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Discovering your inward strength

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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

SKG rewards trade partners launches four new products

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Foremost pharmaceutical company, SKG Pharma Limited, recently held its annual Trade Partners Conference and Awards to appreciate its customers’ loyalty and reward them for businesses transacted with the company in the year 2014.

L-R, Pharm. Okey Akpa, MD SKG Pharma, Peter Bankole, Director of Enterprise Development Centre, Pan-Atlantic University Lagos, Guest Facilitator and Mrs Pat Lloba, General Manager
L-R, Pharm. Okey Akpa, MD SKG Pharma, Peter Bankole, Director of Enterprise Development Centre, Pan-Atlantic University Lagos, Guest Facilitator and Mrs Pat Lloba, General Manager

The annual conference, held at the De-Renaissance Hotel, Ikeja, Lagos, also witnessed the launch of four new products, comprising SKG Rexifen, a 400mg Ibuprofen capsule; SKG Galways 100mg vitamin C drops for newborns up to 12 months old; SKG Novadex Paracetamol 100mg BP drops (sugar-free) for newborns up to 11 months; and SKG Novavite Multivitamin 15ml drops for newborns up to 12 months.
Speaking with newsmen at the event, Managing Director of the company, Pharm. Okey Akpa, said the trade partners forum was meant to appreciate their clients and also get feedback from them about the performance of the company.
“The first thing we gain from this conference is customers’ loyalty,” Akpa said. “Celebrating our customers every year is part of our scheme to retain loyalty. For us, loyalty is a two-way thing; we remain loyal to them, and they are loyal to us.
“The second thing is quality feedback because they (the trade partners) are the bridge between us and the rest of the channels, right down to the consumers. Speaking to them enables us to get quality feedback, without which the business is at risk. So, we see this as a very important occasion where we interact and chart the way forward for the organisation.”
Speaking further, Akpa who is also chairman of the Pharmaceutical Manufacturers Group of the Manufacturers Association of Nigeria (PMG-MAN) appealed to the incoming federal governmentto focus on local drug manufacturing as an avenue to improve Nigeria’s degenerating health care sector, adding that local manufacturing remained one way through which fake drugs could be stamped out of the country.
“That is why manufacturing companies like us (SKG Pharma) are critical to a successful healthcare system. A country like Nigeria with over a 170 Million people cannot but produce. Without production, you cannot guarantee supply; without supply, you cannot guarantee access to drug; and without access to drug, health care system is in jeopardy,” Akpa said.
Also speaking at the conference, Director of Enterprise Development Centre, Pan-Atlantic University, Lagos, Mr Peter Bankole, urged the partners to create value in their services and make a difference in the industry, noting that this would distinguish them from their competitors.
Bankole who explored the topic, “Entrepreneurship”, challenged his audience on the necessity of constantly expanding their knowledge base, citing it as a major way to expand their businesses. He also counselled on the need keep away from business pitfalls, such as unnecessary price reduction and extravagant spending.
The facilitator further advised SKG customers to remain loyal and committed to the organisation, adding that, having been promoted from the level of customers to partners, they should abide by the values of the company, in all ramifications.
The highlight of the event, which was attended by SKG trade partners from all parts of the country,was the presentation of awards and gifts to deserving distributors in various categories. In the national category, Jonaco Pharmacy, Onitsha, won the Best National Distributor Award, while Simba Pharmacy and Eternity Pharmacy came second and third respectively.
The distributors, who were obviously delighted by the company’s initiative, took turns to testify to the quality of SKG products, as well as its relationship with distributors and customers.
Commending SKG Pharma, Mr. Chizoba Oleuku Okeke of Jonaco Pharmacy could not hide his joy at the honour bestowed on him by the company’s management. The grand award winner thanked SKG Pharma for helping him grow his business.
“SKG looks out for its distributors and makes sure they grow along with the company; no one is left behind and I intend to remain in the SKG family” Mr Okeke said, as he lifted his golden trophy.

Finding strength within yourself (Success)

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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

How to control asthma

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Asthma or bronchial asthma is a disease condition that occurs when there is an obstruction of the airways that carry air to and from the lungs, or when there is a swelling or an inflammation of the airways and hyper-responsiveness. This results in asthma symptoms, such as coughing, wheezing, shortness of breath, and chest tightness. If it is severe, asthma can result in decreased activity and inability to talk.

A consultant chest physician, Professor Greg Erhabor of the Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile-Ife, has stated that no fewer than 15 million Nigerians are suffering from asthma.

Identifying the rise in western lifestyle and lack of preventive measures as key factors in asthma upsurge, the expert noted that the disease had become widespread, claiming the lives of several Nigerians.

Erhabor, who is the president of the Asthma and Chest Care Foundation, a non-governmental organisation, however decried government’s attitude towards the management of the disease, noting that the Nigerian government was not doing enough in curbing its spread, diagnosis and treatment.

Stressing that successive administrations in the country had only concerned themselves with eradication of communicable diseases while neglecting non-communicable diseases, the chest specialist urged the three tiers of government in the country to set aside funds for the prevention and care of chest-related problems among Nigerians, as well as recruiting more experts in chest-related conditions who would be in charge of prevention and cure of the diseases.

Addressing a forum organised by the Nigerian Thoracic Society (NTS) in commemoration of World Asthma Day on 5 May 2015, in Lagos, President of the society, Prof. Peters Etete, urged asthmatics to work with their doctors, adding that asthma should not be a limit to anyone’s lifespan, in as much as death from it was controllable.

He however lamented the alarming death rate attributed to the disease, due to lack of education on the condition.

“Despite the availability of different asthma drugs, a significant number of asthma patients are still limited with their asthma, while a sizeable number die from the disease. An estimated 75 per cent of hospital admissions for asthma, and about 90 per cent of the deaths are avoidable. Nigeria has lost many gifted and illustrious sons and daughters prematurely due to asthma. This should not be so.

“This underscores the theme of this year’s WAD, “You Can Control Your Asthma.” More than 75 per cent of asthmatics do not achieve control. The underlying reason for causes of this is inadequate education. There is need for strong patient education that though their asthma may not be cured, it can be controlled; they can live optimally well with no limitation in spite of the asthma,” he stressed.

Describing the ailment as being heterogeneous, that is, originating outside the body, from another individual or species, Etete noted that asthma was one of the most common chronic lung diseases affecting approximately 400 million people worldwide and one which the patients had to deal with on daily basis. He disclosed that around 15 million people in Nigeria were suffering from the ailment; a figure, which he further revealed, could rise with increased urbanisation and uptake of western lifestyle.

He further listed environmental pollution as a factor that could trigger asthma exacerbations. Others include diet and low maternal level of Vitamin D during pregnancy, which subsequently has impact on the child.

Environmental factors, according to Etete, include cigarette smoke, pollution of the atmosphere, and climate change. He called for patient education, which should be focused on appropriate use of controller medications and discourage injudicious use of relievers which are often abused.

Another expert with the Massey Street Children Hospital, Dr Cecilia Abimbola Mabogunje, has stated that there should be a management plan tailored specifically for each child suffering from asthma, such that they are adequately catered for when there is an attack.

“Schools need to be enlightened and empowered to help children with asthma. It is not a death sentence, it can be controlled. There should be a rescue plan in place for acute episode,” she noted.

 

What is asthma attack?

An asthma “attack” or episode is a time of increased asthma symptoms. The symptoms can be mild or severe. Anyone can have a severe attack, even a person with mild asthma. The attack can start suddenly or slowly. Sometimes a mild attack will seem to go away, but will come back a few hours later, and the second attack will be much worse than the first. Severe asthma symptoms need medical care right away.

During an asthma attack, the lining of the airways in the lungs swells. The muscles around the airways tighten and make the airways narrower. All of these changes in the lungs block the flow of air, making it hard to breathe. Knowing what is happening in the lungs during an asthma attack will help you to know why it often takes more than one medicine to treat the disease.

 

What triggers asthma attacks?

The more industrialised a place is, the higher the prevalence of asthma, because areas with industrial/air pollution trigger asthma. Also, the more developed a place is, the more likely they would have a higher rate of asthma cases. For example, Lagos would be expected to have a higher rate of asthma cases than, say, a village. Also, it is believed that in cleaner environments, people are less likely to be exposed to some germs and particles that will stimulate it.

Effluents from cars and industries have also been associated with asthma. Other factors, including heredity and the person’s predisposition to allergies and certain conditions, can equally trigger an attack. For example, a person could be sensitive to infections, virus, bacteria, cigarette smoke, or certain types of food, drugs, a change in weather from cold to hot and vice versa. Some can also react to psychological factors.

What are the symptoms of asthma?

The most common symptom is wheezing. This is a scratchy or whistling sound when you breathe. Other symptoms include:

  • Shortness of breath
  • Chest tightness or pain
  • Chronic coughing
  • Trouble sleeping due to coughing or wheezing

Asthma symptoms, also called asthma flare-ups or asthma attacks, are often caused by allergies and exposure to allergens such as pet dander, dust mites, pollen or mould. Non-allergic triggers include smoke, pollution or cold air or changes in weather. Asthma symptoms may be worse during exercise, when you have a cold or during times of high stress.

Children with asthma may show the same symptoms as adults with asthma: coughing, wheezing and shortness of breath. In some children, chronic cough may be the only symptom.

If your child has one or more of these common symptoms, make an appointment with an allergist / immunologist:

  •    Coughing that is constant or that is made worse by viral infections, happens while your child is asleep, or is triggered by exercise and cold air
  • Wheezing or whistling sound when your child exhales
  • Shortness of breath or rapid breathing, which may be associated with exercise
  • Chest tightness (a young child may say that his chest “hurts” or “feels funny”)
  • Fatigue (your child may slow down or stop playing)
  • Problems feeding or grunting during feeding (infants)
  • Avoiding sports or social activities
  • Problems sleeping due to coughing or difficulty breathing

Patterns in asthma symptoms are important and can help your doctor make a diagnosis. Pay attention to when symptoms occur:

  • At night or early morning
  • During or after exercise
  • During certain seasons
  • After laughing or crying
  • When exposed to common asthma triggers

 

How is asthma diagnosed?

An allergist diagnoses asthma by taking a thorough medical history and performing breathing tests to measure how well your lungs work. One of these tests is called spirometry. You will take a deep breath and blow into a sensor to measure the amount of air your lungs can hold and the speed of the air you inhale or exhale. This test diagnoses asthma severity and measures how well treatment is working.

Many people with asthma also have allergies, so your doctor may perform allergy testing. Treating the underlying allergic triggers for your asthma will help you avoid asthma symptoms.

 

 

 

How important is early detection and treatment?

It is very important because if not treated early, asthma could damage the lungs. Inflammation means there is redness and swelling in the lungs. If the inflammation is not controlled, it could lead to what is called the remodelling of the airway. The airway could be damaged permanently if the problem is not addressed properly.

 

How can one prevent or control triggers?

Here are some common triggers and the actions you can take to control them. Controlling your triggers will help you have fewer asthma symptoms and make your asthma treatment work better.

 

Foods

Sulphites and sulphating agents in foods (found in dried fruits, prepared potatoes, wine, bottled lemon or lime juice, and shrimp), and diagnosed food allergens (such as milk, eggs, peanuts, tree nuts, soy, wheat, fish and shellfish) have been found to trigger asthma.

 

How to control it

  • Wear a medic-alert bracelet that identifies your food allergies
  • Carry injectable epinephrine to provide first aid during an emergency allergic reaction, see your doctor for more information about this. Did you know children can carry their asthma and allergy medications while at school?
  • Read food labels closely to avoid eating hidden triggers

Pollen

Pollen are tiny particles produced by trees, grasses, weeds, and flowers. They are carried on the wind or by insects, and can cause asthma attacks. Air pollution can also cause asthma attacks.

  • Use air conditioning, if possible, during seasons when pollen is highest.
  • Keep windows closed during seasons when pollen is highest.
  • Consider staying indoors during the middle of the day and afternoon when the pollen count is highest.
  • If you are outside when the pollen count is high, it might help if you wash your hair before you go to bed.
  • Check the air indexes, and avoid going outdoors when the pollution or pollen counts are high.

 

Avoid the following indoor/outdoor pollutants and irritants:

  • Wood-burning stoves or fireplaces
  • Unvented gas stoves or heaters
  • Other irritants (e.g., perfumes, cleaning agents, sprays)
  • Volatile organic compounds (VOCs) such as new carpeting, particle board, painting
  • Newly manufactured materials found in floor, wall, and ceiling coverings and furniture have strong odours. Odours from glues, paints, or treatment processes give off chemical irritants, including volatile organic compounds (VOCs). This is called off-gassing.

 

  • Air out new materials in areas with plenty of ventilation
  • Maintain floor, wall and ceiling coverings properly

 

Asthma and pregnancy

During pregnancy, asthma symptoms will worsen for about one-third of all women. Symptoms may be most severe between weeks 29 and 36 (about the seventh to the ninth month) of pregnancy. Asthma symptoms such as coughing, chest tightness, wheezing, and shortness of breath can keep your baby from getting enough oxygen to grow well. A good rule of thumb to remember is, if you are feeling short of breath, your baby will be feeling it much more. If your asthma isn’t under control, your baby could be less healthy and smaller when born, or could even be born too early. But these things don’t need to happen because of asthma.

Asthma can be controlled so that it doesn’t hurt your baby or you. Here are the steps you can take to control your asthma and protect your baby:

Work with your doctor and other health care providers.

Go over your Asthma Action Plan to make sure it is right for you as your baby grows.

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  1. Keep your appointments.
  • Write down all the questions you have before each visit. It helps you remember to ask them all.
  • Tell your doctor about any wheezing, coughing, or shortness of breath that you have.
  • Tell your doctor if you notice any changes in your asthma or breathing patterns
  • Tell your doctor any concerns you have about your medicines or the other parts of your Asthma Action Plan.
  • Make sure you know what your doctor or asthma educator wants you to do before you leave the office.

 

  1. Take your medicines.
  • Follow the directions exactly in your Asthma Action Plan about when to take your asthma medicines and how much of each medicine to take.
  • Don’t stop taking your asthma medicines unless your doctor tells you to.
  • Talk to your doctor before you take ANY new medicines, herbal treatments or over-the-counter drugs (those that you choose yourself at the store, such as headache, cough, or cold medicine).

Remember: Using asthma medicine during pregnancy is much safer than letting your asthma get out of control. Such asthma medicines as inhaled beta-agonists (quick relief medicines like Maxair or Proventil), cromolyn (medicines that prevent triggers from causing reactions in your lungs, like Intal), and inhaled steroids (long-term controller medicines like Flovent) are safe for pregnant women when you take them as directed by your doctor.

 

  1. Watch your asthma and treat symptoms fast.

Pregnancy is a time of change. Your asthma can get worse, better, or stay the same. If this is your first pregnancy, there is no way to predict what will happen with your asthma. If you have been pregnant before, your asthma is most likely to change—or not change—the same way it did with your last pregnancy. It is very important for you to watch your asthma closely.

  • Use a peak flow meter each day, if told to by your doctor, so you can see changes in your asthma and act early.
  • Know how to tell if your asthma is getting worse. Make a list with your doctor or asthma educator of the ways you can tell if your asthma is getting worse.
  • Make an Asthma Action Plan with your doctor for dealing with any sign or symptom that your asthma is getting worse. Make sure you know how to use it, and get a new one if there are changes in your asthma treatment.

 

  1. Stay away from your asthma triggers.

Your asthma triggers are those things that make your asthma worse. House dust mites or damp places, animals, tobacco smoke, and very cold air are some examples of asthma triggers. You can stay away from some triggers. For other triggers, you can take action to keep them from starting your asthma. See our complete list of triggers and learn about how to avoid or reduce contact with them.

 

  1. Do not smoke or stay around people who smoke.
  • Cigarette smoke makes it more likely that you will have asthma episodes.
  • Smoking during your pregnancy makes it more likely that your baby will be born too early and too small. Your baby is more likely to be sick more often, too.
  • If babies breathe in other people’s smoke, the babies’ lungs will not grow and work as well as they should. The baby is likely to have more colds and earaches.
  • When babies live with people who smoke, they have a greater chance of developing asthma.
  • If you smoke, now is the time to stop! Your health care provider will help you. Ask about it now, and find more on second-hand smoke and quitting.

 

Asthma and Exercise

Anyone exercising hard enough may have shortness of breath. But when this happens sooner than expected, or happens along with other symptoms such as chest tightness, wheezing, or cough, then it may be asthma.

Exercise is a common trigger of asthma. The terms “exercise asthma” or “exercise induced asthma” are often used, but these are some common ways that exercise makes asthma worse:

  • Exercise sometimes makes asthma symptoms worse in someone who does not usually need asthma medications (Intermittent Asthma)..
  • No matter which way it happens, breathing may be even harder when the air is colder and drier. At rest, breathing through the nose warms and humidifies (moistens) the air taken in. During exercise, breathing faster through the mouth lets air that is colder and drier than usual into the lungs. The colder and drier air can trigger symptoms like coughing and wheezing.
  • Once the airways are triggered the airway lining may begin to swell (inflammation), smooth muscle bands around the airway can tighten (bronchospasm), and extra mucus can be made. The swelling, tightened muscle bands, and extra mucus can partially block the airways. This makes it harder to get air in and out of the lungs. The exact way this happens may be different in traditional asthma compared to Exercise Induced Airway Narrowing.
  • Activities like long-distance running, hockey, and cross-country skiing are more likely to trigger symptoms because they are held in cold temperatures or have the player working hard for longer amounts of time. Activities like walking and swimming are less likely to trigger symptoms because players use short bursts of action mixed with breaks, or are done in warmer and more humid places.

 

How to prevent symptoms during exercise

There are things that can be done to help prevent symptoms with exercise. Start with a warm up period of light activity before any harder exercise. Avoid exercising in cold and dry air. Avoid exercise when other triggers, such as respiratory infections or smoke, can cause more trouble breathing.

The goal is to be able to exercise without symptoms. Most people with asthma can take part fully in sports or be as active as they would like to be. They need to work with their health care provider and follow their Asthma Action Plan to be able to do this.

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What are the treatment options for asthma?

There is no cure for asthma, but symptoms can be controlled with effective asthma treatment and management. This involves taking your medications as directed and learning to avoid triggers that cause your asthma symptoms. Your allergist will prescribe the best medications for your condition and provide you with specific instructions for using them.

  • Controller medications are taken daily and include inhaled corticosteroids (fluticasone (Flovent Diskus, Flovent HFA), budesonide (Pulmicort Flexhaler), mometasone (Asmanex), ciclesonide (Alvesco), flunisolide (Aerobid), beclomethasone (Qvar) and others).
  • Combination inhalers contain an inhaled corticosteroid plus a long-acting beta-agonist (LABA). LABAs are symptom-controllers that are helpful in opening your airways. However, in certain people they may carry some risks. LABAs should never be prescribed as the sole therapy for asthma. Current recommendations are for them to be used only along with inhaled corticosteroids. Combination medications include fluticasone and salmeterol (Advair Diskus, Advair HFA), budesonide and formoterol (Symbicort), and mometasone and formoterol (Dulera).
  • Leukotriene modifiers are oral medications that include montelukast (Singulair), zafirlukast (Accolate) and zileuton (Zyflo, Zyflo CR).
  • Quick-relief or rescue medications are used to quickly relax and open the airways and relieve symptoms during an asthma flare-up, or are taken before exercising if prescribed. These include: short-acting beta-agonists. These inhaled bronchodilator (brong-koh-DIE-lay-tur) medications include albuterol (ProAir HFA, Ventolin HFA, others), levalbuterol (Xopenex HFA) and pirbuterol (Maxair Autohaler). Quick-relief medications do not take the place of controller medications. If you rely on rescue relief more than twice a week, it is time to see your allergist.
  • Oral and intravenous corticosteroids may be required for acute asthma flare-ups or for severe symptoms. Examples include prednisone and methylprednisolone. They can cause serious side effects if used on a long term basis.

 

People with asthma are at risk of developing complications from respiratory infections such as influenza and pneumonia. That is why it is important for asthma sufferers, especially adults, to get vaccinated annually.

With proper treatment and an asthma management plan, you can minimize your symptoms and enjoy a better quality of life.

 

What are the types of management available for asthma patients?

There are several types. A clean environment is important and asthma occurs because the child is reacting to something. So, the first method is what is called environment manipulation, where those things the child reacts to are removed from the environment. For example, a child with asthma shouldn’t be exposed to a room with rugs because of the particles and house dust in the rug. A carpet is more advisable or something that is cleaned regularly to be free of dust.

Parents who smoke should also stop smoking in the house because it could trigger asthma attacks. So, it is important to modify the child’s environment, especially if it is not a severe case.

Also, generators should not be kept near the windows because of the smoke and heat from it. Also, an affected child can be treated with drugs. The drugs are two types; the relievers and preventers. The relievers are those that work immediately. They are given to the child to relieve them to help their airways dilate. That’s why it is called relievers to relieve that acute situation. A common drug used is Ventolin, which is in tablet, injection and inhaler forms. Its generic name is Salbutamol. There are other types of drugs for treatment and there is an international treatment guideline that every doctor is supposed to know and follow its guideline. If it is an emergency, doctors use oxygen.

The preventers are usually those that work much later. What they do, as their name suggests, is to prevent asthma attacks. Many of the preventers are long active steroids. These steroids, as well as other anti-inflammatory drugs, can decrease the symptoms of asthma. Steroids have some side effects when it is taken periodically. Both types – relievers and preventers – cannot be substituted for one. The former relieves the immediate situation so the patient does not die, while the preventers are supposed to be given so that the asthma attack does not happen later. If it is an emergency case, the doctor would have to admit the patient and give oxygen and some injections.

 

Are there particular ways to manage asthma ?

Yes, it depends on the situation. Early detection and proper treatment helps. There is what is called partnership in asthma management. In medicine, we say self treatment is not good, but this is encouraged in asthma because it helps a lot. So, members of the family must be carried along so that whenever there are any symptoms, they would know how to prescribe the drugs to the child or check the function of their lung and all that. For example, a three-year-old might not be able to use an inhaler, so there is a special device like a pipe, which the inhaler is pressed into and as the child breathes in from the pipe, he inhales the content. Some children are too young to use inhaler because there is a coordinated action of inhalation that the child may not be able to do alone.

 

Should children with asthma be involved in any form of exercise?

Yes, a child with asthma can be involved in doing exercises and outdoor activities, including football and swimming. That child can even play professional football. What should be prevented are those exercises that are intensive and rigorous and take several minutes longer than necessary without a rest period.

 

Advice to parents of asthmatics

Parents shouldn’t panic when they are told their child has asthma. Most children, by the age of six, are likely to outgrow asthma or later in life during their teenage years from the age of 13. Up to 90 per cent or nine out of 10 children will outgrow it by the time they become teenagers.

Asthma is a chronic disease, but it usually doesn’t kill people. Deaths resulting from asthma are less than one per cent. But the major problem is that people don’t follow up on treatment, they just go and buy the inhaler and that’s it. The child should be taken to the hospital for regular checkups, say every three to six months. That would help to ensure that the child does not suffer many of the problems resulting from asthma.

Asthma could affect the psychology and even growth of the child if not properly managed. But if managed and treated properly, the child can outgrow it. Again, the parents should comply with the drugs prescribed by the doctors. They should not wait until the child has the symptoms before they give the medications. They should also keep relievers drugs at home.

 

Report compiled by Temitope Obayendo with information from: American Academy of Allergy Asthma & Immunology; Asthma Initiative of Michigan (AIM), the Eagle Online and The Guardian

I was Destined To Be a Pharmacist – Akinkugbe

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Akinkugbe
Chief Olu Akinkugbe

Chief Oludolapo Ibukun Akinkugbe is a veteran pharmacist of high repute. Aside from being the oldest former president of the Pharmaceutical Society of Nigeria (PSN), he is also the founding director of Palm Chemists and was a pioneer general secretary of the defunct Nigerian Union of Pharmacists (NUP) in the 1950s. Born in Ondo town, on 5 December, 1928, Akinkugbe’s father was a renowned druggist who qualified as a chemist and druggist in 1919. In this no-holds-barred interview with Adebayo Folorunsho-Francis, the pharmacist-turned-businessman spoke on why he still cherishes pharmacy practice, the NUP face-off with the colonial government and the major challenges facing the practice today. Excerpts:

Give us a glimpse of your background in Pharmacy

I went through primary and secondary education in Ondo town and finished at Ondo Boys High School in December 1945 with a good Grade 1 Cambridge School Certificate, which qualified me for exemption from London Matriculation Examination. It was after this in the middle of 1946 that I took the entrance examination to the School of Pharmacy in Yaba, qualifying as a pharmacist in 1949. That was before my 21st birthday.

 

Tell us a bit about the experience of your first job

My first job was at the General Hospital on Broad Street, Lagos, which was the only teaching hospital for medical doctors in Nigeria as at that time. Medical students who shared the same premises with Pharmacy students in Yaba also went to the General Hospital in Lagos for their clinical courses.

After one year of working in the dispensary, I was drafted to the central medical stores with headquarters adjacent to the General Hospital. This central medical store held buffer stock for medical hospitals in Lagos area and also for drugs which required special storage and sometimes high net worth, sensitive and scheduled drugs. In addition to this, there was the main central medical store situated in Oshodi where bulk items were held. This was not only for the hospitals in Lagos but for government-owned hospitals throughout the country.

How did you manage all these positions?

At that time, there was only one central government in the country and this was during the colonial days. I shuttled between the central medical store in Lagos and the one in Oshodi and my duties included coordinating the required mix for medical stores all over the country, indexing them, and forwarding them to the crown agents in the UK who were the central buying agency of the Nigerian government. It was when I was at this job that my colleagues requested me to accept the position of general secretary of the Nigerian Union of Pharmacists (NUP) which was a trade union of pharmacists in the civil service.

 

Were you not considered too young to be a secretary of the union?

What happened then was that my senior colleague, Mr M. C. Okwudili was asked to be president and I was to be the secretary. I considered this request an honour particularly since I had spent only less than two years when the call came. One of the first functions of the NUP at that time was to request the central government to review the remuneration and other conditions of service for pharmacists.

 

What was the central government’s reaction to this development?

