role of the pharmacist from a product-oriented practitioner, concerned only with medication distribution, to a patient-centred practitioner able to meet the complex drug therapy needs of individuals and society.

“No matter where your career takes you, don’t forget that as University of Lagos-trained pharmacists, you must proudly represent the royal purple and remember that what starts here changes the world,” she stressed.

The induction ceremony saw the emergence of five first class graduates – Odunayo Abdulai, Innocent Ijeoma, Chinwe Obiakor, Omoshola Kehinde and Isilamiyat Rufia. Of the five, Odunayo Abdulai was announced the best graduating student. Not only was the young brain given a cash reward but she equally claimed every available prize in sight –the PCN, HealthPlus, Dean and Pfizer Science awards.

The colourful ceremony equally witnessed a massive turnout of participants, including professors, faculty members, pharmacists in academia, pharmacy students, parents, as well as top officials of the PCN and the PSN.

In view of the unending strike actions in the health sector, the Association of Community Pharmacists of Nigeria (ACPN) has urged members of the public not to resort to self-medication and arbitrary consumption of local herbs.

Speaking exclusively with Pharmanews, ACPN chairman, Pharm. (Alhaji) Ismail Adebayo, explained that the association was fully aware of the sufferings experienced by patients and their loved ones during industrial actions such as the recently suspended strikes by the Joint Health Sector Union (JOHESU) and the Nigerian Medical Association (NMA).

“Whenever we have issues like this, you discover that patients will always seek alternatives. Some are forced to visit hospitals and that can be very expensive. Secondly, the quality of the service, especially when it comes to pharmaceutical care, will be poor”, Adebayo said.

“Besides we know that most private hospitals don’t even have pharmacists. And by virtue of that, it is going to affect the quality of health care delivery that will be given to the citizens,” he added.

The ACPN chairman however noted that the most worrisome fallout of health workers’ strikes is the number of people who resort to self-medication, which could be dangerous for them.

“As the national chairman of ACPN, what we preach when we see patients is proper enlightenment and education on what to do. But how many of them can afford even the consultation fees that private hospitals charge? Consequently, they may resort to self-medication. What can we do? One thing is for pharmacists to give advice, another thing is for people to take to it,” he remarked.

According to Adebayo, self-medication is not limited to those who use local herbs, but also those using cheap and substandard medicines because they cannot afford to visit private hospitals or pharmacies during strikes.

“Of course, we know how much it takes to treat ordinary malaria in this country. By virtue of this, I will implore the government to look at this matter holistically,” Adebayo urged.

It would be recalled that the Nigerian Medical Association (NMA), after several dialogues with the federal government, was compelled to call off its 55 days strike on 25 August, 2014. According to a communiqué released to announce the Call-off, the decision was based on current challenges in the country.

Similarly, the Joint Health Sector Union (JOHESU), embarked on strike on 12 November, 2014 over non-implementation of the agreement entered into by the government, which bordered mainly on issues of improved welfare for health workers. The strike was eventually suspended on 2 February 2015. This was sequel to a meeting between President Goodluck Jonathan and JOHESU during which salient issues regarding the grievances of the union were discussed.

Ahead of the 2015 World Tuberculosis Day which is usually mark on March 24 of every year, the World Health Organisation (WHO) has called on all countries to support a new 20-year strategy which aims to end the global tuberculosis epidemic by 2035.

This decision was reached at a World Health Assembly conference convened by WHO in Geneva, in May 2014 to adopt a post-2015 strategy with an ambitious target of ending the disease by 2035.It will be recalled that the eradication of TB was one of the MDGs which was not achieved in 2015.Thus, the emergence of the new strategy.

According to a press release from WHO, the strategy aims to end the global TB epidemic, with targets to reduce TB deaths by 95% and to cut new cases by 90% between 2015 and 2035, and to ensure that no family is burdened with catastrophic expenses due to TB. It sets interim milestones for 2020, 2025, and 2030.

