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The foolishness of intolerance

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

Culled from THE LAW OF SUCCESS by NAPOLEON HILL

‘Register-and-go’ killing pharmacy profession

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Pharm. (Mrs) Felicia Ebaide Oriaifo–Odaro is a Fellow of the Pharmaceutical Society of Nigeria (FPSN) and a former member of PCN governing council. In this incisive interview with Adebayo Folorunsho-Francis, the one-time national chairman of the Association of Lady Pharmacists (ALPs) expressed her views on the tremendous growth of the Nigerian pharmaceutical industry, as well as why she thinks the ‘register-and-go’ syndrome is tearing the profession apart. Excerpts:

Give us a glimpse of your early years

I attended the famous St. Teresa’s College, Oke–Ado, Ibadan, after my primary school education at the Ibadan City Council School, Mokola, Ibadan. I proceeded to the University of Ife, Ile-Ife (now Obafemi Awolowo University) to study Pharmacy. On graduation in 1973, I was posted to Jos, then Benue Plateau State as a corper. I belong to the group that started the National Youth Service Corps (NYSC) in Nigeria.

At the end of my service year, I joined the civil service of the then Mid-Western State as a Pupil Pharmacist with the Hospitals Management Board. I rose through the ranks to become Director of Pharmaceutical Services in Edo State, before being appointed Permanent Secretary in the Ministry of Health.

While in the service, I went back to school for a master’s degree in Pharmaceutical Technology at the University of London, United Kingdom. My postings included the State Medical Stores; Central Hospital; Bendel Pharmaceuticals; Hospital Management Board; and the Essential Drugs Project (EDP), Bendel and Edo. I served as Project Manager of the Essential Drugs Project, which enabled me to have several national and international interactions with colleagues and members of other professions.

 Would you say, studying Pharmacy was a good decision for you?

Absolutely! I am happy and proud to belong to this profession.

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

The profession remains more or less the same; but there have been improvements in the practice. Now, more attention is being paid to the patient. With the unit dose system, pharmaceutical care and patient counselling, patients get better attention from pharmacists than before.

In those days, relationship with the patient was through a hatch in the wall, through which medicines were passed out to the patient. Today, the patient is counselled and explanation on the use of each medicine is given to him.

The pharmaceutical industry also has grown tremendously. There are so many medicines today for treating of all manner of ailments. In academics, the curriculum for training of pharmacists has grown.

Were there some controversial issues and scandals in your time?

What comes to mind easily is the ‘register-and-go’ scourge. When the federal government (FG) gave approval for pharmacists to register premises, even while still in service elsewhere (i.e. ‘private practice’), many applauded it, thinking it was a good idea. Quite a number of pharmacists went ahead and gleefully hung their licences in shops which could not have passed as pharmacies. No one bothered about what went on in those premises. Some pharmacists signed blank order sheets for importation and procurement of all kinds of medicines by just anyone who had the funds.

When the same FG eventually came back and banned ‘private practice’ for pharmacists, the illegal practices could not be stopped. Our people had tasted the ‘forbidden fruit’ and so the rot continues even till today. Many pharmacists are still in the habit of ‘register-and-go’ which is highly injurious to the profession and the country as a whole.

What are the specific challenges facing pharmacy practice in Nigeria and how can they be surmounted?

The challenges are many and multifaceted. Laws regulating the use of medicines exist in Nigeria, as in other countries – good and well thought-out laws – but enforcement of these laws is inadequate or totally non-existent in our country. This is why anyone can walk into any shop that trades in medicines and buy any class of medicine, controlled or otherwise.

Enforcement of the existing laws is a good place to start. Policy guidelines are made, like the National Drug Distribution Guidelines (NDDG); but the implementation is stalled and so the challenge of open drug markets, an all-comers business, remains with us.

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

This is a global issue and so far, in Nigeria, the regulatory bodies – the Pharmacists Council of Nigeria (PCN), NAFDAC and SON are working in concert with the customs, the police, the judiciary, and even the citizenry, to control and contain this ‘monster’ of fake drugs and counterfeit medicines.

Since the trailblazing input of the late Pharmacist (Professor) Dora Akunyili as Director General of NAFDAC, awareness on the dangers of fake drugs and counterfeit medicines has been raised tremendously among the populace. I would say that offenders should be adequately and swiftly punished to act as deterrent. Medicine outlets should be controlled and appropriately regulated to block them from being used as outlets for fake drugs and counterfeit medicines. This brings us back to the issue of enforcement and implementation of existing laws and guidelines.

What is your view about pharmacists in politics?

Pharmacists in politics – yes, it is a good thing; after all, politics is for all of us and being a pharmacist should not disqualify one from having political views, interests or ambition.

To what extent have you been involved in pharmaceutical activities?

Ah! Since I set out to read Pharmacy, I have been involved in pharmaceutical activities, beginning with being an active member of the Pharmaceutical Association of Nigerian Students (PANS). After graduation, I served as financial secretary, public relations officer and later, vice chairman in the Bendel State Pharmaceutical Society of Nigeria (PSN), as well as being a member of the national privileges committee. I co-ordinated the state PSN’s end-of-year activities as chairman for many years.

I was also the national chairman of the Association of Lady Pharmacists (ALPS) from 1992 to 1995. I was a member of the governing council of the Pharmacists Council of Nigeria (PCN)for many years. I still remain an active member of the Pharmaceutical Society of Nigeria (PSN) and relevant technical groups.

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

Yes!Many, for which I am grateful to God. I was made a Fellow of the Pharmaceutical Society of Nigeria in the year 2000. I received three awards while serving as member of the governing council of the PCN. The Association of Community Pharmacists of Nigeria (ACPN) gave me an award in recognition of contributions made to the development of community practice in Nigeria, while serving as Director of Pharmaceutical Service (DPS). The Association of Lady Pharmacists (ALPS) also gave me an award in appreciation of contributions made towards the growth and development of ALPS as national chairman.

How do you see the annual PSN national conferences?

The PSN national conferences are the highlights of the Society’s activities during the respective years. The conference is a meeting point for pharmacists to interact, rub minds with one another and try to advance the profession. At the conference, you learn of new developments in the pharmacy world.

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

I cannot imagine not being a pharmacist. Before I chose to read Pharmacy, I had all the chances in the world to read Medicine, Chemistry, Zoology, Biochemistry or Microbiology. Indeed, I should tell you that I come from a family of medical doctors and scientists. At least, three of my brothers are medical doctors and I could have easily followed them into the medical profession. Yet, I settled for Pharmacy because of my love for it.

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

I would say no. A pharmacist or anyone at that should remain active in whatever calling he chooses or enjoys, so long as he is not incapacitated by ill-health. It is generally believed that a human being should remain active till the end.

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

Young and upcoming pharmacists should strive to uphold the ideals and integrity of the profession, avoid sharp practices and, above all, trust in God.

Why industrial pharmacists need exposure, by FIP president

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

 

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

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

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

Social media impacts on drug development

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

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

 Customised medicines

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

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

Big questions

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

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

Packaging and information essentials

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

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

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

 Site visits and latest research

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

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

Wider perspective

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

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

 When and where?

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

Why I’m dissatisfied with pharmacy practice in Nigeria – Pharm. Bisi Bright

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It was Martin Luther King Jr who once said, “Occasionally in life, there are those moments of unutterable fulfillment which cannot be completely explained by those symbols called words. Their meanings can only be articulated by the inaudible language of the heart.” This perhaps explains the unmistakable joy of fulfillment often reflected on the face of Pharm. (Mrs) Bisi Bright, the executive director, Livewell Initiative, a leading non-governmental organisation committed to delivering health quality care services, especially to the underprivileged.

In this exclusive interview with Pharmanews at her office in Lagos, Pharm. Bright, a Fellow of both the Pharmaceutical Society of Nigeria (PSN), and the West African Postgraduate College of Pharmacists (WAPCP), went down memory lane on the activities of LWI, revealing significant milestones. She also spoke on some general issues affecting pharmacy practice in Nigeria.

Excerpts:

 

Tell us a little about yourself

My name is Pharm. Bisi Bright, I am the chief executive officer, Livewell Initiative, a self-sustaining non-profit organisation that is into public health and education. I am by background a clinical pharmacist and a public health practitioner. I got my first degree in Pharmacy from the then University of Ife (now Obafemi Awolowo University), Ile-Ife, Osun State, after which I worked for many years before going for my first postgraduate programe in Clinical Pharmacy at the West African Postgraduate College of Pharmacists (WAPCP), where I got my Fellowship as far back as 1997. Later on, I did my Masters in Public Health. I also have a diploma in Psychology, Family Planning, and many others.

 

Tell us about Livewell Initiative

Livewell Initiative is a self-sustaining and very innovative non-governmental organisation that is not donor-funded. Even though most NGOs are donor-funded, LWI is not and has never been. By the time we were founded, it was based on the principle of ethics, accountability and transparency. Those are the core values of the organisation and those core values have really helped to drive innovation within the organisation; and because we are innovation driven, we have been able to attain sustainability and have won several awards.

The organisation was inaugurated officially on 20 September, 2007 at the Muson Centre, Onikan, Lagos, under the auspices of His Excellency, Governor Babatunde Raji Fashola, the Lagos State Governor, who was ably represented.At the time we were inaugurated, we had started running some of our programmes. We wanted toto find out if our policy of not being donor-funded would work.

 

Why did you decide not to be donor-funded, knowing full well that running an NGO requires lots of money?

At the time we started off, while we were trying to register the organisation and also get people on board, one of our directors, who was a Swiss and who had worked with the World Health Organisation for about 30 years, advised us not to go for donor-funding. She said most donor-funded NGOs don’t usually survive the “weaning” period – a period when an NGO is not big enough to stand on its own. Should majority of the donors decide to withdraw from further sponsorship, the NGO would not survive the stage and usually becomes underfunded. That was what really informed our policy from the beginning. Expectedly, it was a bit tough at the beginning as we had to use personal funds to start off the organisation. We however ensured that our programmes were very appealing to would-be clients so that they would want to work with us and that was how we started.

 

What kept you going during those trying moments?

When you run a non-profit organisation, you only measure success by sustainability. So we knew from the beginning that finance would be a challenge but we consoled ourselves by accepting the fact that even profit-making organisations do have financial challenges. Therefore, our major inspiration was the fact that, firstly, we realised that our programmes were in high demand. We also found out that we were making an impact, and that we were able to implement cases in which we had deficiency in cash, by barter arrangement, which we found out that most company really liked. That’s what kept us going and encouraged us.

Also, the fact that we could see people getting well; that we could see communties enjoying better health after our organisation’s intervention, kept us going from strength to strength as well.

 

Comparing your aspirations in the university with what you are doing presently, would you say studying Pharmacy was a good decision for you?

When I tell people about Pharmacy, I always tell them that I had always wanted to read Pharmacy, although I don’t like the way it is being practised here in Nigeria. I have never had any regrets studying Pharmacy because it has really helped me a lot in life.

When you read Pharmacy, you learn to have an eye for detail; you learn to be meticulous and you also learn to be resilient. For you to go through the pharmacy curriculum, you must learn to work lengthy hours and work within a very hectic schedule, involving lots of strenuous activities, while others around you are enjoying and relaxing. So, that has prepared me to go through what I am doing presently and it was like going through pharmacy again and I love it.

 

What do you think is wrong with the way pharmacy is being practised in Nigeria?

I will speak within two contexts – Pharmacy as a practice and profession, and secondly, Pharmacy as a practice within the health system. For the first one, I really think we could do a bit more in the sense that while Pharmacy is a versatile profession, I have come to discover that most pharmacists tend to toe a particular line.They either go into hospital, community, industry or the academia – those were the areas we focused majorly on, whereas in other countries of the world, pharmacy is so versatile that you can find 20 pharmacists doing absolutely different things and they all arrive at pharmacy practice.

I see myself today as public health pharmacist, but some of my colleagues would say I am no longer practising Pharmacy because they don’t even know that I am still practising the profession. So, it shows that we don’t really know how versatile and rich the profession is; we don’t even know that a hospital pharmacist could be a clinical pharmacist and even specialise in Paediatric Pharmacy, Oncology Pharmacy and many more. Here, once a pharmacist decides to go into a hospital, such may continue working without even thinking of specialising, although things are changing these days.Presently, I am happy as we now have pharmacists who are specialising in Oncology, Paediatrics and so on, even though they are not so many.

The fact that people are not practising properly (they are not specialising) has, to an extent, prevented our voices from being heard in the comity of healthcare practitioners and that is why I said I don’t like the way Pharmacy is being practised here. Even if a pharmacist is in the industry, he should try and specialise more in a particular area and not just be a generic practitioner. Though there is nothing wrong in being in general practice, that does not mean everybody should be general practitioners.

Also, I don’t really like the way pharmacy is being practised within the health system because we don’t have enough pharmacists who are specialists in certain skills and areas to have a voice. So, if a general practitioner comes in and want to make a pronouncement in an area that is highly specialised, the specialists may disagree because they believe they know more in that field; but if a pharmacist also has specialisation in that field, it would be an issue of exchanging ideas, collaborating and discussing. So, I think for our voices to be heard, there should be more empowerment for the practitioners.

When you have empowered practitioners, they are better integrated within the health system. If you look at the way health care is being practised in advance countries, we have what is called integrated teams or multi-disciplinary teams, in which everybody comes in with their own specialties and they are all practising together, and the patient benefits from it.

 

As a devout Christian, how would you react to the accusation that some NGOs are mere money-making ventures.

An NGO is supposed to be an organisation that identifies and fills social gaps. Incidentally, a social gap is so defined because the government is supposed to be responsible for the people in every nation; but the government cannot do everything. So,when there is a gap which the government ought to be filling but is failing to do so, it is identified as a social gap.An NGO steps in to fill those social gaps and that’s why they are called non-governmental-organisations, in other words, filling the gap for the government.

Now, because of the nature of NGOs, there are lots of donors who usually want to work with them in order to fill in those gaps left by the government. Some of these donors are philanthropists; some are venture-philanthropists who give out money and ensure proper monitoring of the money; while some are just social investors. So people who invest in NGOs do so for different reasons.

Because the human nature is unpredictable, there are some selfish people who go into this non-profit venture because they want to make money and get donor funds. They set up a seemingly philanthropic and charitable organisation under the pretext of filling social gaps, but what they are filling is their own pockets. The corruption that has eaten deep into our society is also affecting NGOs in the country and there are only a few NGOs that are really working with probity.It is even difficult to identify these sincere ones.

 

How would you assess government efforts in supporting NGOs in the country?

I am really sorry to say this but I am going to be very frank: I have not really seen much evidence of any government support for NGOs in the country. Actually, because of the fraud in the sector, government has said that any donor funds coming in to the country must pass through them and they also set up enabling committees through which those funds pass.So most donor agencies pass through the government in order to support NGOs; but the truth is that the funds are nowhere to be found.

Assuming the government had a transparent method of disbursing funds to NGOs that are truly working, they should be able to question the NGOs on what they are doing and possibly make a request for evidences to show they are truly performing. So to me, it’s not a transparent thing at all and, as hardworking as we are at LWI, I don’t want to believe we are invisible to the government, except they shut their eyes to what they don’t want to see. It is very unfortunate but it is the truth.

 

Where do you hope to see LWI in the next five years?

 

When we started off, I remember I made a statement that in 20 years’ time, whenever LWI is mentioned, the WHO would blink an eye; and in 50 years, when the name is mentioned, the WHO would shake. What I was trying to say then was that, we really did want to become an international organisation, even though we started off as a community-based organisation. Now I have seen that those lofty dreams we had at inception will surely come to pass and we will get there.

So, in five years’ time, I see a globalised LWI, even though our goal for globalisation was the year 2017. Considering the way the economy has been going and so many things that have happened in Nigeria, including political instability across the country, I don’t think we can still meet up with our 2017 target, but we are convinced that we will get globalised by the year 2020.By globalisation, I mean we will have our presence in key cities and become an household name in the country and also have our presence in at least, four to five city capitals around the world. That’s where we see ourselves before the year 2020.

 

How do you juggle running an NGO of this magnitude with giving attention to your family life?

 

It is actually the grace of God, because it is not easy combining work and family as a woman. Giving attention to your husband, your children and – for someone like me who is a grandmother – grandchildren at home and, at the same time, actively working, is a difficult task.Butwith God’s grace that has been sufficient for us, I am happy to do it.

Wanted: Revolutionary ideas in health care

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In a recent analysis by The Economist, 35 years from now (2050), Nigeria will be the world’s third largest nation, after India and China. The reason for this projection is obvious – we have a young and growing population. More than 70 per cent of Nigerians are less than 45 years old and are either young parents, soon-to-be parents or children who would be parents in less than 18 years’ time.

The British weekly’s prediction was made considering several factors, which include our present socio-economic state, population growth rate and life expectancy. The prediction shows that despite the relatively higher maternal mortality rates and other poor health care indices in Nigeria, we are still expected as a nation to grow tremendously, population-wise. The quality of that growth, however, is a function of the socio-economic realities that we will be facing in the years to come and the quality of ideas championed by leaders in the health care sector.

Nigeria’s socio-economic growth inevitably depends on the productivity of its citizenry; in other words, the relative aggregate productivity of the population which is a factor of the level of education, quality of life, level of health care and access to local, regional and international markets. The recent upheaval in the crude oil market, which is a major backbone of the nation’s economy is proof that achieving socio-economic development is not a given; strategic thrusts must be made and sustained for us to arrive at our desired destination.

We are in dire need of big, revolutionary ideas as a nation. For a population growing so fast, only such ideas would do. For example, it is common knowledge that every developed nation operates, at least, one form of health care financing structure that provides a relatively cheaper and comprehensive health care package with a very wide coverage, in some cases, for 100 per cent of the population. The NHS in the United Kingdom is one such of such health financing structures – a big and noble idea to say the least. One remarkable thing about the programme is that the cost of care in nations with such structures is relatively cheaper than elsewhere. In other words, the cost of getting health care in Nigeria is far more expensive than is obtainable in Britain, regardless of who is paying for it.

One big idea we are proposing is an ambitious quest for 100 per cent national health insurance coverage in 2019 and this would be more auspicious if our politicians were having the same vision. Working with a current population of over 173 million individuals and an average basic annual health insurance package of 30,000 naira for a family of five, we estimate that with a budget of slightly more than a trillion naira, we would have achieved universal coverage.

Seen in the light of our current GDP and government budget, the expenditure would represent less than 2 per cent of our Gross Domestic Product (GDP) and about 20 per cent of our current fiscal national budget. Compared with the NHS, which represents more than 6 per cent of the GDP of the United Kingdom, ours is still not overly ambitious but rather a step in the right direction.

In view of this aspiration, it is clear that the one per cent consolidated revenue allocation to primary health care provision in the new National Health Act, though not representing the totality of government expenditure on health care (which currently is at 6 per cent of the budget) is still a far cry from what we need if a winning strategy is the goal.

Though the above does not represent the complexity of the proposed level of intervention and the structure of its implementation, it essentially presents a goal we deem achievable. Also, we do not expect that the government would fund the entire project, but rather that participation in such a programme be made mandatory for all employed persons and for unemployed persons to be placed on a special platform (fully government-funded) from which they could migrate to the employed platform and vice versa. At the end, considering the level of unemployment in Nigeria at the moment, government expenditure would be about 15 per cent, in line with the Abuja declaration by African Heads of States in 2001.

While one trillion naira may seem to be a lot of money, it is, in reality, a manageable sum, when compared to the present size of the Nigerian health care and pharmaceutical market combined (worth 3.4 trillion naira, according to BMI, 2014) or that of other competing nations. This, indeed, is the time to start thinking big in the light of our certain future.

An event organised to receive drugs donation from APIN

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

 

APIN donates drugs worth N70m to armed forces

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In a show of support for the Nigerian military in its fight against insurgents, the Association of Pharmaceutical Importers of Nigeria (APIN), has donated drugs worth over 70 million naira and some food items to the Nigerian Armed Forces.