There was the customary resistance from the government; but when pressure from the NUP intensified, the medical department which was the controlling body at that time constituted the Abayomi Committee to review the remuneration and conditions of service of pharmacists all over the country. The chairman of the committee was Sir Kofo Abayomi, one of the most respected citizens of the country at that time. I, along with my colleagues, believed that the NUP made a successful presentation of our case before the committee which lasted a couple of weeks, at the end of which the committee recommended substantial improvement in the remuneration and conditions of service for pharmacists.

 

How did you feel being a part of the revolution?

Well, the success of that endeavour brought me into the limelight early in my career. Soon after, I decided to leave the civil service for the private sector and was offered a job just being vacated by Prince Adeyinka Oyekan, a private pharmacist who, at that time, was competing for the stool of Oba of Lagos, which he got on a second attempt.

The company which offered me the job at that time was Morrison, Son and Jones West Africa Limited, which was the representative of Burrows Wellcome, Evans Medical, Ward Blenkinsop, Lederle Laboratories and a few others. It was my duty to act as medical representative, touring the country, particularly the South-Western zone, servicing doctors both in private and public service, as well as pharmacists in

chief Olu Akinkugbe_large
Chief Olu Akinkugbe

retail and wholesale.

 

Were those companies you mentioned also specialised in ethical products or just OTCs?

Back then, Burrows Wellcome was renowned for medical products for treatment of tropical diseases like malaria, filariasis, schistosomiasis and the likes. Ward Blenkinsop & Company Limited specialised in the production of sulphonamides. Evans Medical produced many non-branded generic products for both oral and parenteral administration. Lederle Laboratories (American Cyanamid) produced antibiotic products for oral and parenteral administration. This, to me, was a transit appointment as it was my intention to start my own independent retail pharmacy at the earliest opportunity.

 

When did you eventually start your dream pharmacy?

That was in February 1952. I registered it as Palm Chemists Ltd – an incorporated company with limited liability – but did not open for business until 1 October , 1952. It was my intention to find a location on the high street of Lagos (Victoria Street). This wasn’t easy as the whole of that portion and the surrounding areas had been billed for redevelopment by the Lagos State Development Board (LADB). I finally found a location on Agarawu Street which was just off Idumagbo Avenue at the junction of Tom Jones which was on Victoria Street.

 

What made you relocate the business to Ibadan?

After waiting for two years with limited success, I decided to move to Ibadan which, at that time, had become even more cosmopolitan than Lagos because of the siting of the University College, Ibadan (Nigeria’s first university campus, now University of Ibadan). Also, the seat of the Western Region government which then included Lagos had attracted many high fliers from Lagos and the surrounding towns in the Western Region.

I managed to find a suitable location on the high Street of Ibadan (New Court Road) close to the premises of many multinational companies at that time. This was an instant success as my approach was innovative both in presentation of premises, range of stock, the courtesy of staff and good managerial skills.

 

Was the idea of studying Pharmacy a personal decision or were you influenced?

Although my father was a pharmacist, he intended another career for me which was to go into the Holy Orders (priesthood) through the roots of a secondary school teacher. As a result, once through my secondary school, I was offered a teaching job in the same school with the hope that after the Cambridge Certificate result, I would start preparation for a teaching career. But soon after the results were out, three of my elder colleagues who were recruited as teachers at the same time travelled to Lagos in search of other opportunities. My own ambition at that time was to study Medicine.

 

Why did you drop the ambition?

The problem was that science was not taught in the school. Courses like Physics and Chemistry were not taught. The closest offered in the school was Botany, in addition to Mathematics and Geography. I knew it would be difficult for me to compete at that stage to qualify for admission into a medical school without good grounding in science subjects like Physics, Chemistry and Zoology.

While still in Lagos, we heard that entrance examination into the School of Pharmacy was being held and the four of us decided to take a chance. Our applications were nearly late and we just managed to be admitted for the exams. There were only 12 places for admission that year and I was the only one among my friends to be offered admission. The other three went further to take exams for admission into higher college three months later. Two out of the three were offered admission for teaching diploma, majoring in History or Geography. Those two were later swept from higher college into the University College of Ibadan as foundation students a year later. The fourth person who wasn’t offered admission eventually had a government scholarship to study Nuclear Physics in the University of Oxford.

I was lucky to be admitted into the School of Pharmacy as I thought it would give me the opportunity to study Physics and Chemistry which would enhance my prospects for admission into a medical school. I wasn’t wrong. After completing my first year at the School of Pharmacy, I was offered admission into Trinity College, Dublin, which was the only University I applied to for Medicine. But this turned out to be an offer that I could not accept because of family and financial reasons. It was at that point that I knew that I had to complete my training as a pharmacist. I was however lucky that this disappointment offered me another opportunity to remain in a career which I eventually enjoyed.

 

What was the profession like in your day compared to today’s practice?

The practice of Pharmacy in my time had features which are no more present today. The main destination after qualification was government and the practice in government hospitals at that time was compounding medicine on biological sources in liquid form and occasionally making them into pills. Chemotherapy was just beginning and dosage forms of tablet were not common. Parenteral administrations were still rudimentary and facilities of the preparation of sterile products were not easily available. Today, the national formulary is different in many hospitals and access to branded and generic products is much easier. Things have changed.

 

How did you later emerge as PSN secretary?

Soon after I left public service and the NUP which wasn’t existing anymore, I became a member of the PSN which is an umbrella body for both pharmacists in public and private sectors. Just about a year after I left government service, I was asked to be secretary of the PSN in 1953. I was still under 25 at that time. The essential function at that time was to bring pharmacists together, socially and professionally, and also to ensure that pharmacists were kept abreast of developments in the profession.

 

What were the major controversies surrounding the pharmacy profession in your time?

At that time, the problems we had majorly were with patent medicine dealers. They were recognised by the Pharmacy Board because they gave them licence to sell over-the-counter products. However they were not allowed to stock scheduled products. But with time we found out that they were over-stepping their boundary and started to encroach on the practice of Pharmacy, like venturing into the acquisition of scheduled products which, at times, were smuggled into the country.

The problem was more pronounced with patent medicine dealers who received the backing of politicians, maybe because most of them were on their level. The struggle was with these charlatans. The fact that they were so few didn’t make it look too serious. When I was admitted to the School of Pharmacy, we were just 12 in number. We all came from different schools – some from Government Colleges (Ibadan and Umuahia), King’s College, St Dennis Memorial Grammar School, Christ the King College, Methodist College, etc. Occasionally, we had some from the Baptist Academy, too. But I presume the number of pharmacists that qualified today is in thousands, all from different universities like ABU, UNN, UNILAG, OOU, UNIBEN etc.

 

What is your view about pharmacists venturing into politics?

Politicians come from various backgrounds and have their own contributions to make. You don’t need a particular qualification to go to the House. Once you are moved to serve your people, there is no reason why you shouldn’t go. And once you are there, you cannot look at things from just a parochial perspective. You need to have a broad horizon. A successful politician is one who is not too highly specialised to the exclusion of other forms of knowledge.

 

How best do you think the issue of fake drugs and counterfeit medicine can be curbed?

We used to have only a few importers of drugs into the country. Most of them were associates or subsidiaries of the major ones in the UK. We had Pfizer (US-owned company), Evans, Boots, May & Baker, Burrows Welcome, Ward Blekinsop and others from the continent, like Roche and Sandoz. All of them brought in quality products from their home countries.

The incidence of fake drugs didn’t spring up until the last 30 years or so. Tackling it demands serious work. NAFDAC is doing well in the control of imported and locally manufactured drugs. But the more we manufacture locally under the control of NAFDAC, the less we have smuggled fake and substandard medicines. There is no reason why Nigeria cannot have many more pharmaceutical manufacturing companies than we presently have. This has to be driven, of course, by government procurement policy. It also follows that all hospitals will only use those drugs manufactured. NAFDAC will ensure that the standards are good. Several companies and people can benefit from there. I suppose the market is growing. Once there is proper regulatory administration and more inspectors, we are likely to have a sort of control.

 

What were your major involvements in pharmaceutical activities?

I worked as a hospital pharmacist, representative of retail and wholesale pharmacy and in manufacturing. I started with Vitalinks Pharmaceuticals which produced cough medicines (liquid and drops), Vicks Inhaler, Aspirin, Calamine Lotion, Dusting Powder, Anti-Malarias and Analgesics (assets now taken over by Procter and Gamble Nigeria Plc of which I was the first Chairman). I was also the Chairman of Beecham (now GlaxoSmithKline). I have also been involved in Vitabiotics Nigeria.

In academics, I was a member of council of University of Ife. I was on the faculty board of pharmacy. It is important to say that I was the fourth President of the PSN and brought international recognition to the society by being invited to serve on the Council and Executive Committee of Commonwealth Pharmaceutical Association (CPA). I was also a member of the Pharmacy Board which was then a regulatory body for the profession.

My contribution to the country is not limited only to Pharmacy but also in the field of both economy (banking, industry and communication) and education (assisted in founding institutions from primary to tertiary, serving on board of governors or as pro chancellor and chancellor of leading universities in the country with honorary degrees in Law, Science and Business Administration). I also received honours from both Great Britain and The Netherlands.

Beyond all that, I have headed many other companies. I have been a director of Barclays Bank in Nigeria and Chairman of Stanbic IBTC.   I was a founding president of the Nigeria Chambers of Commerce in Ibadan and I also brought the chambers of commerce in the commonwealth.

I have served on many commissions and committees at both federal and state levels dealing with matters of national interest and development. To this end, the Nigerian government has also deemed it fit to honour me with CON and now CFR, which I believe is still one of the highest available to citizens of the country who are not ex-officio.

 

Leadership and youth unemployment in Africa

4

A major challenge for African leaders today is youth unemployment. It is demeaning to mentally empower an individual but unfortunately make him unproductive and to create no place for him to practise the skills he has acquired. This challenge is further compounded by the often botched dreams of youth in Africa to secure employment in other countries of the world. The frustration that follows their exit from our continent, combined with their inability to secure expected kinds of job in western countries, make them easy preys in the hands of treacherous people who take advantage of their rich minds and divert them for profitability in dubious ventures.

African leaders’ failure to address youth unemployment head-on is already creating a great danger for sit-tight leaders as well as future leaders, as seen during Arab Spring. The International Labour Organization report for 2013 revealed that the weakening of the global recovery in 2012 and 2013 has further aggravated the youth jobs crisis and the queues for available jobs have become longer for some unfortunate young job seekers. Many are giving up on the job search.

The prolonged jobs crisis also forces the current generation of youth to be less selective about the type of job they are prepared to accept, a tendency that was already evident before the crisis. An increasing number of youth are now turning to available part-time jobs while others are stuck in temporary employments. Gainful employment, which was the case for previous generations – at least in the advanced economies – has become difficult to access by today’s youth.

 

Realities                   

The global youth unemployment rate, estimated at 12.6 per cent in 2013, is close to its crisis peak. As many as 73 million young people are estimated to be unemployed in 2013. At the same time, informal employment among young people remains pervasive and transitions to decent work are slow and difficult.

The economic and social costs of unemployment, long-term unemployment, discouragement and widespread low-quality jobs for young people continue to rise and undermine economies’ growth potential, while posing increased danger to leadership particularly in the African continent.

Skills mismatch in today’s labour markets has become a persistent and growing trend. “Over-education” and “over-skilling” co-exist with “under-education” and “under-skilling” with redundancy brought about by long-term unemployment. Such a mismatch makes solutions to the youth employment crisis more difficult to find and more time-consuming to implement. It is unfortunate that a lot of young people in employment are actually overqualified for the job they are doing. Society is losing their valuable skills and forfeiting stronger productivity growth that would have been achieved had these young people been employed at their appropriate level of qualification.

In developing regions, where 90 per cent of the global youth population lives, stable employment is lacking. Developing regions face major challenges regarding the quality of available work for young people. This report confirms that in developing economies where labour market institutions, including social protection, are weak, large numbers of young people continue to face a future of irregular employment. Young workers often receive below-average wages and are engaged in work for which they are either overqualified or under-qualified.

There is a price to be paid for entering the labour market during hard economic times. Perhaps the most important danger is in terms of the current distrust in the socio-economic and political systems. This distrust has been expressed in political protests such as in the Arab Spring as well as anti-austerity movements in Nigeria (the fuel subsidy crisis), Greece and Spain.

Creative and wide-ranging policy solutions are needed. Improving youth labour market outcomes requires an in-depth understanding of employment and labour market issues that are country-specific. Analysis of youth labour markets, with particular emphasis on the issues that characterise youth transitions to decent work, is crucial for determining country-specific needs and for shaping policies and programmatic interventions. These are urgently required to break the vicious cycle that keeps so many millions of youth out of education and stuck in non-productive employment and poverty.

 

Ramifications

Regional youth unemployment rates show large variations. In 2012, youth unemployment rates were highest in the Middle East and North Africa, at 28.3 per cent and 23.7 per cent, respectively; and lowest in East Asia (9.5  per cent) and South Asia (9.3  per cent). Between 2011 and 2012, regional youth unemployment rates increased in all regions except in Central and South-Eastern Europe (non-EU) and Commonwealth of Independent States (CIS), Latin America and the Caribbean, and South-East Asia and the Pacific.

Encouraging trends of youth unemployment are observed in, for example, Azerbaijan, Indonesia and the Philippines. From 2012 to 2018, the youth employment-to-population ratio is projected to decrease in all regions, except in the developed economies and European Union. The largest decrease is projected in the Asian regions, ranging from 1.1 percentage points in South Asia to 2.5 percentage points in East Asia.

In countries and regions with high poverty levels and high shares of vulnerable employment, the youth employment challenge is as much a problem of poor employment quality as one of unemployment. For instance, South Asia and Sub-Saharan Africa present relatively low regional youth unemployment rates, but this is linked to high levels of poverty, which means that working is a necessity for many young people. In India, there is evidence that youth unemployment rates are higher for families with incomes over the US$1.25 poverty rate than for those with incomes under this poverty line.

We cannot fully cover all the causes of youth unemployment but attempt will be made to cover the most important ones and implications as identified by reports.

First is the rapidly growing urban labour force arising from rural-urban migration. Rural-urban migration is usually explained in terms of push-pull factors. The push factors include the pressure resulting from man-land ratio in the rural areas and the existence of serious under-employment arising from the seasonal cycle of climates. The factors are further exacerbated by the lack of infrastructural facilities, which makes the rural life unattractive.

In addition, there is the concentration of social amenities in the urban centres. This means that the rural areas are neglected in the allocation of social and economic opportunities. Youth move to urban areas with the hope of securing lucrative employment in the industries. Oftentimes, they engage themselves in illegal deals in order to raise money to secure visas to travel out of the shores of Africa, in search of “greener pastures”. Dozens of Africans die trying to cross the sea by boat into these foreign nations.

 

Second, the school curricula in many African countries are outdated and cannot be used to impart acceptable global employment practices. Some scholars and commentators have argued that as far as the formal sector is concerned, the average Nigerian graduate is not employable and, therefore, does not possess the skills needed by the employers of labour for a formal employment. Often, this is attributed to the education system, with its liberal bias. The course contents of most tertiary education lack entrepreneurial contents that would have enabled graduates to become job creators rather than job seekers.

 

Repercussions

The continued rise of unemployment in Africa has serious implications. Our starting point is that youth have difficulty in the labour market because of identifiable – and remediable –deficits as potential valuable talent for employers. These include lack of work-relevant skills, lack of information and connections for acquiring appropriate skills, lack of experience and credentials that could get them started on an upward path, and limited opportunities for entry-level work that is career oriented.

Also, high rates of youth unemployment represent both widespread personal misfortune for individuals and a lost opportunity for critical national and global economic development. Moreover, unemployment among youth has been shown to have life-long effects on income and employment stability, because those affected start out with weaker early-career credentials and show lower confidence and resilience in dealing with labour market opportunities and setbacks over the course of their working lives.

The youth unemployment challenge is also particularly intense in the developed world. In Spain, a youth majority (51.4 per cent) were unemployed as of the third quarter of 2011, and the figure was nearly as high in Greece (46.6 per cent). The youth unemployment rate in Portugal was 30.7 per cent and in the UK 22 per cent. (“The Jobless Young: Left Behind,” The Economist, September 10, 2011).

In the developing world, high youth unemployment represents lost potential for national economic transformation, and high numbers of economically frustrated youth may contribute to social instability.Bubbling with energy and radical ideas, these youth could be used for destabilising influence by the politicians who may wish to capture power at all cost or unleash mayhem to their political opponents.

The presence of large armies of unemployed youths is a clear case of failure of leadership to utilise abundant human and natural resources in the country to create jobs that will engage the youth in productive and meaningful economic activities.Besides, the unemployed youths have become prime targets for political violence; they have been used as local militants to attack, bomb, vandalize and destroy oil pipelines, lives and properties. With this, all kinds of kidnapping including those of the political opponents their relatives have spread thus creating a general state of insecurity.

Furthermore, another implication of youth unemployment is the resurgence of urban urchins popularly called “area boys” in Nigeria. This set of unemployed youths is mostly found in urban towns and cities. These youth could be manipulated by the politicians for a mere token. These groups, besides being used as political thugs, they can also be used for activities that could undermine electoral processes, including ballot box stuffing, ballot box snatching, killing and maiming of political opponents.

In addition, there has been increase in the involvement of youths in various anti-social activities and offences as a result of unemployment. Such offences include; arson, assault, murder, abduction, terrorism, stealing, armed robbery, sex offences, unlawful possession of arms and so on. A large number of youths are into antisocial and criminal activities largely as a result of unemployment. This has the potential to destabilize and truncate the democratic processes across Africa.

 

Remedies

African governments must play their constitutional roles by creating an enabling socio-economic and political environment, as well as provision of necessary infrastructure, to make the industrial climate investment-friendly. This will attract potential investors and thereby create jobs in order to absorb the unemployed youth.

Five key policy areas that can be adapted to national and local circumstances include:

(i)  Employment and economic policies to increase aggregate demand and improve access to finance;

(ii) Education and training to ease the school-to-work transition and prevent labour market mismatches;

(iii)            Labour market policies to target employment of disadvantaged youth;

(iv)            Entrepreneurship and self-employment to assist potential young entrepreneurs; and

(v) Labour rights that are based on international labour standards to ensure that young people receive equal treatment.

 

These policies revolve around improving active employment policies – particularly for young people and other vulnerable groups, establishing social protection floors, promoting international labour standards and strengthening the coherence of economic and social policies.

In conclusion, it is essential to refer to the International Labour Organisation conference resolution in June 2012 that, to tackle unemployment, governments should:

  • Strengthen quality apprenticeship systems and other school-to-work transition programmes in collaboration with the social partners;
  • Provide career guidance and facilitating acquisition of work experience with a view to promoting decent work;
  • Support the provision of youth entrepreneurship measures;
  • Explore voluntary technical cooperation programmes, bilaterally or together with international organisations, as a means to share “best practices” in addressing youth employment;
  • Request the ILO, OECD and other international organisations to work with national institutions in order to better understand the situation of young people and implement national youth employment initiatives with the support of the social partners.

 

Essentially then, in order to combat youth unemployment on the continent, there is need for a talent-focused perspective that offers a framework and rationale for business investment, as well as taking concrete steps that will help create innovative, effective, and sustainable solutions to the challenge.LERE LEADER

Pharmacy human resources

2

Pharm-Lolu-Ojo-1It was not difficult for me to choose the topic of this lecture when I reflected on the impact of Prof. Marquis on Pharmacy education at the “Great Ife”. My conviction that “people make the difference” was strengthened and I decided to talk about pharmacy human resources.

Human resources, as defined by the Wikipedia, “is the set of individuals who make up the workforce of an organisation, business sector, or economy.” It is the most important asset of the enterprise whose value can be enhanced by further learning and development. It is the human capital that, through creative thinking, brings other resources together for appropriate deployment and engagement which will lead to the achievement of the set target.

For Pharmacy to fulfil its role in the society, we must pay adequate attention to human resources. The approach will be to look at what is considered as the proper fit, what is the current situation and what should we do to bridge the gap.

 

Global concern

There is an acute shortage of health human resources (HHR) in the world. The World Health Organisation (WHO) estimates a shortage of 4.3 million health workers, including pharmacists. The shortage is most severe in the poorest countries especially in sub-Saharan Africa. The situation was so serious that WHO declared it “health workforce crisis” on World Health Day 2006. This situation was attributed to decades of underinvestment in health workers education, training, wages, working environment and management.

There are peculiarities which vary from one country to the other. In Nigeria, a critical examination of the situation will show not only a shortage of pharmacists in particular, but a paradoxical underutilisation of the available number. A discussion on pharmacy human resources should not be restricted to pharmacists alone but must include others like the pharmacy technicians, biologists, chemists and others who are involved in one way or the other. However, the scope of this address will be limited to pharmacists only.

A good policy or strategy should be adopted to plan the human resources need for Pharmacy. The objective of the plan is to provide:

– The right number of pharmacists required within a stated period with provision for future need.

– Right knowledge(education and training)

– Right skills and competencies (expertise, proficiency).

– Right attitudes

– Performing the right tasks in the right place at the right time to achieve pre-determined targets.

 

In other words, whatever we do, we must consider each element of the objective for us to achieve the best result for Pharmacy.

 

Pharmacists’ roles

Pharmacists are health care professionals whose practice is mainly concerned or focused on safe and effective use of medication. Historically, the role of the pharmacist was to check and distribute drugs to doctors and institutions; but in modern times, this role has been expanded to include but not limited to:

  • clinical medication management, including reviewing and monitoring of medication regimens
  • assessment of patients with undiagnosed or diagnosed conditions, and ascertaining clinical medication management needs
  • specialised monitoring of disease states, such as dosing drugs in kidney and liver failure
  • compounding medicines
  • providing pharmaceutical information
  • providing patients with health monitoring and advice, including advice and treatment of common ailments and disease states
  • supervising pharmacy technician and other staff
  • oversight of dispensing medicines on prescription
  • provision of non-prescription or over the counter drugs
  • education and counselling for patients and other health care providers on optimal use of medicines (e.g., proper use, avoidance of overmedication)
  • referrals to other health professionals if necessary
  • pharmacokinetic evaluation

 

Pharmacists are often the first point of contact for patients with health inquiries and the emphasis on pharmaceutical care will involve taking responsibility for patients and their disease states, medications and management for improved outcome. The argument will be: how prepared are the pharmacists to take up this role even if the environment permits?

 

Bridging gaps

The current system of pharmacy education in Nigeria is well known to us. We are transiting from the five-year Bachelor of Pharmacy degree to a uniform six-year Doctor of Pharmacy programme. The Nigeria Academy of Pharmacy has just concluded an education summit and the outcome, if implemented, will bring the desired changes.

The possible areas of practice specialisation include:

–                                                                                                         Academic pharmacist (teaching, research, etc)-                                                                                                        Hospital pharmacist (including administrators)-                                                                                     Community pharmacist-                                                                                                                Industrial pharmacist

Each practice area also has sub-specialities like production, quality, regulatory or sales/marketing in industrial pharmacy.

The distribution of health workers in Nigeria shows a preference for urban practice which is even more glaring in the pharmaceutical sector. There are 19,559 Pharmacists in the register of the Pharmacists Council of Nigeria (PCN) but only 11,336 of this number renewed their licences in 2014.

With a population of about 170 million, Nigeria has one of the poorest “pharmacists to 10,000” population figures (less than 1). However, we shall be more concerned with the utilisation of the existing figures and not the alarm that the ratio suggests. How do we account for the 8, 223 Pharmacists that are “missing” in the PCN data? Our universities (17 of them) produced an average of 1,165 pharmacists per year (2012-2014 data). At the current rate, it will take about seven years to produce the missing number.

Again, of the 11, 336 pharmacists who renewed their licences in 2014, how many of them are actually practising Pharmacy in the real sense of it? Within the numbers that are practising, how many of them have the right knowledge, skills and attitudes and are performing the right functions or tasks at the right place and right time? These are questions that will need research-based answers.

My observation over the years has led me to conclude that pharmacy human resource in Nigeria is largely sub-optimised. The very sound education received by the average pharmaceutical scientist has not been properly translated into tangible, recognisable or widespread benefit to the system for a variety of reasons. At the government level, the issue of wages, working environment and management are negative factors limiting the professional advancement of pharmacists. This is particularly true in the hospital system. There are also the obvious gaps in the knowledge, skills and attitudes of the individuals in the profession. The capacity to fill these gaps is within our control as individuals and groups (PSN and her technical groups).

To get the very best from pharmacists in academia, the career path must be chosen very early and a practice opportunity must be created. We just have to figure out how to make this possible. It has even been suggested that pharmacy teachers should take some courses in Education as part of the drive for the right teaching knowledge. Every other practice area will also require the acquisition of the requisite skills either as part of on-the-job training or specially designed and specific training courses.

Some of the functional and behavioural skills or competencies which need to be acquired within or most probably outside pharmacy schools include but not limited to:

–     Self-development: learning continuously and developing professional potential and ability

–     Sense of urgency: creating a focused , agile, productive and fast learning system

–     Accountability for achievement: setting, communicating and committing to the critical, few and clear expectations

–     Performance with integrity: delivering on promises with organisational and individual trustworthiness.

–     Innovation and entrepreneurship: creating and sustaining competitive advantage through well-executed ingenuity.

–     Initiating action

–     Strategic thinking

–     Business management

–     Enhancing the performance of others

The list is long and cannot be exhausted in this lecture. What is apparent is that so many people do not acquire these skills either through personal negligence or the way their career path is configured which gives no room for exposure and learning.

 

Maximising potentials

We have a lot of work to do to get the best from the available pharmacy human resources and to ensure that new ones are adequately prepared to take on the challenges of the contemporary pharmacy practice. I will put this responsibility on the duo of the Pharmacists Council of Nigeria (PCN) and the Pharmaceutical Society of Nigeria (PSN). We must account for everyone and get them to fulfil their roles in the society.

There are many pharmacists out there who are more or less “economic slaves”, renting out their certificates as the only means of livelihood. There are others who are practising sub-optimally. They only have fond memories of their “hot” pharmaceutical classes and examinations, having no sellable skills or competencies. There must be rehabilitation or career renewal programmes to accommodate the “lost sheep of Israel”.

The review of the academic curriculum must put adequate emphasis on career development. As much as possible, the new graduates must be exposed to their role expectations before leaving school. They must not be allowed to be roaming the streets looking for internship placement. The task of creating new pharmacists in the mould of the late Prof V.O. Marquis should be seen as a moving target which must be hotly pursued. We owe our profession and the society a duty to build vibrant, responsible and responsive pharmacy human resources for a better health care delivery system in Nigeria.