Worried by the prevalence of the disease, the WHO Director-General, Dr Margaret Chan, said the ailment has devastating economic consequences for affected families, reducing their annual income by an average of 50%, and aggravating existing inequalities.

“This is a matter of social justice, fundamental to our goal of universal health coverage. Each and every man, woman or child with TB should have equal, unhindered access to the innovative tools and services they need for rapid diagnosis, treatment and care”.

Hence, the call for new commitments and new action in the global fight against tuberculosis – one of the world’s top infectious killers.

Go into the fields and country lanes in the spring-time, and you will see farmers and gardeners busy sowing seeds in the newly prepared soil. If you were to ask any one of those gardeners or famers what kind of produce he expected from the seed he was sowing, he would doubtless regard you as foolish, and would tell you that he does not “expect” at all; that it is a matter of common knowledge that his produce will be of the kind which he is sowing, and that he is sowing wheat, or barley, or turnips, as the case may be, in order to reproduce that particular kind.

Every fact and process in Nature contains a moral lesson for the wise man. There is no law in the world of Nature around us which is not to be found operating with the same mathematical certainty in the mind of man and in human life. All the parables of Jesus are illustrative of this truth, and are drawn from the simple facts of Nature. There is a process of seed-sowing in the mind and life – a spiritual sowing which leads to a harvest according to the kind of seed sown. Thoughts, words and acts are seeds sown, and, by the inviolable law of things, they produce after their kind.

The man who thinks hateful thoughts brings hatred upon himself. The man who thinks loving thoughts is loved. The manuscriptwhose thoughts, words and acts are sincere, is surrounded by sincere friends; the insincere man is surrounded by insincere friends. The man who sows wrong thoughts and deeds, and prays that God will bless him, is in the position of a farmer who, having sown tares, asks God to bring forth for him a harvest of wheat.

He who would be blessed, let him scatter blessings. He who would be happy, let him consider the happiness of others.

Then there is another side to this seed-sowing. The farmer must scatter all his seed upon the land, and then leave it to the elements. Were he to covetously hoard his seed, he would lose both it and his produce, for his seed would perish. It perishes when he sows it, but in perishing it brings forth a great abundance. So in life, we get by giving; we grow rich by scattering. The man who says he is in possession of knowledge which he cannot give out because the world is incapable of receiving it, either does not possess such knowledge, or, if he does, will soon be deprived of it – if he is not already so deprived. To hoard is to lose; to exclusively retain is to be dispossessed.

Even the man who would increase his material wealth must be willing to part with (invest) what little capital he has, and then wait for the increase. So long as he retains his hold on his precious money, he will not only remain poor, but will be growing poorer everyday. He will, after all, lose the thing he loves, and will lose it without increase. But if he wisely lets it go; if, like the farmer, he scatters his seeds of gold, then he can faithfully wait for, and reasonably expect, the increase.

Men are asking God to give them peace and purity, and righteousness and blessedness, but are not obtaining these things; and why not? Because they are not practising them, not sowing them. I once heard a preacher pray very earnestly for forgiveness, and shortly afterwards, in the course of his sermon, he called upon his congregation to “show no mercy to the enemies of the church.” Such self-delusion is pitiful, and men have yet to learn that the way to obtain peace and blessedness is to scatter peaceful and blessed thoughts, words, and deeds.

Men believe that they can sow the seeds of strife, impurity and unbrotherliness, and then gather in a rich harvest of peace, purity and concord by merely asking for it. What more pathetic sight than to see an irritable and quarrelsome man praying for peace. Men reap that which they sow, and any man can reap all blessedness now and at once, if he will put aside selfishness, and broadcast the seeds of kindness, gentleness, and love.

Culled from MIND IS THE MASTER by JAMES ALLEN

When the dawn of intelligence shall spread over the eastern horizon of human progress, and ignorance and superstition shall have left their last footprints on the sands of time, it will be recorded in the last chapter of the book of man’s crimes that his most grievous sin was that of intolerance.