Chief of Defence Staff, Air Marshal Alex Badeh and Pharm. (Sir) Nnamdi Obi, president, Association of Pharmaceutical Importers of Nigeria (APIN), at the event.
Chief of Defence Staff, Air Marshal Alex Badeh and Pharm. (Sir) Nnamdi Obi, president, Association of Pharmaceutical Importers of Nigeria (APIN), at the event.

The drugs, which cut across therapeutic classes of antibiotics, antifungal, antimalarial, antihelminthes, haematinics etc, were presented by APIN to senior officers of the armed forces led by Chief of Defence Staff, Air Marshal Alex Badeh, at a ceremony held at 401 Aircraft Maintenance Depot, Nigerian Airforce Base, Ikeja, Lagos, recently.

Speaking at the occasion, Pharm. (Sir) Nnamdi Obi, president of APIN, said that the donation was APIN’s way of showing appreciation to the brave and dedicated men of the armed forces presently fighting insurgency, which, according to him, is a new phenomenon in the country history.

While saluting the courage of the military men, the APIN helmsman noted that the nation is presently faced with a tremendous challenge as a consequence of the activities of the insurgents, adding that this is the time for all Nigerians to support the armed forces in the quest to rid the North East of insurgents.

Sir Obi disclosed further that aside the drugs, APIN also reached out to some patriotic food companies who equally donated various food items alongside the drugs because APIN understood that the men of the armed forces needed food as well as medicines to be able to effectively discharge their duties.

The APIN president disclosed that Chikki Foods Industries would donate 150 bags of rice, 1200 cartons of Chikki instant noddles and 600 cartons of Chikki Chip chips, valued at 10 million naira, while Beloxxi Industries Limited had decided to donate 1000 cartons of Beloxxi Biscuits worth two million naira.

Also speaking at the occasion, Dr Paul Orhii, the director general of the National Agency for Food and Drug Administration and Control (NAFDAC), said he was proud to be a part of the occasion, noting that APIN members were highly patriotic Nigerians.

He added that he was happy to confirm APIN as an association of genuine pharmaceutical importers. He also affirmed that the products being donated to the Army were not fake, adulterated, expired or unwholesome.

Dr Orhii also stated that the armed forces were doing a great job to make sure Nigerians lived in peace and urged other organisations and individuals to show support to the armed forces.

Orhii thanked APIN for the donation, noting that it was not about how much was donated, but the significance of the act at such moment in the nation’s history.

Air Marshal, Alex Badeh, while accepting the donation, said the event was highly significant as it showed the appreciation of the Nigerian people to efforts of the armed forces to restore peace to the North-East of Nigeria.

Badeh disclosed that the army in the last few weeks had inflicted heavy human and material losses on the insurgents, as well as recovering territories hitherto occupied by the insurgents, adding that this was largely due to support it had received from the nation.

The support of the government, the populace and the international community, Badeh said, has tremendously helped the Nigerian military to intensify efforts to rid the nation of insurgents.

He praised Pharm. Obi, the APIN president, for initiating the benevolent idea and convincing other APIN members to accept it.

He described APIN members as highly patriotic Nigerians and assured them that the donated drugs and food items would be judiciously used to support the quest to crush the insurgents.

Extraordinary leadership and the society

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When people research on leadership titles, they, most of the time, want to learn how to be extraordinary leaders at the workplace. Leadership in the corporate circle is one of the topics in the world, and everyone wants to learn how to become a billionaire and, possibly, be the best boss. However, leadership is not just limited to the work frontier. It extends to all of society. In fact, leadership began as a societal phenomenon much before it evolved into a professional one. Many of the present-day leadership qualities that corporate and professional leaders aspire to could be traced to the exploits of social and political leaders of the yesteryears.

LERE

Man is a social being, living together in large groups. Thus, he needed to adopt different roles and accomplish tasks in different groups. In order to give structure to society and help society grow and develop, people were naturally divided into leaders and followers. The leaders paved the way and moved from one frontier to another, directing the others, while the followers completed the tasks assigned to them and helped to build the society.

Understanding the role and impact of extraordinary leadership in society makes for an interesting study. While it is easy to break down the effects of leadership in the work environment into small, easily identifiable structures; analysing how positive leadership affects society is somewhat complex. Society is a many-sided structure, with a myriad of social forces, elements and factors at play all the time. Society is not limited to a few defined goals;instead, if it is in society, it is an enormous task.

 

Leadership and social change

Leadership is instrumental to achieving social change. All through history, whether it was for abolishing social norms, overcoming social evils or modernising history, social change has been impossible without the right kind of leadership. When it comes to mobilising the masses, igniting passion in people towards a common goal and motivating people to act towards the said common goal, it is not possible to without leadership. Someone has to initiate a movement, and he may not professionally be a leader, and does not have to be a political leader, but he should have the charisma to inspire people and motivate them. A great example from recent times would be that of Anna Hazare, an Indian citizen, who inflamed thousands of Indians against the injustices of the Indian political system and the rampant corruption in society and politics and launched one of the biggest civil movements Asia has seen in a long time. In terms of social change, the leader is the face of the movement while the people form its heart and soul.

 

Leadership for a positive and content society

It is interesting to note that one person or a small group of people has the power to influence the feelings of many. A society that is bereft of competent leaders is invariably thrown into dissatisfaction at a small scale and turmoil and anarchy at a larger scale. A good leader keeps people motivated and inspired, respects his followers and works for the greater good of society. When people have faith in their leader and feel that they are taken care of, be it economically or socially or politically, they are in a better frame of mind on the whole. Good extraordinary leadership creates a happy society, and a happy society can build a strong nation!

 

Leadership for improved professional performance

It is quite remarkable that even when social leadership is effective, it has an impact on people’s professions. When a society is led by a powerful, positive and forward-thinking leader, people enjoy professional development. It goes without saying that professional progress is required for economic growth and that no society can do well without financial stability. Hence, good leaders are those that take all factors into consideration, even if their role is limited to a niche.

A positive leader will always be mindful of the fact that people need to keep achieving in their chosen professions in order to lead the society forward, and hence the leader will emphasise the importance of education, picking the right career, working hard and focusing on performance.

 

Leadership for a strengthened identity

Most people fail to appreciate how a common leader is often the face of the society and a symbol for it. When people elect a leader they are proud of, or they are placed under the care of a leader who does a good job, there is a sense of pride and identification with the individual that also ties the society together. An effective leader is one that people of the society are happy to call their own, and in turn, the leader ends up bringing the society together and giving them a common, positive identity that the people are all happy to have.

Societies are often remembered by their remarkable leaders and not the people; and it is a unique social phenomenon that one man or woman can not only shape the future of several people but can also make them feel closer to one another and strengthen their bonds with each other giving them a common identity.

 

Extraordinary leaders help ordinary people believe the extraordinary

Though there have been multiple efforts to concisely define the importance of leadership, former U.S. President Harry S. Truman came closest when he said, “In periods where there is no leadership, society stands still.”

Africa has been standing still and there is no better time to have extraordinary leadership than now. Good leadership is often the fuel of progress, be it in a business, organisation or in a nation. Not only can good leaders help oil the nuts and bolts that keep society pushing onward, but they can provide the encouragement and support that help people move things along.

In the last few years, we have borne witness to four prime examples of leadership, all incredibly diverse but equally effective – Barack Obama, Queen Elizabeth II, Garrett Fitzgerald and Jonathan Sexton. All of these individuals are leaders and it is important to think about what makes them extraordinary.

First, Barack Obama, the American President, whose skills as an orator helped him to win the toughest battle for leadership in the world-the American presidency- convinced people to come out in their droves of millions to pledge support for his ideas. He captured the hearts and minds of millions of Americans and people around the world who believed in him.

Many believed that America would never see an African-American president but his charisma led people to identify with him and support his belief that ‘yes, we can’. People believed in his vision and more importantly in his capacity to deliver on it and this facilitated his rise to become one of the most powerful men in the world.

Barack Obama displays many of the qualities needed to be a leader: charisma, a belief in his own abilities, a great use of language and an awareness of human emotion. His delivery of words was convincing and inspiring, and his capacity to communicate has earned him the highest position in public life.

Queen Elizabeth II is another notable example. Many have questioned the ability of monarchs to lead, as they are chosen due to their bloodline as opposed to being elected or chosen by the people. However, HRM Queen Elizabeth continues to show a quality of a true leader, which is often underestimated. She demonstrated humility as a sign of regret for mistakes made by her family in the management of their relationship with Ireland over the years. It takes courage to stand up to an enemy but it takes true bravery to stand against one’s own. This characteristic of humility and her capacity to name her own errors or failings is the mark of true leadership.

Also, Dr Garrett Fitzgerald was a distinguished Irish leader in the 1980s. History may not recall him as a dynamic leader or a charismatic orator like Mr Obama but the outpouring of eulogies spoke of his belief in the ‘Irish brand’ and his belief and concern for the Irish people. This quality is one that exists in the ‘statesman leader’. The statesman leader exudes a certain kind of respect and admiration for intellect and good intention and the ability to represent people in any setting. This type of leadership and identification is different but,nonetheless, an important leadership quality.

Finally, you will remember Jonathan Sexton, the young Leinster Rugby player who apparently spoke out in the dressing room at half time. He spoke out amongst his more senior peers and commanded the room to listen to him. Young Sexton rallied his troops around and began to recount the great comebacks in sporting history and he believed that this his team had the capacity for a similar feat. This leading from the front, self-belief and more importantly the capacity to bring others along with you is one of the most remarkable characteristics of leadership.

In the difficult years that lie ahead, it has never been more important to breed leaders in our young people. So, how do we do it? Daniel Goleman identifies a quality called ‘Emotional Intelligence’. This is the concept of being able to read the emotions of others and being aware of the emotional state of ourselves. This quality, he claims, is far more influential over our lives than academic intelligence. Emotional Intelligence is the capacity to tap into the needs of others, respond appropriately and have an in-depth knowledge of one. This is what creates the capacity to lead. It does not equate that those who score 600 points in their First Leaving School Certificate Exams will grow to become great leaders. It is not the case that success and fortune are the signs of great leaders. Leadership comes in many ways but a firm grasp of one’s own emotions and the ability to communicate effectively with others are essential leadership criteria.

In order to raise leaders for the future, we need to teach young people the power of communication. There is need to encourage interpersonal skills and awareness among them. They must be taught to dream, have hope and doggedly see to the attainment of their goals.

In the same vein, budding leaders must be allowed to experience challenges or adversity and they should not be pampered. At times, there is a great need to taste adversity in order to effectively lead and inspire. One has to lose to know how to win. It is important to experience disappointment, frustration and heartache in order to identify with those who experience it. In fact, it is in times of adversity that true leaders emerge. If heroes are ordinary people who do extraordinary things then leaders are those who help ordinary people believe that extraordinary things are possible. In addition, extraordinary leaders provide the following:

 

  • Motivation. Extraordinary leaders provide motivation and inspiration for a group. Whether they are supporting a group member or providing mentoring, leaders can push a team to achieve things they didn’t know were possible. Motivation can improve morale and productivity, as well as encourage participants to think outside of the box and come up with creative ideas.

 

  • Direction. Extraordinary leaders provide direction forthe group. With different people working in various capacities, it is easy for a group to fall out of touch and not realise how their work might jeopardise other people’s efforts. Good leadership will ensure proper delegation of duties, streamlining of activities, and improvement of the efficiency of a team and their overall productivity.

 

  • Mediation. A nearly inevitable component of group work is interpersonal conflict. Whether this conflict stems from competitiveness, work accountability or simply personal irritation, it can disrupt the working process and drag the production of results or decision making. This is where an extraordinary leader can make a difference. A great leader will be able to step in when necessary to mediate interpersonal conflict, serving as an objective for pushing parties to some form of compromise or reconciliation.

 

  • Prioritising. A commonly used maxim preaches the perils of failing to “see the forest for the trees.” When working on individual components of a task, group members may lose sight of the larger objectives. Leaders are charged with the responsibility of the entire project. They have the perspective necessary to set priorities in the work schedule and ensure that tasks are being completed in the most beneficial manner and on the right schedule.
  • Evaluation. The only way a group can work effectively together is if there is some form of accountability. Though it can work in some situations, even levels of authority can lead to an inability to effectively assess and improve upon performance. Extraordinary leadership can aid in continual growth. Because a leader is a level above the group members in authority, he will usually have the experience and perspective necessary to effectively critique work done and provide guidance for improvement.

 

* This is part of the LEADERSHIP INSPIRATION FOR EXCELLENCE series.

 

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

NAPA enlightens students on malignant diseases

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Expert says medical scientists still searching for effective cure

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R-L: Pharm. Oluwatosin Adeyemi, chairman, University of Lagos (UNILAG) branch of NAPA; Pharm. Aminat Oyawaluja, lecturer, department of Pharmacognosy and Dr Rebecca Soremekun, a senior lecturer in the department of Clinical Pharmacy and Biopharmacy, University of Lagos, addressing students of Aturase Junior and Senior Secondary School, Surulere, during the 2015 World Cancer Day awareness seminar held recently.

 

In commemoration of the 2015 World Cancer Day, the Lagos State branch of the Nigerian Association of Pharmacists in Academia (NAPA) has taken its campaign to secondary schools in the state to create more awareness about malignant diseases.

Addressing a large crowd comprising students and teaching staff of Aturase Junior and Secondary School within the premises of the school in Surulere, Lagos, on 4 February, 2014, Pharm. Nelson Okwonna, managing director of Dabar Pharmaceuticals explained that the human body had the capacity to fight off diseases.

“Our job is to help it (the body). Depending on how we go about it, it can build or kill itself,” he said.

While lamenting Nigeria’s dismal health statistics based on World Health Organisation (WHO) 2001 report where the country ranked 187th out of 191 countries, the pharmacist noted that over 65 per cent of the Nigerian populace lived below poverty level.

Okwonna, who is also currently the executive director of West African Pharmaceutical Innovation Project (WAPIP), disclosed that breast cancer, arguably the most common malignancy in Nigeria, claims 25,000 women annually.

He declared that other malignant diseases such as cervical cancer which kills a woman every hour, totalling an estimated 8,000 deaths in a year, and prostate cancer, which affects 100 out of every 100,000 men in the country,were equally dangerous.

The expert stated that, in the absence of screening, it had been discovered that additional 100,000 new cancer cases were springing up and adding to the pool every year.

“Since the discovery of penicillin, medical science has been looking for magic bullets. Chronic diseases, unlike infectious diseases, are not caused by external invasion. Whether it is hypertension, diabetes, cardiovascular diseases or cancer, the body simply fails,” Okwonna noted.

The interactive seminar also gave room for teachers and students in attendance to ask questions on the importance of herbs in treating ailments and the role of diet in the fight against cancer.

Responding to the queries, Okwonna opined that people should watch what they eat.

“Let your food be your medicine. Most of the processed foods you eat are not different. Compare a child who eats noodles and ‘puff-puff’ everyday to one who eats yam and other fresh farm produce. Can they be said to look the same? The fact that a child is growing doesn’t mean he is healthy,” he said.

The Dabar Pharmacy boss equally warned against erection of telecom mast and towers near residential homes, saying they posed serious risks to human health due to the radiation they emit.

Corroborating his statements, Dr Rebecca Soremekun, a senior lecturer in the department of Clinical Pharmacy and Biopharmacy, University of Lagos, wondered why parents would compel children to take noodles when fresh vegetables, fruits and natural produce were so cheap.

“All these foods you are forcing them to eat are processed foods and chemicals. How much does it cost to buy ‘ugu’ (pumpkin leaves) and yam? Some of you also mentioned ‘agbo’ (local herbs) as alternative to proper treatment of ailment and diseases. We are not saying “agbo” is bad. The only problem we have with it is that it has no dosage or scale of measurement. Some claim that they used a cup to measure the dosage. Can we sincerely conclude then that it is safe to use?” she queried.

According to Soremekeun, some mischievous people even hide under the guise of drinking herbs to load their system with alcohol.

“This is the time to take your health serious. If you have been diagnosed as having diabetes, go for regular check-up and continue taking your drugs regularly. A normal blood level is 120/80, in some 120/70. But if yours shoots up, visit your doctor immediately,” she counselled.

The specialist also advised students (in sciences department) to consider studying Pharmacy as a course when applying for university admission.

“Once you are able to pass Physics, Chemistry and Biology, you will make it. Aside being a community pharmacist, you will also have the privilege to become a lecturer in academia like me, work in hospitals, top organisations and politics like our (aspiring) governor, Jimi Agbaje. I believe many of us know that he is a pharmacist,” she said.

Soremekun added further that once the studentswere admitted to study Pharmacy, they would need to undergo five years of training in the faculty of Pharmacy to attain a minimum of Bachelor of Pharmacy degree.

“Once through, you will be required to undergo another one year internship under a registered pharmacist before you can become a licensed pharmacist,” she revealed.

Also in attendance at the event were Pharm. Oluwatosin Adeymi, chairman, University of Lagos (UNILAG) branch of NAPA; Pharm. Bamisaye Oyawaluja, vice chairman; Pharm. Alexander Akinola, lecturer, department of Clinical Pharmacy & Biopharmacy; and Pharm. Aminat Oyawaluja, lecturer, department of Pharmacognosy.

Consideration in contracts, examples of Nigerian cases

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

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

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

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

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

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

The case above involves several legal issues:

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

2.The validity of past consideration.

3.The adequacy of consideration.

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

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

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

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

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

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

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

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

Health sector strikes caused by misplaced priorities – PANS-OOU president

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In this exclusive interview with Pharmanews, Mr Seyi Akinfaderin, outgoing president of the Pharmaceutical Association of Nigeria Students (PANS), Olabisi Onabanjo University (OOU), Ago-Iwoye chapter, spoke on the challenges facing pharmacy students generally. The 500 Level student of the Faculty of Pharmacy, OOU, also stated why more universities in Nigeria should offer the Doctor of Pharmacy (Pharm.D) programme. Excerpts:

Tell us briefly about yourself

My name is Seyi Akinfaderin. I hail from Ondo State and was raised in a family of six. I am an easy going but hardworking person. I am a strong skeptic of the belief that a task is impossible and a staunch believer that where there is a will there is a way.

 

As a pharmacy student and president of PANS, what are the challenges facing pharmacy students in your school?

The challenges are enormous but the major ones include, one, lecturers’ mode of teaching. While lecturers are meant to lecture, the situation is different when it comes to Pharmacy. Lecturers often have to become teachers because the pharmaceutical profession is such that requires the lecturer to meticulously explain the fundamentals of Pharmacy to the students, so as to reduce mere cramming and improve understanding of the course. This is the same way it is done in advanced countries. If it is not done this way, we will continue to breed pharmacy graduates who don’t know anything else other than what their lecturers have taught them.

Also, learning facilities need to improve. Since Pharmacy is a practical course, it is imperative that necessary equipment be made available so that students can understand those abstract but important concepts of Pharmacy. We need well-equipped laboratories and libraries furnished with relevant and up-to-date books. Learning should also be made easy and interesting to students. Government must play its part in all this.

 

You emerged PANS-OOU president about a year ago – what prompted your decision to get actively involved in PANS and what were your plans for pharmacy students?

The question is quite interesting but the answer lies in these words “Be the change you want to see in the world.” I strongly believe that if adequately empowered, the ordinary man can achieve that great dream that he has nurtured all his life.

After staying about seven months in office, the PANS-OOU executives have been able to formulate ideas and organise activities that have helped students to maximise their stay in school. They are not just becoming graduates of Pharmacy but graduates who are knowledgeable to make intelligible contributions in the midst of professionals from other walks of life.

 

How do you see the Pharm.D programme? Should all pharmacy students in Nigeria now go for Pharm.D and not the Pharm.B?

 

Pharm.D is long overdue in Nigeria because its importance can be never overestimated. In fact, looking at it critically, an intelligent mind will know it is the missing piece in the puzzle of a pharmacist’s life. Little wonder other countries in the world, even in Africa, are making it the minimum qualification to be held by a pharmacist! I think such should be applicable in Nigeria as well.

 

How do you see the unending rivalry among health care practitioners in the country?

It’s simply lack of unity among the health practitioners and until there’s unity, we may continue to experience the same scenario. Also, you don’t change principles to suit yourself but you can only change yourself to conform to principles. Until all health care practitioners remove the pathetic mentality that other professions other than theirs are inferior; until we start seeing one another as uniquely important, we will continue to suffer from this canker that is bedeviling the health industry.