God bless Pharmacy, God bless Nigeria.

 

(Extracts of the keynote address delivered by Dr Lolu Ojo FPSN at the Annual Prof. Marquis Memorial Lecture at the Faculty of Pharmacy, Obafemi Awolowo University, Ile-Ife on 6 May, 2015)

What controls your footsteps?

4

In my hometown, if you visit someone and meet him eating, it is believed that you are thinking well of that person. Naturally, he will invite you to join him in eating even though there was no provision for you. Whether you accept the invitation or not is not the issue; the important thing is that you arrived at the right time to meet the food.
Do you sometimes wonder how you get to a place at the right or wrong time? Do you know that someone can walk into an accident and become unfortunate while another person can walk away from a scene just before an accident? It could be a difference of minutes. Was that person who left the scene just before the accident a smarter or more intelligent person? This is a principle of life which applies generally.
The wisest king, Solomon, deeply meditated on this principle of life and made a profound statement as recorded in Ecclesiastes 9:11, “I have seen something else under the sun: The race is not to the swift or the battle to the strong, nor does food come to the wise or wealth to the brilliant or favour to the learned; but time and chance happen to them all.”
There is no doubt that there is an unseen Guide who directs people. All you need to do is to listen carefully and do as directed. You may be directed to do something that seems stupid in your own eyes but that is the right thing to do. Do it. At that moment, do not resort to your natural intelligence or wisdom. Just behave like a child and do what you are told to do.
Many of us make good plans for business, sometimes hiring the best of consultants. But no matter how good the plan may be, only God can make it work. How the business plan will turn out is clearly beyond what any consultant can forecast. That is why Proverbs 16:3 says, “Commit to the Lord whatever you do, and your plans will succeed”(NIV).
In 1979, when I started Pharmanews, I was desperate to secure advert support from the pharmaceutical industry to enable me take off. Some friends and colleagues promised support later while a few gave me the initial adverts but, expectedly no company was willing to pay until the first edition was published. However, I needed the money to publish the maiden edition to convince the companies to support me. I had a vision,but no money.
One afternoon, I remembered seeing the signboard of a pharmaceutical company at Ilupeju, but I had not been there before and did not know anybody there. But God directed my steps to that place. I signed the visitor’s slip which was sent in to the managing director. I was asked to come in. This 6-footer German warmly welcomed me as if we had met before and asked what he could do for me. I quickly shared my vision of a monthly 12-page, A3 size pharmaceutical newspaper distributed to pharmacists and doctors all over the country and asked for adverts to support it. I showed my mock-up, with spaces for adverts. He listened carefully and caught the vision immediately. He asked, “How will you send it to pharmacists and doctors?”“I will fold the copies with brown paper and post them.” “No” he replied. “Use very good white paper and I will advertise on it.”
He received the mock-up and immediately booked some premium spaces and asked me to send him the bill for May to December, to be paid in advance. Then he would retain the spaces and pay upfront every January until he decided to stop. With a cheque for the next eight months in my hand, the business of Pharmanews took off.
Proverbs 20:24 says, “A man’s steps are directed by the Lord. How can anyone understand His own way?”(NIV). I still wonder how God directed my steps to a person I had never met before to launch my business, when I could not find a relation or friend to do so for me. A loan which no bank could have granted me was indirectly given without any application.
I believe that if God gives a commission, He makes the provision. He is always seeking the person to commission and equip. The person may not be the smartest or the most capable but time and chance happen to everything.

Patent medicine vendors indispensable, says PCN

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HME PAGE

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).

Merely You Prescription drugs a.s. HD CZ

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Společnost Merely You Prescription drugs a.s. přináší na globální lékárenský trh moderní farmaceutické a parafarmaceutické produkty.
Cílem společnosti Merely You Prescription drugs a.s. je přinášet na trh vysoce kvalitní a účinné výrobky podpořené profesionálním informačním servisem poskytovaným nejen lékařům, odborníkům, specialistům v lékárnách, ale především konečným zákazníkům, kteří chtějí o své zdraví aktivně pečovat.

supply

Commissioner condemns rivalry in health sector

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Dr.-Emem-Abasi-Bassey

The Akwa Ibom State Commissioner for Health, Dr. Emem-Abasi Bassey has criticised the unhealthy rivalry in the health sector, saying it is neither in the interest of patients nor the nation’s health care delivery system.

Dr. Bassey who was the special guest of honour at the 6th Triennial Delegates’ Conference of the Nigerian Union of Allied Health Professionals (NUAHP) in Uyo, urged health workers’ unions in the country to ensure harmony among themselves for effective healthcare delivery.

The commissioner, represented by Dr Martins Akpan, pointed it out to the health workers that no meaningful progress could be achieved in the sector when there is disunity and rancour among the health unions in the country.

“As you begin deliberations today, it is important to remind you that key to providing effective healthcare to our people is the need to maintain harmony among constituent group in the sector.The current trend in the sector, which is characterised by suspicion, hostility, in-fighting and similar vices, is to say the least, not healthy for the health sector.

“Let me emphasise for the umpteenth time that maintaining harmony and team spirit among healthcare workers is a win-win situation,” he said.

 

 

Head of Novartis Pharmaceuticals David Epstein Shares His Vision for the Future

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Thinking beyond the pill – exploring diagnostic tools, digital support and data analysis to provide better care worldwide.
© 2015 Novartis Pharma AG

source

APF launches website

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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.

APF
L-R: Mr Gbolagade Iyiola, PSN, national secretary; Margaret O. Olele, corporate affairs/health & value director, Pfizer and Sir Anthony Akhimien, APF president, during the launch.

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.

Prof. Osuide at 80, eulogise by all

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Family, friends and colleagues of Professor Gabriel Ediale Osuide gathered at the Civic Centre, Victoria Island, Lagos, on Sunday, 15 March 2015, to mark the 80th birthday celebration of the pioneer pharmacologist and former Vice-Chancellor of Ahmadu Bello University (ABU), Zaria.

The colourful ceremony which featured a citation of the celebrant, presentation of gifts and goodwill messages, witnessed a massive turnout of former colleagues, pharmacists, representatives of professional bodies such as the Pharmacists Council of Nigeria (PCN) and the Pharmaceutical Society of Nigeria (PSN), relatives, friends, mentees and well-wishers.

Prof. Osuide was born on 15 March, 1935. He studied Pharmacology at the University of London where he graduated with First Class (Honours) in July 1963. He acquired his Doctor of Philosophy (Ph.D) degree in Pharmacology in the same university, under a UK Inter-University Council for Higher Education overseas scholarship.

Describing the personality of the distinguished academic, administrator and icon of the profession, Dr Ahmed Mora, dean, Faculty of Pharmaceutical Sciences, Kaduna State University (KASU), disclosed that the late Mallam Adamu Dikko, the late Mallam Peter Omar Ishaku (Pa Ishaku) and Prof. Gabriel Osuide were the three distinguished Nigerian pharmacists, who pioneered the development of Pharmacy education in Northern Nigeria and effectively in Zaria from the old School of Pharmacy, Zaria (1930 – 1940 and 1947 – 1968), to the Department of Pharmacy and Pharmacology, Faculty of Science, ABU, Zaria (1968 to 1977) and to the present Faculty of Pharmaceutical Sciences, ABU, Zaria (1977 to date).

These three teachers of Pharmacy were also reputed to have nurtured the training of pharmacists for the award of Dispenser’s Certificate, Chemist and Druggists Diploma, Pharmaceutical Chemist Diploma, Bachelor of Science (Pharmacy) degree and the present Bachelor of Pharmacy (B. Pharm) degree certificates in the last 85 years in Zaria.

Both Dikko and Ishaku had died on in 1979 and 1981, respectively, having taught Pharmacy at Diploma levels (which was the highest registerable qualification available for persons wishing to practise pharmacy profession from the colonial times to Independence and up to the late 1960s).

Prof. Osuide’s contribution to Pharmacy in the North and Nigeria generally was at the first degree and postgraduate levels and significantly at ABU, from 1968 to 1987.

One of the federal institutions where Osuide worked and indeed rose to prominence is no other than Ahmadu Bello University (ABU), from 1968 as lecturer to 1987 when he transferred his services to the University of Benin (UNIBEN), Benin City. For 19 years, he worked in ABU, and rose from being a lecturer to acting Vice Chancellor of the university.

Although ABU was founded in 1962 by the then Premier of Northern Nigeria, the late Sir Ahmadu Bello, the Sardauna of Sokoto, the Faculty of Medicine was not established until 1967. Interestingly, the first set of students to study Pharmacy at the Bachelor’s degree level, which included the present Vice Chancellor of ABU, Professor Abdullahi Mustapha, were given admission in 1970 with Professor Osuide as the pioneer Head of Department of Pharmacy and Pharmacology, Faculty of Science.

According to Mora, Professor Osuide is recognised as having significantly contributed to the advancement of Pharmacy and Medicine among the youth in the North and other parts of Nigeria. Perhaps no pharmacy lecturer in any of the Nigerian Universities has this level of acceptability and recognition.

It would be recalled that on 15 October, 2011, in a show of appreciation, the governor of Taraba State, Pharm. Danbaba Danfulani Suntai, a 1984 graduate of Pharmacy and student of Professor Osuide, commissioned a twin 250-seat capacity lecture theatre, which was built and donated to the Faculty of Pharmaceutical Sciences, ABU, by the ABU Pharmacy Alumni Association (ABUPAA) in honour of the professor.

The lecture theatres I and II were categorically named Gabriel Osuide Lecture Theatres, a name which students and lecturers of the university have fondly abbreviated to GOLT.

Reports say the theatres cost the Taraba State Government about N300 million. To date, GOLT is still recognised as one of the biggest capital investments initiated by any organ of the alumni association in the 53-year history of the university

For the record, Prof. Osuide was a pioneer of the Faculty of Pharmaceutical Sciences, ABU,   and its first dean (1970). He was the initiator of the degree-awarding faculty, first as a Department of Pharmacy and Pharmacology under the Faculty of Science of the University (1968). He later became the dean of Postgraduate School, ABU, Zaria (1982-1987); deputy vice chancellor, ABU, (1977–1979); and acting vice-chancellor, ABU (1986).

When the Drug Manufacturing Unit of the Ahmadu Bello University Institute of Health was established and commissioned in 1968 and 1970 respectively, Professor Osuide was made the head until he left the services of ABU in 1987. The facility was producing 20 commonly used tablets for ABU Hospital, as well as undertaking quality control tests for other drugs before procurement by the university. Presently it has been renamed Zazzau Pharmaceutical Industries Ltd (ZPIC), Zaria.

Prof. Osuide was also appointed the first director of the Food and Drugs Administration and Control (FDAC) department, Federal Ministry of Health (FMOH), from June to December 1992 and later re-assigned as pioneer director general (DG) and chief executive officer at the National Agency for Food and Drugs Administration and Control (NAFDAC) in 1992 where he served for eight years until 2000.

The pharmacology icon has served as external examiner for medical and pharmacy schools in the following universities: University of Ibadan (1978 & 1979); University of Nigeria, Nsukka (1977); University of Nigeria, Enugu Campus (1981); University of Benin (1976); University of Lagos (1980, 1987, 1990 & 1991); and the University of Jos (1989, 1990 & 1991).

He also acted in the capacity of external examiner for medical and pharmacy schools in Ghana, such as the University Science and Technology, Kumasi, Ghana (M.Sc Thesis, 1975 & 1976) and in Uganda, such as Makerere University, Kampala, Uganda (1978).

Osuide is one of the founding Fellows of the Academy of Science (FAS), as well as being a Fellow of the following bodies: Pharmaceutical Society of Nigeria (FPSN); Council of the World Federation of Biological Psychiatry; Nigerian Society of Neurological Science; Association of Psychiatrists in Nigeria; American Society of Biological Psychiatry; Association of Neurophysiologists of Nigeria; West African Society of Pharmacology; and acting editor, West African Journal of Pharmacology and Drug Research.

A recipient of the National Universities Commission (NUC) Award of Distinguished Professor of Pharmacy (December 2011), the retired don has trained several notable pharmacists such as Pharm. Danbaba D. Suntai (1984 graduate) Governor, Taraba State; Dr S. Z. Nuhu (1978 graduate) Deputy Governor, Niger State (1999-2007); Prof. Abdullahi Mustapha (1972 graduate) Katsina State University (now Umaru Musa Yar’adua University), Katsina; Professor E. M. Abdurrahman (M.Sc, Ph.D graduate), Kaduna State University (2006 to 2011) and Alhaji Hamza A. Sakwa (1970 graduate) Hon. Minister of Water Resources.

Others mentees are Hon. Isa B. Ibrahim (1980 graduate), Hon. Minister of Transport, Youth and Sports; Dr (Mrs) Dere Awosika (nee Okotie-Eboh; 1976 graduate); Prof. Abdullahi Mustapha (1972 graduate); Prof. U. U. Pate (1992 graduate); Prof. Ibrahim A. Yakasai (1986 graduate); Prof. E. N. Sokomba (foundation dean and one time chairman, Pharmacists Council of Nigeria (PCN); Prof. H. A. B. Coker (served as dean several times) (1976 graduate); Prof. C. O. N. Wambebe (former Dean, ABU and founding DG/CEO); Dr Ahmed T. Mora, Faculty of Pharmaceutical Sciences, Kaduna State University (KASU) (1978 graduate); Ms. Hannatu D. Kayit (1970 graduate), PCN Registrar; and Professor K. S. Gamaniel, NIPRD (DG/CEO).

Cash management and financing in health care systems

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The task of staying ahead in the health care sector requires an astute knowledge of financial systems and cash management. In addition, it is important to actively understand health care financing in Nigeria and the world over.

Dr Chidi Ukandu, at the Pharmanews clinical leadership workshop held in December, 2014 quoted Dr Glo Harlem Brundtland, former WHO DG, as saying: “systems are not just concerned with improving people’s health but with protecting them against the financial costs of illness.” He also revealed that, according to the 2000 World Health Report, for health systems to perform optimally, they must undertake four key functions, namely:

  • Provide services
  • Generate the human and physical resources that make service delivery possible.
  • Raise and pool the resources used to pay for health care.
  • Set and enforce the rules of the game and provide the strategic direction for all the different participants involved.

Health financing may be defined as the way and manner funds are collected from various sources such as government, households, businesses and donors; pooled to share financial risks across large population groups, and used to pay for health services from health care providers. The objectives of health financing are:

  • To make funding for healthcare services available
  • To ensure appropriate choice and purchase of cost-effective interventions
  • To give appropriate incentives to providers of healthcare services
  • To ensure that all individuals have access to effective healthcare service

 

In 2002, former World Bank economist, Alexander Precker, asserted that: “more than 1.3 billion people worldwide do not have access to essential health interventions, due to weaknesses in health financing and delivery systems.”

Another renowned economist also concluded in 2007, that “as many as 44 million households worldwide, or more than 150 million individuals, face catastrophic health care expenditures every year and of these, about 25 million households or more than 100 million people are pushed into poverty by health care costs.”

 

Components of health care financing

There are three components of health care financing:

  • Revenue collection
  • Purchasing
  • Pooling

 

Revenue collection is the process by which the health system receives money from households and organisations or companies, as well as from donors. Common methods for revenue collection include:

  1. General taxation
  2. Mandated social health insurance contributions
  3. Voluntary private health insurance contributions
  4. Community-based health insurance contributions
  5. Out-of-pocket payments
  6. Donations

Purchasing is the process by which pooled funds are paid to providers in order to deliver a specified set of health interventions. The principal methods of paying providers are: fee-for-service, per diem or daily payment, case payment, budget and salaries. The type of method used has implications for cost, access, quality and consumer satisfaction.

Pooling refers to the accumulation and management of revenues in such a way as to ensure that the risk of having to pay for health is borne by all members of the pool, rather than each contributor individually. Pooling enables health services to be received based on need rather than ability to pay and it removes the need to pay for health services at the point of care, thus, reducing the possibility of individuals failing to receive care because of financial constraints.

For pooling to occur, there has to be pre-payment. Pre-payment allows individuals to pay for health costs in advance, thus relieving them of uncertainty and ensuring compensation, should a loss occur. Pooling, coupled with pre-payment, enables the establishment of insurance and the re-distribution of health spending between high and low-risk individuals and between high and low-income individuals.

 

Methods of health care financing

There are five major methods for financing health care services. They are:

  • General taxation
  • Mandated social health insurance
  • Voluntary private health insurance
  • Community-based health insurance
  • Out-of-pocket payments and;
  • Donations

 

  • General taxation

This refers to both direct and indirect tax receipts collected by government to fund health care services, among other things. It is regarded as a highly efficient way for funding health care, as it ensures universal access to health care services, irrespective of the ability to pay. It is typically used where a large formal sector and relevant structures are available to collect tax efficiently and cost effectively. Many developed countries employ this method. An example is the NHS in the United Kingdom.

 

  • Mandated Social Health Insurance (SHI)

SHI is a method of health financing where contributions for health services are collected from workers, self-employed people, enterprises and the government. Collections through SHI are often mandatory and backed by a legal act. It is sometimes referred to as national health insurance when it covers the entire population within a country. Literature indicates that about 60 countries all over the world are using SHI as the predominant method for raising money for health services. 27 countries have achieved universal coverage for their populations through this method. A good example is Germany.

 

  • Community-based health insurance (CBHI)

CBHI refers to any financing system that has these common objectives: to meet unmet health needs, increase financial access to health services; to encourage the predominant role of the community in mobilising, pooling, allocating, managing and supervising health care resources. The WHO argues that in situations where government taxation is weak, formal mechanisms for social protection for vulnerable populations absent, and government oversight of the informal sector lacking, community health financing provides the first step toward improved financial protection against the cost of illness and improved access to priority health services.

 

  • Voluntary private health insurance

This refers to health insurance cover provided to individuals or groups based on an assessment of the risks they carry. It differs from social health insurance because it is usually voluntary and can be very expensive and usually not equitable.

 

  • Out-of-pocket payments (OOP)

Out-of-pocket payments refer to payments that are made at the point of accessing health services and could be in the form of direct payments to health providers, user fees or co-payments. OOP in the form of user fees and direct payments represents a major method for financing health services in low-income countries. OOP payments imply the absence of pooling. They are not sustainable; hence, are regarded as the most ineffective method for financing health services.

 

  • Donations

This refers to financial assistance from other countries, bilateral and multilateral organisations, as well as NGOs. Literature indicates that financial assistance from donors is a major source of funding for health services in low-income countries. In 48 per cent of the 46 countries in Africa, donor funding accounted for more than 20 per cent of the total health expenditure. It is not a sustainable method for financing health services.

 

Attracting funding for business

Very importantly, while we look forward to improving health care financing in Nigeria, leaders in health care must be good managers of cash for effective set-up and delivery of goods and services. Initiating businesses and sustaining them is directly linked to expertise in fund raising and cash-flow management.

At the just-concluded Pharmanews Health Care Entrepreneurship Workshop held in March, Mr Emmanuel Tarfa, presented a paper on Business Financing and Cash Management. He discussed the need for business leaders to have a clear understanding of the financial workings of the health industry.

Business financing simply refers to how a business sources for capital to fund its start-up; its operations; and its expansion/investments – acquisition of a fixed asset, distribution line etc.

Whichever option you choose from the above, the underlying issue is purpose. This is the true motive behind business financing and is usually a critical determinant of whether or not a business will attract the right kind of funding. There are broadly two sources of business funding: debt and equity.

Debt is a short or long term obligation that is required to be paid over a period of time. Its approval is not tied to the ownership of the company, except if the debt is convertible to equity, based on some agreed terms. On the other hand, equity is a certain level of ownership and control relinquished in exchange for the funds. Investors expect a certain level of return on their investments. So, how best should a business leader position his business to attract funding?

First, he must determine whether or not he actually needs funding. This is obvious when he has identified a clear opportunity and has a business case to back it up (mostly for start-ups). Second, he must choose a source of funding – debt or equity. Also, he should determine if he has what it takes to handle and pay back the loan or give investors a certain level of return on investment. This is reflected in:

  • The track record – in business or out of business;
  • The potential of the idea or opportunity, based on the market numbers;
  • The structure of the company – are you in a partnership? etc.

 

Packaging the business to look more attractive in order to access funding requires the following:

 

  • Structure – Get a management board first: You cannot afford to appear to be alone. Build a team of people who believe in your vision and can lend their goodwill.
  • Build capacity and acquire experience: You need knowledge and skills in the area of the business. Sometimes you need to begin from the basics.
  • Get a good business plan: If you cannot write one, get a professional to prepare a business plan for you, or at least the financials. Sometimes, consultants could accept less cash than you think.
  • Be patient: Raising money is a difficult and sometimes a very long process. You must be patient with your prospects and should display that calmness.

 

Furthermore, every business leader must be able to effectively pitch for funds to support his business. A good pitch must contain the business proposition – the idea, concept or actual business must have a clear value proposition, a target audience and a clear connection between the two. Also, the leader should do a market and industry analysis to show the difference between the market and industry and to determine intricacies of both.

In addition, a good pitch should state the risks and mitigation. The list of risks must be exhaustive; it should show a plan on how to deal with such threats and carefully thought-through. The financials should contain the capital requirement, the projection of financial statement (income, cash flow and balance sheet) and the financial ratios, with focus on return on investment capital.

 

Managing funds for business growth

Having successfully accessed funds, its management is very critical. Cash management refers to a broad area of finance involving the collection, handling, and usage of cash. It involves assessing market liquidity, cash flow, and investments.

There are different motives for cash management, namely:

  • Transaction motive: This refers to holding of cash to meet routine cash requirements and to finance the transactions which a firm carries out in the ordinary course of business. Cash is held to pay for goods or services.  It is useful for conducting our everyday transactions or purchases.
  • Precautionary motive: Cash balances are held in reserve for random and unforeseen fluctuations in cash flows. It is a cushion to meet unexpected contingencies such as: floods, strikes and failure of customers, unexpected slowdown in collection of accounts receivable, sharp increase in cost of raw materials, cancellation of some order of goods.
  • Speculative motive: The motive for holding cash/near-cash is to quickly take advantage of opportunities typically outside the normal course of business. Positive and aggressive approach helps one to take advantage of:
    • An opportunity to purchase raw materials at reduced price
    • Make purchase at favorable prices
    • Delay purchase on anticipation of decline in prices
    • Buying securities when interest rate is expected to decline
  • Compensating motive: The motive for holding cash/near-cash is to compensate banks for providing certain services or loans. Clients are supposed to maintain a minimum balance of cash at the bank which they cannot use themselves.

 

Today, the issue of financing and cash management remains at the front burner among leaders in the health care sector. Given the swings in the global economy, instability in price regimes, and existing government policies, there is need to maintain distinct leadership through innovative ideas and an understanding of health care financing and management.

 

  • References

Tarfa,E.(2015) “Business Financing and Cash Management.”Pharmanews Centre For Health Care Management Development, March 24, 2015.

Ukandu,C.(2014) “Health Care Financing” Pharmanews Centre For Health Care Management Development, December 3,2014

 

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All is set for the International Workshop on Health Care Leadership, Financing and Innovation organized by Pharmanews Centre for Health Care Management Development in collaborations with Aster DM Health Care Dubai. The workshop, which is scheduled for May 17-22, 2015 is designed for pharmaceutical and health care industry leaders, doctors, nurses, pharmacists and other health care personnel. Registration is on-going, be assured you will benefit immensely from this workshop.

 

 

 

 

 

 

 

 

Diabetes often misdiagnosed in children – Endocrinologist

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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.

Why PCN should obligate internship for pharmacy students – PANS president Raymond Okokoh National President, PANS

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In this exclusive interview with Pharmanews, the current national president of the Pharmaceutical Association of Nigeria Students (PANS), Raymond E. Okokoh, reveals why the Pharmacists Council of Nigeria should make Industrial Training (IT) compulsory for pharmacy students in the country. He also discloses the achievements of his administration so far, as well as some of the challenges dogging pharmacy education in Nigeria. Excerpts:
As a student, how would you assess pharmacy profession in Nigeria?
Pharmacy profession in Nigeria has attained a height enviable by other professions in the health sector. Pharmacists play a very vital role in the society. Apart from being drug experts, they also play other important roles in the society, so much that people consider them indispensable. However, there is still the misconception in some quarters that pharmacists are mere traders. This needs to be addressed so that people will know that Pharmacy is beyond buying and selling of drugs. In Nigeria, pharmacists are everywhere and in all endeavours as they fit in well into any role assigned to them due to the quality of training they get from pharmacy schools.

What, in your own opinion, are the major challenges facing pharmacy education in Nigeria?
I would say that pharmacy education is a very demanding one and requires well-equipped, standard laboratories and equipment. But there is the challenge of inadequate funding on the part of the government, which has led to some schools having substandard or inadequate equipment and teaching aids.
That aside, most pharmacy schools don’t incorporate Industrial Training into their curriculum. And this has constituted a great drawback in the learning of students and their familiarity with the practical aspect of Pharmacy. Pharmacy is a professional course and if you are not grounded in the practical side of it, you cannot practise successfully.
A Fellow of the Pharmaceutical Society of Nigeria (PSN) once told us that we should endeavour to grow from being professionals to practitioners. He said Pharmacy does not end in answering “pharmacist” as a title but that we must be able to deliver when it comes to practical and real life cases. I would therefore recommend that the Pharmacists Council of Nigeria (PCN) incorporates a compulsory Industrial Training programme in pharmacy curriculum, because, as they say, ‘experience is the best teacher’.

What do you think the government can do to improve the standard of pharmacy education in Nigeria?
I think the lecturers and deans of pharmacy schools across the country are all capable and up to the task, but the major challenge still remains lack of funds and other resources to work with. Government should ensure availability of funds for pharmacy schools so that we can start operating at par with other pharmacy schools in the world.
Our lecturers are capable, but lack of necessary equipment to work with and lack of motivation from government has always been the barrier militating against the development of pharmacy education in the country.