The bitterest intolerance grows out of religious, racial and economic prejudices and differences of opinion. How long, O God, until we poor mortals will understand the folly of trying to destroy one another because we are of different religious beliefs and racial tendencies?

Our allotted time on this earth is but a fleeting moment. Like a candle, we are lighted, shine for a moment, and flicker out. Why can we not learn to so live during this brief earthly visit that when the great “caravan” called death draws up, we will be ready to fold our tents and silently follow out into the great unknown without fear and trembling?

I am hoping that I will find no Jews or Gentiles, Catholics or Protestants, Germans, Englishmen or Frenchmen when I shall have crossed the bar to the other side. I am hoping that I will find there only human souls, brothers and sisters all, unmarked by race, creed or colour, for I shall want to be done with intolerance so I may rest in peace throughout eternity.

Man engages his brothers in mortal combat because of competition. The three major forms of competition are sex, economic and religious in nature. Twenty years ago, a great educational institution was doing a thriving business and rendering a worthy service to thousands of students. The two owners of the school married two beautiful and talented young women, who were especially accomplished in the art of piano playing. The two wives became involved in an argument as to which one was the more accomplished in this art. The disagreement was taken up by each of the husbands. They became bitter enemies. Now the bones of that once prosperous school “lie bleaching in the sun.”

In one of the great industrial plants, two young foremen “locked horns” because one received a promotion which the other believed he should have had. For more than five years the silent undertow of hatred and intolerance showed itself. The men under each of the foremen became inoculated with the spirit of dislike which they saw cropping out in their superiors. Slowly, the spirit of retaliation began to spread over the entire plant. The men became divided into little cliques. Production began to fall off. Then came financial difficulty and, finally, bankruptcy for the company. Now the bones of the once prosperous business “lie bleaching in the sun,” and the two foremen and several thousand others were compelled to start all over again, in another field.

Down in the mountains of West Virginia lived two peaceful families of mountain-folk-the Hatfields and the McCoys. They had been friendly neighbours for three generations. A razorback pig belonging to the McCoy family crawled through the fence into the Hatfield family’s corn field. The Hatfields turned their hound loose on the pig. The McCoys retaliated by killing the dog. Then began a feud that has lasted for three generations and cost many lives of the Hatfields and McCoys.

In a fashionable suburb of Philadelphia, certain gentlemen of wealth have built their homes. In front of each house the word “INTOLERANCE” is written. One man builds a high steel fence in front of his house. The neighbor next to him, not to be outdone, builds a fence twice as high. Another buys a new motor car and the man next door goes him one better by purchasing two new cars. One remodels his house adding a colonial style porch. The man next door adds a new porch and a Spanish style garage for good measure. The big mansion on top of the hill gives a reception which brings a long line of motor cars filled with people who have nothing in particular in common with the host. Then follows a series of “receptions” all down the “gold-coast” line, each trying to outshine all the others.

The “Mister” (but they don’t call him that in fashionable neighbourhoods) goes to business in the back seat of a Rolls Royce that is managed by a chauffeur and a footman. Why does he go to business? To make money, of course! Why does he want more money when he already has millions of dollars? So he can keep on out-doing his wealthy neighbours.

Poverty has some advantages – it never drives those who are poverty-stricken to “lock horns” in the attempt to out-poverty their neighbours.Wherever you see men with their “horns locked” in conflict, you may trace the cause of the combat to one of the three causes of intolerance – religious difference of opinion, economic competition or sex competition.

The next time you observe two men engaged in any sort of hostility toward each other, just close your eyes and THINK for a moment and you may see them, in their transformed nature. Off at one side you may see the object of combat – a pile of gold, a religious emblem or a female (or females).

Remember, the purpose of this easy is to tell some of the TRUTH about human nature, with the object of causing its readers to THINK. Its writer seeks no glory or praise, and likely he will receive neither in connection with this particular subject.