 

How do you see the issue of incessant strike actions among health care professionals in the country?

I think the whole issue boils down to misplaced priorities. It is misplaced priorities that make the government to continue paying lip service to the development of the health care sector and the well-being of its citizens. The government has a selfish agenda; so they prefer to divert the economy’s money to their pockets than increase allocation to the health sector or even pay the salaries of health workers. This often forces the health practitioners, too, to misplace their priorities by placing their own priorities above the well-being of their patients.

 

What’s the effect of strike actions by university workers on pharmacy students?

To be sincere, its effect has been massively negative, demoralising and dementing – so much that a five-year course, if care is not taken, can last for eight years; while a six-year course can take up to 9 to ten years. In fact, some students are now marrying each other while still in school and the story continues to get worse. So a panacea is urgently needed, to once and for all, put a stop to this endemic condition.

 

Where do you see PANS- OOU, in the next few years?

Coincidentally, I will be leaving office in a few days’ time, while a new leadership will come in. But I am glad that PANS, OOU, is far better than how we met it when we came into office last year. I am hopeful that the next administration will be far better than ours.

When should you rest from work?

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In the late forties, when I was in the primary school, our class teacher was fond of giving us homework. One Sunday night, I was battling with my homework on Arithmetic. My mother observed my body movements and knew that I was racking my brain about something. She came closer and asked, “Anyi, what is the problem?” I felt somehow relieved by her question, even though I knew she might not be able to help me because of her level of education. In her time, not many of them, especially females, were literate.

My mother learnt to read and write as a young adult after her parents were converted to Christianity. Therefore, she could read the Igbo Bible and also write letters in Igbo. In any case, I told her that I was having difficulty in solving one Arithmetic problem. She simply asked me to follow her. I stood up and followed her outside the house, somehow confused. Pointing at the moon, she asked me to look at the man on the moon breaking firewood. I saw the man clearly (or so I thought) with his heavy axe, bending over the log. Then she said, “God took a picture of the man and placed it on the moon because he was breaking the firewood on Sunday. This thing you’re doing on Sunday is work. Stop it or God will put your picture on the moon. You can study English but not Arithmetic on Sunday.” From that day, I believed that studying Arithmetic is a serious work.

As for working on Sunday, it is believed that Sunday is a day of rest. However, the actual day of rest God commanded is the seventh day, which is Saturday. Exodus 20:8-10 says,Remember the Sabbath day, to keep it holy. Six days shalt thou labour, and do all thy work: But the seventh day is the Sabbath of thy God: in it thou shalt not do any work, thou, nor thy son, nor thy daughter, thy manservant, nor thy maidservant, nor thy cattle, nor thy stranger that is within thy gates.

Some groups, like the Seventh Day Adventist, believe that God requires that church service be held on Saturday, the day of rest. However, in honour of Christ’s resurrection on Sunday, the early Christians observed Sunday, as a day to specially worship Jesus Christ.

The seventh day of the week is in remembrance that God created the universe in six days and rested on the seventh day. Since most churches observe Sunday as their day of rest and worship, Christians regard Sunday as the Sabbath day.

In the Bible, Nehemiah confronted the people of Judah for working on the Sabbath. He spoke against treading winepresses, bringing in grain, wine, grapes, figs and loading them on donkeys on the Sabbath day. He condemned all forms of work, buying and selling (Nehemiah 13:15-17). A similar stern message was given by Prophet Jeremiah in chapter 17: 21-27.

However, the concept of the Sabbath day has changed in the present dispensation. That is why Jesus said that the Sabbath was made for man, not man for the Sabbath. He did the work of healing on the Sabbath and was attacked by the Pharisees. The principle is that Sabbath was instituted to relieve man of his labours, just as Jesus came to relieve us of attempting to achieve salvation by our works. We no longer rest only for one day in the week, but forever cease our labouring to attain God’s favour. There is no other Sabbath rest besides Jesus. He alone satisfies the requirements of the Law.

In Colossians 2: 16-17, Apostle Paul declares,Therefore, do not let anyone judge you by what you eat or drink, or with regard to a religious festival, a New Moon celebration or a Sabbath day. These are a shadow of the things that were to come; the reality, however, is found in Christ.” We are no longer commanded to cease to work on the Sabbath. The statement by Apostle Paul in Romans 14:5-7 is instructive:One man considers one day more sacred than another; another man considers every day alike. Each one should be fully convinced in his own mind. He, who regards one day as special, does so to the Lord. He, who eats meat, eats to the Lord, for he gives thanks to God.

Health care workers, in particular, who work fully on the Sabbath day or Sunday, should not feel guilty. Pilots, as well as ship captains and commercial drivers of vehicles, who move people from place to place on the Sabbath day are not sinners. Suppliers of items which people need on the Sabbath day are rendering valuable services. Students who study on the Sabbath day are not offending God. But the fellowship of the saints must not be neglected. Corporate worship has its own benefits.

The question is, do you give adequate rest to your body which God has given you to serve Him? Is your work taking the place of God in your life? Do you worship your God only one day in the week instead of worshipping Him daily?

The change Nigerians deserve

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The appropriate definition of “change” for the purpose of this article (and when it is used as a verb) is to “become altered or modified”. The alteration or modification usually takes place when there is a new impact, be it environment, challenges or exposure. For instance, some products change colour when they are exposed to sunlight.

Nigeria, as a nation, is due for a change. Our future and the future of the generation yet unborn cannot be guaranteed if we continue to do things as we are currently doing. We had, in the past few months, been inundated with flowery expressions by politicians that we are living in paradise as Nigerians. The incumbents – the president, the governors and other political office holders tell us how they have made the country so good that everything works! The aspirants make promises of what new ‘heaven’ they will turn Nigeria into, if elected. But we know the truth. We feel the pain in our everyday life. When we are told that all promises on power have been delivered, we know it is not true. We know that we still rely on our generators to power our offices and homes.

 

The choice to make

Currently, there is no particular political group that can be singled out as an outstanding agent of change. They all, to different degrees, have their hands soiled in the cesspool of decadence that has brought our country to its knees. Therefore, there is no very strong justification to choose one over the other as to who will bring the needed change that we want, the change that we truly deserve.

Unfortunately, we must make a choice. We must make a choice because that is what the constitution says. We must make a choice because that is the only way we can bring about the changes desired. For the incumbent, it is a straight line consideration. He has not, in the past six years, demonstrated enough capability to lead us to Eldorado. Is there any evidence that he has accepted this reality and is ready, like Mathieu Kerekou, to repent and turn things around? In what can we pin him down on his words? Will anything really change in the next four years if we vote for the current order?

This last question must be answered with the reality of the fact that President Jonathan, as a person, is no longer coming to ask for our votes. Is there any incentive for him to change to what we want: effective governance? Honestly, the probability of getting anything new by voting for the current order is very small. On the other side of the divide, there is really nothing fantastic to rejoice about. The only cheerful news from that quarter is the spartan life or disposition of candidate Buhari and the expectation that this will weigh heavily on his presidency. There is not so much other attributes in terms of management, economics or strategic skills that can make us bet all our life on this candidate. However, the definition of our change here is the alteration or modification of our national life. Therefore, we may be flying at a more comfortable altitude by taking this path.

We should not forget that what we change is 16 years of unpleasant story. At 72, I will not think that primordial acquisition of wealth that our leaders are famous for will be candidate Buhari’s pre-occupation. I think he means well for the country. I will cast my vote for him.

 

 

The change we need

Now, what are those changes that we want and that we richly deserve? Firstly, we really do not need anyone to tell us that we are living in a corrupt country. It is all around us. This is not just about the president and his ministers. The entire system stinks to high heavens. What is it that you can do in this in this country without having to pay something extra? To get driving licence, passport, motor vehicle plates and licences, post office key and ID cards, etc. We can go on and on and everybody pretends that things are normal. It is much bigger ‘at the top’ where there is much bigger cake to cut and share. Any time I hear or read that the federal government is spending billions of naira, my body shivers because I know we will not get any value that is commensurate with the amount mentioned.

We need a new style of leadership that will change our thinking and return our system to normalcy. We want to pass through customs and immigration at the airport without being harassed about ‘what did you bring for me?’ We want confidence to be restored in the entire value chain. We want officers who will not undertake the budget procedure for their selfish ends only. We want a new set of managers who will not sub-optimise the budget provisions year after year. To get this change, we need a new leader whose entire being will personify the attributes desired.

Secondly, the disposition (and orientation) of our political class to the populace is that of a master and servant. Once they assume a position of authority, they become untouchable, unreachable and unrealistic. Some of them see their new position as their inheritance bequeathed to them and, thus, behave as if tomorrow will never come. What we need are leaders who are conscious of the ephemeral nature of their power; leaders who have vision of a brighter tomorrow and are prepared to roll up their sleeves and work for it. We want leaders who will feel uncomfortable with the pervasive and abject poverty in the land. Leaders who have what it takes to impact the society positively. We do not need globe-trotting, siren-blaring, elitist and elusive leaders any more in this country. This is the change we want and the change we deserve.

Thirdly, most of our ministers are tactical in their approach to governance. They assume positions just to cut their “shares” of the national cake because their “time has come”. There is no deep thought about the tasks to be accomplished or the results expected. We need strategic managers as ministers in the various ministries; ministers, who will properly define their purpose, map out plans and execute flawlessly to produce results. We need ministers who will be conscious of their positive impact(s) on the nation during their tenure. For instance, we need a health minister who will properly segment the health sector and design development and growth paths for each of the segment. In the pharmaceutical segment, we need a minister who will come up with a master plan for full optimisation of the nation’s pharmaceutical resources. We need a minister who will take Nigeria to the height that the likes of India and other forward looking nations are currently are. We need a minister who will accept responsibility for ending the recurring and destructive acrimony among the different cadres of health care workers. This is the change we need, the change we deserve.

Fourthly, there are too many unemployed people in the land. As you move through the traffic every day, you see them lining the streets, with distress and hopelessness written on their faces. We need to get jobs for them – I mean REAL jobs, not the propaganda stuff that cannot be touched. We need to encourage the manufacturing sector to work. When the factories are working, people will get jobs. The operating environment must be made conducive for manufacturing. Our current imports-laden taste bud is only improving the economies of other countries and providing jobs for their citizens. In the pharmaceutical sector, 70 per cent of our national consumption is imported. Local manufacturing is not very attractive due to high cost of operation and low patronage. We can make it work with the right leadership focussed on making things work. This is the change that we need and that which we richly deserve.

Furthermore, countries like Canada and the USA are running innovative programmes to encourage people from different nations to come and contribute to their development. These countries thrive on the diversity of their societies. In Nigeria, the cleavages are palpable. We are a country and not a nation. We are comfortable only with people from our ethnic group and treat others with suspicion. The current political debates have been tilted along the ethnic divides and no rational argument can be articulated without someone pointing fingers at your face. We need a national leader who can unite this country. We need to see ourselves as Nigerians and the quick resort to ethnic origins must stop. The country is too divided. The change we want is that which will unite this country and make us stronger.

In addition, there must be a way to hold the public office holders accountable for their actions and inactions while in office. We must come up with fool-proof and transparent criteria to measure service delivery. Every election must be a reward time. If you do well, you will be rewarded with re-election. Otherwise, you will be voted out and this will serve as a lesson and performance template for others to follow.

Most importantly, without security of lives and properties, nothing can be achieved. Nigeria must not be left to the whims and caprices of the criminal elements in our midst. There must be adequate security for all and sundry. No one should live in fear as this will emasculate creativity. Undesirable elements or groups must not be allowed to blossom. Political thugs must be re-educated and rehabilitated. The society must show enough concern for the less privileged and prevent them from embracing crime as a way of life.

We can start by pursuing excellence at the basics. Let us be truthful and deliver on promises made. Let us eschew bitterness and embrace love of others at all times. Let us hold our leaders accountable for the resources under their care. Let us work together to build a great nation. Then, we will have the change we want and the change we deserve.

Embrace pharma manufacturing, Mopson boss charges students

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

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L-R: Pharm (Mrs) Ogochukwu Amaeze, NAPA financial secretary; Dr Chikezie Amadi, a consultant cardiologist with Lagos University Teaching Hospital (LUTH); Prof. Oluwakemi Odukoya, dean, UNILAG Faculty of Pharmacy; Pharm. Oluwatosin Adeyemi, chairman, Lagos branch of NAPA; and Pharm. Bamisaye Ogawaluja, NAPA vice chairman, during the presentation of certificate for participation.

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

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

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

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

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

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

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

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

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

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

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

Don laments rise in breast cancer cases

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DON

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

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

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

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

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

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

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

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

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

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

Treatments for skin infections

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Skin infections or disorders constitute a significant proportion of consultations in Clinics. However, there is paucity of data on the prevalence of dermatological lesions in hospitalised children and adults in Nigeria.

According to the Nigerian Journal of Clinical Practice, skin diseases are one of the three common causes of morbidity in the developing countries of sub-Saharan Africa, along with malaria and diarrhoea. The development of acute glomerulonephritis, following skin infection with Group A b-hemolytic streptococcus, has been demonstrated to be a risk factor for albuminuria and hematuria in adult life.

Although skin diseases do not feature prominently in the paediatric morbidity and mortality trends reported from many hospitals in Nigeria, it is essential to pay attention to bacterial skin infections complicating scabies and insect bites.

Basically, skin infection is an infection of the skin. Infection of the skin is distinguished from dermatitis, which is inflammation of the skin, but a skin infection can result in skin inflammation. Skin inflammation due to skin infection is called infective dermatitis.

 

Bacterial infections

*    Impetigo is a highly contagious bacterial skin infection most common among pre-school children. It is primarily caused by Staphylococcus aureus, and sometimes by Streptococcus pyogenes.

*    Erysipelas is an acute streptococcus bacterial infection of the deep epidermis with lymphatic spread.

*    Cellulitis is a diffuse inflammation of connective tissue with severe inflammation of dermal and subcutaneous layers of the skin. Cellulitis can be caused by normal skin flora or by exogenous bacteria, and often occurs where the skin has previously been broken – cracks in the skin, cuts, blisters, burns, insect bites, surgical wounds, intravenous drug injection or sites of intravenous catheter insertion. Skin on the face or lower legs is most commonly affected by this infection, though cellulitis can occur on any part of the body.

 

Fungal infections

Fungal skin infections may present as either a superficial or deep infection of the skin, hair, and/or nails. They affect as of 2010 about one billion people globally.

 

Parasitic infestations, stings, and bites

Parasitic infestations, stings, and bites in humans are caused by several groups of organisms belonging to the following phyla: Annelida, Arthropoda, Bryozoa, Chordata, Cnidaria, Cyanobacteria, Echinodermata, Nemathelminthes, Platyhelminthes, and Protozoa.

 

Viral infections

Virus-related cutaneous conditions are caused by two main groups of viruses–DNA and RNA types–both of which are obligatory intracellular parasites.

 

Athlete’s foot

Athlete’s foot is a very common infection. The fungus grows best in a warm, moist environment such as shoes, socks, swimming pools, locker rooms, and the floors of public showers. It is most common in the summer and in warm, humid climates. It occurs more often in people who wear tight shoes and who use community baths and pools.

 

What causes athlete’s foot?

Athlete’s foot is caused by a microscopic fungus that lives on dead tissue of the hair, toenails, and outer skin layers. There are at least four kinds of fungus that can cause athlete’s foot. The most common of these fungi is trichophytonrubrum.

 

What are the symptoms of athlete’s foot?

Signs and symptoms of athlete’s foot vary from person to person. However, common symptoms include:

*    Peeling, cracking, and scaling of the feet

*    Redness, blisters, or softening and breaking down of the skin

*    Itching, burning, or both

 

Types of athlete’s foot

*    Interdigital: Also called toe web infection, this is the most common kind of athlete’s foot. It usually occurs between the two smallest toes. This form of athlete’s foot can cause itching, burning, and scaling and the infection can spread to the sole of the foot.

*    Moccasin: A moccasin-type infection of athlete’s foot can begin with a minor irritation, dryness, itching, or scaly skin. As it develops, the skin may thicken and crack. This infection can involve the entire sole of the foot and extend onto the sides of the foot.

*    Vesicular: This is the least common kind of athlete’s foot. The condition usually begins with a sudden outbreak of fluid-filled blisters under the skin. Most often, the blisters develop on the underside of the foot. However, they also can appear between the toes, on the heel, or on the top of the foot.

 

How is athlete’s foot diagnosed?

Not all itchy, scaly feet have athlete’s foot. The best way to diagnose the infection is to have your doctor scrape the skin and examine the scales under a microscope for evidence of fungus.

 

How is athlete’s foot treated?

Athlete’s foot is treated with topical antifungal medication (a drug placed directly on the skin) in most cases. Severe cases may require oral drugs (those taken by mouth). The feet must be kept clean and dry since the fungus thrives in moist environments.

 

How is athlete’s foot prevented?

Steps to prevent athlete’s foot include wearing shower sandals in public showering areas, wearing shoes that allow the feet to breathe, and daily washing of the feet with soap and water. Drying the feet thoroughly and using a quality foot powder can also help prevent athlete’s foot.

Jock itch

Jock itch, also called tineacruris, is a common skin infection that is caused by a type of fungus called tinea. The fungus thrives in warm, moist areas of the body and as a result, infection can affect the genitals, inner thighs, and buttocks. Infections occur more frequently in the summer or in warm, wet climates. Jock itch appears as a red, itchy rash that is often ring-shaped.

 

Is jock itch contagious?

Jock itch is only mildly contagious. The condition can be spread from person to person through direct contact or indirectly from objects carrying the fungus.

 

What are the symptoms of jock itch?

*    Itching, chafing, or burning in the groin or thigh

*    A circular, red, raised rash with elevated edges

*    Redness in the groin or thigh

*    Flaking, peeling, or cracking skin

 

How is jock itch diagnosed?

In most cases, jock itch can be diagnosed based on the appearance and location of the rash. If you are not certain that the condition is jock itch, contact your doctor. The doctor will ask about your symptoms and medical history, and will perform a physical exam. A microscopic exam of the scales of skin can confirm the diagnosis.

 

How is jock itch treated?

In most cases, treatment of jock itch involves keeping the affected area clean and dry and applying topical antifungal medications. Jock itch usually responds to over-the-counter antifungal creams and sprays. However, prescription antifungal creams are sometimes necessary. During treatment of jock itch, be sure to:

*    Wash and dry the affected area with a clean towel

*    Apply the antifungal cream, powder, or spray as directed

*    Change clothes – especially underwear – everyday.

 

Ringworm

Ringworm, also called tineacorporis, is not a worm, but a fungal infection of the skin. It can appear anywhere on the body and looks like a circular, red, flat sore. It is often accompanied by scaly skin. The outer part of the sore can be raised while the skin in the middle appears normal. Ringworm can be unsightly, but it is usually not a serious condition.

 

Is ringworm contagious?

Ringworm can spread by direct contact with infected people or animals. It also may be spread on clothing or furniture. Heat and humidity may help to spread the infection.

 

What are the symptoms of ringworm?

Ringworm appears as a red, circular, flat sore that is sometimes accompanied by scaly skin. There may be more than one patch of ringworm on the skin, and patches or red rings of rash may overlap. It is possible to have ringworm without having the common red ring of rash.

How is ringworm diagnosed?

A doctor can diagnose ringworm based on the appearance of the rash or reported symptoms. He or she will ask about possible exposure to people or animals with ringworm. The doctor may take skin scrapings or samples from the infected area and look at them under a microscope to confirm the diagnosis.

 

Boils

A boil is a skin infection that starts in a hair follicle or oil gland. At first, the skin turns red in the area of the infection, and a tender lump develops. After four to seven days, the lump starts turning white as pus collects under the skin.

The most common places for boils to appear are on the face, neck, armpits, shoulders, and buttocks. When one forms on the eyelid, it is called a sty.If several boils appear in a group, this is a more serious type of infection called a carbuncle.

 

Causes of boils

Most boils are caused by a germ (staphylococcal bacteria). This germ enters the body through tiny nicks or cuts in the skin or can travel down the hair to the follicle.