Let’s talk about PANS. How have you been coping financially?
Lack of funds has really dealt with my administration, especially in this period when the country is in transition of leadership. PANS has, over the years, depended on donations and support from corporate bodies and pharmaceutical companies for carrying out its activities. But this year, being an election year, things have not been easy for the PANS leadership, as all potential sponsors keep telling us to check back after the elections.
Most of our activities had to be put on hold because of lack of funds. For instance, we needed to pay capitation to the International Pharmacy Students Forum (IPSF). We also needed to upgrade our website and renew its subscription but we couldn’t achieve any of these. In fact, we have been borrowing from people to run the association and it has been demoralising. Some executives of PANS have great ideas and plans for the association but funding has been a big challenge.

Tell us some of the programmes you plan for PANS before leaving office
I’d love to start with one important programme that we have been working assiduously on, which is tagged “Neros Pharmaceuticals Tournament”. We have come up with the idea of having an Annual Sports Festival programme among pharmacy schools and the tournament will cover a period of two months. Matches will be played only during the weekends and the final match will take place during our national convention.
We have designed it in such a way that each pharmacy school will represent a particular pharmaceutical company or a pharmacy. For example, we may have a Neros Pharmaceuticals team taking on an Emzor Pharmaceuticals team and so on like that. We therefore appeal to pharmaceutical companies, as well as established pharmacies, to support us in this regard by providing sport wears and funds to any school that chooses to represent them.
Also, we are planning to have our next national convention tagged “Diversity 2015” from 9 to 16, August and the theme is “Preparing the Nigerian Pharmacy Students for Global Challenges”. So, we are in dire need of sponsorship and support so as to successfully host this year’s Annual National Convention as we call on individuals, corporate bodies and Pharmaceutical companies to come to our aid.
In addition, the African Pharmacy Students Symposium comes up in Rwanda in June this year, while the International Pharmacy Students Forum (IPSF)comes up in India, in August. It is pertinent that PANS is well represented at these conferences; so we need sponsors to assist us.
There have also been some suggestions on ways to get steady income for the association. These include establishment of a PANS Table Water factory. We believe PANS is no longer a small association and that if we own such a business venture, it will benefit us all as students. Therefore we have planned that the company will be managed by paid personnel, while the PSN regulates the affairs of the company.
PANS activities will be sponsored from the profits made from the business. Scholarships will also be awarded to pharmacy students from the proceeds. In addition, we are proposing establishing a mobile application called ipharm, which will be useful for pharmacy students as well as pharmacists who are already working. It will also be used to generate funds for the association. We therefore need partners who will sponsors these proposed projects and consequently help us solve the problem of underfunding in PANS.
Finally, what is your message to pharmacy students across the country?
This is to tell my colleagues in all pharmacy schools across the country that the profession they have chosen is not a mistake. Pharmacy is a noble and respectable profession they should be proud of; so, no matter the challenges, they should endeavour to finish well.
I also want to remind them that our profession is an honourable one; so we should never feel inferior to other students that are studying health-related courses. You are pharmacists in the making, which means you are people of honour. We must work hard so as to maintain our integrity and values.

Benefits of concentration

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Concentration, or the bringing of the mind to a centre and keeping it there, is vitally necessary to the accomplishment of any task. It is the father of thoroughness and the mother of excellence. As a faculty, it is not an end in itself, but is an aid to all faculties, all work. Not a purpose in itself, it is yet a power which serves all purposes. Like steam in mechanics, it is a dynamic force in the machinery of the mind and the functions of life.

The faculty is a common possession, though in its perfection it is rare – just as will and reason are common possessions, though a perfectly poised will and a comprehensive reason are rare possessions – and the mystery which some modern mystical writers have thrown around it is entirely superfluous. Every successful man, in whatever direction his success may lie, practises concentration, though he may know nothing about it as a subject of study. Every time one becomes absorbed in a book or task, or is rapt in devotion or assiduous in duty, concentration, in a greater or lesser degree, is brought into play.

Many books purporting to give instructions on concentration make its practice and acquisition an end in itself. Than this there is no surer nor swifter way to its destruction. The fixing of the eyes upon the tips of the nose, upon a door-knob, a picture, a mystical symbol, or the portrait of a saint; or the centering of the mind upon the navel, the pineal gland, or some imaginary point in space (I have seen all these methods seriously advised in works on this subject) with the object of acquiring concentration, is like trying to nourish the body by merely moving the jaw as in the act of eating, without taking food. Such methods prevent the end at which they aim. They lead toward dispersion and not concentration; toward weakness and imbecility rather than toward power and intelligence. I have met those who have squandered, by these practices, what measure of concentration they at first possessed, and have become the prey of a weak and wandering mind.

Concentration is an aid to the doing of something; it is not the doing of something in itself. A ladder has no value in and of itself, but only in so far as it enables us to reach something which we could not otherwise reach. In like manner, concentration is that which enables the mind to accomplish with ease that which it would be otherwise impossible to accomplish; but of itself it is a dead thing, and not a living accomplishment.

Concentration is so interwoven with the uses of life that it cannot be separated from duty; and he who tries to acquire it apart from his task, his duty, will not only fail, but will diminish, and not increase, his mental control and executive capacity, and so render himself less and less fit to succeed in his undertakings.

In the task of the hour is all the means for the cultivation of concentration – whether that task be the acquiring of divine knowledge, or the sweeping of a floor – without resorting to methods which have not practical bearing on life; for what is concentration but the bringing of a well-controlled mind to the doing of that which has to be done?

 

Culled from MIND IS THE MASTER by JAMES ALLEN

 

The process of purpose

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Your life purpose is a process. It is not a quick fix. It is not like fast food, which will satisfy your appetite but provide you with little nutritional value.

Purpose leads to greatness when you are properly connected to the Source. Jesus said, “…without me ye can do nothing.”(John 15:5). One benefit of being constantly in tune with God is that when you deviate from your purpose, He brings you back to the right track because He wants you to fulfil your destiny.

Have you ever watched a shepherd moving along his sheep? Occasionally, one or two stray away. What the shepherd does is to move a little faster to redirect the one going astray and bring it back to the fold. Our God is the Good Shepherd.

Your wrong direction may be God’s plan. He allows you to make a detour to teach you a lesson. He allowed the Israelites to wander in the wilderness for forty years for a purpose. However, when you veer in the wrong direction you will know because it is not the right way to true prosperity. If you find yourself in such a situation, retrace your steps like the ‘prodigal’ son as quickly as possible. Don’t lose your bearing for too long like a ship without a compass or sheep without a shepherd.

I had an unforgettable experience of missing my way sometime in the eighties. I was invited by the Pharmaceutical Association of Nigeria Students (PANS) of the University of Nigeria, Nsukka, for a function. From Enugu, I knew I must turn left somewhere to enter Nsukka town. I had a new car and was speeding to get to the venue in good time. Unknowingly, I had passed where I should make a left turn before I started watching out for it. After a long distance, I knew something was amiss. Therefore, I stopped and asked two men walking towards me. They replied that they didn’t understand Igbo language. I was already in Benue State.

We are all created as unique individuals in order to make a difference. Success comes from making that difference. In other words, without making a difference, there is no basis for claiming success or significance.

The pursuit of purpose is the process to fulfilling destiny. The enemy of your soul knows your purpose and constantly works to frustrate it. Deviation from your purpose results in failure which is success to the enemy. Therefore, you must be at alert. Watch and pray. “Be sober, be vigilant, because your adversary the devil, as a roaring lion, walketh about, seeking whom he may devour” (1 Peter 5:8).

The process of purpose is usually full of challenges. But you can overcome the challenges by the power of God. To fight the devil does not require tangible weapons as our soldiers use in fighting the Boko Haram insurgents. We are fighting a spiritual warfare and not a physical one. Even the so-called physical warfare is preceded by the spiritual one. 2 Corinthians 10:4 says, “For the weapons of our warfare are not carnal, but mighty through God to the pulling down of strong holds.

God is also concerned with your environment because you are a product of your environment. Your environment greatly influences your destiny. Many years ago, my good friend in the USA advised me to apply for an immigrant visa and relocate. It was a good opportunity. Many have relocated. But the question is, am I among the ones to relocate? Where am I destined to be?

There is a place one should be and a place one should not be. In Genesis 12:1 God gave a definite instruction to Abram, “Leave your country, your people and your father’s household and go to the land I will show you” (NIV.) God moved him out of Ur of the Chaldees for him to become the person he should be. If he had stayed in his own country he would have missed his blessing. In the case of his son Isaac, he was in the land of the Philistines when there was a famine and his counterparts were migrating to Egypt. But the Lord told him, “Do not go down to Egypt; live in the land where I tell you to live. Stay in this land for a while, and I will be with you and will bless you...” (Genesis 26: 2-3, NIV).

Disobedience is a great enemy of purpose. Many are not enjoying the full blessings of God because they are not obeying Him fully. Do not be like King Saul who lost his crown because of his partial obedience. God demands complete obedience from all who desire to fulfill their purpose.

National competitiveness: Creating the impossible

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Some things are impossible until they happen. One of such, I believe, would be the emergence of Nigeria as a global power with a very competitive national economy. Till then, there is no harm in discussing how best we can make things happen even when they appear impossible to many.
From a pharmaceutical industry perspective, it is the stated conviction of many others beside this author that a lot of headway can be achieved by the mutual commitment of concerned stakeholders towards specific objectives. As our nation transitions to a new leadership, it is important that we keep certain issues on the front burner. However, before we proceed to mention specific areas of intervention, it is important to mention the five pillars of successful advocacy:
A. Ability to generate and communicate evidence
B. Intra-sectorial stakeholder engagement
C. Long-term partnerships and networks
D. Sufficiency of resources
E. Ability to effectively assess risks

With the above in mind, we could progress by considering the Porter’s Diamond Model of national competitiveness. The Porter’s Diamond, developed by Prof. Michael Porter of the Harvard Business School provides a very popular tool for analysing national competitiveness.
The essential thought behind this model is that it is the interplay of these four factors in every nation that determines the level of competitiveness of a particular industry in that nation compared to other nations. Using the pharmaceutical and health care industry as our case study, a comparative assessment of the level of human and material resources (factor conditions) with that of North American nations, India and China provides useful insights.
A study also of the demand conditions (the local and neighboring markets) – the size, complexity and mobility –will provide further clues and then the character of the supporting industries and the nature of the firms – their set up, organization, rivalry and regulation. Improving our national competitiveness therefore can be done by interventions that target either or all of these four areas and for each area, there are different stakeholders to engage. Our focus, however, is on the pharmaceutical and health care industry.

Demand conditions
In virtually every report on the Nigerian pharmaceutical industry, a mention is usually made of the chaotic drug distributorship network. The chaotic drug distributorship network is a characteristic feature of our demand conditions that constitute an area of intervention. Also, the size of the local market which is not too large, compared to that of nations like India, China and even South Africa is an indicator of the challenges of the manufacturing sector.
Increasing the size of the local market by interventions like the NHIS-based dedication of 1 per cent of Nigeria’s revenue earnings to primary health care would result in an increased domestic demand. This demand of course would also grow with the size of Nigeria’s GDP and the rise in chronic diseases. Expanding to other West African markets can also be achieved by standardising regulatory procedures such that products registered in any West African country can be sold in member states.
An assessment of the size of the demand which is served by indigenous firms would also point to the competitiveness of the nation. An import-dependent scenario would suggest that other factors like supporting industries, factor endowments and firm structure do not support local production and vice versa or that the prevailing policies do not compel such.

Factor conditions
The brain drain syndrome is a very big challenge for Africa in general and there are no immediate signs that it is abating. For the health care industry, we do have an emergency. For example, Nigeria is 127th on the physician density ranking and Cuba is 1st(2012).
The salient fact here is that doctors work in hospitals and a low physician population implies a low hospital density which directly affects the size of the pharmaceutical and health care industry. In coherence with this reasoning, Nigeria is 166th on the global hospital bed density ranking (CIA World Fact Book, 2012).
If Nigeria were to dedicate 1 per cent of her revenues to primary health care through a NHIS structure as enshrined in the recently signed Health Bill, the figure would be in the neighbourhood of $300 Million. Assuming the entire amount was placed in a co-pay health insurance plan of N12,000 per person/annum (this is the official rate of the NHIS Adoption Tree health plan) where participants or their state government pay half the sum and the Federal government the rest. That is, at N6000 copay per person, the $300 Million would account for 10 million Nigerians.
The WHO-recommended norm is one doctor per 1,000population; hence, ideally to serve these 10 million Nigerians, we would need 10,000 medical doctors at the primary care level. At present, Nigeria has about 30,000 practising physicians, according to the Nigerian Medical Association, of which 6000 are in Lagos alone.
The point is that throwing money at the problem is good but it is not enough; we need to have more schools to train health care personnel and to create institutions where they can work. Assuming someone gives us enough money throughan insurance scheme to cover 100 million Nigerians, we would need about 100,000 doctors to meet that demand. Considering that Nigeria’s population would double by 2050 (35 years from now) and the average gestation period for training health care personnel is six years, we need a lot of pace to catch up.
Personally, I think we need to invest seriously in telemedicine to be able to maximise the number of doctors that we have without compromising on the quality of care. Besides the numerical strength of our human resources, other factor conditions like the quality of our knowledge base are another challenge. This is one area that Nigeria could gain from the diaspora community. Interventions designed to increase our human resource capacity must be made to reflect present and emerging needs.

Related and supporting industry
The pharmaceutical industry, for example, is dependent on other industries like the petrochemical industry, the agricultural industry, the financial industry, the health insurance industry, the packaging industry, the mechanical engineering industry and the power sector.A consideration of the development of these sectors, in part, informed Prof Charles Soludo’s dialogue in a paper titled, “Can Nigeria’s Manufacturing and Pharmaceutical Industry Compete?” presented to the Nigerian Association of Industrial Pharmacists in 2011. In it, he noted that the pharmaceutical industry cannot compete in a non-competitive manufacturing environment without creating islands of competitiveness.
Creating such islands of competitiveness, for example, would involve perhaps designing a special pharmaceutical fund. Note that when different aspects of an economy are seeking specialist funds, it is an indicator of the level of development of the nation’s financial industry. Fostering the supporting industries could also involve special medicinal plant projects involving the ministries of agriculture and science and technology, led by the private sector.

Firm strategy and structure
There are a lot of attempts at the moment to tweak the legislation that affect the ownership of retail pharmacies – the result of which would be greater influx of cash to this sector, resulting in the development of chain pharmacies and of a host of newcomers to the retail pharmacy space enjoyed by pharmacists at the moment.
Such decisions are for the government to make.Though this particular step will bring an immediate increase to the competitiveness of the pharmaceutical sector, it is also the belief of this author that if other issues raised in these articles are treated, the retail subsector of the Nigerian pharmaceutical industry would achieve an organic growth without major changes in legislature.
Another major concern is the intellectual property regime. The fact that Nigeria’s patent law is non-examining means that patent practitioners – individuals who should be filing patents – have not been examining existing patents to see if they can file something new. I was not a little bit surprised as a rookie research and development consultant that some of the pharmaceutical research scientists I was working with had never seen a patent document, not to talk of students in our universities. The direct result of this state of affairs is the observed low absorptive capacity of our industries. It is difficult for industry to absorb something that is not there in the first place. From experience, I know that when a research scientist sees a patent, the first comment is “I can do this.”

We can do this
In conclusion, there are so many areas of interventions within the outlined areas above. As individuals, we cannot do all of them, so we all have different areas of contribution. As a group, we can contribute to these different areas at the same time. A structured mediating centre that coordinates these activities would help in ensuring we arrive at our destination.
According to a popular Igbo adage, it is when someone wakes up that is his morning. So, I might as well conclude this piece by saying, “good morning”.

Why health businesses suffer fund shortage – Expert

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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.

WORKSHOP
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.

Intention to enter into legal relations By Dozie David Atueyi

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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

Poor health indices: Pharm. Bright seeks stakeholders’ intervention

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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.

MADAM
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.”

The first line sales manager

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This is a follow up to the earlier article, “The Medical Representative’s Manual”. The comments and the follow up questions received indicated that the discussion resonated well with the target audience. There is, therefore, a motivation to do a follow up on the middle level management.

Not much can be achieved in the field without an effective middle level management organisation. Like the Regimental Sergeant Major in the barracks or the army troop operations, the success or otherwise of the organisational sales plans depend on the attitude and work approach of first line sales managers. These managers are known by different titles, depending on the culture and size of the organisation: Area Sales Manager, Business Development Manager, Field Sales Manager, Regional Manager or just Sales Manager.

In ordinary circumstances, the title should not have any impact on the output or drive of the holder, for as long as culture of the organisation is well known to everybody. However, there have been instances where people have shown preference for or get motivated by a particular title. It should be stated clearly that the organisation reserves the right to determine whatever title is to be given to her employees.

In this piece, we will briefly examine the major responsibilities, accountability and authority of the first line sales manager. We will also discuss the key elements of sales planning, values and role modelling expectations.

 

Responsibilities of the first line sales manager

The key to success in the first line management, as it is at the other levels, is ownership. It is not uncommon to see the newly promoted or employed sales manager taking on the role of the BOSS almost immediately at the beginning of his (or her) job. In this role, he sees himself as the taskmaster or enforcer and not the task facilitator or motivator. He blames everything on the medical or sales representative in his territory. He complains without end on the incompetence, laziness and other identifiable drawbacks in his men and women.

Essentially, the first line manager is a pathfinder; he takes the lead in the battlefield. The territories in the region or area belong to him and he is directly responsible for their development. The region and the territorial targets are his responsibility and he must take ownership and be held accountable for whatever result is achieved in line with the target.

The following, in an outline form, are his major responsibilities:

*   Translate national sales plan into executable regional plan of action.

*   Submit regional plan of action revised monthly, latest by last Friday of each month. This plan includes, but not limited to, sales promotion, group detailing, customer appreciation, demand generation activities, etc.

*   Prepare a budget for regional activities and present to the direct boss for approval. This budget is to be reviewed monthly in line with target achievement.

*   Supervision, coaching and motivation of direct reports to ensure target delivery.

*   Develop, motivate, sustain and keep a list of friends in all major hospitals/pharmacies/government and its agencies in the assigned territory. This list should be reviewed with the direct boss monthly.

*   Develop, motivate, sustain and keep a list of key customers in the assigned territory. This list should be reviewed with the direct boss monthly.

*   Ensure that the representatives in the region performed their duties as assigned.

*   Ensure total and effective coverage of the region to maximise the potentials therein. No important customer should be left unattended to in the region.

*   Deliver the region target (in value and units) as set and formally communicated by the direct boss.

*   Ensure that payments for sales made are promptly collected to prevent debt accumulation.

*   Keep the total debt outstanding at not more than 10-20 per cent of the total sales at any given period.

*   Evaluate and approve representatives’ expenses in line with agreed guidelines.

*   Keep a ledger of the representatives’ transactional activities in the region. This ledger will be examined by the direct as may be required.

*   Write reports of the region activities promptly:

  1. Write a weekly sales and payment summary and submit to the direct boss on or before close of business on Mondays.
  2. Send a monthly summary of all activities in the region together with representatives’ report to the direct boss before the end of first week of each month.

iii.     Submit report on travels not more than 24 hours after event.

With the use of smart-phones and internet connection, some of these reports can be of real time delivery depending on management expectations.

*   Maximise sales and minimise cost of operation.

*   Operate a monthly float (the size and nature of which depend on the company) and submit your expense form promptly for reimbursement.

*   Manage your region as a worthy company representative.

*   Recommend, in writing, proposals for short, medium and long term activities for the development and growth of the region in particular and the company in general.

*   Participate in the recruitment of staff for the region and company.

*   Attend and contribute wisely at meetings for the growth and development of the company.

*   Identify, coach, and motivate a successor who will do your job when the need arises.

*   Be a team player.

 

Authority of the first line sales manager

In terms of authority, the first line sales manager is usually empowered to:

* Creatively exploit the potential of the assigned region.

*   Take critical and urgent decision on the spot and commit the company where necessary. The superior authority must be informed within 24 hours on the nature and magnitude of the commitment and his (retroactive) approval in writing.

*   A specific amount (or a range) can be expended above approved limit where absolutely necessary and a substantial business prospect is involved. However, a justification within 24 hours must be provided and a written approval obtained from the higher authority.

  • Deploy resources allocated to the region in line with territorial potentials.

*   Discipline, redeploy, and recommend for promotion or disengagement, any of the direct reports in consultation with the direct boss and in line with company policy.

 

The exact nature and depth of the first line manager’s authority will depend on the culture of the company and the policies which are usual contained in the company’s handbook.

In terms of accountability, the first line manager is liable:

*   To the consequences of not achieving the territorial target.

*   To the consequences of not keeping all territorial expenses (salary, operating expenses, etc) within the acceptable limit and also in line with the revenue (or cash) accruing from the territory.

*   To the consequences of non-performance, misbehaviour and any negative effects arising from the activities of his/her direct reports.

 

Planning and role-modelling

The planning role is fundamental to the success of the first line manager. As earlier mentioned, he will be actively and deeply involved in the field activities; the planning aspect of the job cannot be ignored. Managers are paid to THINK! The core elements of planning at this stage include:

*    Nature of the business: A thorough understanding of what the business of the organisation is and how the company is positioned to achieve success. The dynamics of the region or the territory is important:

*    Who are the major players (hospitals, distributors, agencies, associations, government, general trade, etc)?

*    The medical community and its stratification

*    The competition (per product)

*    People: The human capital is a fundamental factor of success. The manager must critically appraise the different sides of people under his control for:

*    Quantity and quality: How many representatives are in my region versus how many will be needed for target achievement? Are my people capable of delivering my targets?

*    Deployment: How are my people currently deployed? Do I have the right person in the right place?

*    Skill gap analysis: An analysis of the skill gap(s) is important. Where and what are the weak points per person? What can I do about it in terms of coaching, OJT (on-the-job training), classroom training or new territory exposure? How do we improve our motivational, training and development plans?

*    Working tools: Are the tools current and adequate? How are they being used? etc.

 

As a role model, the first line manager is expected to:

*    Face reality – in terms of management and leadership style, target achievement, efforts versus results and reward applied, situations that may be largely out of control, etc.

*    Be honest and straightforward.

*    Persuade through reason.

*    Walk the talk.

*    Give others a fair share of credit for the result obtained.

*    Make necessary changes before he is forced to.

*    Present himself as an influential personality and not a victim.

*    Persist in the face of opposition or tough situation.

 

Finally, possession of value-adding attributes will put the manager in a vantage position to succeed. Some of these attributes include, but not limited to:

*    Commitment

*    Teamwork

*    Accountability

*    People

*    Quality

*    Integrity

 

Dr Lolu Ojo FPSN is Chairman/CEO, Merit Healthcare Limited

Potential use of botanicals in diabetes: A review of stevia By Oluwole A. Williams, B.Sc., Pharm.D., R.PH.

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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.

 

We’re planning a bigger Sir Atueyi competition – Ugwumba

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In this interview with Adebayo Folorunsho-Francis, Samuel Lena Ugwumba, immediate past president of the Pharmaceutical Association of Nigeria Students (PANS), UNIBEN chapter, reveals why he jettisoned his Aeronautical Engineering dream for Pharmacy, the challenge of hosting a contest like the Sir Ifeanyi Atueyi National Essay and Debate Competition and how prepared the planning committee is for this year’s edition. Excerpts:

Why did you drop your dream of studying Aeronautical Engineering for Pharmacy?
My teachers in secondary school said that I was quite brilliant and had a great flair for the sciences, especially Geography and Biology. In fact, I was the best-graduating student in my school and I can remember winning many trophies for my school at quiz competitions. I stayed at home for a while because I actually wanted to study Aeronautical Engineering but when it wasn’t forthcoming, I had to change my gear to Petrochemical Engineering. That, too, didn’t work out, so before I decided to go into the medical field, I didn’t really get to hear of a course like Pharmacy because in my all-boys secondary school, we often heard of Medicine, Law and Engineering; and most of the boys opted for Engineering, in order to show off their masculinity and not to look weak, with a few going for Medicine and Law. I didn’t really like Medicine (I am yet to find the reasons) neither did I want to be a lawyer because it wasn’t among my predilections.
When my preferred courses weren’t clicking, I decided to try Medicine but, behold, I met a friend prior to our Post-UME who told me virtually everything about Pharmacy and I had to quickly make the switch that landed me in the faculty of pharmacy, UNIBEN. But it might shock you to discover that Pharmacy was actually what God had planned for me to study because, the joy I later discovered in myself outweighed what I would have found in Aeronautical Engineering. The discovery that pharmacists are truly the number one health care practitioners (a status I had erroneously ascribed to medical doctors) given the fact that all that is used to treat patients in the hospitals and everywhere is produced and certified by pharmacists, amazed me.
So, being in Pharmacy, to me, is like God’s plan and I have enjoyed every bit of the training, though it is a very demanding course that would definitely toughen anyone that chooses to study it.

What made your administration conceive the maiden edition of Sir Ifeanyi Atueyi Essay and Debate Competition?
When I started my classes and was allocated a hostel space, I was lucky to have a member of the SUG parliament by name Ugochukwu Youngbill Unachukwu, who was my room-mate. We became very close and he used to take me to some of his political meetings. I believe that was when my interest in politics was kindled. Consequently, I became a parliamentarian in my faculty; after which I went up to SUG Parliament. I had the desire of running for SUG Presidency but I went back to my faculty where I served as the Public Relations Officer (PANS PRO) before emerging as the President in a keenly-contested election with my very good friend, Egwuche Jeremiah.
All the ideas I had birthed during my SUG involvements were test-run when the pharmacy students gave me the mandate to become their president. Consequently, in our bid to appreciate our patrons for their longstanding financial and moral support, and to recognise Nigerian pharmacists who had made us proud in their different niches, we came up with the Sir Ifeanyi Atueyi National Essay and Debate Competition, among other programmes that were featured during our 2014 Legacy Health Week, including the presentation of awards of excellence to distinguished pharmacists such as Pharm Olumide Akintayo (our able PSN President), Sir Anthony Akhimien (former PSN President), Pharm Nihimetu Llai Momodu, Sir Larry Ifebigh, Chief Osadolor, Pharm Paul Enebeli, Pharms Bukky George, Adeshina Opanubi, Damian Izuka, Prof Azuka Opara, Dr (Barr) Henry Okeri (PANS UNIBEN First Legal Adviser) and other great personalities too numerous to mention.
Basically, the idea behind the National Essay and Debate Competition being named after Sir Ifeanyi Atueyi was in recognition of his fatherly role to pharmacy students across the globe and equally to immortalise him as the founder of the foremost West African health journal, Pharmanews, which he has always made available to pharmacy students across Nigeria in order to sensitise them to the limitless opportunities in the profession.
Moreover, Sir Atueyi is one pharmacist that loves students and has often displayed that through the various financial and mentorship support schemes he has rendered to pharmacy students over the years. So, naming the competition after him was apt because there’s no other Nigerian pharmacist who is into pharmacojournalism, except Sir IfeanyiAtueyi.And because pharmacy students do not give posthumous honour, we decided to do it for him now that he’s very much alive so that the general public would realise that to be good always pays.