Andrew Carnegie and Henry C. Frick did more than any other two men to establish the steel industry. Both made millions of dollars for themselves. Came the day when economic intolerance sprang up between them. To show his contempt for Frick, Carnegie built a tall sky-scraper and named it the “Carnegie Building.” Frick retaliated by erecting a much taller building, alongside of the Carnegie Building, naming it the “Frick Building.”

These two gentlemen “locked horns” in a fight to the finish. Carnegie lost his mind, and perhaps more, for all we of this world know. What Frick lost is known only to himself and the keeper of the Great Records. In memory, their “bones lie bleaching in the sun” of posterity.

Culled from THE LAW OF SUCCESS by NAPOLEON HILL

What’s in store at this year’s World Congress of Pharmacy and Pharmaceutical Sciences? Michael Anisfeld, president of the International Pharmaceutical Federation’s Industrial Pharmacy Section, provides pharmacists with a preview of the programme.

If you keep your head buried in your work, you will miss the bigger picture of how your work fits into real-world patient needs. If you do not expand your horizons, your career will be very much the poorer.

The International Pharmaceutical Federation’s 2015 annual congress of pharmacy and pharmaceutical sciences will enable industrial pharmacists, pharmaceutical scientists, practitioners, researchers and academics from all over the world to delve into the issue of working towards the best possible pharmacy practice, which should be based on pharmaceutical sciences and evidence driven. This especially includes the practice area of industrial pharmacy.

The federation’s Industrial Pharmacy Section(IPS) has planned a number of stimulating sessions for the congress, covering a wide range of areas, from quality assurance to social responsibility.

Social media impacts on drug development

In the news recently was a story that the British Army is setting up a new unit that will use psychological operations and social media to help fight wars “in the information age”. Just as the armed forces cannot afford to ignore social media, neither can pharmacists. In all sectors, community, hospital or industry, pharmacists need to get acquainted with the rapid changes and adapt to quick communication and more transparency in the whole health care system.

A session, “Transparency and social media — the pharmacist as the spider in the web”, will explore the role and implications of this rapidly growing channel of communicationin new drug development, including planning and performing clinical trials. For example, what would happen if patients traded details of their clinical trial experiences on social media, potentially unblinding a trial? Issues such as these will be discussed during the session.

 Customised medicines

Another growing area is the demand by patients and doctors for customised medicines, not least because of increasing drug shortages all over the world. The session, “Compounding — a core competence for the pharmacist”, will look at compounding at community, hospital and industrial levels and participants will be able to hear, among others, speakers from the Central Laboratory of German Pharmacists Association (Zentrallaboratorium), which was founded in 1971 with the aim of increasing safety, through the testing of medicines.

Presentations will include “Assuring the microbiological quality of individual preparations” and “External quality control and certification of the pharmaceutical quality management system — the German way”.

Big questions

“Medicines for all” has been a World Health Organisation and FIP mantra for over two decades. But this eminently laudable goal is yet to be achieved. A session, “Medicines for all — what is hindering progress?”, will look at the impediments to achieving our goal. Are these obstacles in drug development, clinical trials, drug usage patterns, drug pricing, logistics, product development, social norms or national health policies?And how are they preventing at-risk populations worldwide from having access to medicines? These are big questions that deserve attention.

“An often debated topic is, to what extent the international pharmaceutical industry have a responsibility to make medicines available for all; this session will explore the extent of that responsibility,” says speaker Ulf Janzon (FIP IPS, Sweden). During the session, potential solutions will be discussed.

Packaging and information essentials

The FIP congress is an international meeting of professionals, bringing together around 220 speakers from 40 countries, and is attended by thousands of pharmaceutical colleagues. Perhaps, then, it is fitting that the IPS has jointly organised a session called, “Lost in translation — preserving scientific knowledge across languages.”

During this session, industrial pharmacists will be able to look into how linguistic translation impacts the proper use of medicines. For example, are patientsat risk due to poor translation of patient package inserts? And should we be using pictograms to enhance patient compliance with drug regimens?