 

Symptoms of boils

A boil starts as a hard, red, painful lump usually about half an inch in size. Over the next few days, the lump becomes softer, larger, and more painful. Soon a pocket of pus forms on the top of the boil.

These are the signs of a severe infection:

*    The skin around the boil becomes infected. It turns red, painful, warm, and swollen.

*    More boils may appear around the original one.

*    A fever may develop.

*    Lymph nodes may become swollen.

 

When to seek medical care:

*    You start running a fever.

*    You have swollen lymph nodes.

*    The skin around the boil turns red or red streaks appear.

*    The pain becomes severe.

*    The boil does not drain.

*    A second boil appears.

*    You have a heart murmur, diabetes, any problem with your immune system, or use immune suppressing drugs (for example, corticosteroids or chemotherapy) and you develop a boil.

Boils usually do not need immediate emergency attention. If you are in poor health and you develop high fever and chills along with the infection, a trip to a hospital’s emergency room is needed.

 

Exams and tests

Your doctor can make the diagnosis with a physical exam. Many parts of the body may be affected by this skin infection; so some of the questions or exam may be about other parts of your body.

Boils treatment – home remedies

*    Apply warm compresses and soak the boil in warm water. This will decrease the pain and help draw the pus to the surface. Once the boil comes to a head, it will burst with repeated soakings. This usually occurs within 10 days of its appearance. You can make a warm compress by soaking a wash cloth in warm water and squeezing out the excess moisture.

*    When the boil starts draining, wash it with an antibacterial soap until all the pus is gone. Apply a medicated ointment and a bandage. Continue to wash the infected area two to three times a day and to use warm compresses until the wound heals.

*    Do not pop the boil with a needle. This could make the infection worse.

 

Leprosy

Leprosy is an infectious disease that causes severe, disfiguring skin sores and nerve damage in the arms and legs. The disease has been around since the beginning of time, often surrounded by terrifying, negative stigma and tales of leprosy patients being shunned as outcasts. At one time or another, outbreaks of leprosy have affected, and panicked, people on every continent. The oldest civilisations of China, Egypt, and India feared leprosy was an incurable, mutilating, and contagious disease.

However, leprosy is actually not highly contagious. You can catch it only if you come into close and repeated contact with nose and mouth droplets from someone with untreated, severe leprosy. Children are more likely to get leprosy than adults.

Today, more than 200,000 people worldwide are infected with leprosy, according to the World Health Organisation, most of them in Africa and Asia. About 100 people are diagnosed with leprosy in the U.S. every year, mostly in the South, California, Hawaii, and some U.S. territories.

 

What causes leprosy?

Leprosy is caused by a slow-growing type of bacteria called Mycobacteriumleprae (M. leprae).Leprosy is also known as Hansen’s disease, after the scientist who discovered M. leprae in 1873.

 

What are the symptoms of leprosy?

Leprosy primarily affects the skin and the nerves outside the brain and spinal cord, called the peripheral nerves. It may also strike the eyes and the thin tissue lining the inside of the nose.

The main symptom of leprosy is disfiguring skin sores, lumps, or bumps that do not go away after several weeks or months. The skin sores are pale-coloured.Nerve damage can lead to:

*    Loss of feeling in the arms and legs

*    Muscle weakness

It takes a very long time for symptoms to appear after coming into contact with the leprosy-causing bacteria. Some people do not develop symptoms until 20 or more years later. The time between contact with the bacteria and the appearance of symptoms is called the incubation period. Leprosy’s long incubation period makes it very difficult for doctors to determine when and where a person with leprosy originally got sick.

 

Forms of leprosy

Leprosy is characterised according to the number and type of skin sores you have. Specific symptoms and your treatment depend on the type of leprosy you have. The types are:

*    Tuberculoid: A mild, less severe form of leprosy. People with this type have only one or a few patches of flat, pale-coloured skin (paucibacillary leprosy). The affected area of skin may feel numb because of nerve damage underneath. Tuberculoid leprosy is less contagious than other forms.

*    Lepromatous: A more severe form of the disease. It involves widespread skin bumps and rashes (multibacillary leprosy), numbness, and muscle weakness. The nose, kidneys, and male reproductive organs may also be affected. It is more contagious than tuberculoid leprosy.

*    Borderline: People with this type of leprosy have symptoms of both the tuberculoid and lepromatous forms.

 

How is leprosy diagnosed?

If you have a suspicious skin sore, your doctor will remove a small sample of the abnormal skin and send it to a lab to be examined. This is called a skin biopsy. A skin smear test may also be done. With paucibacillary leprosy, no bacteria will be detected. In contrast, bacteria are expected to be found on a skin smear test from a person with multibacillary leprosy.

 

How Is leprosy treated?

Leprosy can be cured. In the last two decades, more than 14 million people with leprosy have been cured. The World Health Organisation provides free treatment for all people with leprosy.

Treatment depends on the type of leprosy that you have. Antibiotics are used to treat the infection. Long-term treatment with two or more antibiotics is recommended, usually from six months to a year. People with severe leprosy may need to take antibiotics longer. However, antibiotics cannot reverse nerve damage.

Anti-inflammatory drugs are used to control swelling related to leprosy. This may include steroids, such as prednisone.Patients with leprosy may also be given thalidomide, a potent medication that suppresses the body’s immune system. It helps treat leprosy skin nodules. Thalidomide is known to cause severe, life-threatening birth defects and should never be taken by pregnant women.

 

Leprosy complications

Without treatment, leprosy can permanently damage your skin, nerves, arms, legs, feet, and eyes.

Complications of leprosy can include:

*    Blindness or glaucoma.

*    Disfiguration of the face (including permanent swelling, bumps, and lumps).

*    Erectile dysfunction and infertility in men.

*    Kidney failure.

*    Muscle weakness that leads to claw-like hands or an inability to flex the feet.

*    Permanent damage to the inside of the nose, which can lead to nosebleeds and a chronic, stuffy nose.

*    Permanent damage to the peripheral nerves, the nerves outside the brain and spinal cord, including those in your arms, legs, and feet.

Nerve damage can lead to a dangerous loss of feeling. A person with leprosy-related nerve damage may not feel pain when the hands, legs, or feet are cut, burned, or otherwise injured.Approximately 1 to 2 million people worldwide are permanently disabled because of leprosy.

 

Carbuncles

A carbuncle is a red, swollen, and painful cluster of boils that are connected to each other under the skin. A boil (or furuncle) is an infection of a hair follicle that has a small collection of pus (called an abscess) under the skin. Usually single, a carbuncle is most likely to occur on a hairy area of the body such as the back or nape of the neck. But a carbuncle also can develop in other areas of the body such as the buttocks, thighs, groin, and armpits.

 

Cause

Most carbuncles are caused by Staphylococcus aureus bacteria, which inhabit the skin surface, throat, and nasal passages. These bacteria can cause infection by entering the skin through a hair follicle, small scrape, or puncture, although sometimes there is no obvious point of entry.

Filled with pus – a mixture of old and white blood cells, bacteria, and dead skin cells — carbuncles must drain before they’re able to heal. Carbuncles are more likely than boils to leave scars.

An active boil or carbuncle is contagious: the infection can spread to other parts of the person’s body or to other people through skin-to-skin contact or the sharing of personal items. So it’s important to practice appropriate self-care measures, like keeping the area clean and covered, until the carbuncle drains and heals.

Carbuncles require medical treatment to prevent or manage complications, promote healing, and minimise scarring. Contact your doctor if you have a boil or boils that have persisted for more than a few days.

 

Risk factors for carbuncles

Older age, obesity, poor hygiene, and poor overall health are associated with carbuncles. Other risk factors for carbuncles include:

*    Chronic skin conditions, which damage the skin’s protective barrier

*    Diabetes

*    Kidney disease

*    Liver disease

*    Any condition or treatment that weakens the immune system

Carbuncles also can occur in otherwise healthy, fit, younger people, especially those who live together in group settings such as college dorms and share items such as bed linens, towels, or clothing. In addition, people of any age can develop carbuncles from irritations or abrasions to the skin surface caused by tight clothing, shaving, or insect bites, especially in body areas with heavy perspiration.

 

Symptoms of carbuncles

The boils that collect to form carbuncles usually start as red, painful bumps. The carbuncle fills with pus and develops white or yellow tips that weep, ooze, or crust. Over a period of several days, many untreated carbuncles rupture, discharging a creamy white or pink fluid.

Superficial carbuncles – which have multiple openings on the skin’s surface – are less likely to leave a deep scar. Deep carbuncles are more likely to cause significant scarring. Other carbuncle symptoms include fever, fatigue, and a feeling of general sickness. Swelling may occur in nearby tissue and lymph nodes, especially lymph nodes in the neck, armpit, or groin.

 

Complications of carbuncles

Sometimes, carbuncles are caused by methicillin-resistant Staphylococcus aureus (MRSA) bacteria, and require treatment with potent prescription antibiotics if the lesions are not drained properly.

In rare cases, bacteria from a carbuncle can escape into the bloodstream and cause serious complications, including sepsis and infections in other parts of the body such as the lung, bones, joints, heart, blood, and central nervous system.

Sepsis is an overwhelming infection of the body that is a medical emergency and can be fatal if left untreated. Symptoms include chills, a spiking fever, rapid heart rate, and a feeling of being extremely ill.

 

Home treatment for carbuncles

The cardinal rule is to avoid squeezing or irritating a carbuncle, which increases the risk of complications and severe scarring.

Warm compresses may promote the drainage and healing of carbuncles. Gently soak the carbuncle in warm water, or apply a clean, warm, moist washcloth for 20 minutes several times per day. Similar strategies include covering the carbuncle with a clean, dry cloth and gently applying a heating pad or hot water bottle for 20 minutes several times per day. After each use, washcloths or cloths should be washed in hot water and dried at a high temperature.

Washing the carbuncle and covering the area with a sterile bandage also may promote drainage and healing and help prevent the infection from spreading. Over-the-counter medications such as acetaminophen or ibuprofen can help relieve the pain of an inflamed carbuncle.

It is important to thoroughly wash your hands after touching a carbuncle. Launder any clothing, bedding, and towels that have touched a carbuncle and avoid sharing bedding, clothing, or other personal items.

 

Medical treatments for carbuncles

See your doctor if a boil or boils do not drain and heal after a few days of home treatment; or if you suspect you have a carbuncle. Also, seek medical evaluation for a carbuncle that develops on your face, near your eyes or nose, or on your spine. Also see a doctor for a carbuncle that becomes very large or painful.

Your doctor may cut and drain the carbuncle, and ensure that all the pus has been removed by washing the area with a sterile solution. Some of the pus can be collected and sent to a lab to identify the bacteria causing the infection and check for susceptibility to antibiotics.

If the carbuncle is completely drained, antibiotics are usually unnecessary. But treatment with antibiotics may be necessary in cases such as:

*    When MRSA is involved and drainage is incomplete

*    There is surrounding soft-tissue infection (cellulitis)

*    A person has a weakened immune system

*    An infection has spread to other parts of the body

Depending on severity, most carbuncles heal within two to three weeks after medical treatment.

 

Impetigo

Impetigo is a highly contagious bacterial skin infection. It can appear anywhere on the body but usually attacks exposed areas. Children tend to get it on the face, especially around the nose and mouth, and sometimes on the arms or legs. The infected areas appear in plaques, ranging from dime to quarter size, starting as tiny blisters that break and expose moist, red skin. After a few days the infected area is covered with a grainy, golden crust that gradually spreads at the edges.

In extreme cases, the infection invades a deeper layer of skin and develops into ecthyma, a deeper form of the disease. Ecthyma forms small, pus-filled bumps with a crust much darker and thicker than that of ordinary impetigo. Ecthyma can be very itchy, and scratching the irritated area spreads the infection quickly. Left untreated, the sores may cause permanent scars and pigment changes.

The gravest potential complication of impetigo is post-streptococcal glomerulonephritis, a severe kidney disease that occurs following a strep infection in less than 1 per cent of cases, mainly in children. The most common cause of impetigo is Staphylococcus aureus. However, another bacteria source is group A streptococcus. These bacteria lurk everywhere.

It is easier for a child with an open wound or fresh scratch to contract impetigo. Other skin-related problems, such as eczema, body lice, insect bites, fungal infections, and various other forms of dermatitis can make a person susceptible to impetigo.

Most people get this highly infectious disease through physical contact with someone who has it, or from sharing the same clothes, bedding, towels, or other objects. The very nature of childhood, which includes lots of physical contact and large-group activities, makes children the primary victims and carriers of impetigo.

 

Pilonidal cyst

A pilonidal cyst occurs at the bottom of the tailbone (coccyx) and can become infected and filled with pus. Once infected, the technical term is pilonidal abscess. Pilonidal abscesses look like a large pimple at the bottom of the tailbone, just above the crack of the buttocks. It is more common in men than in women. It usually happens in young people up into the fourth decade of life.

 

Causes

Most doctors think that ingrown hairs cause pilonidal cysts. Pilonidal means “nest of hair.” It is common to find hair follicles inside the cyst.Another theory is that pilonidal cysts appear after trauma to that region of the body. During World War II, more than 80,000 soldiers developed pilonidal cysts that required a hospital stay. People thought the cysts were due to irritation from riding in bumpy Jeeps. For a while, the condition was actually called “Jeep disease.”

 

Symptoms

The symptoms of a pilonidal cyst include:

*    Pain at the bottom of the spine

*    Swelling at the bottom of the                         spine

*    Redness at the bottom of the                         spine

*    Draining pus

*    Fever

 

When to seek medical care for a pilonidal cyst

A pilonidal cyst is an abscess or boil that needs to be drained or lanced, to improve. Like other boils, it does not improve with antibiotics. If any of the above symptoms occur, consult a doctor.

 

Exams and tests

A doctor can diagnose a pilonidal cyst by taking a history (asking about the patient’s history and symptoms regarding the cyst) and performing a physical exam. The doctor may find the following conditions:

*    Tenderness, redness, and swelling between the cheeks of the buttocks just above the anus

*    Fever

*    Increased white blood cells on a blood sample (not always taken)

*    Inflammation of the surrounding skin

 

Home remedies

Early in an infection of a pilonidal cyst, the redness, swelling, and pain may be minimal. Sitting in a warm tub may decrease the pain and may decrease the chance that the cyst will develop to the point of requiring incision and drainage.

 

Medical treatment for a pilonidal cyst

Antibiotics do not heal a pilonidal cyst. Doctors have any of a number of procedures available, including the following treatments.

*    The preferred technique for a first pilonidal cyst is incision and drainage of the cyst, removing the hair follicles and packing the cavity with gauze.

Advantage- Simple procedure done under local anaesthesia

Disadvantage – Frequent changing of gauze packing until the cyst heals, sometimes up to three weeks

*    Marsupialisation – This procedure involves incision and draining, removal of pus and hair, and sewing of the edges of the fibrous tract to the wound edges to make a pouch.

Advantages – Outpatient surgery under local anaesthesia, minimises the size and depth of the wound without the need to pack gauze in the wound

Disadvantages – Requires about six weeks to heal, needs a doctor trained in the technique

*    Another option is incision and drainage with immediate closing of the wound.

Advantages – Wound completely closed immediately following surgery without need for gauze

Disadvantages – High rate of recurrence (it is hard to remove the entire cyst, which might come back). Typically performed in an operating room, it requires a specially trained surgeon.

 

Skin and molluscum contagiosum

Molluscum contagiosum is a viral skin infection that causes either single or multiple raised, pearl-like bumps (papules) on the skin. It is a chronic infection and lesions may persist from a few months to a few years. However, most cases resolve in six to nine months.

 

Causes

Molluscum contagiosum is caused by a virus (the molluscumcontagiosum virus) that is part of the pox virus family. The virus is contagious through direct contact and is more common in children. However, the virus also can be spread by sexual contact and can occur in people with compromised immune systems. Molluscumcontagiosum can spread on a single individual through scratching and rubbing.

 

Symptoms

Common locations for the molluscumcontagiosum papules are on the face, trunk, and limbs of children and on the genitals, abdomens, and inner thighs of adults. The condition usually results in papules that:

*    Are generally painless, but can itch

*    Are small (2 to 5 millimetre diameter)

*    Have a dimple in the centre

*    Are initially firm, dome-shaped, and flesh-coloured

*    Become softer with time

*    May turn red and drain over time

*    Have a central core of white, waxy material

 

Molluscum contagiosum usually disappears spontaneously over a period of months to years in people who have normal immune systems. In people who have AIDS or other conditions that affect the immune system, the lesions associated with molluscumcontagiosum can be extensive and especially chronic.

 

Diagnosis

Diagnosis of molluscum contagiosum is based on the distinctive appearance of the lesion. If the diagnosis is in question, a doctor can confirm the diagnosis with a skin biopsy — the removal of a portion of skin for closer examination. If there is any concern about related health problems, a doctor can check for underlying disorders.

 

Treatment

Molluscum contagiosum is usually self-limited, so treatment is not always necessary. However, individual lesions may be removed by scraping or freezing. Topical medications, such as those used to remove warts, may also be helpful in lesion removal.

Note: The surgical removal of individual lesions may result in scarring.

 

Prevention

To prevent molluscum contagiosum, follow these tips:

*    Avoid direct contact with anyone who may have the condition.

*    Treat underlying eczema in children.

*    Remain sexually abstinent or have a monogamous sexual relationship with an uninfected individual. (Male and female condoms cannot offer full protection as the virus can be found on areas not covered by the condom.)

 

Shingles

Shingles (herpes zoster) results from a reactivation of the virus that also causes chickenpox. With shingles, the first thing you may notice is a tingling sensation or pain on one side of your body or face. Painful skin blisters then erupt on only one side of your face or body along the distribution of nerves on the skin. Typically, this occurs along your chest, abdomen, back, or face, but it may also affect your neck, limbs, or lower back. The area can be very painful, itchy, and tender. After one to two weeks, the blisters heal and form scabs, although the pain often continues.

The deep pain that follows after the infection has run its course is known as postherpetic neuralgia. It can continue for months or even years, especially in older people. The incidence of shingles and of postherpetic neuralgia rises with increasing age. More than 50 per cent of cases occur in people over 60. Shingles usually occurs only once, although it has been known to recur in some people.

 

What causes shingles?

Shingles arises from varicella-zoster, the same virus that causes chickenpox. Following a bout of chickenpox, the virus lies dormant in the spinal nerve cells. But it can be reactivated years later when the immune system is suppressed by:

*    Physical or emotional trauma

*    A serious illness

*    Certain medications

Medical science doesn’t understand why the virus becomes reactivated in some people and not in others.

 

Chickenpox

Chickenpox (varicella), a viral illness characterised by a very itchy red rash, is one of the most common infectious diseases of childhood. It is usually mild in children, but adults run the risk of serious complications, such as bacterial pneumonia.

People who have had chickenpox almost always develop lifetime immunity (meaning you can’t get it again). However, the virus remains dormant in the body, and it can reactivate later in life and cause shingles.

Because the chickenpox virus can pass from a pregnant woman to her unborn child, possibly causing birth defects, doctors often advise women considering pregnancy to confirm their immunity with a blood test.

 

What causes chickenpox?

Chickenpox is caused by the herpes zoster virus, also known as the varicella zoster virus. It is spread by droplets from a sneeze or cough, or by contact with the clothing, bed linens, or oozing blisters of an infected person. The onset of symptoms is seven to 21 days after exposure. The disease is most contagious a day before the rash appears and up to seven days after, or until the rash is completely dry and scabbed.

D1 D2 D3 D4 D5

 

Reports compiled by Adebayo Folorunsho-Francis with addition information from webmd.com/skin-problems-and-treatments and wikipedia.org/wiki/Skin_infection

Verghese reveals how drug production in Nigeria can be self-sufficient

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In this interview with Yusuff Moshood, Mr Varkey Verghese, founder and managing director of the Jawa Group of companies, spoke on how Jawa overcame the challenges it faced at inception and rose to its present level as one of the top ten pharmaceutical manufacturing companies in Nigeria. Verghese, who received the prestigious Member of the Order of the Federal Republic (MFR) national merit award in 2001, also spoke on measures that can be taken to transform the pharmaceutical sub-sector and enable it contribute more to the Nigerian economy. Excerpts:


Pharmaceutical manufacturing business in this clime is a venture seriously hampered by a number of challenges. You could have chosen other businesses that are less problematic but still chose to invest in pharmaceutical manufacturing business, what prompted your decision?