What were the challenges you encountered in organising the event?
One thing that has always defined the difference between the limitless ideas circulating is the constancy of challenges. Challenges are always there to actually test if you believe in what you have thought up in your mind. So, organising the maiden edition of the competition was not an easy task, especially when it has to do with pharmacy terrain where every little thing must assume some measure of difficulty before it can work. But I give God the glory whose words constantly kept me in shape, mentally and spiritually, during my administration. The challenges were too many but we were able to surmount them.
Among the tangible challenges were how to get Sir Atueyi to believe that it was an honour we meant and not some kind of fund-raising spree; getting pharmacy students across the nation to send in their various essays without having to come down to UNIBEN; getting the correct examiners for the essay, and the mode of grading; encoding and decoding the various essays before forwarding them to the examiners in order to be totally transparent without giving favour to anyone; as well as providing enough accommodation and feeding for all the pharmacy students across the nation who would be coming down to UNIBEN for the debate.
The one that nearly weighed down our Legacy team was how to effectively publicise the competitions in time, so that no school would feel being marginalised and how to get them to submit the articles before the deadline. I must confess that we had to continually shift the deadline to make up for late submissions.
Time will not permit me to acknowledge all who made the programme work but I wouldn’t forget the inputs of Pharm.(Dr) Saba Andrew, to whom I entrusted everything concerning the competition, and the careful manner he went about the whole organisation.

Why the choice of UNIBEN for hosting the maiden edition?
The choice of UNIBEN for hosting the competitions is not far-fetched. First, the idea originated from UNIBEN and we needed to test-run it properly, identify and make provisions for the challenges that might be faced in organising the programme in the future, make timely, accurate and precise recommendations, package and add some global nuances into it, create an enviable brand out of it, before smartly integrating it into the programmes of the national PANS especially during annual conventions.
Additionally, we needed to give the competition the ‘Pharm.D’ touch of excellence and uniqueness, having been the only institution in Nigeria and, hitherto, in sub-Saharan Africa (before Ghana) to run the Pharm.D programme successfully. PANS UNIBEN, under my administration, saw the emergence of great speakers and writers who needed a great platform to showcase their various talents. So, the University of Benin which is central to other pharmacy schools was considered the best location for hosting the programme.

How did you raise fund for such a programme?
Well, we didn’t really encounter any difficulty with raising the funds for the competitions because Sir Atueyi took up the responsibility of providing the take-off fund. Basically, we were only involved in logistics while Pharmanews sourced for the funds.
Meanwhile, I must not fail to acknowledge the magnanimous stance of Sir Atueyi who initiated the idea of rewarding the participants, though that was not in our original plan. We had wanted it to be completely an honour without any monetary bearings. After our discussion, he requested that I draw up a proposal for the competition which I did and submitted within a week because we were very close to our Health Week, and we wanted the maiden edition to be held during the Health Week.
The proposal was meant to be submitted to companies so that they could be part of the competition and it was awesome seeing the likes of Shalina Healthcare, Greenlife Pharmaceuticals and Afrab-Chem Industries sending their representatives with overwhelming souvenirs and other corporate materials needed to make the competition a huge success. Aside that, the Pharmanews’ crew was equally around to cover the events which saw the University of Benin and the Olabisi Onabanjo University compete in the debate series since the contingent from Igbinedion University, Okada, came after the debate had been concluded.
I must also state that the short period within which the competition was organised affected the funds raised and, by extension, the prizes we had earlier budgeted for the winning participants. However, we are elated that the programmewas, to say the least, were successful,given the short period within which it was organised.

What is the plan for this year’s edition like?
Well, this year’s edition promises to be better organised than the maiden edition. Actually, we intended to integrate it fully into PANS National activities as I earlier stated; but we noticed that some grey areas needed to be clarified before packaging it for PANS National.
Also, one of the recommendations we had nursed about the programme was for its organisation to rotate among the Nigerian pharmacy schools so that each school would have the opportunity of a hosting-right, just the way PANS national secretariat moves from school to school. Actually, we have not fine-tuned all these recommendations and doing the second edition in UNIBEN will afford another chance to critically appraise the recommendations and come out with the best possible pattern of organisation.
Equally, we have begun radical sensitisation about the competitions and Pharmanews has agreed to use some of the pictures taken during the maiden edition to publicise the event. More schools are expected, especially for the debate and we are working on getting Sir Atueyi to be physically present during the second edition. We have settled the issue of accommodation and are working currently on getting a bigger venue, since we expect more schools to be in attendance.
This year’s edition will surely be the cream of the competitions. Television stations are going to be around to cover and air the event, apart from the regular crew of Pharmanews that would surely be around. On the prizes to be given out, we are reviewing upwardly the prizes for the various categories and so much more would definitely come around this time.

After school, what are your goals?
To start with, Samuel Lena is a very ambitious and goal-oriented person, always having the interest of the greater majority at heart. Having excelled in various key positions in PANS, SUG and JCI UNIBEN that culminated in my becoming the PANS President, I will definitely continue with rendering first-class services to my people after graduation. (I choose not to call it politics because of the bastardisation of the word).People should look out for my campaign posters in 2019 for Abia State House of Assembly where, with God’s help, we will be making laws that will turn around the fortunes of my state and by extension, the Nigerian society. I plan not to stop there as I believe so much that I will be the first pharmacist and Igbo man to be elected as Nigeria’s president.
Outside of politics, I plan to set up various kinds of foundations that will address the seemingly insurmountable problems bedeviling our society such as poverty, erosion of our values system and the spate of moral decadence, indiscipline and corruption; strengthening our cultural heritage, reviving our educational systems to be, at least, the best in Africa; as well as other kinds of humanitarian programmes

Sustainable Development Goals: The road ahead

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The 70th regular session of the General Assembly (UNGA 70) is scheduled to open at the UN Headquarters in New York from Tuesday, 15 September 2015. From 25 to 27 September, the summit for the adoption of the post-2015 development agenda will convene, with the aim of achieving a consensus among member states on the modalities for achieving the Sustainable Development Goals (SDGs).

In the full report of the Open Working Group of the General Assembly on Sustainable Development Goals, the group stated that the SDGs build on the foundation laid by the Millennium Development Goals (MDGs), while equally responding to new challenges. The SDGs constitute an integrated, indivisible set of global priorities for sustainable development. Targets are defined as aspirational global targets, with each government setting its own national targets guided by the global level of ambition, but taking into account national circumstances. The goals and targets integrate economic, social and environmental aspects and recognise their interdependence in achieving sustainable development in all its dimensions.

For Africa, which comprises mostly developing nations, the vision of the UN, though compelling, would be one that calls for a new way of thinking in development practices.The focus on sustainability in this new course of action would influence how development projects are financed, the conditionality for donor funding, trade practices that relate to climate change, environmental protection and a greater focus on global partnerships and influence.

One of the shortcomings of the MDGs was that,while they were successful in generating global concern and financial commitments from developed nations at an unprecedented scale, they failed in dealing with the internal operations of donor recipients.Simply put, while they helped generate a lot of money, it was obvious that the answer to the world’s problems was not just money – developing nations have to be competitive, and developmental plans have to be sustainable. That is the new language at the United Nations – achieving sustainability and global partnerships.

Apart from the issue of a greater focus in the internal operations, another focus is the thorny issue of climate change. We say climate change because of the practical ramifications of a global focus on reducing pollution. For fossil fuel-dependent nations like Nigeria, “sustainability” in this case would include issues like reduced carbon emissions, reduced global demand for crude oil, as well as increased focus on alternative energy and the likes.

The United States, at the end of 2014, had over 20GW of cumulative solar electric capacity, roughly the same amount that is expected to be installed from 2015 to 2016. In Germany, solar and wind energy sources combined generated about 15 per cent of the country’s energy in 2014.Even in developing nations like India, the targets for renewable energy sources are quite ambitious – the country plans to add about 100GW of solar power capacity by 2020, which is five years from now.

Considering that Nigeria currently has less than 5GW of total electricity capacity, one begins to get an idea of the size of the changes already made. These developments, to us, constitute the language of sustainable development and it is hinged on global partnerships focusing on environmental protection. Our concern is whether Nigeria and the rest of Africa are prepared for such ramification of development.

Our concerns aside, it is worth noting that eradicating poverty and hunger are some of the chief targets of the SDGs (Goals One and Two); same as the promotion of healthy lives and wellbeing (Goal Three). However, achieving environmental protection and sustainable economic development constitute the greater bulk of the proposed 17 Goals. For us, in the health care industry, we must prepare for a greater focus on national health insurance. Similarly, the in-coming government in Nigeria must know that the country’s health targets – which are in line with the global agenda on health – would only be achievable through the instruments of a well thought-out health insurance system. The one per cent dedication of consolidated revenue to primary health care, as enshrined in the new National Health Law, has already set the pace for this.

Our expectation, from the changing tide of international development, is that there would be decreased tolerance for non-performance by the global network of leading nations, taking a cue from the operations of the European Union. We envisage increased influence on national political and economic processes for established powers. This is a challenge to Nigeria to rise as one of the global mediators of good governance and development practices in Africa. To effectively do this, she must seek to be self-sustaining in a “sustainable” world.

How to manage hypertension

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Hypertension or high blood pressure is a condition in which the blood pressure in the arteries is chronically elevated. Blood pressure is the force of blood that is pushing up against the walls of the blood vessels. If the pressure is too high, the heart has to work harder to pump, and this could lead to organ damage and several illnesses such as heart attack, stroke, heart failure, aneurysm, or renal failure.

According to the Medilexicon’s medical dictionary, hypertension means “high blood pressure; transitory or sustained elevation of systemic arterial blood pressure to a level likely to induce cardiovascular damage or other adverse consequences.”

A consultant neurosurgeon at Cedacrest Hospitals, Abuja, Dr Abiodun Ogungbo, said physicians have estimated that about 25 per cent of adults in Nigeria have hypertension. Ogungbo noted that the reality is that only one per cent of this 25 per cent know that they have high blood pressure, hence the need for aggressive awareness on early detection of the disease in the country.

Ogunbo further stressed that a patient is said to be hypertensive when the blood pressure is 140/90 mmHg or above most of the time, adding that, “Unfortunately, I and other specialists like cardiac physicians and nephrologists see people with organ failures caused by poorly controlled hypertension.”

Ogungbo said hypertension is often referred to as the silent killer because it has no symptoms. He stated that it has been proven that high blood pressure is a major cause of sudden deaths.

“The problem with high blood pressure is that it sneaks up on you. Doctors in Ibadan studied many autopsies and discovered that the patients died from complications of hypertension,” Ogungbo said, adding that “two autopsies studies have also shown that hypertension is the commonest underlying cause of sudden natural deaths. It has no signs; by the time it gives you symptoms such as headaches, anxiety, visual problems and chest pains, it would have done damage to an important part of the body.”

Ogungbo also said there is need to educate physicians and health care providers and Nigerians on the causes of high blood pressure to erase many misconceptions.

“Hypertension is not caused by stress, lack of sleep or depression. Nor is it caused by the old woman in the village or by an evil arrow sent by a colleague at work or your next door neighbour. In about 90 per cent of all cases, the cause of hypertension still remains unknown.”

Also, the Chief Medical Director of Dayspring Hospitals, Ajah, Lagos, Dr Samuel Adebayo, opined that high blood pressure is no respecter of age, as cases of hypertension in children and adults in their 20s and 30s is rising.

He said, “When I was a house officer many years ago, we diagnosed a 35 year-old with hypertension, it was a shock throughout the hospital. But now, we diagnose 20-30 year olds with hypertension every time, it is no more an anomaly but we are crying out now because it is increasing abnormally, young people still have a better chance of living well with hypertension if they know.”

Adebayo, a family physician, said though the disease could be hereditary, the increase in number of young Nigerians with high blood pressure has been linked to increased intake of salt and fatty foods, obesity, lack of exercise and inadequate intake of vegetables and fruits among this generation.

 

He said, “Young people must begin to watch their diet and their lifestyle so that they do not become obese or overweight. Eating fatty and salty food is now a risky way of life, and no more a luxury. Drinking alcohol and smoking is no longer going to be a trend but a danger. These are all habits that young people must run from if they want to live longer.”

Corroborating this statement, the managing director of Pathcare Nigeria, Dr Pamela Ajayi, described hypertension as a disease of the African race, as statistics has shown that Africans were more genetically predisposed to developing high blood pressure.

She, however, stated that in spite of its prevalence among Africans, more Nigerians are dying of the disease because of ignorance, poor socio-cultural beliefs and poor health seeking behaviours.

According to her, though there is no cure, high blood pressure can be effectively managed for life when the patient is diagnosed earlier. She stated that to quickly address this challenge of undetected cases of hypertension to save lives, every Nigerian must know their high blood pressure status.

 

What causes hypertension?

Though the exact causes of hypertension are usually unknown, several factors have been associated with the condition. These include:

  • Smoking
  • Obesity or being overweight
  • Diabetes
  • Sedentary lifestyle
  • High levels of salt intake     (sodium sensitivity)
  • Insufficient levels of calcium,   potassium and magnesium in   the body.
  • Vitamin D deficiency
  • Alcohol consumption
  • Stress
  • Ageing
  • Medicines such as birth control pills
  • Heredity
  • Chronic kidney disease
  • Adrenal and thyroid problems or tumours

What are symptoms of hypertension?

There is no guarantee that a person with hypertension will present any symptoms of the condition. About 33 per cent of people actually do not know that they have high blood pressure, and this ignorance can last for years. For this reason, it is advisable to undergo periodic blood pressure screening even when no symptoms are present.

Extremely high blood pressure may lead to some symptoms, however, and these include:

  • Severe headaches
  • Fatigue
  • Dizziness
  • Nausea
  • Problems with vision
  • Chest pains
  • Breathing problems
  • Irregular heartbeat
  • Blood in the urine

How is hypertension diagnosed?

Hypertension may be diagnosed by a health professional who measures blood pressure with a device called a sphygmomanometer – the device with the arm cuff, dial, pump, and valve. The systolic and diastolic numbers will be recorded and compared to a chart of values. If the pressure is greater than 140/90, you will be considered to have hypertension.

A high blood pressure measurement, however, may be spurious or the result of stress at the time of the exam. In order to perform a more thorough diagnosis, physicians usually conduct a physical exam and ask for the medical history of you and your family. Doctors will need to know if you have any of the risk factors for hypertension, such as smoking, high cholesterol, or diabetes.

If hypertension seems reasonable, tests such as electrocardiograms (EKG) and echocardiograms will be used in order to measure electrical activity of the heart and to assess the physical structure of the heart. Additional blood tests will also be required to identify possible causes of secondary hypertension and to measure renal function, electrolyte levels, sugar levels, and cholesterol levels.

How is hypertension treated?

The main goal of treatment for hypertension is to lower blood pressure to less than 140/90 – or even lower in some groups such as people with diabetes, and people with chronic kidney diseases. Treating hypertension is important for reducing the risk of stroke, heart attack and heart failure.

High blood pressure may be treated medically, by changing lifestyle factors, or a combination of the two. Important lifestyle changes include losing weight, quitting smoking, eating a healthful diet, reducing sodium intake, exercising regularly, and limiting alcohol consumption.

Medical options to treat hypertension include several classes of drugs. ACE inhibitors, ARB drugs, beta-blockers, diuretics, calcium channel blockers, alpha-blockers, and peripheral vasodilators are the primary drugs used in treatment. These medications may be used alone or in combination, and some are only used in combination.

In addition, some of these drugs are preferred to others depending on the characteristics of the patient (diabetic, pregnant, etc.). If blood pressure is successfully lowered, it is wise to have frequent checkups and to take preventive measures to avoid a relapse of hypertension.

How can hypertension be prevented?

Hypertension is best prevented by adjusting your lifestyle so that proper diet and exercise are key components. It is important to maintain a healthy weight, reduce salt intake, reduce alcohol intake, and reduce stress.

In order to prevent severe health challenges such as stroke, heart attack, and kidney failure that may be caused by high blood pressure, it is important to screen, diagnose, treat, and control hypertension in its earliest stages. This can also be accomplished by increasing public awareness and increasing the frequency of screenings for the condition.

Exams and Tests

Your health care provider will check your blood pressure several times before diagnosing you with high blood pressure. It is normal for your blood pressure to be different depending on the time of day.

Blood pressure readings taken at home may be a better measure of your current blood pressure than those taken at your doctor’s office. Make sure you get a good quality, well-fitting home device. It should have the proper sized cuff and a digital readout. Practise with your health care provider or nurse to make sure you are taking your blood pressure correctly.

Your doctor will perform a physical exam to look for signs of heart disease, damage to the eyes, and other changes in your body.Tests may be done to look for:

  • High cholesterol levels
  • Heart disease, such as an echocardiogram or electrocardiogram
  • Kidney disease, such as a basic metabolic panel and urinalysis or ultrasound of the kidneys

Treatment

As earlier said, the goal of treatment is to reduce blood pressure so that you have a lower risk of complications. You and your health care provider should set a blood pressure goal for you.

If you have pre-hypertension, your health care provider will recommend lifestyle changes to bring your blood pressure down to a normal range. Medicines are rarely used for pre-hypertension.

You can do many things to help control your blood pressure, including:

  • Eat a heart-healthy diet, including potassium and fibre, and drink plenty of water.
  • Exercise regularly – at least 30 minutes of aerobic exercise a day.
  • If you smoke, quit – find a programme that will help you stop.
  • Limit how much alcohol you drink – one drink a day for women, two a day for men.
  • Limit the amount of sodium (salt) you eat – aim for less than 1,500 mg per day.
  • Reduce stress – try to avoid things that cause you stress. You can also try meditation or yoga.
  • Stay at a healthy body weight – find a weight-loss programme to help you, if you need it.

Your health care provider can help you find programmes for losing weight, stopping smoking, and exercising. You can also get a referral from your doctor to a dietician, who can help you plan a diet that is healthy for you.

There are many different medicines that can be used to treat high blood pressure. Often, a single blood pressure drug may not be enough to control your blood pressure, and you may need to take two or more drugs. It is very important that you take the medications prescribed to you. If you have side effects, your health care provider can substitute a different medication.

Possible complications

When blood pressure is not well controlled, you are at risk for:

  • Bleeding from the aorta, the large blood vessel that supplies blood to the abdomen, pelvis, and legs
  • Chronic kidney disease
  • Heart attack and heart failure
  • Poor blood supply to the legs
  • Stroke
  • Problems with your vision.

When to contact a medical professional

If you have high blood pressure, you will have regular appointments with your doctor.Even if you have not been diagnosed with high blood pressure, it is important to have your blood pressure checked during your yearly check-up, especially if someone in your family has or had high blood pressure. Call your health care provider right away if home monitoring shows that your blood pressure is still high.

Prevention

  • Adults over 18 should have their blood pressure checked regularly.
  • Lifestyle changes may help control your blood pressure.
  • Follow your health care provider’s recommendations to modify, treat, or control possible causes of high blood pressure.

Compiled by Adebayo Folorunsho-Francis with additional reports from Punch Online, American Heart Association/American Stroke Association and Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine..

 

Why young pharmacists snub community practice – Pharm. Nwokoro

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In this incisive interview, Pharm. Jerome Onyisi Nwokoro, coordinator of the Association of Community Pharmacists of Nigeria, Ifelodun Zone, and MD/CEO, Jogen Pharmacy Nigeria Limited, Ajegunle, argues that community practice today is better than what it used to be. He also speaks on why young pharmacists shun community pharmacy, leaving the practice for the few old ones and the numerous charlatans. Excerpts:

How would you assess community pharmacy practice in Nigeria?

Community pharmacy practice is still developing. Although there are so many issues surrounding its development, the fact remains that it is developing. We have so many issues, ranging from the practitioners to other external factors, such as the economy – because whatever affects a sector of the economy affects every other aspect. And since community pharmacy is a service-oriented profession, whatever affects the economy will definitely affect the practice. But by and large, despite all the challenges and distractions, we can say that community pharmacy practice is developing in the country.

 

How do you see the practice today compared to when you started almost 20 years ago?

I can say, to an extent, that there is improvement in the practice, as community pharmacists are now more enlightened and knowledgeable about happenings in the health care sector and how to contribute to its development. Pharmacy today is no longer about drug dispensing. We now have pharmaceutical care, which affords the pharmacist opportunity to know his or her patients’health needs and ensure those needs are met.

As community pharmacists, we are the first port of call when people have challenges with their health, so we can say that people are now getting more awareness on whom a pharmacist is. I remember in those days, it was difficult for people to differentiate between a certified pharmacist and a drug seller; but today, things have changed, as people are more enlightened about the services a pharmacist can render and that alone shows that Pharmacy is developing.

We hope that with the revolution going on in the industry, pharmacy profession will be better than what we are even witnessing today; and with better law enforcement, quackery and drug faking which are our major challenges today will become history.

 

Tell us some of the challenges you have noticed in this profession and how they can be surmounted.

The challenges concern both external and internal factors. The first has to do with the challenge of drug faking and counterfeiting.If you go to our markets, whethersmall or large, you will see people putting drugs on their heads and some selling in trucks, and you will discover that there is no regulation at all. We had this same issue in the past and despite several efforts, the challenge is still there till today and it’s a major challenge to us as practitioners.

The internal factor has to do with us, the practitioners, as majority of our colleagues are running away from the profession in order to take up employment in money-spinning industries like telecommunication and banking, while some are even leaving the country. It is saddening that most of our young graduates are always after money, which is why they are running away from the community practice. It is not easy practising community pharmacy as the profession is not meant for those who want to make money as quickly as possible. There is money in community pharmacy practice, but the money comes in trickles. It is only those who are ready to endure that can practise at the community level.My fear for the practice is, what happens to it after the old ones have all gone?

 

Exactly how lucrative is community pharmacy?

Just like I said earlier, there is so much money in community pharmacy but there are sacrifices to be made to get the money. The sacrifices include perseverance, endurance, commitment and passion for the profession.

There was a time I obtained a postgraduate diploma in Finance from the University of Ibadan, but instead of abandoning community practice, I decided to apply the knowledge I had gained to the profession. This is what I called passion for one’s work. Although money is important, fulfillment is more important than money and that’s what community pharmacy gives you.

 

What keeps you going in this profession?

The fact that I have the opportunity to interact with people in my community, attend to their needs, offer services to them, solve their problems and put smiles on their faces is enough reason to give me joy.

Pharmacy itself is a profession that trains you to meet the need of people and offer them hope.And in doing these, you earn their trust and respect and you also become popular among them. In my community, they call me all sorts of names like pastor, doctor, daddy, etc., based on what I have done for them and how I have affected their lives. Those are the things that keep me going.

There was an instance when I was given a quit notice in one of my former apartments. People of that community rose up in my defence that the quit notice should not be effected. In fact, they were the ones who got another befitting apartment for me so as to keep me in the community. This shows how relevant and important I had been to them. As community pharmacist, you are a friend to everybody and this is what gives us joy.

 

What is your assessment of community pharmacy practice in Ajegunle community?

Community pharmacy, just like I said earlier, is still developing; and the same thing applies to Ajegunle community. There are many illegal outlets here. In fact, the majority of people in this community do not know the difference between a pharmacy and a drug vendor. These are some of the challenges we are facing. In fact, there are cases that a patient will come to me and I will recommend that all they need is rest and they will look at me with disbelief, expecting that I should have given them drugs instead. Of course, there are some who are enlightened and who appreciate our work and we are happy for that.

Another thing that distinguishes this community from highbrow areas is the purchasing power of most people here. In affluent areas, you will find out that there are some very expensive drugs that one can sell in those areas that you dare not sell in this area; so what we do is look out for those drugs that will sell more in our area. That’s what we do to survive here; however, our major challenge has always been fake drugs and quackery.

 

What are the major illnesses that bring people in this area to your pharmacy?

The major disease is malaria and the reasons are obvious. First, our dirty and non-conducive environment, which provide breeding ground for mosquitos. Second, the economic power of majority of our people also contributes to it as majority of them can hardly afford an insecticide-treated net; therefore, they are prone to mosquito bites.

Another common disease is sexually transmitted diseases (STIs), and the reason for that is as a result of several hotels and brothels around us which expose majority of people to unprotected sexual intercourse. So, malaria, sexually transmitted disease and, to some extent, skin infections are the major health challenges that bring people in this community to the pharmacy.

 

Dr Thomas Meier CEO, Santhera Prescription drugs Holding Ltd

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supply

Teva Pharmaceuticals: Past, Present, Future

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Teva’s history is one of growth and leadership in global healthcare.
Through innovative strength and a uniquely integrated organization, we offer quality medicines and more accessible treatment options to millions worldwide.

source

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Pharm. Bayo Adepoju is the Managing Director/CEO, Bezaleel Healthcare Limited, a consultancy firm, specialising in sales and marketing of pharmaceutical and healthcare products.

 

Born on 8 February, 1966, Adepoju is a native of Okemesi-Ekiti in the present-day Ekiti State. He had his secondary education at Ijaye High School in Ibadan, Oyo State (1979-1984). In 1985, he got admission to study Pharmacy at the Obafemi Awolowo University, Ile- Ife, where he graduated in 1989. Some years after, he got a Master’s degree in Business Administration (2001-2003) from Ondo State University, Akungba Akoko.

 

Adepoju had his internship at the University College Hospital, Ibadan (1989-1990), where he won the hospital’s best Intern Pharmacist Award. In fulfillment of the National Youth Service Corps (NYSC) programme, he was posted, 1991, to the School of Health Technology, Kaduna, to teach Chemistry and Pharmacology, among other courses.

 

Between 1992 and 1994, Adepoju worked as Medical Representative with MSD (Associated Pharma Products Limited) Lagos, before travelling to Saudi Arabia to work as community pharmacist with Uml-Qura Pharmacy, Misfala, Makkah (1994-1995).