But translation is much more – scientific translation is a key to scientific communication, enabling research and findings to cross linguistic borders and facilitates exchange and understanding. Translation involves much more than simply transferring the words into another language. It requires research, thorough understanding of both the original and target languages, cultural knowledge, and specific training on the topic to be translated. Focus will be given to who judges if the translations received are really adequate and the economic profile of scientific translation.

 Site visits and latest research

Each year, the IPS organises a number of fantastic industrial insights in the congress host country. A visit to Johnson & Johnson’s manufacturingsite is an outing especially designed for students; but the section plans to offer other visits to state-of-the-art facilities. Specific locations will be revealed as these plans are finalised.

The congress is also the place to hear short oral presentations from industry pharmacists on research in progress. Come and find out what others are doing and be inspired!

Wider perspective

Novel perspectives on industry topics from around the world are to be heard at the FIP congress. But it is amazing just how much you can learn from hearing from other cultures and about other approaches to topics from other sectors of pharmacy.

For example, if you had drifted into one of the Military and Emergency Pharmacy Section sessions at the Bangkok Congress last year, you would have heard a remarkable discussion on how Tokyo is planning the drug supply chain in preparation for the next earthquake, which is estimated to negatively impact over 30 million people. Startling food for thought, especially when you ask what your home city is doing in its emergency preparedness efforts against future disasters, and the role you can play. The preliminary congress programme for 2015 is now available, and offers 230 hours of sessions (go to www.fip.org/dusseldorf2015).

 When and where?

The 2015 World Congress of Pharmacy and Pharmaceutical Sciences will take place in Germany. If you come to Düsseldorf from 28 September to 3 October this year, no matter where you are from, you will be surprised at how much you have in common with your other pharmacy colleagues, how much you will learn, and how your career will be enhanced.

L-R Mrs. Oge Mac Johnson, oral care consultant; Mr Chestin Twigg, profession manager, East/West Africa; Mrs Hannah Oyebanjo, marketing director, and Mr Gbadesola Adenrele, brand manager

While working in New York, Dr Kaine is offered employment at the Anambra State University Teaching Hospital. His employment letter states that the contract of employment may be terminated by either party with one month’s notice.

Dr Kaine subsequently negotiates for provisions to be made to transport his entire family with him to Nigeria. Flight tickets are paid for him, his wife, six children and younger sister.

On arrival in Nigeria, he is requested to sign an undertaking to refund the cost of the flight tickets, if he were to leave the employment of the state government within three years. He signs the undertaking and commences work at the teaching hospital.

After two months of working, however, Dr Kaine submits a notice of resignation. He has been offered a more lucrative job with a private hospital in Abuja and has already agreed to start working with them in the next one month. The Anambra State Government immediately issues a letter, demanding a refund of expenses incurred in relocating his family to Nigeria. The letter adds that, in the alternative, he may remain in employment for one year, which would be considered adequate for the costs of the flight tickets.

In view of this, what is Dr Kaine’s legal position?

For a contract to be valid between two parties, there must be an offer and an acceptance. Something must be given by one party, while the other party responds with something of value. What is exchanged may be money, a product, a service or a promise to perform a certain action. In law, consideration is the thing of value that is exchanged by parties in a contract. For a party to be able to enforce a contract, he or she must have furnished some consideration in support of it. When goods are sold, for instance, the seller’s consideration is the transfer of ownership of the goods to the buyer. While the buyer’s consideration is the payment of money to the seller. Hence, it is said that “consideration must move from the promisee”.

The case above involves several legal issues:

1.The place of consideration in the    formation of a contract.

2.The validity of past consideration.

3.The adequacy of consideration.

The definition of consideration was established in the case of Currie v. Misa by Justice Lush. He said that “a valuable consideration in the eye of the law may consist either in some right, interest, profit or benefit accruing to the one party, or some forbearance, detriment, loss or responsibility, given, suffered or undertaken by the other… So, it is irrelevant whether one party benefits but enough that he accepts the consideration and that the party giving it does thereby undertake some burden, or lose something which in contemplation of law may be of value.”