 

Pharmaceutical business is indeed very challenging, particularly manufacturing. The reason we chose pharmaceutical manufacturing business is because of certain basic criteria. First, for human beings, the following are basic essentials – food, shelter, clothing and healthcare. Health care provision is essential and we require it as a basic requirement in all situations.

As a person, I have always been interested in helping to enhance the quality of life of people and I am happy doing this through healthcare delivery. We also know that Nigeria has a huge population and the potential for growth for healthcare business is very high compared to all other African countries.

 

Jawa started in the 90s with about five OTC products, but the company now has over 50 products covering diverse therapeutic range, how did you manage this remarkable growth?

 

Jawa started with five products and 50 staff members. Yes, we have achieved reasonably modest growth in our business despite the fact that we were hit badly by a serious challenge two years after we commenced production and faced a similar challenge again about three years after we had the first problem. Regardless of these challenges, God Almighty gave us the grace and wisdom to take every challenge as an opportunity to grow.

The challenges we faced had to do with the withdrawal of two of our shareholders at an interval of two years each, after the commencement of operations. It was a serious setback.

Apart from the pull out of our shareholders, we also inherited a bank loan at the time the partition was done. However, by God’s grace we were able to overcome the challenges and got to this stage. I would attribute our success to the support of our staff from the lowest to the highest. They all stood and supported the management at the most critical time, even when we could not meet salary obligations. Some expatriates managers left but my Nigerian colleagues, particularly the seniors, stood with us.

 

Two other factors also aided our growth as a company. The first is the goodwill of our customers and the quality of our products from inception; the second is the patronage of Jawa’s products by our valued distributors, wholesalers, retailers, government and hospitals both in the public and the private sectors. Currently, we have 425 staff working for the Jawa Group. We have three divisions, namely,OTC drugs, ethical drugs and veterinary drugs.

For our OTC Drugs division, we have haematonics, antacids, cough syrup, anti-diarrhoea, anti-malaria syrups and multivitamins. We also make external liquid preparation. Apart from this, we also make ointment and creams,including antiseptic, antifungal and muscular relief drugs.

For our Ethical Drugs division, we have antibiotics, antimalarials, anaesthetics and other injectables imported in our own brand name.However, for our Veterinary Drugs division, we manufacture anti-helmenthetics for deworming, as well as multivitamins and anti-septic ointments.In all, we have 117 registered products with NAFDAC and another 42 products under registration with NAFDAC.

The impressive support of Nigerians for our company and products informed our decision to also pay back to the society for every unit of product we sell in Nigeria. This is to ensure we contribute to the community in a positive way. Some of our Corporate Social Responsibility (CSR) activities include donation of drugs for ante-natal care, child health, and accident & emergency interventions in Osun, Oyo, Ondo, Ekiti, Katsina and Cross River States.

We also donated drugs and clothes to the Internally Displaced People (IDP)’s camp in Yola, Adamawa State, as well as a delivery van to the Kano State Drug Medical Agency and the Katsina State Ministry of Health.

Also, as part of our CSR and on humanitarian grounds, some patients known to us through our customers and friends were sponsored for treatment in India for ailments like heart surgeries, cancer, liver abscess, bone surgeries, etc. We equally partnered with the Tulsi Chanrai Eye Foundation and conducted free eye operations for 450 patients across the country.

We take CSR seriously and I can assure you that for every unit of Jawa product you patronise, a portion goes back to the community to touch lives.

 

Last year (2014), four pharmaceutical manufacturing companies in Nigeria attained the WHO prequalification status. How do you see this new trend of local pharmaceutical manufacturers going for the WHO prequalification and what can the government do to ensure these companies and the entire populace benefit from the prequalification status?

 

Getting the WHO prequalification by four companies is a very big achievement and Nigeria can be very proud of this. In the whole of Africa, Nigeria is the only country where four manufacturing plants are accredited. This has opened the eyes of many manufacturers in Nigeria. The WHO accreditation, which was considered not achievable in Nigeria is now achievable. This has encouraged many others to follow suit and we hope many more will get qualified.

To further improve the pharmaceutical sector, the federal government should consider having a pharmaceutical sector development fund as they have done for the textile and agricultural sectors. The Bank of Industry should also be adequately funded to enable it deliver on its mandate.

 

The pharmaceutical industry as a sub-sector of the Nigerian economy has been said to have the potential to contribute more to both national income and wellbeing. As a key player in this sector for years, how true is this and what factors are impeding the industry from realising its full potential?

 

The pharmaceutical industry as a sub-sector of the economy is worth three billion United States dollars (USD) which clearly shows that it has a potential to contribute more to the Nigeria economy and still there is room for growth. The main impediment is lack of patronage by government agencies and the political will not to accept funds from donor agencies that will always prefer to buy from foreign companies. Nigeria, while accepting donor funds, should insist on the sourcing of the products from local manufacturers.

 

How can we stop the huge dependence of Nigeria and Nigerians on external sources (importation) for local medicine needs?

 

There are 120 pharmaceutical manufacturers in Nigeria in the category of small, medium and large; and all the companies put together have the capacity to produce 70 per cent of the country’s requirements. This can be achieved over a period of five years, provided the federal and state governments can support the pharma sector through adequate long-term funding to expand and upgrade existing facilities, patronage of local manufacturers, and increase in the medicines on import prohibition list, especially those medicines that can be manufactured locally.

Also, importers should not be allowed to bring in products that can be made in Nigeria. This alone will help to improve the capacity utilisation of existing plants.

It may be equally worthwhile to see how other nations achieved self-sufficiency in local manufacturing. Take the examples of India and China. They were closed economies for a long time and this did not allow any importer to come in. During this period, companies operating in those two countries looked inwards and developed local industries which have matured to great heights. They have now opened their countries to importation from outside; but other countries are not able to compete with them because of the economy of scale they have achieved.

It is worth emulating such countries so that Nigeria can become self-sufficient not only to meet local demands but to also export products to other countries.

 

In our quest to rid the nation of the menace of fake drugs, are there things we should be doing that we are not doing? How can we further strengthen the fight against drug counterfeiting?

 

I commend the NAFDAC for the war against fake drugs. The introduction of the Mobile Authentication Service (MAS) sticker for selected products by NAFDAC is a welcome development and, in due course, it should be expanded to other products also.

However, it is important to state that fake drugs usually enter the country basically through three avenues- seaports, airports and land borders. Therefore, if the federal government and NAFDAC can properly police the loopholes at these entry points, it will go a long way to minimise the problem of fake drugs. NAFDAC should equally be adequately funded and equipped to consistently deliver on its mandate.

UNILAG Pharmacy Faculty marks 2nd ‘White Coat ‘ceremony

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The second annual ‘White Coat’ ceremony was recently held by the Faculty of Pharmacy, University of Lagos (UNILAG), Idi-Araba, with a massive turnout of students and academic staff.

UNILAG2

L-R: Dr Rebecca Soremekun, lecturer, Clinical Pharmacy and Biopharmacy, University of Lagos; Pharm. Joseph Oiseoghaede, secretary, National Association of Pharmacists in Academia (NAPA); Prof. Bola Silva, head of department, Pharmaceutics and Pharmaceutical Technology; Prof. Olukemi Odukoya, dean of the faculty; Dr Bola Aina, lecturer, Clinical Pharmacy and Biopharmacy; Pharm (Mrs) Ogochukwu Amaeze, NAPA financial secretary; Pharm. Amina Oyawaluja, lecturer, department of Pharmacognosy; Pharm. (Mrs) Fatima Ikolaba, NAPA treasurer during the White Coat ceremony.
Addressing the 175 pharmacy undergraduates at the ceremony which took place at the school auditorium on 13 March, 2015,Kayode Olatunji, one of the four 300 level students with distinction brought to educate the 2014/2015 intakes on achieving excellence in pharmacy education, charged them to brace up for the challenges ahead.
Olatunji, in his keynote address,counselled the students on the need to define what they aimed to achieve the moment they gained admission to study Pharmacy.
“By now, you should have decided what you want to become the moment you graduate. Whether you hope to sell drugs, go into academia, work in hospitals and so on,” Olatunji said, adding that “studying pharmacy is very stressful; but you shouldn’t allow the stress to get to you. You must remain focused, read to understand and avoid cramming.”
According to the young sch

International workshop on health care leadership, financing and innovation (DUBAI)

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In every health care delivery system, there is need for productive leadership to ensure the provision of optimum health care service. All over the world, governments and private institutions are developing and implementing unique models for meeting present and emerging challenges in health care delivery. For the past 21 years, it has been our task at Pharmanews to help deliver the requisite capacity development required to proactively champion sustainable models of service delivery among health care and pharmaceutical industry players.

We wish to invite you to participate in our international workshop on “Health Care Leadership, Financing and Innovation”, taking place in Dubai, The United Arab Emirates.

Date:            Sunday 17 – Friday 22 May, 2015

Time:            9.00a.m – 5.00p.m (daily)

Venue:         Aster DM Health Care, 33rd Floor,

                     Tower D – Aspect Towers, Executive Towers at Bay

                     Avenue, Business Bay, Dubai, United Arab Emirates

 Target Participants

Doctors, Pharmacists, Nurses, Medical Laboratory Scientists and other clinical, administrative, management and technical personnel in the public and private health care system.

 Course Contents:

  • Developing and Managing Strategic Change
  • Quality Management
  • Health Care Financing Models and Structure
  • Investment Models in Health Care Facility Development
  • Comparative Study of Global Health Care Entrepreneurship Models
  • ICT in Health Care Systems
  • Essentials of Clinical Leadership

 Learning Objectives:

At the end of the workshop, participants will be able to:

  • Lead effectively, communicate clearly and deliver optimal health care service within the health care delivery system.
  • Understand basic concept in managing and developing strategies for effective change.
  • Understand globally accepted and sustainable techniques in quality management protocols.
  • Understand global health care financing models, challenges and it’s opportunities for Innovation in Africa.
  • Comprehend best investment models and current management approaches and strategies for achieving effective facility development.
  • Learn global best-case models for driving health care entrepreneurship ventures.
  • Effectively initiate and supervise ICT integration with operational processes of health care service

Registration Fee

  • $1,950 (or Naira equivalent) per participant on or before 30th April, 20
  • $2,050 (or Naira equivalent) per participant after 30th April, 2015.

 Group discounts: 3 – 5 participants: 10%,    6 participants and above: 15%

Registration fee covers: Tour, workshop materials, tea/coffee break, lunch, certificates, and visa processing ONLY.

Participants are to take care of their travel expenses, dinner, and accommodation.

 Hotel Accommodation

Participants can get accommodation close to the workshop venue at an average rate of $80 $100 per night. For more options on hotel accommodation, please visit the online booking site: www.agoda.com

Cancellation

For cancellation of registration fee, 70% of the fee will be refunded, if cancelled at least seven (7) days to the workshop and the information communicated to us by sms or email, using: info@pharmanewsonline.com

There will be no refund if cancelled thereafter.

Method of Payment

Participants should pay registration fee into Pharmanews Ltd account in Zenith Bank Plc (A/c No.

1010701673) or Access Bank Plc (A/c No.0035976695) and send their full names and bank deposit slip

numbers by sms or email to Pharmanews Ltd. Payments in dollars should be made to Pharmanews Domiciliary Accounts: GTB A/c No. 0005082226

Payment Online

Payments can also be made through our payment portal on GTBank SME market hub facility. To make payment online, visit: https://pharmanews.smemarkethub.com

Please note that payment in naira can only be accepted in Nigeria. In Dubai, the dollar equivalent will be paid.

 Financial Transactions in Dubai

Your financial transactions in Dubai will be done in the local currency, UAE Dirham. The current rate is 3.7 Dirham to 1 US$.

Arrival and Departure

Participants are expected to arrive on or before Sunday, 17th and depart Friday, 22nd.

City Tour

For the tour, temperature will be at an average of 34° Celsius. We advise casual wear with shoes suitable for walking. Cameras will be useful for pictures.

Travel Information

 By Air

Intending participants are advised to make reservation for flight ticket to Dubai through these online booking sites: www.wakanow.com or www.opodo.co.uk. Available airlines on the booking sites are Emirates, Kenyan Air, Etihad, Ethiopian Airways, and Qatar Airways, among others.

Visa

After registration, participants will be contacted on the procedures for visa procurement. The visa fees are covered in the registration fee.

For further information, please contact:

Cyril Mbata                                –  +234 706 812 9728

Nelson Okwonna                         –  +234 803 956 9184

Ernest Salami                               –   +234 703 986 8837

Elizabeth Amuneke                     –   +234 805 723 5128

Click here to download a pdf version of the Dubai workshop invitation

 

Kick Depression out for good with Setral

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Indication:
Sertraline is used for treating depression, obsessive-compulsive disorder (OCD), panic disorder, and post-traumatic stress disorder and postmenstrual dysphoric disorder (PMDD).

Contraindication:
Drug abuse or dependence. Servere hepatic or renal function impairment, seizures disorder, sensitivity to sertraline

Setral – 50
Each film coated tablet contains:
Sertraline Hydrochloride
Equivalent to Sertraline          50mg
Excipients                                      q.s
Colour:                    Approved colour

Setral – 100
Each film coated tablet contains:
Sertraline Hydrochloride
Equivalent to Sertraline          100 mg
Excipients                                          q.s
Colour:                        Approved colour

Setral

 

Giving back life to the mind with Olanza

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Olanzapine Tablets is indicated for the treatment of schizophrenia.
Olanzapine is effective in maintaining the clinical improvement during continuation therapy in patients who have shown an initial treatment response.
Olanzapine is indicated for the treatment of moderate to severe manic episode. In patients whose episode has responded to olanzapine treatment, olanzapine treatment, olanzapine is indicated for the prevention of recurrence in patients with bipolar disorder.

Olanza

 

 

 

 

 

Hitting BPH where it matters most… Finstal-5

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Hitting BPH where it matters most with Finstal-5 (Marketed by PharmacyPlus Limited)

Finstal-5

 

 

Emzor (ZORAMIN)

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It Contains Essential Elements Such as:
Amino Acids
Multivitamins
Minerals

It helps in:
Cell building & Stress relief
Effective antioxidant & General Well-being
Improved metabolic activities & Suitable for all agesemzor2

Kezitil achieves first time success in community acquired bacterial infections

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Kezitil achieves first time success in community acquired bacterial infections
Kezitil is active against a wide range of resistant bacteria.

emzor3

Government debt crippling pharma industry – Drugfield MD

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In this exclusive interview with Pharmanews, Pharm. Olakunle Ekundayo, managing director and chief executive officer of Drugfield Pharmaceuticals Limited spoke on the challenges facing the pharmaceutical manufacturing sub-sector of the Nigerian economy and argued that the greatest undoing to the sector presently is the billions of naira owed pharmaceutical companies by the government. He also spoke on how the recent devaluation of the naira, the insurgency in the north and policy inconsistency are hindering the development of the pharmaceutical manufacturing industry. Excerpts:

The manufacturing sector of the economy, including the pharmaceutical manufacturing sub-sector, depends heavily on imported inputs for its production. How are issues such as the devaluation of the naira and the recently released new classification of imports by the Central Bank of Nigeria (CBN) affecting the industry?

 The devaluation of the currency has so many implications for manufacturing. The number one implication is that we now need more working capital to import and pay for essential items which are used in manufacturing. The number two effect is that, with the low inflow of foreign exchange into the economy, we now have a situation whereby the raw materials used for pharmaceutical manufacturing are now re-classified as finished products. We really don’t know why the government should do that. Maybe it’s because of the scarcity of foreign exchange. This is why they have come up with some of these tricks to push manufacturers to source foreign exchange through other means, like the Interbank or even the black market. They just want to reduce pressure on the government Dutch option system.

The number three effect is that even when we now have to patronise the Interbank foreign exchange, the bank now puts up a trading system full of instabilities. For instance, they can tell you that the exchange rate as at this minute is185 naira to one US dollar, but that that rate is valid for only ten minutes. You can imagine that, as a manufacturer. What decisions or conclusions can you make within ten minutes to ensure you secure that rate? So there is so much confusion in the system.

When you put all these together, you begin to ask yourself how manufacturing operations can be run with such level of instability and confusion. Right now, it is really affecting the industry. I know, at least, two big companies around here who went on Christmas shutdown late last year and asked the staff not to resume in the new year until the situation had become conducive. This is the real challenge confronting us, with the devaluation of the naira and the drop in the price of oil which accounts for at least 70 per cent of the country’s foreign exchange income.

In trying times like this, governments are expected to be proactive by coming up with palliative measures to keep industries going. Are there steps the government can take to keep the pharmaceutical manufacturing industry afloat in the current situation?

 There is nothing the government is doing or has done so far. And we cannot see any measure being taken even in the immediate future. The government, I think, seems to be in a confused state because of the oil price that keeps falling. Yet it must be recognised that drugs are essential items that should not be played around with. This is because, with drugs, it is the health of the people that is at stake.

I think that the government should look into the sector and do things that will provide respite to the pharmaceutical industry, as well as giving the necessary concession that can keep the sector going and ensuring that prices of drugs are reasonably affordable to Nigerians.

The year 2014 was quite turbulent for the health sector generally, with strikes of health workers and insurgency in the north affecting pharmaceutical businesses. Looking at those challenges, what are your expectations for the sector in 2015?

 Your observations are correct. The insurgency in the north has reduced area of coverage for business. The northeast for us as a company was a very good outlet for our products getting across our borders into neighbouring countries. That has stopped completely. Even in certain towns and cities in the northeast, like Maiduguri, we cannot do business. That has reduced the incomes of our company and other companies who do business in that area.

However, beyond insecurity and insurgency, the government has also refused to pay drug manufacturers who supplied drugs on tender to the Federal Ministry of Health and to different government agencies. I think this is one of the greatest injustices to the sector. They owe the drug industry in billions and they forget that these supplies were mostly done with borrowed funds. It is thus a double jeopardy for manufacturers. We all know the situation that the banks are in today. Government owes manufacturers, and delay in payment of this debt is making the situation worse for the sector and for the banks. There is even no ray of light at the end of this dark tunnel because there is no sign that the payment is imminent.

We are also calling on the government to change the classification of the pharmaceutical manufacturing sector. We want them to do what they have done in other sectors like the textile or automotive industry and get the sector moving. It will be a tragedy if Nigeria allows the pharmaceutical sector to collapse. No country in the world should allow that to happen. In these days of all sorts of warfare including biological warfare, no country should rely on imports of drugs for its own people. That can be a veritable tool by the enemy to wipe out a whole population.

The refusal of the US government to give ZMapp to Nigeria during our trying period of Ebola crisis last year once again reinforced the need for Nigeria not to depend on external sources for local medicine needs. What other lessons should we learn from that incident and how can we institutionalise Research and Development (R&D) in the pharmaceutical manufacturing sector to ensure we are able to solve our health problems?

 I think the lesson to learn should be on the side of the government. Government should take the lead in this effort. When Ebola came, there was very little the local pharmaceutical industry could do other than to support government and provide palliative drugs that could help, which we actually did. In fact, it was surprising that we donated drugs but they were never officially received by the Federal Ministry of Health. The Pharmaceutical Manufacturing Group of the Manufacturers Association of Nigeria (PMG-MAN) asked members to donate drugs to support government efforts in taming Ebola, which we actually did; but no one could receive the drugs on behalf of the government.

Beyond that, in the last few years, a number of Nigerian companies have signed on to upgrade their facilities for the World Health Organisation Good Manufacturing Practice (WHO-GMP) qualification and the United States Pharmacopoeia (USP) standard. Very expensive ventures! A lot of investments have been made by these companies. We are grateful to God and also to NAFDAC which facilitated the process that, at the end of the day, four Nigerian companies have received WHO-GMP certification at very high costs. And that was just the first phase to the whole process. The end-point is when you have products that are pre-qualified by the WHO. Therefore, what the four companies have received is the first phase approval. They now must come forward with the products they want WHO to prequalify so that they can compete in international tenders.