On his return to Nigeria in 1995, the Bezaleel Healthcare boss took up an appointment as Superintendent Pharmacist/Part-time Lecturer at the University of Agriculture, Abeokuta and left in 1997 to join Grunenthal (Bolar Pharmaceuticals Limited) in Ikeja, Lagos, as pharma sales supervisor.

In 2001, Adepoju moved to Fidson Healthcare, Ringroad, Ibadan, as divisional manager. By 2003, he had risen to become the company’s national sales manager in a period that saw Fidson’s sales increased by 400 per cent in four years. His last appointment was with Sequoia Pharma Limited, Oshodi, Lagos, where he acted in the capacity of the managing director between 2008 and 2011, before the idea of starting his own private practice gradually crept into his mind. Adepoju commenced his dream business – Bezaleel Healthcare Limited – in 2012.

Aside from being a national president of Ijaye High School Old Students Association (2011 to date) and former general secretary of the Pharmaceutical Society of Nigeria, Ogun State chapter (1995-1997), the pharmacist is also a member of National Association of Industrial Pharmacists (NAIP).

Among his numerous professional honours are Pharmacist of Excellence 2006 (awarded by PSN Ekiti State); Distinguished Pharmacist 2007 (awarded by ACPN Ogun state) and Platinum Mentor 2008 (awarded by PSN Abuja).

The pharmacist is married with children.

World congress canvasses effective use of medicines

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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

Thought for today – April 2015 The pillar of integrity

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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

Issuance of medicine vendors’ licence must be reviewed

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In this interview with Adebayo Folorunsho-Francis, Pharm. Bolade Luke Adeeko, a Fellow of the Pharmaceutical Society of Nigeria (PSN) and founding member of Nigerian Association of General Practice Pharmacists (now Association of Community Pharmacists of Nigeria, ACPN) opens up on challenges facing the profession and why he thinks the arbitrary manner Patent & Proprietary Medicines Vendors Licence (PPMVL) are issued should be reviewed.

What influenced your decision to study Pharmacy?

A career-talk in my final year in secondary school influenced my decision to study Pharmacy. The wide variety of career opportunities Pharmacy offered (and still offers) was a motivating factor. Retail and hospital pharmacy practice (as it was then) was very inviting with pharmacists smartly and neatly dressed, with sparkling white overalls.

 

 

How would you compare Pharmacy in your day to today’s practice?

Pharmacy practice then was well-structured and better organised. Pharmacists were more professional,more disciplined, and carried themselves with pride. They were respected in the society. The same cannot be said today of Pharmacy and pharmacists.

 

Were there controversies and scandals surrounding the profession during your time?

 

Controversies and scandals were not commonplace in those days. Intrigues and other disturbing issues reared their ugly heads mostly within the civil service. There was generally peace, cohesion and professionalism within the private sector. Competition was there, but there was no bitterness or rancour.

 

What would you say are the challenges facing pharmacy practice today?

The challenges facing Pharmacy practice in Nigeria are hydra-headed and pharmacists themselves do not seem to be helping matters.The standard of practice has fallen and professionalism has taken a backseat. Pharmacists, especially the young ones,need a complete and thorough re-orientation on ethical practice. The “Register & Go” syndrome is a major issue that has refused to die. The problem of fake and counterfeit drugs is a national cankerworm. The continued indiscriminate issuance of Patent& Proprietary Medicines Vendors Licence (PPMVL) should be seriously reviewed. Most of them go beyond their brief and dent the image of pharmacists by posing to be and acting as one. The present chaotic and all comers’method of drug distribution should be seriously looked into. The ongoing effort to redefine and streamline the distributive channels should also be seen to a workable conclusion.

 

Let’s talk about the perennial issue of fake and counterfeit medicine. Do you think it can be curbed?

A lot has been done and is still being done to tame this monster.Federal and state task forces on fake drugs and unwholesome food have to up their game. They need to be better funded for more frequent raids and given powers to prosecute and speedilybring erring drug counterfeiters and fakers to justice. Moreover, NAFDAC and the PSN should collaborate more to ensure the monster is tamed. They should be seen to bark and bite. Pharmacists should also play a protective role of the profession by ensuring that they don’t collaborate with or assist these enemies of the people in their nefarious and murderous activities.

 

To what extent have you been involved in pharmaceutical activities?

I have been involved in pharmaceutical activities since my university days. I was secretary and later president of PANS (1969-1970). I am a founding member of NAGPP (now ACPN) in 1983. At various times, I also held the following positions: Member,Lagos State task force on fake and counterfeit drugs and unwholesome food (2000-2013); member, Pharmaceutical Inspection Committee, representing Lagos State PSN(2000-Date); National Secretary NAGPP(1986-1988); Vice Chairman,NAGPP, Lagos State(1989-1991); Chairman Egbeda/Dopemu/Akowonjo(EDA) Zone of ACPN (1999-2001); member, PSN Privileges Committee (1994); member, PSN Law and Ethics Committee (2007-2009); and member,PSN Ad hoc Committee on 3rd M & B Professional Service Award in Pharmacy (2007).

 

Were there some major awards given to you in recognition of your selfless service?

Well, I have been privileged to be honoured with the following awards: Lagos State PSN Merit Award for noble contributions and services to the profession of pharmacy and PSN Lagos State(May 2000); Lagos State PSN Distinguished Pharmacist Award (August 2006) and PSN Fellowship Award (2009).

 

What is your impression of the annual PSN national conferences?

I have attended an above-average number of PSN National conferences. There,you meet and interact with colleagues.You can also get a deserved rest which you may have denied yourself. Because the conferences are yearly moved across Nigeria, they provide the opportunity to know the country more. However the planning committees should de-emphasise commercialisation of the conference. This phenomenon seems to have overshadowed the educational and scientific benefits the conference should afford participants.

 

If you were not to be a pharmacist, what other profession would you have opted for?

Before I entered the university to study pharmacy, I worked as a technical assistant at the then Western Nigeria Television (WNTV) and the Western Nigeria Broadcasting Service (WNBS)in Ibadan. If I had not studiedPharmacy, maybe I would have ended up as a technical man in the radio and television industry.

 

Is there any particular age that an active pharmacist should retire?

A pharmacist should still be professionally active, even in old age, as long as his physical and mental health allows him. Each individual should know when to draw the curtain and take a deserved rest.

 

As an elder in the pharmacy profession, what is your advice to young pharmacists?

My principal during my secondary school days, used to tell us, “Festina Lente”, meaning, “Make haste slowly.”Our young pharmacists should be more ethical in their practice of the profession and avoid sharp practices in an attempt to make quick money. They should desist from practices that demean Pharmacy and the dishonour of pharmacists. They should remember that “Life is honour – it ends when honour ends.”

Why Pharmacy needs more people like Pharm. Atueyi – PANS editor

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In this exclusive interview with Pharmanews, the current national editor-in-chief for the Pharmaceutical Association of Nigeria Students (PANS), Ebuka Joseph Alakwem, reveals some of the achievements of his administration, as well as the challenges facing the editorial department of PANS. The final year student of Pharmacy Department, University of Nigeria, Nsukka, also discusses the contribution of Sir (Pharm.) Ifeanyi Atueyi, publisher of Pharmanews to the development of pharmacy practice in the country. Excerpts:

 PAN4

Why did you choose to study pharmacy?

My decision to study pharmacy was prompted by the professional role pharmacists play in the society – which is to improve the quality of lives of individuals in the society, using both therapeutic and non-therapeutic approaches.

 

What made you contest for the post of editor-in-chief?

I would say it’s actually due to the passion I have for the association. Also, I contested for the position in order to help keep PANS alive, as well as ensure necessary information is available at every point in time to all pharmacy students across the country.

It has also been my desire to help produce a magazine that will serve the interest of all pharmacy students in the country and, by the grace of God, we now have in the pipeline a magazine called Pharmedia, which will circulate in all member schools. Through this, we hope that our voice, as the future of pharmacy profession, will be heard in the country and beyond.

 

What are your goals as PANS editor-in-chief?

That is a very interesting question. Basically, the function of the editor-in-chief is to see that high quality publications are published and also ensure that details of PANS’ activities are made available to all students. Therefore I am trying to make sure that at least an article from each school of pharmacy is published in our proposed magazine. The magazine itself will be distributed across all pharmacy schools in the country. I hope, by God’s grace, to achieve this before the end of my tenure.

 

Since your election as the editor-in chief, what challenges have you noticed within the association?

Since I assumed office, the major challenge I have observed is finance. The association is highly underfunded. Imagine, nothing was in the association’s account as at when it was handed over to us. This is really affecting us, especially members of the editorial board. We have been borrowing money from different people, hoping to give them back, when we can.

Related to this challenge is the fact that PANS does not have any primary source of income; we therefore have to source for funds each time we have a national programme. We source for funds from companies and individuals, sometimes to the extent of missing classes, so as to make sure that the association runs successfully. It is that bad, but I thank God for the wisdom given to the PANS leadership, as we are always equal to the task.

 

What specific challenges have you faced in your capacity as the editor-in-chief, and how did you handle them?

The greatest challenge I have faced is lack or inadequacy of resources required to carry out editorial work. As I said before, we were handed an account with zero balance, and there were no tools for us to work with. We don’t even have important editorial necessities like laptops, recorder or camera. It has been a very big challenge for me but I am working assiduously in making the work easier for the next PANS chief editor by providing him or her with the necessary equipment to do the work effectively.

 

How would you assess the contribution of Pharmanews publisher, Pharm. Ifeanyi Atueyi, to pharmaceutical journalism?

Seriously, Sir (Pharm.) Ifeanyi Atueyi is doing great in his chosen career, pharmaceutical journalism, and I admire him so much for this. With no iota of doubt, his contribution to Pharmacy has proven to us that the profession is broad and that pharmacists are the most intelligent people, among healthcare professionals. He is a rare gem and a man that has the interest of pharmacy students at heart. He is a mentor to me and I am sure to numerous pharmacists, both old and young. My prayer is that God will preserve his life and also bless us with more people like him, so that the pharmacy profession can be better than what we are witnessing presently.

 

Tell us about some of the programmes you intend to carry out before the end of your tenure.

I’m working on organising a quiz competition and essay writing from different schools of pharmacy.This will help to create awareness for the convention that is coming up on 9-15 August 2015 at the University of Nigeria Nsukka, Enugu State. Gifts will be awarded to the 1st, 2nd and 3rd positions.

 

Where do you see PANS editorial department by the time you leave office?

I believe that a good name is better than, money. I will ensure that before leaving office, PANS editorial board would have been provided with the necessary items needed to work effectively so as to enable the incoming PANS editor-in-chief to work without encountering unnecessary challenges like the ones I am facing now.

 

The sufficiency of consideration

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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

Integrating corporate strategy with social responsibility

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By Pharm. Nelson Okwonna

Earlier this month, I was invited to make a presentation to a small group of development practitioners in Lagos. The event was a brainstorming session to rethink approaches to development practice in general, and for a development organisation in particular.

At the end of the session, we all agreed that at the heart of development in Africa is achieving socio-economic development, which can only occur when we have sustainable productive entities – that is, profitable firms. A good development agenda therefore must be holistic and should be tailored to address the challenges that limit our competitiveness as a nation, rather than focusing on increasing specific inputs, which though good initself, cannot bring us to the intended path.

For example, while donations to charities as part of corporate social responsibility is a good deed and is intended to help with the wellbeing of the recipients, if it does not improve the chances that a profitable sustainable productive entity would emerge, then it is not a sufficient contribution by itself; though necessary, it is not sufficient.

Considering that the bulk of our private and corporate giving is in this category, it is not surprising that Africa has not been helped much by even well-intentioned aids. The simple reason is that the factors that make the African business environment non-competitive have not been sufficiently addressed. For example, increasing the volume of research and development funding, without developing sufficient platforms for interactions between research institutes and the industry, is an inefficient strategy for innovation development.

When Finland adopted a policy that each undergraduate student must have an industry partner for their projects, the government set the stage for creating industry-relevant personnel; it saw the need for a catalytic systemic approach that emphasised the complementary nature of the inputs that make for national development. When such a structure exists, it is still not sufficient; access to finance and a robust intellectual property regime would also be critical requirements.

Firm strategy in the health care sector

To be profitable and remain in business, organisations must not only be more competitive than their competitors, they also have to exist in a nation that offers some certain levels of competitiveness. For instance, an equal investment in two pharmaceutical firms, one situated in Nigeria and the other in India, would offer different returns, even when both firms are focused on the Nigerian market.

Several factors act to contribute to the national competitiveness of a particular industry and the aim of this article is to state that we would all do better if the corporate social responsibility investments of firms are made to increase the national competitive soil within which they compete.

MR NELSON

The diagram above reflects the factors that influence national competitiveness as outlined by Prof Michael Porter of the Harvard Business School. The four factors identified as Porter’s Diamond contribute to the competitiveness of any industry.

The pharmaceutical industry, for example, would benefit from increases in demand conditions if the Nigerian government pursues a more aggressive health insurance policy. An industry-sponsored health insurance promotion programme directed at the government to influence policy could be packaged as a corporate social responsibility programme with the attending tax benefits.

For example also, I have personally been leading a programme (www.wapip.org) to promote the interaction between research and industry actors for the advancement of pharmaceutical innovation in West Africa. To us, supporting such an initiative is a fantastic corporate social responsibility initiative as it offers numerous advantages, such as increased rate of pharmaceutical research industry partnerships for product development and lead identification. The first event we helped make happen – the NIPRD Industry Business Summit which held at Sheraton, Lagos in 2013 – witnessed some firms making strategic commitment in the area of increased dialogue and alliance formations with NIPRD. We are also working to help make similar contributions in the area of innovation capacity analysis and industry report to assay areas of national competitiveness.

Such efforts, as the ones enumerated, are within the arena of “factor endowments” – in other words, the nature and quality of human and material resources. The factor endowments in the Indian pharmaceutical and health industry would include the rich educational structure that has succeeded in producing a large number of industry-relevant professionals. This factor endowment, coupled with other factors, makes the Indian pharmaceutical industry relatively more attractive for direct foreign investment.

Investments in fostering the quality and volume of the human resources in the Nigerian health care sector cannot be overestimated. Personally, I believe that this is one of our biggest challenges, hence, efforts like those made by Juhel Pharmaceuticals with the support of the Faculty of Pharmacy, Nnamdi Azikiwe University, Awka, is quite laudable. We’ve also been canvassing for investments in pharmaceutical research structures where a sponsoring industry partner could dictate the research questions an MSc or a PhD project should seek to answer. When structured properly, an arrangement of this nature could pass for a corporate social responsibility initiative.

In the area of promoting the supporting industries – besides the health insurance industry, the finance, agricultural and petrochemical industries are other areas that companies can focus their corporate social responsibility efforts on. The phyto-pharmaceutical industry in Nigeria offers immense opportunities, considering the volume of local demand, with the right factor conditions (the kind we are trying to create) and with the right supporting industry (agriculture), there is a lot that can be done when the corresponding firm strategy and structures are in place.

One of such structures has to do with intellectual property protection which lacks strong enforcement in Nigeria. This is perhaps one good reason why despite the courage of the private sector, it still would take a good government to help Nigeria emerge from her myriad of challenges. The private sector could, however, help in articulating what the remedies should look like.

An innovation system perspective

To help buttress the earlier points, which for me, involves a challenge – that of helping well-meaning organisations synthesise these thoughts to practical projects(a gap we also identified at the brainstorming session) –I’ll employ the illustration below.

MR NELSON2

From the diagram above and from the Porter’s Diamond, the factors   contributing to the innovative nature of firms are most times beyond   the scope of their regular business operations. Identifying, designing and implementing projects that would help boost their competitive advantage, even if the advantage is not limited to their firms alone, would go a long way. The options become even more attractive if those projects can be constructed as corporate social responsibility projects.

Finding individuals with the depth and breadth of knowledge base required to make such projects feasible is another challenge on its own. Even though this author has been contributing in this area, the demand gap is still huge, considering the level of time and resource commitments required to see appreciable impact.

Beyond CSR to CSI

At the brainstorming session, we coined a phrase that summarised the thoughts above – “Beyond CSR to CSI” – Beyond Corporate Social Responsibility to Corporate Social Integration. The underlying thought frame is that, most times, the same things that would help a nation to be competitive are the same things that would make its citizens and its firms competitive.

References

Porter, M. E., and Mark R. Kramer. “Strategy and Society: The Link between Competitive Advantage and Corporate Social Responsibility.

NAIP charts progress plan for pharma industry

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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.

L-R: Pharm. (Sir) Nnamdi Obi, MD/CEO, Embassy Pharma & Chem. Ltd; Pharm. Patrick Osele, MD/CEO, Pemason Pharmaceuticals Ltd, special guest of honour; Pharm. Okey Akpa, MD/CEO, SKG Pharma. Ltd, chairman of occasion; and Dr Akin Ogunbiyi, GMD, Mutual Benefits Plc, guest speaker, during the association’s first 2015 bimonthly meeting/lecture, held in Lagos, recently.
L-R: Pharm. (Sir) Nnamdi Obi, MD/CEO, Embassy Pharma & Chem. Ltd; Pharm. Patrick Osele, MD/CEO, Pemason Pharmaceuticals Ltd, special guest of honour; Pharm. Okey Akpa, MD/CEO, SKG Pharma. Ltd, chairman of occasion; and Dr Akin Ogunbiyi, GMD, Mutual Benefits Plc, guest speaker, during the association’s first 2015 bimonthly meeting/lecture, held in Lagos, recently.

 

 

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.

Shun unethical practices, PCN urges graduating pharmacists

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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.

L-R: Prof. Olukemi Odukoya, dean of the Faculty of Pharmacy, University of Lagos, Innocent Ijeoma, one of the five first class graduates, Pharm. Bukky George, managing director of HealthPlus Pharmacy; and Pharm. Ike Onyechi, chairman of the occasion, during the award presentation.

 

 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.

Purpose-driven leadership in Africa

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During the last Christmas and New Year holidays, a number of my colleagues in diaspora complained about the state of affairs of things back home in Africa. We argued extensively on who is responsible between the leaders and the followers who elected them. We agreed on the need for our people in diaspora to come back home to Africa and join the public or private sector in order to help address our issues, salvage whatever is remaining and help transform our continent so that we can be respected wherever we choose to visit in the world. We recognised that the African continent, which is as big geographically as a combination of Europe, China, USA and India, is richly endowed with many resources (human, raw materials, money, good weather, etc). We also agreed on the urgent need for a valuable purpose-driven leadership in both public and private sectors of Africa to harness these resources towards achieving clear goals that will benefit generations.
The problems of leadership in Africa are not genetic but rather due to lack of necessary tools, abilities, skills, right attitude, knowledge, right actions, poor results, failure to learn from failures and history, etc.Most African leaders have no clear purpose for being in leadership roles; all they have is a desire to have raw power in order to amass wealth for their greedy selfish ends rather than do something concrete for the benefit of the citizenry.
Most African leaders suffer from lack of self-confidence and internal validation. Their minds are not yet fully developed; so they pursue primarily accumulation of money rather than pursuit of a veritable legacy. They have very little knowledge about creating an enabling environment for posterity. Many new business managers and leaders are also very task-focused and bottom-line oriented. They often complain that their team is stuck and the organization culture is not a healthy one. They share communication challenges and lack of accountability across their organisations. Some are very quick to point the finger at another manager and fail to realise where the solution resides.But how can you hold yourself accountable if you have not taken the time to reflect on who you are as a leader, why you chose to lead, and what matters to you right now? My question to emerging leaders are: “Do you have a leadership purpose or do you know your WHY? (The purpose, drive, or values that inspire you to be a leader every day)?
Purpose and values are vital to successful leadership. As a leader, you can’t delegate purpose and values to Human Resources or middle management. The top executives of every organisation need to focus and believe in the values and purpose of the organisation. They need to exemplify them in a way that is visible to everyone they engage with on a daily basis.
Great leaders lead by example when they walk the talk and become stewards of purpose in their organisation. Leaders who are in tune with their purpose don’t send company emails and memos only. They want to connect and engage with people in their organisation. They have strong convictions andtry to live by them. They take the time to listen by soliciting people’s feedback; they solve problems and manage challenges.
Roy Spence once said, “What is a purpose? Simply put, it is a definitive statement about the difference you are trying to make. If you have a purpose and can articulate it with clarity and passion, everything makes sense, everything flows. You feel good about what you’re doing and clear about how to get there.”
So, how can you be clear about your leadership purpose? Here are three questions to help you navigate and discover your WHY:

What do you stand for?
Purpose-driven leaders know what they stand for. They identify critical values in their operating philosophy that help them make important decisions that drive the company culture. They do not leave those for chance. So, ask yourself today: What do I really stand for? Is it innovation? Is it integrity? Trust?Accountability? Why are you in business?

What problem can you help solve?
Every challenge comes with a dose of opportunity. Our world is full of challenges,as well as great opportunities that call for great leadership. There are plenty of problems around us. But the real question is, how do we want to help make the world a better place? How can we solve a problem today? The best leaders did not shy away from problems and challenges. Winston Churchill, Abraham Lincoln and Martin Luther King Jr. all faced a world in despair. But, they saw a great calling to serve humanity for generations to come and they seized the opportunities presented by the prevailing challenges.

What business are you in?
Each of us is part of a whole. But what are we trying to accomplish? Better customer service? Better product? Better innovation? As a leader of any business, we need to know why we exist. Why are we doing what we are doing and who dothe products and services help at the end of the day? A great example of this is Apple. By creating quality trustworthy products and services that make people’s lives easier and more effective,people identify with their brand and purpose.

Jim Collins and Jerry Porras who wrote “Built to Last” share the following insight on leading with purpose:“Purpose refers to the difference you are trying to make in the world; mission is the core strategy that must be undertaken to fulfil that purpose; a vision is a vivid, imaginative conception or view of how the world will look once your purpose has been largely realised.”

Becoming a purpose-driven leader
What separates the best leaders from the rest? What do they have that trumps up their success? Is it knowledge? Motivation?Money?Great leadership begins on the inside of every person. It begins with discovering our life’s purpose!
Purpose is that deepest dimension within us that tells us who we are, where we came from, why we are here, and where we are going. If you are not fired up and energised about something you deeply care about, then most likely people will not follow.The passion in you is the power that will elevate the world to a better place. When a leader has a compelling purpose, the people around him want to become a part of the inspiring mission to change lives.
Leaders who are purpose-driven are on a life-long quest to be connected with something larger than their own life.Bill Gates did not start Microsoft to become the richest man in the world. He saw the potential of personal computers to transform the lives of many people. He was determined to create a software that would make them useful for every person in the world.He followed his passion and purpose and, in the process, became the richest man in the world. That was the outcome, not the goal. His purpose was to change how we live.
Steve Job’s vision was not to make a load of money and retire rich one day. Steve Job’s purpose was to help people unleash their creativity. He wanted to enrich people’s lives.He was passionate and had a purpose to enrich people’s lives through the products that Apple created.He wanted people to be connected to an experience, whether it was a phone or a computer. When we live on purpose we make decisions and choices to live a life of legacy.
In the book, Good to Greatby Jim Collins, surveying several companies in different industries, the author makes the case that Level 5 leaders were building teams around a common vision and purpose. These companies went beyond the purpose of making money and meeting the shareholders expectations.They found a higher calling and purpose by changing the world through their services and contribution. Purpose was more important that profits.
Happiness at work illustrates that personal job satisfaction is closely linked to feeling like we are on a path to a higher purpose, or that we’re doing something that we really believe in.
Tony Hsieh, CEO of Zappos.com and author of “Delivering Happiness: A Path to Profits, Passion and Purpose, says that, “When people do something that actually contributes to a higher purpose that they really believe in, research has shown that this actually is the longest lasting type of happiness.”
So how can you become a purpose-driven leader?

Purpose is on the inside-Connect with your heart first and be authentic about what is it that you want to help people about? It doesn’t have to be a big cause. When you have a clear purpose, you can articulate it to others with fire and passion. You feel good and energised about who you are as a human being.

• Choose a purpose that is bigger than yourself-Having a purpose that can be compelling and encourage participation on the part of the followers is something that Jeff Bezos, the founder of Amazon.com says, “Choose a mission that is bigger than the company.”

• Create value for people-Great leaders have something in common.They focus on adding value to whatever their passion and purpose is. When you can add value to people’s lives, whether through a product or service, their lives becomes more meaningful and in some respect better than they were yesterday.

Nothing is ever the same once you tap into your life’s purpose and your leadership calling. You begin to sense higher positivity and energy that you thought did not exist in you. Life becomes truly fulfilling and rewarding.

The misunderstood art of leading
Linda Hill, the Wallace Brett Donham Professor of Business Administration at Harvard Business School, is a champion of leadership through empowerment. Her work focuses on leaders who have excelled by enabling others to do the doing.In other words, if you seek professorial wisdom,vocal displays of assertiveness are not necessarily leadership.Her work on Nelson Mandela’s leadership style highlights her research-based beliefs that in the business world, too, there are countless benefits to viewing leadership as a collective activity. So do her insights on the stealth leaders within organisations – those unheralded members of the rank-in-file who take charge of key initiatives.Hill’s latest book, “Collective Genius: The Art and Practice of Leading Innovation”, makes a fascinating argument that Hill has made before: namely, that to lead innovation, you should not view leadership as a take-charge, bull-by-the-horn-grabbing activity.Instead, your job should be to create, populate, and inspire a flexible ecosystem, in which employees feel comfortable proposing radical ideas and challenging long-held corporate beliefs.

Find the strengths of your culture
For example, there’s a change-management myth that tends to inflate the roles of leaders. The myth generally involves asuper-leader, imported from another company, arriving and making wholesale changes which produce demonstrable wins in the first 100 days.
From my experience, that type of top-down approach isn’t the best way to motivate employees to do what innovation requires. The best way, is to tap into emotions those employees already feel.Those emotions could lie in a product’s quality, or in the overall role a company plays on the world’s stage.Regardless of what those emotions are, the most important thing a leader can do – early on in a change-management initiative -is discover where those emotions and pride-points lie and connect with employees through these points.
There is also need for paradigm shift from change-management concept to leading change. While the former is a reaction to change, leading change is proactive and much productive in releasing the energies of the workforce.