In this matter involving Dr Kaine and the Anambra State Government, an offer of employment was made, the terms were negotiated and an agreement was reached. Each party made a promise to provide certain value. On the side of the state government, it was the employment package with the added benefit of transporting the entire family of Dr Kaine. On the side of the doctor, it was his services in employment at the teaching hospital. It is sufficient to say that both parties provided consideration and thereby had a valid contract.

Unfortunately, a dispute has arisen on account of Dr Kaine’s resignation. It is quite clear, from the terms of employment, that he could terminate his services with a notice of one month. However, there is the unresolved issue of transportation costs incurred in relocating nine members of his family to Nigeria. The demand for refund is based on the undertaking the doctor was made to sign.

On moral grounds, it would seem that Dr Kaine had indeed made a promise to either work for a minimum of three years or refund the cost of the flight tickets. However, a moral responsibility is not seen as consideration in the sight of the law. In return for such an undertaking, there must be a reciprocal value provided by the state government. The terms of the contract had already been concluded before Dr Kaine’s arrival in Nigeria and the making of that undertaking. It therefore follows that the promise to refund was not based on any additional value to be provided by the state government. Merely extracting a promise afterwards is an attempt to rely on past consideration, which unfortunately, is not enforceable.

In the case of Bendel State v. Okwumabua, which had similar circumstances, Justice Uwaifo declared that “the best that can be said of the so-called undertaking given by the defendant in reply to the request is that it was a subsequent promise. The question is, as regards this promise, what was the consideration for it to make it a binding contract? In my view, there was no consideration.”

Finally, it may be the opinion of some, that for costs incurred in a transaction, there should be commensurate value returned. In other words, the consideration received must be adequate. In this situation, the state government considered that the doctor’s service for one year would be the right compensation for their expenses. Nevertheless, in the absence of fraud, duress or misrepresentation, the courts will not question the adequacy of consideration. Neither will they declare a contract invalid because one party got a better deal than the other.

Dr Kaine is well within his rights to resign, having fulfilled the terms of his contract by taking up the employment. In the words of Justice Kalgo, “once consideration is of some value, in the eye of the law, even the courts have no jurisdiction to determine whether it is adequate or inadequate.”

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

Managing director of Mopson Pharmaceuticals Limited, Pharm. Michael Paul, has urged pharmacy students in Nigerian tertiary institutions to take active interest in pharmaceutical manufacturing after graduation.

Addressing final year students of the Faculty of Pharmacy University of Lagos (UNILAG) during the maiden edition of practice grand rounds, organised by the Nigeria Association of Pharmacists in Academia (NAPA), on 27 February, 2004, Pharm. Paul said he was saddened by the fact that after almost 50 years of training pharmacists, the Nigeria pharma manufacturing was yet to get it right.

“By now we should have young Nigerian pharmacists who can make syrup and capsule with ease. What do we get instead, Nigerians importing just anything! Are we saying Nigerians can’t produce ordinary antacid?” he queried.

The Mopson boss wondered why foreign brands were made to look more superior to local products, adding that it was funny how people hoped to run away from their own creation.

While admonishing the gathering not to give up on the dream of a viable pharmaceutical manufacturing sector, the pharmacist admonished that people should be proud of made-in-Nigeria products.

A Fellow of the Pharmaceutical Society of Nigeria (PSN), Paul also berated the overzealous nature of fresh pharmacy interns who only focus on how much they can earn instead of garnering industrial experience and contributing to the growth of the profession with passion.

While describing such practice as unethical and detestable, Paul said that he had observed that most interns were in the habit of demanding to be paid N100,000.

“Where is that coming from? Listen to me, as young pharmacists, what you need is the industrial experience, especially if you are interested in going into manufacturing. It is achievable! Let me be frank with you, I started with Mist Mag after leaving the industry as a sales rep.

“Today there is nothing in BPC (British Pharmaceutical Company) that I cannot produce. If you ask me, that should be an achievement for any pharmacist,” he said.