As we speak, the Nigerian government has not done anything to encourage the sector or these companies. They have not said that “because of the huge investment you have made and the honour you have brought to Nigeria, we are giving you tax break, we are paying off the debts we owe to your sector or we are going to support you with this to enable you invest in research and development to come up with new drugs or even vaccines.” Nothing like that has come from the government.

Many of our colleagues are disappointed that, having invested huge amounts of money on this upgrade, not even proper recognition of what they have done has come from the government. But we are Nigerians and this is our country. We must continue to strive and work hard and talk when we need to do so and be hopeful that things will change.

Last year, Drugfield was celebrated for introducing Chlorxy-G (Chlorhexidine) Gel, an innovative low cost product for prevention of umbilical cord infections in newborn and a drug said to be quite invaluable in our quest as a nation to reduce infant mortality. What prompted your decision to manufacture this product and is this an indication that Drugfield will be doing more in the area of infant care medicines?

 Thank you very much for this question. First, as a company, we pride ourselves on always looking for opportunities and areas of healthcare where there are gaps and needs to be filled. We have always tried to make products available in areas where there is scarcity. This has been our philosophy all along. Therefore when we saw in the newspapers that the United States Pharmacopoeia (USP) was asking Nigerian companies to express interest in producing Chlorhexidine Gel, we quickly jumped at it.

We did that for a number of reasons. One, as at that time, we had four products in gel form in our portfolio which we manufactured locally. So we have a lot of experience in the manufacture of gel. The second reason is that since the product was a United Nations (UN) commodity, we thought “why not give it a shot to show how experienced we are to the global community?”The third reason is that we know that the product could launch us into the international market and contribute to maternal and child health care in a way that could be positively effective.

One thing which we never imagined was that, as simple as the product is, it could put us in the limelight. By the time the USP visited Nigeria to look at the companies that had shown interest, we already had the packaging material made. We were already waiting to clear the raw materials at the airport. They were pleasantly surprised that we moved so rapidly. It helped us in a lot of ways. We already had TSHIP (Targeted States High Impact Project)’s support. TSHIP is an NGO financed by the United States Agency for International Development (USAID) and a few other world bodies working with Chlorhexidine Gel imported from Nepal in a few states in the North. They were using it in Sokoto and Bauchi States in umbilical cord care. The product was imported from Nepal which was then the only country in the world producing it. We then became a kind of a partner to USP and TSHIP. USP was providing the Good Manufacturing Practice (GMP) coverage, looking at what we had on ground and the necessary improvement we needed to make because the product is an international one.

Before they came for their second visit, the product samples were ready and we sentone to their office in Washington DC. USP was happy and TSHIP was also very happy. Subsequently, there was to be a world meeting of the different partners who were involved in Chlorhexidine development in May 2014 and TSHIP said we should come to be a part of the meeting. They got Bill and Melinda Gates Foundation to co-finance the trip with us and we took the product along and introduced it at the meeting to the group. At that meeting, Drugfield Pharmaceuticals was admitted into the World Chlorhexidine Working Group. We thus became the second country in the world and the number one in Africa to produce Chlorhexidine Gel for umbilical cord care. We were getting calls from all over the world. Calls were coming from many of the NGOs and foundations. Many of them visited us.

The usage of the gel also received a boost in Nigeria, with states signing on to its usage and we were supplying. But the real issue is that government agencies that are supposed to be the biggest buyers are the worst to do business with. Notwithstanding, many of what we have supplied have been paid for by some of the interested NGOs and we are hopeful that the business of Chlorhexidine Gel will grow.

We have sent samples to a few others African countries like Kenya, Mali and even Haiti in South America, based on the request they made to us. We supplied to them free of charge to also let them know how to undertake the development of this product in these countries. We are hopeful that if they want it in the future and cannot produce it, we can supply them finished products to use because we have the capacity.

How is the Nigerian government taking this product?

 The sad thing, really, is that, even though our government has put this product on the Essential Drug List, the kind of awareness we expected the government to give to such a lifesaving product is not forthcoming. Before this product, which has now helped to save the lives several new born babies, was introduced, Nigeria was the number one in Africa with cases of umbilical cord infection and number four in the world. So, one would have expected that our government would take advantage of the fact that we now produce the product in Nigeria to change the situation.

One Dr Ado Yobo, a Ghanaian, who works for USAID, came visiting us because of this product. After a tour of our facility, he said he would talk to the Ghanaian government that Nigeria had the capacity to supply Chlorhexidine Gel for use in Ghana. He also said if the development of the product had taken place in Ghana, he was very sure that the government would have banned the use of methylated spirit and all manners of life-threatening materials for the treatment of umbilical cord in newborns, and legislate that only Chlorhexidine Gel should be used in all hospital delivery rooms across the country. He wondered why Nigerian had not done that. We know things don’t work that way here. But we hope that, one day, Nigeria will get it right.

Drugfield has, over the years grown to become a reputable indigenous pharmaceutical manufacturer with over 140 registered products, what is the philosophy driving your processes and operation?

 Let me first of all thank God for what he has enabled us to achieve since our establishment. I am not the only one who worked with a multinational company before venturing into pharmaceutical manufacturing. So, I am not the only one who has experience. However, one thing that has helped us is that we have always looked for opportunities and products that are needed in the country and are essentially being imported. That was why we started with ointment and creams. When we started, people thought they were not significant products, until recently when everybody is now going in that direction. I must say that these are products that all the people use, irrespective of social class. So, to look at areas of need and gaps to fill has always been the driving philosophy of our business and it has paid off over the years.

Our philosophy also informed our decision to go into sterile manufacturing processes – making eye drops, small volume injectables and large volumes infusion products. These are areas of opportunity that we don’t have many companies going into. So, we believe Nigeria has a lot of opportunity to offer to those who can see it. This is why a lot of foreigners come into this country. They see these opportunities and take advantage of them. This is a huge country with a large population. The country has the potential to be a rich nation if our resources are well managed. The future also looks good for pharmaceutical manufacturing if the right things are done.

Towards effective cancer management in Nigeria

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The annual World Cancer Day was marked on 4 February, 2015. The goal was to intensify awareness campaign on the disease, as well as discuss new methods of curbing it. This year’s theme, ‘Not beyond us’, gives hope to cancer patients and their relatives, as it implies the possibility of cancer remedies across the globe and within our reach.

According to a report on World Cancer Day 2015, the campaign will explore the implementation of existing preventive measures, early detection, treatment and care, and in turn, open up to the exciting prospect that can impact the global cancer burden – for the better. Four key areas will constitute the focal point of the campaign, which are: choosing healthy lives; delivering early detection; achieving treatment for all; and maximising quality of life.

If all stakeholders would give this crusade all it takes to be a success, the alarming rate of 100,000 new cases of cancer recorded annually in the country will be drastically reduced.

A professor of radiotherapy and Oncology with the College of Medicine, University of Lagos, Akoka, Aderemi Ajekigbe, had while leading a campaign against cancer in January, asserted that Nigeria records 100,000 new cases of cancer annually. He added that except a timely intervention of government occurs, through the provision of functioning radiotherapy machines across the country, more cases will be recorded.

Ajekigbe attributed the increasing rate of the disease in developing countries like Nigeria to the poor state of health facilities, poor funding of cancer care, late diagnosis and detection of the deadly disease in the country. He emphasised the need for government to play a major role in the crusade as there are many poor Nigerians groaning under the pain of cancer, who cannot afford the treatment option.

“We cannot afford to lose more Nigerians to cancer. Government should dedicate the proceeds from an oil block to the provision of cancer equipment and treatment. It is a need,” he said.

What is cancer?

Cancer is a class of diseases characterised by out-of-control cell growth. There are over 100 different types of cancer, and each is classified by the type of cell that is initially affected.

Cancer harms the body when damaged cells divide uncontrollably to form lumps or masses of tissue called tumours (except in the case of leukaemia where cancer prohibits normal blood function by abnormal cell division in the blood stream). Tumours can grow and interfere with the digestive, nervous, and circulatory systems and they can release hormones that alter body function. Tumours that stay in one spot and demonstrate limited growth are generally considered to be benign.

More dangerous or malignant tumours form when two things occur:

  1. a cancerous cell manages to move throughout the body using the blood or lymph systems, destroying healthy tissue in a process called invasion
  2. that cell manages to divide and grow, making new blood vessels to feed itself in a process called angiogenesis.

When a tumour successfully spreads to other parts of the body and grows, invading and destroying other healthy tissues, it is said to have metastasized. This process itself is called metastasis, and the result is a serious condition that is very difficult to treat.

 Symptoms of cancer

  1.  Persistent cough or hoarseness. While a cough here and there is nothing to worry about, a consistent cacophony or a cough accompanied by blood is definitely a cause for concern. “Most coughs are not cancer,” says Therese Bartholomew Bevers, M.D., professor of clinical cancer prevention and the medical director of the Cancer Prevention Centre at the MD Anderson Cancer Centre. “But certainly a persistent cough needs to be evaluated to see if it could be lung cancer.” Your physician should recommend a chest X-ray or CT scan to rule out cancer as a possibility.

 

  1. Persistent change in bowel habits. When your bowel movements aren’t as easy as they once were or your stool appears larger than normal or somewhat deformed, this could be a sign of colon cancer, says Bartholomew Bevers. “It could be a sign that there is a mass impeding the transit of the stool from the bowel,” she says. “This is a symptom where a person should go to the doctor and schedule a colonoscopy to see if there indeed is a mass.”
  1. Persistent change in bladder habits. “If there is blood in the urine, that could be indicative of bladder or kidney cancer—but more commonly this is a sign of a urinary tract infection,” says Bartholomew Bevers. Check for an infection first, then pursue other treatment options.
  1. Persistent unexplained pain. “Most pain is not a sign of cancer, but persistent pain must be checked out,” says Bartholomew Bevers. “If you have persistent headaches, for example, you likely don’t have brain cancer—but it is still something that must be looked into. Persistent pain in the chest could be a sign of lung cancer. And pain in your abdomen could be ovarian cancer.”
  1. Change in the appearance of a mole. While not all moles are indicative of melanoma, spotting a new mark or one that has changed is something you should bring up with a dermatologist who can screen for skin cancer, says Bartholomew Bevers.
  1. A sore that does not heal. If you have a sore that’s hanging on past the three-week mark, you should bring it up with your doctor. “We would have expected our body to have healed itself by now,” says Bartholomew Bevers, “and you should absolutely get that checked out.” That kind of sore could be a sign of carcinoma.

 

  1. Unexpected Bleeding. Vaginal bleeding—outside of your normal cycle—could be an early sign of cervical cancer, while bleeding from the rectum could indicate colon cancer, says Bartholomew Bevers.

 

  1. Unexplained weight loss. “As adults, we try very hard to lose weight,” says Bartholomew Bevers. “But if weight is falling off of you without any effort on your part, that is a big concern and can be indicative of a serious medical problem.” One of those problems, she says, could be malignancy or a tumour.

 

  1. An unexplained lump. “Any time you have a lump that is new or a lump that is changing, that is something you should absolutely have looked at by your doctor,” says Bartholomew Bevers. While it could be a benign cyst (and likely is), it could also be “a cancer that is in the subterranean tissue. A lump in the chest, of course, is a very common symptom of chest cancer.” See your physician to get more information.

 How is cancer classified?

There are five broad groups that are used to classify cancer.

  1. Carcinomas are characterised by cells that cover internal and external parts of the body such as lung, breast, and colon cancer.
  2. Sarcomas are characterised by cells that are located in bone, cartilage, fat, connective tissue, muscle, and other supportive tissues.
  3. Lymphomas are cancers that begin in the lymph nodes and immune system tissues.
  4. Leukaemias are cancers that begin in the bone marrow and often accumulate in the bloodstream.
  5. Adenomas are cancers that arise in the thyroid, the pituitary gland, the adrenal gland, and other glandular tissues.

 

Cancers are often referred to by terms that contain a prefix related to the cell type in which the cancer originated and a suffix such as -sarcoma, -carcinoma, or just -oma. Common prefixes include:

*    Adeno- = gland

*    Chondro- = cartilage

*    Erythro- = red blood cell

*    Hemangio- = blood vessels

*    Hepato- = liver

*    Lipo- = fat

*    Lympho- = white blood cell

*    Melano- = pigment cell

*    Myelo- = bone marrow

*    Myo- = muscle

*    Osteo- = bone

*    Uro- = bladder

*    Retino- = eye

*    Neuro- = brain

 How fast does cancer spread?

Scientists reported in Nature Communications that they have discovered an important clue as to why cancer cells spread. It has something to do with their adhesion (stickiness) properties. Certain molecular interactions between cells and the scaffolding that holds them in place (extracellular matrix) cause them to become unstuck at the original tumour site, they become dislodged, move on and then reattach themselves at a new site.

The researchers say this discovery is important because cancer mortality is mainly due to metastatic tumours, those that grow from cells that have travelled from their original site to another part of the body. Only 10 per cent of cancer deaths are caused by the primary tumours.

The scientists, from the Massachusetts Institute of Technology, say that finding a way to stop cancer cells from sticking to new sites could interfere with metastatic disease, and halt the growth of secondary tumours.

In 2007, cancer claimed the lives of about 7.6 million people in the world. Physicians and researchers who specialise in the study, diagnosis, treatment, and prevention of cancer are called oncologists.

Malignant cells are more agile than non-malignant ones. Scientists from the Physical Sciences-Oncology Centers, USA, reported in the journal Scientific Reports (April 2013 issue) that malignant cells are much “nimbler” than non-malignant ones. Malignant cells can pass more easily through smaller gaps, as well as applying a much greater force on their environment compared to other cells.

Professor Robert Austin and team created a new catalogue of the physical and chemical features of cancerous cells with over 100 scientists from 20 different centres across the United States. The authors believe their catalogue will help oncologists detect cancerous cells in patients early on, thus preventing the spread of the disease to other parts of the body.

Prof. Austin said. “By bringing together different types of experimental expertise to systematically compare metastatic and non-metastatic cells, we have advanced our knowledge of how metastasis occurs.”

 How is cancer diagnosed and staged?

Early detection of cancer can greatly improve the odds of successful treatment and survival. Physicians use information from symptoms and several other procedures to diagnose cancer. Imaging techniques such as X-rays, CT scans, MRI scans, PET scans, and ultrasound scans are used regularly in order to detect where a tumour is located and what organs may be affected by it. Doctors may also conduct an endoscopy, which is a procedure that uses a thin tube with a camera and light at one end, to look for abnormalities inside the body.

Extracting cancer cells and looking at them under a microscope is the only absolute way to diagnose cancer. This procedure is called a biopsy. Other types of molecular diagnostic tests are frequently employed as well. Physicians will analyse your body’s sugars, fats, proteins, and DNA at the molecular level. For example, cancerous prostate cells release a higher level of a chemical called PSA (prostate-specific antigen) into the bloodstream that can be detected by a blood test. Molecular diagnostics, biopsies, and imaging techniques are all used together to diagnose cancer.

 How can cancer treated?

Cancer treatment depends on the type of cancer, the stage of the cancer (how much it has spread), age, health status, and additional personal characteristics. There is no single treatment for cancer, and patients often receive a combination of therapies and palliative care. Treatments usually fall into one of the following categories: surgery, radiation, chemotherapy, immunotherapy, hormone therapy, or gene therapy.

 Surgery

Surgery is the oldest known treatment for cancer. If a cancer has not metastasised, it is possible to completely cure a patient by surgically removing the cancer from the body. This is often seen in the removal of the prostate or a breast or testicle. After the disease has spread, however, it is nearly impossible to remove all of the cancer cells. Surgery may also be instrumental in helping to control symptoms such as bowel obstruction or spinal cord compression.

Innovations continue to be developed to aid the surgical process, such as the iKnife that “sniffs” out cancer. Currently, when a tumour is removed surgeons also take out a “margin” of healthy tissue to make sure no malignant cells are left behind. This usually means keeping the patients under general anaesthetic for an extra 30 minutes while tissue samples are tested in the lab for “clear margins”. If there are no clear margins, the surgeon has to go back in and remove more tissue (if possible). Scientists from Imperial College London say the iKnife may remove the need for sending samples to the lab.

 Radiation

 

Radiation treatment, also known as radiotherapy, destroys cancer by focusing high-energy rays on the cancer cells. This causes damage to the molecules that make up the cancer cells and leads them to commit suicide. Radiotherapy utilises high-energy gamma-rays that are emitted from metals such as radium or high-energy x-rays that are created in a special machine. Early radiation treatments caused severe side-effects because the energy beams would damage normal, healthy tissue, but technologies have improved so that beams can be more accurately targeted. Radiotherapy is used as a standalone treatment to shrink a tumour or destroy cancer cells (including those associated with leukaemia and lymphoma), and it is also used in combination with other cancer treatments.

 Chemotherapy

Chemotherapy utilises chemicals that interfere with the cell division process – damaging proteins or DNA – so that cancer cells will commit suicide. These treatments target any rapidly dividing cells (not necessarily just cancer cells), but normal cells usually can recover from any chemical-induced damage while cancer cells cannot. Chemotherapy is generally used to treat cancer that has spread or metastasised because the medicines travel throughout the entire body. It is a necessary treatment for some forms of leukaemia and lymphoma. Chemotherapy treatment occurs in cycles so the body has time to heal between doses. However, there are still common side effects such as hair loss, nausea, fatigue, and vomiting. Combination therapies often include multiple types of chemotherapy or chemotherapy combined with other treatment options.

 Immunotherapy

Immunotherapy aims to get the body’s immune system to fight the tumour. Local immunotherapy injects a treatment into an affected area, for example, to cause inflammation that causes a tumour to shrink. Systemic immunotherapy treats the whole body by administering an agent such as the protein interferon alpha that can shrink tumours. Immunotherapy can also be considered non-specific if it improves cancer-fighting abilities by stimulating the entire immune system, and it can be considered targeted if the treatment specifically tells the immune system to destroy cancer cells. These therapies are relatively young, but researchers have had success with treatments that introduce antibodies to the body that inhibit the growth of breast cancer cells. Bone marrow transplantation (hematopoietic stem cell transplantation) can also be considered immunotherapy because the donor’s immune cells will often attack the tumour or cancer cells that are present in the host.

 Hormone therapy

Several cancers have been linked to some types of hormones, most notably breast and prostate cancer. Hormone therapy is designed to alter hormone production in the body so that cancer cells stop growing or are killed completely. Breast cancer hormone therapies often focus on reducing estrogenic levels (a common drug for this is tamoxifen) and prostate cancer hormone therapies often focus on reducing testosterone levels. In addition, some leukaemia and lymphoma cases can be treated with the hormone cortisone.

 Gene therapy

The goal of gene therapy is to replace damaged genes with ones that work to address a root cause of cancer: damage to DNA. For example, researchers are trying to replace the damaged gene that signals cells to stop dividing (the p53 gene) with a copy of a working gene. Other gene-based therapies focus on further damaging cancer cell DNA to the point where the cell commits suicide. Gene therapy is a very young field and has not yet resulted in any successful treatments.

 Using cancer-specific immune system cells to treat cancer

Scientists from the RIKEN Research Centre for Allergy and Immunology in Yokohama, Japan, explained in the journal Cell Stem Cell (January 2013 issue) how they managed to make cancer-specific immune system cells from iPSCs (induced pluripotent stem cells) to destroy cancer cells.

The authors added that their study has shown that it is possible to clone versions of the patients’ own cells to enhance their immune system so that cancer cells could be destroyed naturally.

Hiroshi Kawamoto and team created cancer-specific killer T-lymphocytes from iPSCs. They started off with mature T-lymphocytes which were specific for a type of skin cancer and reprogrammed them into iPSCs with the help of “Yamanaka factors”. The iPSCs eventually turned into fully active, cancer-specific T-lymphocytes – in other words, cells that target and destroy cancer cells.

 How can cancer be prevented?

Cancers that are closely linked to certain behaviours are the easiest to prevent. For example, choosing not to smoke tobacco or drink alcohol significantly lowers the risk of several types of cancer – most notably lung, throat, mouth, and liver cancer. Even if you are a current tobacco user, quitting can still greatly reduce your chances of getting cancer.