Using people’s talents
Using what he learnt, De Meo was able to make his branding goals less of a top-down initiative and more of a community-based desire, built around a mutual sense of purpose. He did this in two ways: (1) He directly involved employees in the creation of a centralised brand; (2) he tied the importance of creating a centralised brand to the pride-points of quality engineering and the auto industry. Specifically, he did this by organizing a massive three-day off-site devoted to brainstorming about the brand. Instead of PowerPoint presentations, the off-site-held at a Frank Gehry-designed building in Berlin–was more like a design lab, filled with prototyping, testing, and most of all, discussing and arguing across the rank and file.
De Meo recalled it as “artwork everywhere, loud rock music signaling transitions between activities, snapshots showing the history of the automotive industry mixed in with conversations about the future of mobility.”
You can see how this approach would engage employees who were already prideful about their industry and their product. And there was another piece of the engagement too: De Meo’s inclusive approach made branding something the entire company was involved in. Employees were creatively collaborating, brainstorming, and participating, rather than responding to just another mandate from “those big guys on top in Wolfsburg.”

Power of purpose
Generally, we don’t use people’s talents as fully as we can. By contrast, De Meo’s approach created a branding effort behind which a historically decentralised company found unity. He believes you build a brand from the inside out.
As for results, they were tangible: By the time De Meo left VW for Audi, the VW brand had risen in the ranking of all brands worldwide from 55th to 39th. Sixteen points jump! But more than this quantifiable accomplishment, De Meo had proven that real change can occur when you engage your employees on a personal level, and find out why your organisation (and its posterity) matters to them. VW became a textbook-worthy case of that easy-to-preach, hard-to-practice principle of purpose-driven, community-centric leadership.
Purpose – not the leader, authority, or power – is what creates and animates a community. It is what makes people willing to do the hard tasks of innovation together and work through the inevitable conflict and tension.
It was the German philosopher Frederick Nietzsche who observed that “he who has a why can endure any how”. Leaders who know their why are better able to navigate and achieve success in the fast changing and uncertain world of today.Consider some of the leaders of the past who persevered in the face of difficult circumstances. Leaders such as Nelson Mandela, Winston Churchill,Mahatma Gandhi, Martin Luther King Jnr and so many others. These leaders connected to a purpose that matter to them. For Nelson Mandela, it was the liberation of the people of South Africa. For Winston Churchill, it was to prevent Hitler from conquering the world. The reason we remember these leaders was their commitment to a bold purpose. It’s this courage and commitment to a purpose that inspires us still today.
Whilst great leaders of times past were purpose-driven, it may surprise to know that many leaders today lack clarity of purpose. Research cited in the article “From Purpose to Impact” by Nick Craig and Scott A. Snook, found that fewer than 20 per cent of leaders have a strong sense of their own individual purpose. Even fewer can distill their purpose into a concrete statement. A number of African leaders lack clarity of purpose. These are the ones who indulge in attacking personalities rather than address the issues. Whilst leaders can identify the pain and problems that keep them up at night, very few are able to tell you what makes them get out of bed in the morning!

Power of purpose-driven leadership
It was Howard Schultzwho said, “When you are surrounded by people who share a passionate commitment and common purpose, anything is possible.” Having and knowing your purpose is important. Do you know your company’s mission or vision statement? If not, sad to say, you are not alone. According to a survey conducted by TINYPulse (http://bit.ly/1puoP3z) of over 300 hundred companies and 40,000 anonymous responses, the survey revealed that only 42 percent of employees know their organisation’s vision, mission, and values or the WHY of their organisations.
If your employees do not know your company’s vision, mission, or values, then they will be poor representatives of your company. If you, as the leader, have not clearly communicated those core values then you have fallen down on the job. How can your employees represent what they do not know? Purpose-driven leadership is essential to your success. Here are three reasons why:

• It gives context to your past
In order to understand where you are and where you are going it is important to understand your past. Knowing the back-story of your organisation – all the successes and failures and how it emerged in the formative years – is foundational information worth understanding.Marcus Garvey said, “A people without the knowledge of their past history, origin and culture is like a tree without its roots.” Seek to understand where you have come from in order to make sense of where you are going. From that knowledge you can have a greater understanding and appreciation for where you are today.

It keeps you focused on the present
When your purpose and vision is clear it gives your employees the focus they need to succeed. If your team is in the dark about its mission and vision they are without the most basic of tools needed for success. Your employees cannot lead your organisation to its intended destination if they do not understand why they are going there or the values that will guide them.A clear understanding of your purpose gives them the ability to focus like a laser on accomplishing their goals and objectives when they focus on their mission.

It gives you direction for the future
When you can put your past in context and focus on the present then you can build for the future. When you have a purpose that is known, with employees who are really engaged, then you have a future that is promising.

“Even though the future seems far away,” said Mattie Stepanek, “it is actually beginning right now.” Purpose-driven leadership is about empowering and equipping your team. Purpose-driven leadership is the rudder of your ship and will keep you on course. Your future is only as promising as your ability to empower. The time is now to lay claim to your purpose, make known your mission and vision, and discover the possibilities before you.

Lere Baale is a Director of Business School Netherlands, www.bsnmba.org and a Certified Management Consultant with Howes Group – www.howesgroup.com

What path are you following?

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An old Italian proverb says, “Destiny is determined not by chances but by choices.” Occasionally, in my quiet moments, I reflect on life’s journey. It is a journey that starts from somewhere and ends somewhere. At any time, one can tell how it started, but no one can tell how it will end. Only God knows. That is why He is the Alpha and the Omega, the Beginning and the End. Where you are today is as a result of the decisions and choices you have made. Each action you take leads you to somewhere, positive or negative, along your path in life. Good decisions, choices and actions will lead you to your expected end.

God wants to take you somewhere good and He will do it in a mysterious way. He may decide to create a storm to throw you away from one location to another one. If you keep long in your comfort zone and refuse to move to where God wants you to go, He can even cause a thunderstorm to disorganise you in that comfort zone. You might have experienced a storm in your workplace – the type of storm that caused your sack or compulsory resignation. Or maybe, the storm caused you to change the line of your business.

John 16:33 gives us comfort: “In the world ye shall have tribulation: but be of good cheer; I have overcome the world.” People of God are overcomers like Jesus. Storms and tribulations only make them tougher, harder and better, like gold refined by fire.

One critical thing one should not miss is God’s guidance at all times. Have you ever been directed by someone who does not know where you want to go? I have been misled a few times by ignorant persons who tried to help me find my way. They complicate your itinerary, instead of making it easier for you. But God is omniscient. He knows the end from the beginning and is waiting for us to ask Him for direction to our destination.

In Psalm 32:8, God promises, “I will instruct thee and teach thee in the way which thou shalt go: I will guide thee with mine eye.” This guidance becomes critical when there are storms and important decisions or choices to make. It is therefore essential to seek His face before taking any step in any direction.

Sometimes we think that certain decisions are too easy to ask God for guidance. However, we know that a decision that appears insignificant can result in disastrous consequences. Proverbs 14:12 says, “There is a way that appears to be right, but in the end it leads to death” (NIV).

Many people prefer to depend on the opinions of others in solving their problems, instead of seeking God’s view. When faced with challenges in business, career, family or personal lives, we are sometimes worried about decisions and choices to make and the directions to go. We think that another human being has the answer and can solve our problems. We spend quality time seeking advice from counselors, consultants and so on. The truth however is that while these can help from the experience they have acquired, they cannot offer the knowledge they do not have.

Man’s experience and knowledge are limited. Therefore, the solution does not lie with any man. In fact, God is not happy when we depend on these other sources for help without approaching Him. He is not ready to come to your help if you do not call on Him. Psalm 147:10-11 says, “He delighted not in the strength of the horse: he taketh not pleasure in the legs of a man. The Lord taketh pleasure in them that fear him, in those that hope in his mercy.”

Let us depend upon the promises of our faithful God. Through Prophet Isaiah, God promises, “I will bring the blind in a way that they do not know, in paths that they have not known I will guide them…” (Isaiah 42:16). It is only God that can take us through an unknown path. No amount of hassle can lead us through the right path. Our desperate efforts can only result in avoidable stress, worry and anxiety. We lose sleep and peace of mind and attract all manner of diseases because we carry unnecessary burden.

In this high-tech and information age, things are moving very fast. But there is need to slow down and think deeply, meditate and get direction from the only Person who knows the end from the beginning. Do you know that there are certain things He will disclose to you only when you are alone with Him? Why not give Him the opportunity of talking to you in your quiet and private moments? It is during such moments that He will direct your steps to lead you to your expected destiny.

Pharmacy practice in Nigeria: Quo vadis?

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I consider it a great honour to be invited to deliver the keynote address at the 2015 edition of the Induction/Oath-taking ceremony of the Faculty of Pharmacy, University of Benin. My association with Benin and the University of Benin started more than 30 years ago: first, visiting as a student (PANS) activist and later as an MBA and PharmD student of the University.

A keynote address delivered by Dr Lolu Ojo FPSN at the Induction/Oath-taking ceremony of the Faculty of Pharmacy, University of Benin, on Wednesday, 25 March, 2015.

My formal industrial Pharmacy practice career started (and was nurtured) in Benin. I will, forever, remain grateful to the city, the state (then known as Bendel) and the people for the tender care and overwhelming support received during these formative and difficult years. I made friends, who, even as at today, remain great influencers of my life. One of those friends, today, is my wife, Bridget, who has made life more meaningful and my association with Edo State permanent. I am grateful to the dean, Prof. J. E. Akerele (one of the great friends of those days) and the planning committee for giving me this unique opportunity to share my thoughts on Pharmacy and sundry issues using this very unique platform.

The choice of the topic, “Pharmacy in Nigeria: Quo vadis?” is apt and contemporary. There are, presently, a lot of activities being undertaken to redefine Pharmacy and its practice in Nigeria. We have just concluded a one-day retreat where various groups representing different areas of practice made presentations on the way forward. We are still working on the blueprint arising from the retreat. The Nigeria Academy of Pharmacy is also organising an education summit which will come up between 22 and 24 April, 2015. All these activities are meant to answer the same question that you have challenged me to provide answers to with this topic.

My first contact with the term “Quo vadis” was in the early eighties when we had the privilege to watch a film with the same title at the famous Oduduwa hall of the University of Ife. Quo vadis is a Latin word which translates to mean: “Where are you going?” It was recorded that, Peter, the great apostle of Jesus Christ, was running away from the prevailing persecution of Christians in Rome. On his way, he met the risen Christ carrying a cross and walking on the opposite side. Peter asked the famous question: Quo vadis, that is: Where are you going?

Our task today is to chart a new path for Pharmacy practice in Nigeria by examining the direction to which it is heading. We cannot possibly do a good job of fortune-telling without first examining where we are right now and how we got there.

The history of Pharmacy practice predates the formal establishment of Pharmacy in Nigeria. The healing of the sick was carried out by herbalists who prepared concoctions, balms and ointments from leaves, barks and roots of plants. The herbalist was the doctor and the pharmacist combined. He was very well respected in the community and was the consultant on all health matters. Then, there was peace in the “house of medicine”. Today, things have changed. The professions of Pharmacy and Medicine have been separated and have become more specialised.

It was in 1887 that the first Pharmacy ordinance was set up to control medicines. It was also in 1887 that the first Pharmacy shop was set up, owned and managed by ‘Dr’ Zaccheus Bailey. He was reputed to be kindhearted with a high standard of professional conduct. These attributes made people to call him doctor. Pharmacy then was treated almost like an appendage of Medicine and most of the dispensers were chosen and trained by the medical doctors.

The history of Pharmacy in Nigeria has been well documented and I will urge everyone to read the writings of Chief Andrew Egboh and Dr Fred Adenika (both late) on this subject. The early pharmacists were not accorded official recognition and most of them struggled throughout their careers. However, with perseverance and ardent struggle of our patriarchs, Pharmacy in Nigeria has advanced from the low level of the early beginning to the dynamic state that we have now. Pharmacists now have the opportunity of University education, including postgraduate studies and also with official recognition in the government, academia, hospitals and the community.

One of Dr Fred Adenika’s theses in his 1998 book: ‘Pharmacy in Nigeria’ was that ‘pharmacy development has suffered a remarkable downturn in the last decade’. The decade he was referring to was that preceding 1997 when he wrote the book, that is, 1980 to 1990. This was the period when some strange words crept into our lexicon: fake drugs, import licence, etc. It was also the period when some negative policies were introduced and the gains of previous years were practically eroded. Pharmacy suffered a decline in fortune in the hospital system. The ministry of health practically became the ministry of doctors. The regime of late Prof Olikoye Ransome-Kuti ensured that the relative parity between doctors and pharmacists were removed. The pharmacist became an orphan in the hospital system. It took years of struggle for some semblance of sanity to prevail but, even at that, the harm had been done. If Dr Adenika were to be alive, I wonder what description he would give the state of Pharmacy in Nigeria today.

My thesis for this address is that, in the past two decades, that is, 1995 to date, Pharmacy has had a challenged development in all fronts. While it is true that we have witnessed some individual and collective strides, the overall outlook still leaves much to be desired. From the individual pharmacist to the practice areas, there is no particular section that is spared of challenges:

–       The crisis of professional identity persists. What exactly is my role as a pharmacist in the hospital system? What is the task being performed which is reserved for or can only be performed by a professional of my kind? These unanswered questions have taken so many young pharmacists looking elsewhere for satisfaction – acquisition of unrelated degrees, taking up roles completely out of sync with the profession, etc.

–       While there are more schools of Pharmacy (about 17 now), the infrastructure and personnel needed to perform at the optimal level are lacking. I am not too sure if the necessary laboratory equipment and reagents are available in all the schools to guarantee adequate exposure for the students. The upheavals in the academic system have compounded the situation which has taken its toll on the quality of graduates produced. I am also not too sure of the adequacy of research grants available to make our teachers perform the research function. Where exactly are we in the struggle for development of new remedies for new and emerging diseases?

–       The hospital space is closed. I have heard a lot of complaints on the differential treatment the doctors received in terms of remunerations and other perquisites. Pharmacists feel alienated and the discontent is high. To me, the crisis in the health sector is due to leadership failure. I have written about this before and my conviction remains very strong.

–       The community pharmacy sector has not fared any better. There are about 10,000 registered premises known to and regulated by the Pharmacists Council of Nigeria. However, there are more than 50,000 illegal premises scattered all over the country. The open market is a tolerated illegality. They have almost assumed a position of immortality, desecrating everything that Pharmacy stands for.

–       The global pharmaceutical industry is an oligopolistic US$ 900 billion market, consolidated mainly in the US, Europe and Japan – with the Asia-Pacific as the new frontiers, and dominated by 15 global conglomerates. It is an industry rapidly growing in countries like China, India, Malaysia, South Korea, Indonesia, South Africa, and Israel. India is the third largest pharmaceuticals producer in the world, while at over 20 per cent growth per annum, China has the fastest growing market. Nigeria, with one of the world’s fastest growing population (currently at 170 million), evidently has a potential huge domestic demand that can support a vibrant pharmaceutical industry. But the story is, lamentably, different:

o      With pervasive poverty and extreme inequality, only a small percentage of the population can afford quality health care and quality drugs.

o      With an estimated size of $1-1.6billion (PMG-MAN, Frost & Sullivan), the Nigerian pharmaceutical industry is less than 0.3 per cent of the national GDP and is practically non-existent in the world pharmaceutical map.

o      Only 30 percent of the drug sold in Nigeria is manufactured locally. 70 percent is imported, largely from China and India.

*      Frost & Sullivan estimates “nearly 17 percent of essential generic medicines and as high as 30 percent of anti-malarial are routinely faked in Nigeria”

*      Current capacity utilisation rate in Nigeria is only 45 per cent.

*      High cost of operation due to high interest rate, multiple taxation, lack of power, etc, making the locally manufactured products less competitive compared to the imported ones.

*      Failure to address loopholes in the distribution system.

*      There is practically no R&D activity as most of the research-based companies only have scientific offices in Nigeria.

*      It is important to note that as at last year, we have about four companies that had been prequalified by WHO in Nigeria. This is a significant improvement in the global rating and has the potential of improved productivity and patronage by international organisations.

 

This is where we are today and the next question will be: How did we get here? As an emerging profession in Nigeria, we have tried and have been relatively successful in putting Pharmacy on a higher pedestal. There is so much to be done and some of the change factors are under our control as individuals and groups. The story of Pharmacy approximates that of Nigeria as a whole: potentials largely sub-optimised. As a result of mismanagement in the system, our profession has equally been misgoverned.

Now, to the last question: Quo vadis – Where are we going? I am not sure that I have a direct answer for you because it is a system thing. The trajectory should be defined by the policy makers and executors as it is done in other climes.

We are aware of the determination of the countries in Asia particularly India and China to develop the pharmaceutical sector. We expect the same situation here in Nigeria. We had a high hope about the implementation of the New Drug Distribution Guidelines but I am not too sure if this optimism is shared at the highest level of government.

The appropriate question which I can answer directly is: Where should we be going? I am convinced within me that we should be and we have the capacity to move towards professional excellence in all its ramifications. Our success will be determined and or guaranteed if we faithfully pay attention to and implement the following:

 

  1. Professionalism: By training, we are, first and foremost, pharmaceutical scientist. We must always carry this toga anywhere we found ourselves. The commercial aspect may be the second or parallel nature of our profession but it is certainly not the primary one. There is a question that we all need to provide answer to – Who is a successful pharmacist?

 

  1. Education:I think the time has come for us to speak with one voice on the training of Pharmacists in Nigeria. Apart from advocating for wholesale adoption of PharmD as the minimum qualification for registration and licensing to practise, I will also advocate for a practice-based exposure for all students in the last two years of their training. This aspect should be handled by real life practitioners in the relevant field. I am sure there will be many out there who will be ready to render services without much ado. The new graduates must be protected and guided to succeed right from time zero as pharmacist. Encouragement of personal development initiative is fundamental and I want to challenge all the technical groups to develop appropriate training courses in association with relevant organisations. I am happy that the Nigeria Academy of Pharmacy is working on this.

 

  1. Pharmacists in Academia:There must be something that makes us different from others around us. The emphasis on research must be given a new definition. We must find a way to make this work. There is an urgent need for collaboration with other technical groups. What constitutes a model community pharmacy or industrial or even hospital practice? I think it is the duty of our academicians to be pathfinders in this search.

 

  1. Community pharmacy:We are still grappling with the challenge of differentiation between a professional outlet and just a store. I think the time has come for us to have a common minimum standard of operation. It must be an enforceable rule for every practisingpharmacist to follow. I wish the ACPN can rise to this challenge and give every caller at a Pharmacy premise the chance to be able to recognise that this is a premise run by pharmacists. It is also time for us to intensify efforts on group practice. All the practitioners before us are all gone with few exceptions. If we do not wish to be like them, then this is the time to do something different.

 

  1. Drug distribution:Without solving the problem of drug distribution, it may be practically impossible to have the pharmacy practice of our dream in Nigeria. We should all support the implementation of the New Drug Distribution Guidelines (NDDG). It is a necessary first step towards sanity in the drug distribution in Nigeria. I have gone round the country trying to educate pharmacists on the provisions of these guidelines. We may not get the attention of the government until the election issues are settled. We are going ahead to set up a Mega Drug Distribution Centre which will protect the system and the public. This is the social enterprise advantage embedded in our plan.

 

  1. Hospital pharmacy: We must get this sector right. It is the window through which the public perceives the profession. There must be a directed effort to build capacity in this sector. As a group, we cannot afford to let it hang. I have told the last three presidents of the PSN on the need to adopt certain hospitals as models. We must make these model centres to do exactly what hospital pharmacists are doing in a chosen ideal setting abroad. The benefits of the practice from these centres will then be used to convince the government on the need to adopt the system created.

 

  1. The industrial sector: The industry must not be allowed to roll on its own. The society and the regulator must define a path for the sector. As it is now, it is highly fragmented, with virtually everybody coming in and out. Various attempts have been made to weld the industry together but differing interests have made the modest gains less impactful as it should be. We need an industry that will be ethical in its activities. We need an industry that will engage in research and support research activities in the universities. We need an industry that will put emphasis on local production not only of formulations but also of raw materials.

 

  1. Regulatory aspect: The pharmaceutical sector is a regulated industry. Much of the developmental challenges are from the regulators. It is known that only those who submitted themselves to rules and regulations get challenged every time. The Pharmaceutical space is dirty and is in need of urgent clean up. The PCN is statutorily empowered to regulate the practice of Pharmacy in all its ramifications. I think this is the time for the agency to live up to its name. Leaders should serve and not be waiting to be served. We have lost substantial time to undue emphasis on the ephemerals in the past and with the new lease of life, the expectations are quite high. It is important that the PCN pays attention to Pharmacy human resources. This will be a subject of another lecture in early May at the Obafemi Awolowo University. We must account for everyone.

 

  1. The Pharmaceutical Society of Nigeria(PSN):The PSN has been largely responsible for the progress made so far in the profession and that is a befitting tribute to our past and current leaders for their vision and commitment. The current leadership has been exceptionally dogged in the struggle to emancipate the pharmacy profession. However, the next leadership will need a new set of skills to navigate Pharmacy out of the turbulent waters. There is a need for creativity and a move away from problem fixation. New ideas will certainly be helpful. This applies to all the technical groups where action on the Pharmacy of tomorrow will be needed.

It is my hope and belief that the next and pleasant destination is assured if we follow some of these recommendations. Someone once said that “Well done is better than Well said”. How do we match our words with action? We cannot continue to have seminars ad-infinitum without a proper execution plan or capacity. The theme of the last PSN retreat was ‘Walk the talk’ and I want to persuade myself to look forward to a new dawn in the pharmacy profession.

To the graduating students and new pharmacists, my colleagues, I say a big congratulation. You have succeeded in joining a noble profession. Despite all the challenges, Pharmacy is a profession for the brightest and the best. I want to assure you, with all emphasis at my command, that Pharmacy, which you have embraced now, will provide a path for your self-actualisation. Please remember that your PharmD is not the end; rather it is the beginning of the end. You have to start learning how to practise. It is good for you to know that success in life is not always measured by fortune or acclaim. A venture tried, a challenge met, a future that you embrace is successful if only it makes the world a better place to live.

Once again, congratulations. Thank you and God bless.

 

 

 

OneStart Americas 2015 Semi-finalist: Riparian Prescribed drugs – Will Adams

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OneStart, co-organised by SR One and the Oxbridge Biotech Roundtable, is the world’s largest life science startup accelerator programme. Study how one can get prolonged mentoring and win £100okay/$150okay for your enterprise thought at http://onestart.co

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Towards a revamped health care sector

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In recent times, so much has happened within the Nigerian political and economic landscapes. From the hullabaloos over elections, to the slump in the prices of oil and the attendant effects on the value of the naira, Nigerians have had so much to witness and so much more to discuss.

However, in the health care sector, an atmosphere of worrisome stillness and stagnation prevails. Our problems remain colossal – high maternal mortality rates, poor access to medicines, unregulated drug distributorship network, encroaching malaria parasite drug resistance, inadequate access to finance, very low health insurance coverage, health labour force disputes and inter-professional wrangling, to name a few.The supporting industries that help to make health care accessible and affordable are underdeveloped and developing, the manpower limitations daunting and the need for fresh ideas will still be very much a critical requirement.

It is within the context of these present challenges that we affirm that the Nigerian government is auspiciously faced with an opportunity to create a modern day miracle. While we acknowledge that the numerous challenges besetting our health sector are not so easy to wipe away, we strongly believe that our capacities are correspondingly huge and adequate.We maintain the standpoint that if the Nigerian government dedicates a conservative 15 per cent of the nation’s budget to health care, it would create the much needed effective demand for care, which would in turn lead to a faster development in the level of private sector-led investment in health care. With judicious management, this should contribute significantly to a reversal in the brain drain suffered by the Nigerian health care industry.

It is important to note that the USA, with a population of about 350 million, has a practicing physician population of about 839,000 compared to Nigeria with less than 40,000 physicians serving a population of 170 million. The United Kingdom, on the other hand, has a population of less than 65 million individuals but boasts of a physician population of more than 200,000.Considering that Nigeria is projected to be the third largest nation by 2050 after India and China and that our locally-trained health care professionals contribute significantly to the health care team pool in developed nations, these figures become more significant and thought-provoking.Also noteworthy is that the USA, for instance, estimates that the demand for health care professionals in the years to come would outstrip the supply.

Another intervention that we expect of the government in revitalising the health care sector is the introduction of a drug pricing regime. The growth of the retail and hospital pharmacy industries has been severely hampered by the absence of this; the result of which is a price competition that helps no one, least of all expensively-trained health care professionals who are less competitive than the quacks who bear a lower operating and overhead costs.

With improved demand for care – created by a sound health financing policy, and proper legislations that create barriers-to-entry for quacks, the result would be a more investment-friendly health care sector which would not only result in a reversal in the brain drain syndrome, as earlier stated, but also strengthening of the local pharmaceutical industry which should continue to enjoy particular preferential treatment in the areas of access to finance and purchases by public organisation.

Another opportunity the government would do well to pursue is in a critical evaluation of the educational structures for health care personnel. The country certainly needs more health care professionals, who would stay and work in Nigeria. Not only is the health care brain drain an outright subsidisation of health care in developed nations but it should equally be noted that a sizeable volume of finances is expended by health care professionals on gaining postgraduate education.Should we aggregate this demand under a structure – say for example, the Nigerian–University College of London Health Care programme, which offers a variety of postgraduate health care courses, even at similar overseas costs, the result would be an education that is tailored to meet the unique challenges of Nigeria, led by dedicated scholars.

We believe that if implemented, this proposed programme, which should encompass the pharmaceutical and biotechnology industry with a management touch, would greatly help in sustaining the top-notch academic dialogue and knowledge development required to lead the necessary changes in the different aspects of our health care sector.

While some of the suggested initiatives may appear demanding in the light of prevailing circumstances, we believe that it is only with the desire to rethink the current system and a commitment to evaluating innovative ideas for feasibility that we can find practical solutions to the myriad crippling our health care sector.

 

 

Defeating malaria in Nigeria

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World Malaria Day is commemorated on every 25 April. It recognises global efforts to control malaria. The theme for this year’s celebration is “Invest in the future, defeat malaria”, as it has been since 2013. Globally, about 3.3 billion people in 106 countries are at risk of malaria. In 2009, 781 000 people died from malaria, mainly women and children in Africa.