The 2015 NAPA-organised practice grand rounds for pharmacy students in 300, 400 and 500 levels was the inaugural edition.

In attendance were Pharm George Okon, zonal chairman, Eti-Osa branch of the Association for Community Pharmacists of Nigeria (ACPN); Dr Chikezie Amadi, a consultant cardiologist with the Lagos University Teaching Hospital (LUTH); Prof. Oluwakemi Odukoya, dean, UNILAG Faculty of Pharmacy; and Pharm. Oluwatosin Adeyemi, chairman, Lagos branch of NAPA.

Others were Pharm. Bamisaye Ogawaluja, NAPA vice chairman; Pharm. (Mrs) Fatima Ikolaba, treasurer; Pharm (Mrs) Ogochukwu Amaeze, financial secretary; Dr Chukwuemeka Azubuike, staff adviser and Pharm. Joseph Oiseoghaede, secretary.

In what appears to be a challenge in the fight against malignant diseases, a senior lecturer in the Faculty of Pharmacy, University of Lagos has raised the alarm over astronomical rise in the incidence of breast cancer in the country.

Addressing health care professionals at the Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos on 4 February, 2015, Dr Arinola Joda told a bewildered audience that cancer had become a major cause of suffering and death around the world.

In her presentation during the Mandatory Continuing Professional Development (MCPD) programme for pharmacists, which also coincided with World Cancer Day, the pharmacist explained that a report she got from a recent survey of population-based cancer registries in Nigeria showed that the age group most commonly affected by cancer in men is 65 years and above, while in women, cancers are commonly seen between those between 45 and 55 years of age.

“Unfortunately, the study also showed that there has been a 100 per cent increase in breast cancer incidence in Nigeria over the last decade” she said.

According to Joda, malignant disease, cancer and neoplasia are all general terms used to describe the uncontrolled multiplication of cells that have become insensitive to the normal growth control mechanisms.

The pharmacist also warned that women who drink alcohol stand a risk of having breast cancer, adding that the risk is heightened by the amount of alcohol consumed.

“Women who take two to five drinks a day increase their risk by one-and-a-half, when compared to women who do not drink alcohol. One drink a day only slightly elevates a woman’s risk. Secondly, having a mother, sister, or daughter with breast cancer doubles your risk of the disease,” she stressed

Dr Joda however opined that pharmacists had major roles to play if they were to make a difference. In her view, these roles include identification and referral services, drug management (selection, storage and stocking, supply and dispensing), refill services, drug counselling and advice and patient counselling. Others are medication adherence, identification of drug interactions, liaison with patients/ other healthcare providers, pharmacovigilance services and identification of drug therapy problems.

It would be recalled that, in 2012, the then Minister of Health, Professor Onyebuchi Chukwu, disclosed that data collected from 11 federal tertiary hospitals by the National System of Cancer Registries showed 7,000 new documented cases of cancer, which corresponded with the average estimated 100,000 new cases of cancer reported in Nigeria annually. From data available, 60 per cent of cancers occur in women and 39.8 per cent in men. Experts have predicted that by 2020, the number of cancer patients in Nigeria will rise from 24 million to 42 million (90.7/100,000 and 100.9/100,000 in men and women respectively). It is also feared that by same 2020, death rates from cancer in Nigerian males and females may reach 72.7/100,000 and 76/100,000 respectively.

According to the National System of Cancer Registry, the five most common cancers affecting Nigerian men are prostate, colorectal (large intestine), lymphomas (lymph nodes), liver and skin cancers; while in women, the most common cancers are cancers of the breast, cervix, ovary, lymphomas and skin. It is documented that the commonest cancers in Nigerian women – breast and cervical, which constitute 60 per cent of all cancers affecting Nigerian women – are either preventable or curable if detected early, even with the facilities available in Nigeria. He lamented, however, that the behaviour of many Nigerians has contributed to hindering successful treatment of cancer.