Skin cancer can be prevented by staying in the shade, protecting yourself with a hat and shirt when in the sun, and using sunscreen. Diet is also an important part of cancer prevention since what we eat has been linked to the disease. Physicians recommend diets that are low in fat and rich in fresh fruits and vegetables and whole grains.

Certain vaccinations have been associated with the prevention of some cancers. For example, many women receive a vaccination for the human papillomavirus because of the virus’s relationship with cervical cancer. Hepatitis B vaccines prevent the hepatitis B virus, which can cause liver cancer.

Some cancer prevention is based on systematic screening in order to detect small irregularities or tumours as early as possible even if there are no clear symptoms present. Breast self-examination, mammograms, testicular self-examination, and Pap smears are common screening methods for various cancers.

Researchers from Northwestern University Feinberg School of Medicine in Chicago reported in the journal Circulation that the 7 steps recommended for protection against heart disease can also reduce the risk of developing cancer,. They include being physically active, eating a healthy diet, controlling cholesterol, managing blood pressure, reducing blood sugar and not smoking.

 

Other means of combating cancer

 Exercise and cancer

Exercise can help control fatigue, muscle tension, and anxiety in those with cancer. Patients tend to feel better if they do exercises such as walking or swimming. Exercise has also been shown to improve the outcomes associated with cancer treatment.

 Mind/body medicine for cancer

Some mind/body therapies improve quality of life for cancer patients through behaviour modification; others encourage expression of emotions. Behaviour therapies such as guided imagery, progressive muscle relaxation, hypnotherapy, and biofeedback are used to alleviate pain, nausea, vomiting, and the anxiety that may occur in anticipation of, or after, cancer treatment. Individual or group counselling allows patients to confront problems and emotions caused by cancer and receive support from fellow patients in a group setting. Patients who pursue these types of therapies tend to feel less lonely, less anxious about the future, and more optimistic about recovery.

 Nutrition, diet, and cancer

Scientific evidence suggests that nutrition may play a role in cancer prevention. Observational studies have shown that cancer is more common in some people with certain dietary habits — such as colorectal cancer in people who have diets rich in meat products. So far, data has not supported the use of any vitamins or supplements to decrease the risk of cancer. In fact, studies show some supplements may increase cancer risk, such as lung cancer risk in smokers taking beta carotene and prostate cancer risk in men taking high doses of vitamin E.

Also, experts don’t recommend stopping standard treatment in place of complementary medicine, but many therapies can help people with cancer feel better.

 Acupuncture and acupressure

Acupuncture and acupressure are examples of “complementary” medicine for cancer. While neither claims to cure the disease, some evidence shows that they help reduce symptoms and side effects of the illness and its treatment.

Other tips:

*    Join a cancer support group.

* Get plenty of rest, balanced with light exercise.

*    Rather than feeling compelled to maintain a “positive attitude,” express your emotions honestly. Don’t worry if you sometimes feel depressed or afraid: These are normal feelings and legitimate reactions that will not affect your cancer.

*    Fill your days with activities you enjoy. Reading a good book, listening to music, and talking with friends are surprisingly therapeutic.

 

Report compiled by Temitope Obayendo with additional information from:

WebMD Medical Reference; World Cancer Day 2015; womenshealthmag.com

 

NANTMP president seeks proper documentation in herbal medicine

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In this exclusive chat with Pharmanews, President of the National Association of Nigeria Traditional Medicine Practitioners (NANTMP), His Royal Highness Chief (Prof.) T.O. Omon Oleabhiele highlights the importance of clinical record keeping in traditional medicine, urging every practitioner to strictly adhere to the rules. He also pinpoints the various misconceptions about alternative medicine practice, while calling on the government to assist herbal practitioners financially. Excerpts:

How would you assess the performance of herbal practitioners in the last two years?

It is in two folds, if you mean assessment in the production of traditional medicines, they are actually trying; however I will reprove them for their unscrupulous behaviour in displaying fake certificates, which they use for dubious purposes. Nonetheless, we are working on curbing this malpractice in the profession.

One major challenge of alternative medicine practice is lack of proper documentation. Is there any plan by NANTMP to correct this?

Presently, we have devised our own means of record-keeping in the profession, which the government is ready to collaborate with us on; but it appears medical doctors are not prepared to acknowledge the documented lists of patients certified cured with herbal treatment, which we have as our evidence. We have the list of patients who were so bad at the time they came to us, but they are now very well, to the point that one can hardly believe they were once ill. There are physical results that are verifiable, because the patients are well, and they have started bearing children, building houses, and so on.

Every traditional doctor does not only document his formulas, but he documents patients’ medical history, places visited, stages of illness, and recovery time. All this information is now documented in trado-medical homes. So, documentation is really vital, and every traditional doctor must ensure he keeps patients’ bio-data and medical history.

There is widespread assumption that traditional medicines lack peer review and scientific scrutiny, which make them untested for safety and efficacy. How true is this?

That is a wrong assumption because most traditional medicines, as at today, are registered by NAFDAC, and NAFDAC registration shows that the toxicological aspects of the medicines are valued, viewed, scrutinised, and certified safe for consumption. In fact, NAFDAC has a pharmacovigilance section which monitors drug adverse effects on patients, and also confiscates those drugs capable of affecting patients negatively. In order to control the circulation of such drugs, the pharmacovigilance department checks them batch by batch, to detect the harmful drugs and curtail their spread. Traditional medicine is standardised now.

The practice whereby alternative medicine practitioners refuse to reveal active ingredients in their products for the fear of losing their patent right is on the increase. How can this challenge be best resolved?

The issue is that what their grandfathers passed down to them is their source of information. However, the situation is changing gradually, as the leadership of NANTMP is leading by example for others to emulate and change their unethical practices. For instance, someone called me from Akure in Ondo State recently, and said he was surfing the web on remedies for an infection in his body. He said he discovered I could cure the case with a plant called cassia prodocappa. If I didn’t reveal the content of the medicine, it would be difficult for the patient to know cassia prodocappa. To this end, I will say that we normally reveal our active principles – though not all practitioners are practising on a level ground. However, since my humble self as the president of NANTMP has started the campaign, others have no choice than to do same.

On dosage, from time immemorial, dosage has always been available for various herbal medicines, but break in communication creates confusion among patients. It is the practitioner who formulates a compound that can actually give the right dosage for the compound. Dosage of traditional medicines is either half a teaspoon, a teaspoon, a shot or half a shot, and it could be powder or liquid.

In what ways can the government and research institutions assist traditional practitioners to make their products safety and efficacy compliant?

Government can give grants to herbal practitioners or instruct the bank of industry to create soft loans for manufacturers, with laid down criteria for beneficiaries to fulfil. This will go a long way in expanding our traditional herbal medicine industry. Such grant has never been in the past.

As the president of NANTMP, what is your vision for the practice in 2015?

Traditional medicine is gradually becoming the household medicine everybody is embracing because it is less hazardous, compared to artificially synthesised drugs. Intellectuals, especially, are shifting to traditional medicines, particularly those that are NAFDAC certified and are decently packaged.

Years back, the elite rejected herbal medicines due to unprofessional packaging. Now that the industry is advancing in knowledge, with fascinating packs for local drugs, majority of the elite now prefer alternative medicines to conventional drugs. With this development, I can confidently say that traditional medicines will dominate the market in 2015, with revolutionised packaging.

PCN threatens sanction against erring pharmacists and health care providers

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…As UNN inducts 121 pharmacy graduands.

Irked by the high rate of unprofessionalism among health care providers, especially pharmacists in the country, the registrar, Pharmacists Council of Nigeria (PCN), Pharm. NAE Mohammed, has threatened that the council would withdraw the professional licence of any member tarnishing the image of the pharmacy profession in the country.

Mohammed stated this at the induction and oath-taking ceremony of the 2013/2014, graduates of the Faculty of Pharmacy, University of Nigeria, Nsukka, which was held at the Princess Alexandra Auditorium Hall, University of Nigeria, Nsukka, last December.

Pharm. Mohammed, who was a guest of honour at the event, disclosed that some members of the council, through their unethical acts, were bringing the profession to disrepute, saying the council was putting measures in place to ensure that, before 2016, registration of members would commence online to monitor every pharmacist in the country.

“It is because of the mad rush for money that fake drugs have been on a daily increase, claiming many innocent lives and making it impossible for certain illnesses to be cured. Join the pharmacy profession today; ensure you abide by the ethics of the profession by respecting the do’s and don’ts of the profession. Also, your first mission should be to save lives, and in the course of saving lives, money will get into your hands,” he said.

In his keynote address, titled, “Networking: A tool for Digital Wealth Creation”, Pharm. Clifford Emenike, chief executive officer, Eagles Vision Investment Concept, explained networking as a process or practice of building up and maintaining informal relationship, especially with people whose friendship could bring advantages, like job and business opportunities to one. He further explained that networking is a tool for health creation, advising that the graduands should be prepared to be consummate team players, in order for them to create digital wealth that would last for generations.

Speaking in the same vein, Prof. Emmanuel Chinedu Ibezim, dean, Faculty of Pharmacy, UNN, said the theme of the induction, “Networking as a Tool for Digital Wealth Creation”, was aptly chosen to capture the global heartbeat of the moment, adding that there were lots of veritable resources flying around, accessible only to those who were well informed. He therefore advised the graduands to translate the laudable feat, they had achieved, to their future life endeavours.

While urging the staff and students of the faculty to contribute their quotas to ensuring a successful re-accreditation of the faculty in 2015, the university don disclosed that pharmacy profession was currently going through a period of positive transformation by trying to key into its proper place in the health sector.

The highpoint of the event was the award presentation to the 2013/2014 best graduating student, Miss Ibeanu Nkiru Ozioma, who graduated with 21 distinctions. Prizes she won include the PSN-Enugu Award for Best Graduating Student, and cash prizes from Nemel Pharmaceuticals Company Limited, Enugu; O’NELL Pharmaceuticals and Health Care Limited, Lagos; and Impact Pharmaceuticals Limited, Enugu.

Speaking with an emotion-laden voice, Ibeanu Nkiru recalled that life was not pleasant throughout her five years as an undergraduate, but her determination and perseverance help her surmount all challenges and graduate in flying colours.

“It has been a journey of difficulties, many ups and downs, successes and failures; but I am grateful that the journey which started about five years ago has finally reached its pinnacle today. I cannot but acknowledge the role of our dean, Prof. Chinedu Ibezim, in shaping and molding us all through the years.”

Other dignitaries at the event include, Pharm. (Sir) Jasper K. C. Onyeka, FPSN, MD/CEO, Impact Pharmaceuticals; Prof. A.A. Attama, chairman, Induction Ceremony Planning Committee; Pharm. Prof. S.I. Ofoefule, head, Pharmaceutical Technology; Pharm. Prof. K.C. Ofokansi, head, Department of Pharmaceutics; Pharm. Prof. Stella Inya-Agha; Prof. Vincent Okorie, former Dean, Faculty of Pharmacy, UNN; Pharm. Dr T.C. Okoye; and many other dignitaries.

Commercial transactions (2): Accepting a business offer

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Badagry Local Government Council has just announced plans to establish a health centre. Local Purchase Orders are being issued for the supply of goods and services for the new facility. An LPO is sent to Ojo & Sons, wholesale distributors in Ibadan, for the provision of anti-malaria drugs. The terms are that payment will be made on supply of goods with a crossed cheque in favour of the distributor. Unknown to the council, the letter is never delivered, due to an error in the postal office.

Another LPO for the same order is sent to Francis Pharmaceuticals, a Lagos-based distributor. Francis replies immediately, accepting the order, with a request that payment be made with an open cheque to enable them recover their expenses after the drugs have been supplied.

The Local Government chairman sends an LPO, for the same order, to a neighbourhood pharmacy the council has been dealing with. He attaches a personal note saying, “Femi, if you cannot deliver these drugs, please let me know.” Femi receives the message and decides to supply the drugs the following week.

By the end of that week, a letter is received from Ojo & Sons. Apparently, they have heard about the establishment of the health centre and sent a Sales Quotation for anti-malaria drugs at the approved price. They promise to be able to deliver by Monday.

On that fateful Monday, all three distributors arrive at the health centre with the required drugs. Each of them has been sent an LPO. All of them have made investments in the purchase of anti-malaria drugs and need to recover their expenses. Now, which of these distributors has a valid contract with Badagry Local Government?

A contract has been defined as an agreement between two parties which is enforceable. For a contract to be valid,there must have been an offer by one party and then an acceptance by the other. Acceptance must be a final and unqualified expression of agreement.

The situation above involves the following legal issues:

1. The effect of a counter-offer in a transaction.

2. The validity of a cross-offer in securing a contract.

3. The communication of acceptance for a valid contract.

The rules guiding the acceptance of offers were clearly defined by Justice Tobi in the case of Orient Bank (Nig.) Plc. v. Bilante International. In the words of the learned judge, “An acceptance of an offer is the reciprocal act or action of the offeree to the offer in which he indicates his agreement to the terms of the offer as conveyed to him by the offeror… It is the element of acceptance that underscores the bilateral nature of a contract.”

Clearly then, for an acceptance to be valid, there must be a notification of assent to the terms of offer by documentation, by words or by conduct. Any amendment of the terms will constitute a counter-offer which cancels the original offer.

With Badagry Local Government, Francis Pharmaceuticals purported to accept the offer with a request for a variation in payment system. Subsequently, that qualified acceptance resulted in a new offer being presented. In the case of Hyde v. Wrench, where a party sought to vary the terms of transaction, it was declared that the party had rejected the original offer and was in effect making a counter-offer. Consequently,there was no obligation whatsoever between the parties.

On the part of Ojo & Sons, a company made an offer to supply goods, totally unaware of the fact that an LPO had already been sent to them for the supply of the same goods. When two offers, identical in terms, are sent by two parties to each other, the resultant effect is a cross-offer. However, for there to be a contract, there must be an acceptance in response to a specific offer. In essence, there will be a consensus ad idem (a meeting of minds). In the classic case of cross-offers, Tinn v. Hofman, it was held that in such a situation, there were merely “two simultaneous offers”. There was no contract.

Finally, the neighbourhood pharmacy managed by Femi received the LPO and fully intended to fulfil the terms of the offer. It is noteworthy that a personal relationship existed between the pharmacist and the chairman of the local government. Furthermore, the note sent by the chairman requested for a notification in the event that the goods would not be deliverable. This seems to have rendered unnecessary the need to communicate acceptance, in view of the fact that the drugs would be supplied.Nevertheless, the rules of acceptance require a definite notification to the offering party. In Felthouse v. Bindly, a man had agreed to sell his horse to his uncle but failed to communicate his intention. The court held that there was no valid acceptance for the sale.

In conclusion, it is apparent that none of the distributors had a valid contract. Not Francis, on the basis of his counter-offer. Not Ojo, on account of a cross-offer. Not even Femi, for the reason of non-communication.

Acceptance of contracts must involve the external manifestation of an internal agreement with a specific proposal. As Justice Achike puts it, “if acceptance were to be based on silence or mental assent, then its ascertainment is bound to be illusory and at best, a guesswork, unless the judge was a superhuman who would be bound to unfold the innermost recesses of the heart of the party making the mental assent.”

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

 

Former PCN registrar, Mora, gives daughter’s hand in marriage

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It was a great day for the family of Dr Ahmed Tijjani Mora (Wakilin Maganin Zazzau), as the former registrar of the PCN and current dean of the Faculty of Pharmaceutical Sciences, Kaduna State University (KASU), Main Campus, Kaduna, gave out his daughter, Fai’zah Ahmed Mora, a Law graduate from ABU, Zaria, in marriage to her heartthrob, Mallam Muhammad Bello Abdulkareem, a lecturer with the Nasarawa State University, Keffi, Nasarawa State.

Many people from within and outside Kaduna State attended the wedding fatihah which took place on Saturday, 3 January, 2015 at the family house in Tudun Wada, Zaria.

Among those who attended were Alhaji (Dr) Bashari Aminu (Iyan Zazzau), district head of Sabongari Zaria, who represented His Highness, the Emir of Zazzau, Alhaji Shehu Idris, CFR at the event. Others include Professor Abdullahi Mustapha, FPSN, Vice Chancellor, ABU, Zaria; Professor E.M. Abdurahman, FPSN, Vice Chancellor, Bauchi State University (BASU), Gadau, Bauchi State; Professor Abdulmumini Hassan Rafindadi, Vice Chancellor, Federal University, Lokoja (FUL) and former Barewa College classmate of Dr Mora; Professor M.A Mainoma, Vice Chancellor, Nasarawa State University, Keffi; Honourable Ahmed Ibrahim Yakasai, FPSN, one-time Honourable Commissioner, Kano State, and many professors of Pharmacy, including Professors J.A Onaolapo, A. Anuka, Isa Marte Hussaini, Ibrahim Adamu Yakasai and others.

Drug fakers should be treated as armed robbers – Pharm. Adeleke

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In this interview with Adebayo Folorunsho-Francis, Pharm. Ebenezer Adeyeye Adeleke, FPSN, a former chairman of PSN Board of Fellows and national treasurer of the Pharmaceutical Society of Nigeria (PSN), goes down memory lane on the activities of the PSN, including the struggle pharmacists put up before the government officially upgraded them to Scale A salary structure. He also disclosed why he thinks convicted drug counterfeiters should be treated as armed robbers. Excerpts:

What was your childhood like?

I finished my primary school in 1957. I later went to Titcombe College for my secondary school, Egbe, Kogi State. Subsequently I went to Plateau State for my higher school certificate in Gindiri Secondary School for two years. I taught for some time and later moved to the University of Ife (now Obafemi Awolowo University) in 1966 after I got admission to study Pharmacy on Northern Nigerian government’s scholarship. Before then, Ife used to be known as the Nigerian College of Arts, Science and Technology. I had my honours degree in June 1970.

What was your work experience like?

I started work as an intern pharmacist at State Hospital, Abeokuta, from June 1970 to June 1971. There was no youth corps programme during our time. After my internship, I got employment with Nicholas Laboratory at Ilupeju as a medical representative. I rose to become the marketing manager. In those days, things were quite good. We finished our examinations on Friday and start work the following Monday even before the results were released. It was as simple as that. The chief pharmacist of the Western State just came to us and announced that anybody who wanted to work with the Western state should put down their names. From there, they allocated us to different towns. I was sent to Abeokuta, some to Ijebu Ode, and so on. When the exams results came, those who were unsuccessful returned to the school.

Is it true that the School of Pharmacy, University of Ife, wasn’t a degree awarding institution?

The school of Pharmacy started at Yaba where Chemists and Druggist diploma was awarded. Thereafter it moved to Ife where Diploma in Pharmacy was awarded. However the school changed to a degree awarding institution and produced its first graduates in 1966.

What was people’s impression of Pharmacy during your time?

At that time, Pharmacy was looked upon as a very noble profession. When we were in school, we walked with our shoulders high and we were highly respected. While other students were playing, we were often going about in our laboratory coats. Also, to gain admission to study Pharmacy was not easy at all. To breakthrough, you had to be very well above average.

 

Do you have any regret studying Pharmacy as a course?

In truth, I have not regretted studying Pharmacy at all. To date, pharmacists still have an edge when they are looking for employment anywhere. It is a professional course. If anybody wants to study Pharmacy, I will always encourage him.

One thing I know is that there is no profession without challenges. The feeling is that the grass is greener on the other side. I once met a medical doctor who wished he had studied Pharmacy because he thought we didn’t have challenges. Whereas I knew we had our own challenges. Two of my children are medical doctors and I know they have their own challenges too. Various professions, of course, have their various challenges. In summary, I will say Pharmacy is still a good course

Tell us about controversies and scandals during your time

Pharmacy practice has been faced with challenges –the gradual movement from diploma course in dispensary training to moving on to chemists and druggists level. I remember the School of Pharmacy in Zaria. The school went on strike in 1967 because, although the training was free and the students were fairly treated, they (the students) felt that they needed to pursue a degree course instead of diploma. So the school was closed down. That was a real challenge. With time, however, the degree programme came.