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World Malaria Day was established in May 2007 by the 60th session of the World Health Assembly, the decision-making body of the World Health Organisation. The day was established to provide education and understanding of malaria and spread information on year-long intensified implementation of national malaria-control strategies, including community-based activities for malaria prevention and treatment in endemic areas.

The World Malaria Day theme provides a common platform for countries to showcase their successes in malaria control and unify diverse initiatives in the changing global context. Malaria-endemic countries have made incredible gains in malaria in the last decade, but sustaining them will take extra efforts until the job is finished and malaria is eliminated worldwide.

While efforts to prevent, diagnose and treat malaria have gained important momentum over the past years, an annual shortage of US$ 3.6 billion threatens to slow down progress, particularly across Africa where high-burden countries are facing critical funding gaps. Unless the world can find a way to bridge the funding gaps and endemic countries have the resources and technical support they need to implement sound malaria control plans, malaria resurgence will likely take many more lives.

In view of this reality, the National Agency for Food and Drug Administration and Control (NAFDAC) recently entered a partnership with the Cuban government, in order to employ the country’s biotechnology in eradicating malaria in Nigeria.

The Cuban Ambassador, Carlose Trejo Sosa, speaking on the development, said Cuba, as a country rich in biotechnology, could improve the health care of the Nigerian population, under the surveillance of NAFDAC.

“I think and I am sure Nigeria has many things to offer Cuba in the aspect of experience and investigation that have been made in this country, which could be of greatest interest to Cuban people”, Sosa said.

On his part, Dr Paul Orhii, NAFDAC DG, said: “Cuba has a very rich cultural heritage and has good ties with Nigeria; but more importantly, from a health perspective”.

Affirming the authenticity of the partnership, Orhii noted that Cuba is the global leader in biotechnology, developing new technologies to fight diseases, adding that most of the technologies Cuba would be bringing to fight diseases attack diseases in a more natural way.

“For example, the biolarvaesal programme on malaria that we are talking about is not just spreading chemicals that will broadly kill every other thing that will come its way; it specifically targets some disease-causing larvae, all sorts of malaria, and black flies that cause river blindness. As a leader in biotechnology in the whole world, I think we have a lot to gain and learn in this relationship. Even on eliminating malaria alone, you cannot put a naira sign. We are talking about eradicating malaria in Nigeria. We know that anti-malaria drugs are the most often used in high volumes in Nigeria because most people in Nigeria suffer from malaria”, Orhii said.

The partnership with Cuba is just one of several efforts to curb malaria in Nigeria. Hopefully, more initiatives will emerge in the course of the year. However, we shall endeavour to discuss the disease in detail below.

 

What is malaria?

Malaria is a mosquito-borne infectious disease of humans. It is widespread in tropical and subtropical regions, including much of Sub-Saharan Africa, Asia and the Americas. The disease results from the multiplication of malaria parasites within red blood cells, causing symptoms that typically include fever and headache, in severe cases progressing to coma, and death.

Malaria is not just a disease commonly associated with poverty but also a cause of poverty and a major hindrance to economic development. Tropical regions are affected the most; however, malaria’s furthest extent reaches into some temperate zones with extreme seasonal changes. The disease has been associated with major negative economic effects on regions where it is widespread. During the late 19th and early 20th centuries, it was a major factor in the slow economic development of the American southern states.

Globally, the World Health Organisation estimates that in 2013, 198 million clinical cases of malaria occurred, and 500,000 people died of malaria, most of them children in Africa. Because malaria causes so much illness and death, the disease is a great drain on many national economies. Since many countries with malaria are already among the poorer nations, the disease maintains a vicious cycle of disease and poverty.

There are four species of the Plasmodium parasite that can cause malaria in humans: P. falciparum, P. vivax, P. ovale, and P. malariae. The first two types are the most common. Plasmodium falciparum is the most dangerous of these parasites because the infection can kill rapidly (within several days), whereas the other species cause illness but not death. Falciparum malaria is particularly frequent in sub-Saharan Africa and Oceania.

 

Causes of malaria

You can only get malaria if you’re bitten by an infected mosquito, or if you receive infected blood from someone during a blood transfusion. Malaria can also be transmitted from mother to child during pregnancy.

The mosquitoes that carry Plasmodium parasite get it from biting a person or animal that’s already been infected. The parasite then goes through various changes that enable it to infect the next creature the mosquito bites. Once it’s in you, it multiplies in the liver and changes again, getting ready to infect the next mosquito that bites you. It then enters the bloodstream and invades red blood cells. Eventually, the infected red blood cells burst. This sends the parasites throughout the body and causes symptoms of malaria.

Malaria has been with us long enough to have changed our genes. The reason many people of African descent suffer from the blood disease, sickle cell anaemia, is because the gene that causes it also confers some immunity to malaria. In Africa, people with a sickle cell gene are more likely to survive and have children. The same is true of thalassemia, a hereditary disease found in people of Mediterranean, Asian, or African-American descent.

 

 

Symptoms and complications of malaria

Symptoms usually appear about 12 to 14 days after infection. People with malaria have the following symptoms:

  • abdominal pain
  • chills and sweats
  • diarrhoea, nausea, and vomiting (these symptoms only appear sometimes)
  • headache
  • high fevers
  • low blood pressure causing dizziness if moving from a lying or sitting position to a standing position (also called orthostatic hypotension)
  • muscle aches
  • poor appetite
  • In people infected with P. falciparum, the following symptoms may also occur:
  • anaemia caused by the destruction of infected red blood cells
  • extreme tiredness, delirium, unconsciousness, convulsions, and coma
  • kidney failure
  • pulmonary oedema (a serious condition where fluid builds up in the lungs, which can lead to severe breathing problems)

 

  1. vivax and P. ovale can lie inactive in the liver for up to a year before causing symptoms. They can then remain dormant in the liver again and cause later relapses. P. vivax is the most common type in North America.

In recent years, some human cases of malaria have also occurred with Plasmodium knowlesi – a species that causes malaria among monkeys and occurs in certain forested areas of South-East Asia.

 

Transmission of malaria

Malaria is transmitted exclusively through the bites of Anopheles mosquitoes. The intensity of transmission depends on factors related to the parasite, the vector, the human host, and the environment.

About 20 different Anopheles species are locally important around the world. All of the important vector species bite at night. Anopheles mosquitoes breed in water and each species has its own breeding preference; for example, some prefer shallow collections of fresh water, such as puddles, rice fields, and hoof prints. Transmission is more intense in places where the mosquito lifespan is longer (so that the parasite has time to complete its development inside the mosquito) and where it prefers to bite humans rather than other animals. For example, the long lifespan and strong human-biting habit of the African vector species is the main reason about 90 per cent of the world’s malaria deaths are in Africa.

Transmission also depends on climatic conditions that may affect the number and survival of mosquitoes, such as rainfall patterns, temperature and humidity. In many places, transmission is seasonal, with the peak during and just after the rainy season. Malaria epidemics can occur when climate and other conditions suddenly favour transmission in areas where people have little or no immunity to malaria. They can also occur when people with low immunity move into areas with intense malaria transmission, for instance to find work, or as refugees.

Human immunity is another important factor, especially among adults in areas of moderate or intense transmission conditions. Partial immunity is developed over years of exposure, and while it never provides complete protection, it does reduce the risk that malaria infection will cause severe disease. For this reason, most malaria deaths in Africa occur in young children, whereas in areas with less transmission and low immunity, all age groups are at risk.

When a mosquito bites an infected person, a small amount of blood is taken in, which contains microscopic malaria parasites. About a week later, when the mosquito takes its next blood meal, these parasites mix with the mosquito’s saliva and are injected into the person being bitten.

Because the malaria parasite is found in red blood cells of an infected person, malaria can also be transmitted through blood transfusion, organ transplant, or the shared use of needles or syringes contaminated with blood. Malaria may also be transmitted from a mother to her unborn infant before or during delivery (“congenital” malaria).

Anyone can get malaria. Most cases occur in people who live in countries with malaria transmission. People from countries with no malaria can become infected when they travel to countries with malaria or through a blood transfusion (although this is very rare). Also, an infected mother can transmit malaria to her infant before or during delivery.

 

Malaria diagnosis

Malaria is diagnosed by seeing the parasite under the microscope. Blood taken from the patient is smeared on a slide for examination. Special stains are used to help highlight the parasite. Sometimes, it is possible to identify the species of Plasmodium by the shape of the parasite, especially if gametocytes are seen. Whenever possible, smears should be reviewed by someone with expertise in the diagnosis of malaria. If the smears are negative, they can be repeated every 12 hours. Smears that are repeatedly negative suggest another diagnosis should be considered.

Two types of other tests are available for diagnosis of malaria. Rapid tests can detect proteins called antigens that are present in Plasmodium. These tests take less than 30 minutes to perform. However, the reliability of rapid tests varies significantly from product to product. Thus, it is recommended that rapid tests be used in conjunction with microscopy. A second type of test is the polymerase chain reaction (PCR), which detects malaria DNA. Because this test is not widely available, it is important not to delay treatment while waiting for results.

 

Antimalarial drug resistance

Resistance to antimalarial medicines is a recurring problem. Resistance of P. falciparum to previous generations of medicines, such as chloroquine and sulfadoxine-pyrimethamine (SP), became widespread in the 1970s and 1980s, undermining malaria control efforts and reversing gains in child survival.

In recent years, there has been a massive reduction in malaria-related morbidity and mortality in regions of high endemicity in the last decade, which was in part due to the effectiveness of the ACT regimen. However, these successes are threatened by the emergence of artemisinin-resistant strains of Plasmodium falciparum from the Thai-Cambodian border and Thai-Myanmar border.

Indeed, artemisinin resistance is a major threat to global health, particularly in low- and middle-income countries (LMICs), in which the disease burden is highest. Substandard or counterfeit ACT compounds are widely available, and systems for the monitoring and containment of resistance are inadequate. There is little existing knowledge regarding ACT-resistant malaria in many SSA countries, including Nigeria, and the most recent reports of ACT treatment failures were in travellers who had recently visited African countries.

Additionally, there have been no reports of delayed parasite clearance in routine therapeutic efficacy studies conducted in Africa. Thus, arguments for the presence of artemisinin resistance in Africa have been based solely on in vitro and/or molecular analyses of parasites collected from autochthonous patients or returning travellers. However, standard in vitro tests are not reliable tools for monitoring artemisinin resistance. In addition, none of the putative molecular markers for antimalarial drug resistance has been correlated with delayed clearance after treatment with artemisinin.

 

Prevention

Vector control is the main way to reduce malaria transmission at the community level. It is the only intervention that can reduce malaria transmission from very high levels to close to zero. For individuals, personal protection against mosquito bites represents the first line of defence for malaria prevention.

Two forms of vector control are effective in a wide range of circumstances:

 

  • Insecticide-treated mosquito nets (ITNs)

Long-lasting insecticidal nets (LLINs) are the preferred form of ITNs for public health distribution programmes. WHO recommends coverage for all at-risk persons, and in most settings. The most cost-effective way to achieve this is through provision of free LLINs, so that everyone sleeps under a LLIN every night.

 

  • Indoor spraying with residual insecticides

Indoor residual spraying (IRS) with insecticides is a powerful way to rapidly reduce malaria transmission. Its full potential is realised when at least 80 per cent of houses in targeted areas are sprayed. Indoor spraying is effective for 3–6 months, depending on the insecticide used and the type of surface on which it is sprayed. DDT can be effective for 9–12 months in some cases. Longer-lasting forms of existing IRS insecticides, as well as new classes of insecticides for use in IRS programmes, are under development.

 

Antimalarial medicines can also be used to prevent malaria. For travellers, malaria can be prevented through chemoprophylaxis, which suppresses the blood stage of malaria infections, thereby preventing malaria disease. In addition, WHO recommends intermittent preventive treatment with sulfadoxine-pyrimethamine for pregnant women living in high transmission areas, at each scheduled antenatal visit after the first trimester. Similarly, for infants living in high-transmission areas of Africa, three doses of intermittent preventive treatment with sulfadoxine-pyrimethamine is recommended delivered alongside routine vaccinations.

 

Surveillance

Tracking progress is a major challenge in malaria control. In 2012, malaria surveillance systems detected only around 14 per cent of the estimated global number of cases. Stronger malaria surveillance systems are urgently needed to enable a timely and effective malaria response in endemic regions, to prevent outbreaks and resurgences, to track progress, and to hold governments and the global malaria community accountable.

 

Elimination

Malaria elimination is defined as interrupting local mosquito-borne malaria transmission in a defined geographical area, i.e. zero incidences of locally contracted cases. Malaria eradication is defined as the permanent reduction to zero of the worldwide incidence of malaria infection caused by a specific agent; i.e. applies to a particular malaria parasite species.

On the basis of reported cases for 2013, 55 countries are on track to reduce their malaria case incidence rates by 75 per cent, in line with World Health Assembly targets for 2015. Large-scale use of WHO-recommended strategies, currently available tools, strong national commitments, and coordinated efforts with partners, will enable more countries – particularly those where malaria transmission is low and unstable – to reduce their disease burden and progress towards elimination.

In recent years, four countries have been certified by the WHO Director-General as having eliminated malaria: United Arab Emirates (2007), Morocco (2010), Turkmenistan (2010), and Armenia (2011).

 

Vaccines against malaria

There are currently no licensed vaccines against malaria or any other human parasite. One research vaccine against P. falciparum, known as RTS, S/AS01, is the most advanced. This vaccine has been evaluated in a large clinical trial in seven countries in Africa and has been submitted to the European Medicines Agency under art. 58 for regulatory review. A WHO recommendation for use will depend on the final results from the large clinical trial and a positive regulatory review. The recommendation as to whether or not this vaccine should be added to existing malaria control tools is expected in late 2015.

 

Treatment

The choice of drug depends on the species of Plasmodium and the risk of drug resistance in the area where the malaria was acquired. In sub-Saharan Africa, for example, older drugs like chloroquine are largely ineffective.

Most medications are available only as tablets or pills. Intravenous treatment with quinidine may be needed in severe malaria or when the patient cannot take oral medications. Malaria during pregnancy requires treatment by someone who is an expert in this area. Miscarriage and maternal death may occur, even in the best of hands.

Patients with P. vivax or P. ovale may not be completely cured by the above medications, even though the symptoms resolve. This is because the parasites can hide in the liver. A medication called primaquine is used to eradicate the liver form, but this drug cannot be given to people who are deficient in an enzyme called G6PD.

Treatment usually lasts for 3 to 7 days, depending on the medication type. To get rid of the parasite, it’s important to take the medication for the full length of time prescribed – don’t stop taking the medication even if you feel better. If you experience any side effects, your doctor can recommend ways to manage them or may choose to give you a different medication.

If you’re travelling to a malarial region, you should take a course of preventive treatment. Medications similar to those used to cure malaria can prevent it if taken before, during, and after your trip. It’s vital to take your medication as prescribed, even after you return home. Before travelling, check with your doctor or travel clinic about the region’s malaria status.

 

Reports compiled by Temitope Obayendo with additional information from: The World Health Organisation (WHO); National Agency for Food and Drug Administration and Control (NAFDAC); bodyandhealth.com; and cutecalendar.com

Pharm. Okeke wins Bowl of Hygeia award

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Pharm. Linda Okeke (2nd left) receiving the “Bowl of Hygeia” from Pharm. Bukky George, managing director of HealthPlus Pharmacy, to the admiration of her parents and Prof. Olukemi Odukoya, dean of the Faculty (far right).

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Young Pharm. Linda Chidinma Okeke has been announced winner of the maiden edition of the prestigious Bowl of Hygeia award in Nigeria.

The newly decorated pharmacist, who was among 138 graduates of the Faculty of Pharmacy, University of Lagos (UNILAG) whose induction and oath-taking ceremony took place on 5 March 2015, was given a standing ovation, as she climbed the podium to receive her prize.

During the award presentation, Prof. Olukemi Odukoya, dean of the Faculty of Pharmacy, explained that the Bowl of Hygeia award is the highest award in Pharmacy, adding that it is usually awarded to pharmacists that possess outstanding records of civic leadership in their communities.

“Our community is a community of scholars primarily for students. On the occasion of the celebration of 30 years of pharmaceutical excellence in the University of Lagos, the Bowl of Hygeia is being awarded for the first time in the history of Pharmacy in Nigeria,” she intoned.

Odukoya further stressed that the choice of Okeke was hinged on her outstanding qualities and contributions within the faculty.

“As a student, she was an admirable, brilliant (with a CGPA of 4.43), coordinated, decent, diligent, elegant, fantastic, graceful, honourable, intelligent, joyful, orderly, obedient, peaceful and punctual student – now a pharmacist!” she announced.

Remarking on the symbolism of the Bowl of Hygeia, Odukoya noted that the pharmaceutical profession had used numerous symbols over the past centuries, includingt he Rx sign, the show globe, the green cross, the “A” sign for apothecary (Apotheke), and the current mortar and pestle, otherwise known as the Bowl of Hygeia.

“The Bowl of Hygeia is the most widely recognised international symbol of Pharmacy,” she said.

She further narrated that, in Greek mythology, Hygeia was the daughter and assistant of Asklepios, the god of medicine and healing. Hygeia’s classical symbol was a bowl containing a medicinal potion with the serpent of wisdom partaking in it, she said, adding however that the serpent image is now popularly represented with a pestle.

“Now the bowl represents a medicinal potion, and the snake represents the pestle to make the medicines for healing. Healing through medicine is precisely why Pharmacy has adopted the Bowl of Hygeia Symbol,” she stressed.

In attendance at the event were Prof. Folasade Ogunsola, provost, College of Medicine, UNILAG; Dr (Mrs) Taiwo Ipaye, registrar, UNILAG; Prof. Duro Oni, deputy vice chancellor (management sciences), UNILAG; Dr (Mrs) Olukemi Fadehan, University Librarian, UNILAG; and Mrs Yetunde Situ, director of treasury, representing the bursar.

Others were Pharm. N.A.E Mohammed, registrar, Pharmacists Council of Nigeria (PCN); Pharm. Ike Onyechi, chairman of the occasion; Prof. Babajide Alo, deputy vice chancellor (academics and research) representing the vice chancellor; and Pharm. Bukky George, managing director of HealthPlus Pharmacy.

Colgate introduces acid-neutraliser toothpaste

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Leading global oral care company, Colgate Palmolive, has introduced a new product, Colgate Maximum Cavity Protection plus Sugar Acid Neutraliser toothpaste, into the Nigerian market.

 

L-R:Oral Care Consultant, Mrs Oge Mac Johnson; Profession Manager,EWA, Mr Chestin Twigg and Marketing Director, Mrs Hannah Oyebanjo, all of Colgate Palmolive Nigeria, during the company’s media launch of Maximum Cavity Protection Sugar Acid Neutraliser MCP+SAN Toothpaste in Lagos.

The latest addition to Colgate Nigeria’s product line is specially formulated to offer a new standard of care in preventing cavities and is intended for consumers who are primarily or exclusively interested in deriving the best protection against cavities from their toothpaste.

Speaking at the media unveiling of the technology-driven product at an event held at Eko Hotel & Suites, Lagos, Colgate Marketing Director for East and West Africa (EWA), Mr Chris Hall, said:“Colgate Maximum Cavity Protection plus Sugar Acid Neutraliser toothpaste is a breakthrough in the treatment and prevention of cavities.”

According to Mr Hall, with regular twice daily use, the sugar acid neutraliser formula works to neutralise harmful acids that are formed by bacteria from sugar, to reduce early caries while also strengthening and restoring enamel to help prevent cavity formation. Colgate Maximum Cavity Protection plus Sugar Acid Neutraliser toothpaste, he said:“has been demonstrated in various clinical studies to be more efficacious at reducing cavities than conventional toothpaste with fluoride alone.”

Mr Hall explained further that the product, which is a result of years of research and technological breakthrough, is formulated to reduce and prevent cavities by strengthening teeth and decreasing demineralisation by acids. Hall said the Sugar Acid Neutraliser technology works to create a healthy environment for the teeth by increasing the plaque pH and further preventing demineralisation and promoting remineralisation of the teeth.

Also speaking on the product, Colgate Professional Manager (EWA), Mr Cheslin Twigg, said the Sugar Acid Neutraliser technology and Fluoride were designed to help arrest and reverse the caries process by decreasing demineralisation and increasing remineralisation much more effectively than fluoride alone and this results in less cavitation than when fluoride alone is used.

While explaining further how the new product works, he said, “It tackles the cause of caries by targeting acid produced from sugars by bacteria in plaque, in addition to providing the conventional benefits of fluoride.” In contrast, traditional cavity treatments based upon fluoride alone focus solely on treating the symptoms of caries by strengthening the teeth.”

Also speaking at the event, Colgate Palmolive Nigeria Marketing Director, Mrs Hannah Oyebanjo, explained that “Sugar Acid Neutraliser technology actually works biologically by targeting the primary cause of caries, the plaque biofilm, to reduce the effects of acids produced from sugars before they can harm the teeth. Specifically, it promotes the beneficial activity of arginolytic bacteria that convert arginine into ammonia to directly neutralise the “sugar acids” in plaque, creating a healthier environment for the teeth.”

Oyebanjo stated further that Sugar Acid Neutraliser is Colgate’s trademark name for the technology, consisting of arginine and an insoluble calcium compound, which it has developed and added to fluoride toothpaste to deliver superior cavity protection when compared to toothpaste with fluoride alone.

 

Colgate Palmolive Nigeria General Manager, Mr Davis Kanyama also noted that the company will continue to avail Nigerian market with quality and specially formulated products that ensure oral wellbeing of discerning consumers. He said Colgate is known worldwide for continuous improvement, global teamwork and care, backed by over two centuries of experience and maintain number one market share in 146 counties globally.

“We have built a hallmark of exceptional global consumer products including toothpastes and brushes for our consumers, shoppers, customers and professionals in 223 countries. Colgate products are being sold worldwide and we are committed to offering Nigerians the same world-class products that offer total wellness to everyone in the family,” he said.

Lagos ACPN elects Abiola Paul-Ozieh as chairman

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The atmosphere at the Pharmacy Villa, Ojota, Lagos, was recently agog with excitement as Pharm. (Mrs) Abiola Olubunmi Paul-Ozieh was announced new chairman of the Association of Community Pharmacists of Nigeria (ACPN), Lagos State.

The announcement came as she emerged victorious in the chairmanship election conducted at this year’s Annual General Meeting of the association.

Aunty Abiola, as she is fondly called,was until her election, vice-chairman under the administration of the immediate past chairman, Pharm. Aminu Yinka Abdulsalam. Prior to that, she was the secretary of the association under the administration of Pharm. Anieh Felix Anieh.

A 1986 graduate of the Obafemi Awolowo University with a master’s degree in Pharmacology and another in Business Administration, Pharm. Paul-Ozieh has been in community service for 12 years, out of the 29 years she has spent practising Pharmacy. She recently completed her West African Postgraduate College of Pharmacists (WAPCP), examinations.

Beaming with smiles,the new chairman disclosed to journalists that her emergence was an act of God, adding that it was a call to responsibility and a challenge which required much sacrifice in order to consolidate on the achievements of the previous administration and move the association to the next level.

Speaking further, Pharm. Paul-Ozieh, who is also the chief executive officer of High Rock Pharmacy, Ifako-Ijaiye, explained that even though she was part of the outgoing administration, there were still some thorny issues to be tackled from the point the outgoing administration stopped. She listed the issues to include the Mobile Authentication Service, illegal pharmaceutical premises, and membership mobilisation.

Also speaking at the event, the outgoing chairman, Pharm. Aminu Yinka Abdulsalam, encouraged the newly elected executive members to brace up, stressing that the task ahead of them was an uphill one, requiring full time commitment.

While calling on community pharmacists across the state to give the new executives maximum support and cooperation, Pharm, Abdusalam equally pledged his continued support.

“Even though the journey started three years ago, I thank God it is ending today and I want to assure you that even though I will be leaving the boardroom of power of the ACPN, I will not be too far from the corridor, as I will continue to play my part actively,” he said.

The outgoing ACPN boss also took time to recognise the contributions of some eminent personalities, whom he described as pillars and sources of inspiration to the association. The list includes President of the PSN, Pharm. Olumide Akintayo; Chairman, Board of Trusties of ACPN, Pharm. Deji Osinoiki; and Chairman, PSN, Lagos, Pharm. Gbenga Olubowale.

Speaking further, Aminu noted that the year under review was full of challenges for the association, adding that more challenges were still ahead for the incoming administration.

“The challenges are enormous because pharmacists are cynosures in the health care landscape; but I do not see the challenges as insurmountable if we are working together as formidable force.”

Regarding membership strength, the outgoing ACPN boss lamented that while over 800 members paid their various dues and registered with the PCN in 2012, the numbers of financial members reduced to 779 in 2013 and 749 in 2014, noting that the dwindling membership strength calls for concern.

Abdusalam also used the opportunity to urge the federal government to be wary of encouraging foreign investments in the pharmaceutical industry, saying such move could frustrate the goals of the National Drug Policy and preventself-sufficiency, service delivery and professionalism in the local pharmaceutical industry.

“Ineffective drug administration and control, high dependence on foreign sources for finished drug products and the lack of political will to provide safe and good quality medicines to meet the health needs of Nigerians are key challenges we are facing in the pharmaceutical sector; therefore we have to critically evaluate and consult widely before we jump at any form of transformation coming to pharmacy practice, if only to avoid liberalisation of our profession,” he advised.

Other members of the newly elected executive members are, Pharm. Olabanji Benedict Obideyi, vice-chairman; Pharm. Lawrence Ekhator, secretary; Pharm. Moyosore Michael Ademola, assistant secretary; Pharm. Ismail Kola Sunmonu, treasurer; Pharm. Ambrose Sunday Ezeh, financial secretary; Pharm. Obiageri Ethel Ikwu, public relations officer; and Pharm. Timehin Ogungbe, editor-in-chief.

Roche in 60 seconds

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Roche is a frontrunner in research-focused healthcare with mixed strengths in prescription drugs and diagnostics. Roche is the world’s largest biotech firm, with actually differentiated medicines in oncology, immunology, infectious illnesses, ophthalmology and neuroscience. Discover out extra about Roche in 60 seconds by watching this video and/or visiting our web site: www.roche.com

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