What about the challenges you encountered during the clamour for Scale A salary struggle?

The scheme that pharmacists were running then was CT Scale (technical grade) which obviously wasn’t the same with those on Scale. A salary structure (degree holders’ scale). It was a serious struggle for pharmacists to move up from CT Scale to Scale A. Can you imagine? Pharmacists who had three A-Levels and had gone to the university to study and on completion of course were not entitled to Scale A; whereas other students who didn’t have three papers would gain admission and come out with a degree and would be on Scale A. How would you feel? It was a serious struggle.

Eventually, we achieved the needed Scale A recognition. My set was the first to receive Scale A salary month by month. The set before us got theirs in arrears. That was in the Western States. The East was luckier because they got their Scale A before others across the country.

What is your view about the frequent face-off between doctors and other healthcare workers, especially pharmacists?

The issue of rivalry between doctors and pharmacists has always been there. It didn’t just start today. Yet, it should be that when you are under the firmament of the sky, you note that there is room for everybody. There is no need whatsoever to start proving to the other that you are superior. My feeling is that the patient is your focus. Make your own contribution to the health of the patient and I will make mine. But if the professionals stand aloof and each one argues, you know the saying that when two elephants fight, it is the grass that suffers. It is the country that will suffer the consequences more than anything at the end of the day.

I believe the country has spent a lot of resources and money to train all these professionals. So the best thing we can do for this country is do our best. We should learn to live with one another for the improvement of the citizenry. When we fail to do that, we have failed. It doesn’t matter whether we are laboratory scientists or pharmacists, doctors, radiographers, radiologists etc. No, we have failed totally.

Is there a role the government can play in this direction?

Pharmacists are not fully fulfilled. When you consider the level of education they have and what they are practising. The gap is a bit wide. Let us also consider the issue of recognition by the government. There is no need to give preferential treatment to one profession at the expense of others. The government should create the necessary environment. Because the environment is not conducive, many of our colleagues have moved out in droves to America, the United Kingdom and other countries abroad. Some of those still in the country have been forced to change professions and they are doing well. The sort of training we have received is that you can raise your head anywhere you may be.

How best do you think the issue of drug counterfeiting can be handled?

The issue of charlatans, people who have little care for professionalism, is another headache. The essence is just to make money. You have forgotten that drug is special commodity. It is just like a double-edged sword. You can use it wisely to attack enemy and you can use wrongly to attack yourself. If care is not taken, you can kill your neighbour. A good use of the sword is to attack the enemy. But if you misuse it and start killing yourself, it is pitiable.

Drugs are not commonplace items. You still find people selling drugs around, not creating the enabling environment. Some are exposed to the sun, adverse effects and other weather conditions which people are largely ignorant about. Once somebody is able to speak well – a lady who is not even properly educated can just sweet-talk you and you just start buying her products. It is just a chaotic situation. We still have problems with distribution of drugs, problem of faking and so on.

What should be done to dissuade people from faking drugs?

To me, those who fake drugs should have the same punishment as those burglars and armed robbers who go about killing people. They should not be treated with kid gloves. There was a time I was in a place to buy a drug. When I saw the place in which it was kept, I told them, “This drug is meant to be kept in a refrigerator.” The man in charge looked at me and said “Oga, wait! I will quickly put it in the fridge and it will get cold. Then you can take it.” That is the level of ignorance in which we find ourselves

How do you see the annual PSN national conferences?

It has provided a forum where we look at challenges and possible solutions. It is a place where seasoned speakers are also invited. It has also provided a forum where elections are held. This last one was an experiment by elongating it by a further day. I am not sure whether it has gone well with many people. But I remember the last one that was held at Akwa Ibom. Many people left before the end of the conference.

 What do you think was responsible?

Maybe many of them were not fully ready to sacrifice an additional day. So the PSN should look into that and see how to marry things together. It is not easy seeking solutions to problems and having many topics without enough time for relaxations. Or to find out whether these professionals will be ready to sacrifice an additional day. There must be a balance. Unless the organisers will make the features so attractive that people wouldn’t find an additional day boring.

Anyway I still think it was an experiment. They will make some trials and then see whether it can work or not. I will never subscribe to people saying that the annual conference is not useful or has lost focus. I had been the chairman of the conference planning committee years ago when I was highly involved. Now I think it is even more complex. Fortunately, the computer age has come in and they have been able to get in touch more, getting the day-to-day activities done, preparing for the conference, and even when the conference is on-going, getting across to participants, etc. I can say during my time when I was chairman of the organising committee, it was like analogue. Everything has now gone digital. Getting in touch with participants was quite stressful. In fact there were some days even the phone would not work. You then start writing letters, some would receive, some won’t. But right now, you just press buttons and everything is right there in their palms. And I specially commend the chairmen of these conference committees.

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

When I was in secondary school, I had a fall and two of my teeth were broken. So it became necessary for me to visit a dentist. After some time, I was so fascinated with his office, appearance, dressing – everywhere was sparkling white so much that I told myself this was one profession I would like to do. He left a lasting impression on me that I said I would like to study dental surgery. But, in the end, I opted for Pharmacy.

How deeply involved were you in pharmaceutical activities?

My interest in pharmaceutical activities developed during our school’s Pharmacy Week where we got orientation about what the profession was all about, what we should prepare for, what our lot was when we finished and so on. It was then I knew that pharmacy graduates were not placed on Scale A and I wasn’t happy about it. Since then, I had developed a keen interest and my pharmacy struggle started.

How did you end up becoming PSN treasurer?

Immediately I started work, I had a boss who took an interest in me. Whenever they were going to PSN meetings, he took me along. On one of the occasions, there was an election. There and then, I was elected financial secretary. That was in 1972. I held on for two years before becoming state treasurer. I then moved on to become national treasurer in 1977 and occupied same office for seven years. Then I came back to the Lagos State branch and got elected as vice chairman. The new salary scale that came almost pitched pharmacists and doctors at the same level, except that the doctors were two steps ahead. It was during the tenure of Prof. Olikoye Ransome-Kuti that the doctors carved a new scale for themselves. During my time, I called several conferences where I commended those ministers who were doing well and scolded those who were not. At that time, there was a Commissioner for Health in Kwara State whom doctors stood against simply because he wasn’t a doctor. They regarded him as a square peg in a round hole. They were indeed very wrong.

Was the case resolved?

Yes.I fought against such stand saying that if he was being described as such, were they saying that just because somebody studied Pharmacy, he could no longer be a commissioner or minister? I told them the ministry of health should be viewed like the ministry of works where you had engineers, architect, surveyors and all sorts. The interesting thing is that any of them can rise to be a permanent secretary or a minister. Of course, we have had ministers of health from different professions. Aminu Kano was a minister of health, yet he did not study medicine. Dr. Adetoro, at a time, was minister of health, he too never read medicine. In UK for instance, they appoint lawyers as secretary for health. The same thing applies to the United States and other climes. I felt very happy when Prince Adelusi-Adeluyi became minister of health. Kafaru Tinubu was also minister of health but he never read medicine. He was a police commissioner.

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

Sure. When I presented my financial report in 1984 at the Benin conference in my capacity as the treasurer, the entire gathering was impressed and gave me a standing ovation. Anytime I remember that, I feel elated. That was the year I left voluntarily. In fact, there was no limit to the number of years you could spend in office as at that time. I was one of the longest serving treasurers. I was also among the first set of merit award recipients in Lagos State. In fact, we started the merit award itself in 1988. When the first set (ten of us) first compiled the list, some enraged notable members reported us to the national president that I was creating awards that were parallel with Fellowship awards.

Were you sanctioned?

No. I was not reprimanded because not all our people making contributions would be able to have Fellowship award. But it was obvious that they are making several contributions in their individual states. In 1991, I was given Fellowship award along with 24 other recipients at the Enugu conference. You know Fellowship award is the highest honour the PSN can give anybody. Lest I forget, I became the chairman of the PSN board of fellows (2003 – 2006).

I have served in various committees as chairman or secretary, whether it was building, finance conference or any other. I have represented the PSN on the Pharmacists Board (now PCN). Even in the PCN, I have served at various committees. For instance, I was chairman of the sub-committee in charge of the PCN secretariat in Idu, Abuja.

 

Combining leadership with academics was tough – former PANS president

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Arinze Awiligwe is a recent graduate of Pharmacy from the University of Lagos (UNILAG). He was president of the Pharmaceutical Association of Nigerian Students (PANS) in the 2012/2013 session and vice-president, PANS-UNILAG. In this exclusive interview with Pharmanews, Awiligwe, who is presently a research intern with R20, a Swiss-based non-governmental organisation (NGO), spoke on some of the challenges that he encountered as PANS president, as well as some of the achievements of his administration. Excerpts:

Tell us about PANS

The Pharmaceutical Association of Nigerian Students (PANS) was established in 1972 and, since then, it has been the foremost leading advocacy organisation of all pharmacy students in Nigeria. We are a group of pharmacy students with interest in promoting improved public health through provision of information, education, networking, and a range of publications and professional activities in the country.

 Now that you’re out of office, do you still have any relationship with PANS?

Yes, by virtue of my positions then as president, PANS national, and vice-president, UNILAG Chapter, and with the support of the leadership of the Pharmaceutical Society of Nigeria (PSN) I was instrumental in the registration of PANS with the International Pharmaceutical Students Federation (IPSF). As a result, I am recognised by the body. I am presently a part of the policy and public health committee of IPSF. It means I still participate actively in PANS and IPSF, directly or indirectly.

 What were your greatest challenges as PANS National president?

One of my greatest challenges as president was having to work with people from diverse backgrounds and students from different schools. Even though we shared the common goal of upholding the constitution and fighting for the right of pharmacy students, it wasn’t easy as such as the diverse backgrounds we had prevented us from implementing many of our objectives. However, I am happy we were able to record some tremendous achievements and part of it was the successful registration of PANS with IPSF.

Also, we were able to create a meaningful network between pharmacy students and pharmaceutical companies, because we found out that one of the biggest challenges of young pharmacists was detachment between the old players in the industry and the incoming ones. Many young pharmacists graduate, do their internship and youth service, after which they develop little or no passion to go further in the profession because there is lack of network between them and the experienced ones. So we end up having young pharmacists who are merely driven by money, materials and things that are not really needed to progress in the profession.

As an individual, my greatest challenge was that of combining the responsibilities of being a national president with being a student. It was not easy but God saw us through.

 How did you cope with the challenge of being a Lagos-based president who had to work with executives from other schools?

Actually, the goal of running a students’ association like PANS is to ensure that the interest of every member is protected and as well to ensure they all have a sense of belonging. It is clearly stated in the constitution that there must be rotation of presidency among pharmacy schools. It is also stated that if the national president comes from a particular school, the chapter president of that school automatically becomes the vice-president at the national level and same thing also applied to other chapters’ presidents. So no one is actually elected as vice-president. Also, the general secretary, as well as some key officers like treasurer and financial secretary, also comes from the same school as the national president, while the remaining positions are thrown open to other schools.

However, when I took over from my predecessor, we had the challenge of continuity as we didn’t have the platform to engage the incoming leaders into embracing the vision of our predecessors. In advanced countries, there is a programme called ‘Leadership in Training’ which allows the next set of leaders to be trained on the nitty-gritty of leadership position. We lack such here and that has been affecting the successive leaderships of the association, as every new administration that comes in has to start from the scratch. I really suggest that PANS improves on this and ensure that the succeeding executives learn from the outgoing leadership.

Also, each incoming leadership should be made to learn from the structure of our parent body, the PSN, as well as an international organisation like the IPSF. The two bodies have a lot in common.

One thing that I held as a priority during my administration was the importance of IPSF, because so many advanced countries that have partnered with this global organisation were able to learn so many things about best pharmacy practice and international pharmacy practice.

 

Some people believe you were too gentle to be an effective leader, what can you say about this?

I know so many great leaders who are not today categorised as being great based on their agility or loudness, so to say. I believe that there is a difference between a leader and a politician, because as a leader, you want to, as much as possible, carry everybody along, protect the interest of your members and ensure that the rules and regulations guiding the association are followed to the letter.

An association like PANS is not a business venture; it is a strong association that has made many marks and we want to maintain that culture of greatness. This is why I have remained who I am. My humility and gentleness cannot be confused with being cowardly or ineffective, even though there were disadvantages in this regard during my time as president as I devoted more time to listening to people before taking actions. That affected us a little because student unionism requires a lot of aggressiveness and agility which were not there on my part. Still, we had a fantastic administration as we achieved a lot within one year that we were in office.

 How do you think PANS will benefit from IPSF?

Pharmacy students are in for a great time, because PANS is registered with IPSF on a national basis; that is, every university that is accredited in Nigeria is registered. Therefore, every pharmacy student in Nigeria is a potential member of IPSF and the benefits are immense. Membership will afford them networking opportunities, through social media and other means, with other pharmacy students that are also members of IPSF across the world.

Also, the IPSF national congress allows every member to relate and share ideas, exchange scientific knowledge, engage in meaningful discussion and also learn from one another. So it’s a two-way thing.

PANS also benefits through the adoption of IPSF methods in approaching pharmacy education and learning process.

What is your aspiration in life?

My aspiration in life is to constantly be a better person than I am, and to improve the life of everyone around me in the best possible way.

 

Symptoms of poor blood circulation

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Heart disease

(By R. Sharp)

Circulatory problems do not begin in a day. In other words, you could call the heart a very patient organ, which can take years of abuse and when it cannot take it anymore, breaks out with symptoms.

At the outset, we need to remember that poor circulation is an outcome of certain lifestyle choices which we make which are detrimental to our health. Coupled with these are factors like imbalanced diet and lack of physical exercise. All these factors lead to fatty deposits on the arterial walls, which, when hardened, are called plaques. These plaques then block or create obstructions to the smooth passage of blood to and from the heart.

Plaques take a long time to be formed; that is the reason, we find circulatory problems affecting the elderly more often than they affect children. Our food habits also add to an unhealthy build-up of cholesterol which may increase the viscosity of the blood, which again creates anomaly in the smooth flow through arteries and veins.

Since the circulatory system covers our entire body, the problems can also be manifested in numerous ways. For instance:

 

The brain – Our brain receives 20 per cent of the blood circulated in our body. With a drop in the flow, our brain functions sub-optimally, resulting in feeling lethargic, loss of memory, lack of mental clarity, etc. Frequent unexplained headaches and sudden attacks of dizziness are also seen as symptoms of poor blood circulation to the brain.

 

The heart – When poor blood circulation affects the heart, the symptoms would be chest pain, high blood pressure and rise in the level of cholesterol. Difficulty in performing any common task, like climbing stairs; walking a stretch could make you very tired and breathless.

 

The liver – When you suffer from lack of appetite or experience sudden weight loss and your skin looks lustre-less, it is quite possible that your liver is getting ‘sluggish’ and these are the early symptoms of poor blood circulation to the liver.

 

The kidneys – This organ plays an important role in regulating and monitoring our blood pressure other than eliminating the waste and excess water from our bodies. When poor blood circulation affects the kidneys, we notice swelling of hands, feet and ankles, rise in blood pressure, altered heart rate and we feel tired all the time.

 

The limbs – Poor blood circulation can have serious impact on our arms and legs. We can experience sudden numbness of our hands, feet and fingers or suffer painful leg cramps. Symptoms of serious blood circulation problems can be varicose veins or a condition called cyanosis – which is when part of our skin turns blue or black due to lack of adequate oxygen to the concerned tissues.

 

Sex drive – Poor blood circulation can affect our reproductive organs as well. The symptoms are lack of sex drive and fatigue. Symptoms would also include lack of vitality. Serious blood circulation problems could also make one impotent.

 

Source:www.healthguidance.org

 

Lakeshore Cancer Centre opens in Nigeria

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In a renewed effort to bring quality care closer to patients, Lakeshore Cancer Centre (LCC) has formally launched its operations in Nigeria.

lakeshore
L-R: Bindiya Chugani, business manager at Lakeshore Cancer Centre; Dr Chumy Nwogu, the CEO &medical director, special oncologist and cancer prevention expert, Lakeshore; Dr Yinka Akinyemiju, pain & palliative care specialist, Lakeshore; and Dr Jimoh Mutiu Akin, consultant radiation/clinical oncologist, Lakeshore, during the media launch of Lakeshore Cancer Centre in Lagos

The ribbon-cutting ceremony, which took place in the state-of-the-art facility in Victoria Island, Lagos, on 24 January, 2015 witnessed a massive turnout of participants.

Aside offering skeletal services since July 2014, LCC is solely designed by a team of global experts on surgical and radiation oncology, for high quality prevention and treatment of cancer.

Affiliated to the Roswell Park Cancer Institute (RPCI) in Buffalo, New York, USA, Lakeshore Cancer Centre is the oldest cancer centre in the world. The RPCI provides training, education and clinical care oversight and research programmes to the centre.

Speaking at the event, Chief Executive Officer and Medical Director at LCC, Dr Chumy Nwogu, noted that cancer kills more people globally than malaria, HIV and Tuberculosis (TB) combined, and disproportionately affects low to middle income countries like Nigeria.

He explained that the 2012 data of the International Agency for Research on Cancer, stipulates 102,079 new cancer cases every year and 71,571 cancer deaths annually in Nigeria.

“This is probably a marked underestimation, as cancer registration is really poor in Nigeria. Over 70 per cent of patients die despite the fact that we do not capture all of them – over 20 percent of people with cancer are still not captured. This is because many patients usually seek alternative treatments, traditional healers or prayer houses. These numbers are predicted to rise dramatically over the next few years,” Nwogu disclosed.

The medical director, who is a highly respected cancer epidemiologist and thoracic surgical oncologist, further stated that, “the World Health Organisation (WHO) estimates that one third of cancers can be prevented, one third cured and one third effectively palliated; hence the great need for education, screening and early detection.”

He said the LCC is committed to providing cancer patients with tools for early detection, diagnosis and consultation with excellent oncologists, without having to travel away from loved ones at home.

The centre also launched the Foundation for Cancer Care in West Africa (FCCWA) to provide cancer care to the less privileged in Nigeria and across West Africa.

“The treatment for cancer is capital intensive and long term, so most individuals cannot sustain the cost. The Foundation is therefore focused on fostering collaboration between government agencies, corporate organisations, various medical facilities and advocacy groups. Philanthropic donations are always welcome and much appreciated for the care of cancer in West Africa,” Nwogu explained.

Also speaking at the event, Associate Professor of Oncology at the RPCI, Dr Tracey O’Connor, said that early screening and detection are indispensable in the prevention and management of cancer.

“Three cancers – breast, cervical and prostate – claim the highest number of lives in Nigeria. But all of them, if brought to medical attention early in their development, are highly curable. So, basically, testing and early detection can hugely reduce fatalities,” she stated.

O’Connor counselled Nigerians to go for screening. She also recommended the Human Papillomavirus (HPV) vaccine for young girls of 11 to 12 years.

“The vaccine is to prevent the human papillomavirus which cause most cervical cancers,” she explained.

Wife of the Lagos State Commissioner for Transport, Mrs Abiodun Opeifa, who represented the First Lady, Mrs Abimbola Fashola, commended the LCC for establishing “this great cancer facility in Lagos State. This will sure increase awareness about cancer prevention and treatment; and drasticallyreduce incidences of preventable cancer deaths.”

The LCC provides diagnostic imaging services, mammography, pap smear, laboratory services, public education awareness, tissue biopsis, outpatient operative procedures chemotherapy services, and palliative care. The facility also provides minor surgery, oncology consultation, cancer treatment planning as well as outpatient pharmacy.

Now that JOHESU’s strike is over.

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I know what its takes for a staff to be off work for almost three months, all in the name of an industrial action.The good news is that the prolonged strike has been called off after the intervention of Mr President, who had promised to look carefully into all there demands.
Pharmanews Limited- the West Africa’s Foremost Health Journal, seizes this opportunity to wish all health workers happy resumption, and quick recovery on all lost grounds while at home.

Professor Paul Akubue becomes Professor Emeritus

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4x6 main

The Vice-Chancellor, University of Nigeria, Professor Benjamin C. Ozumba (left), congratulates Professor Paul Akubue (right) after conferring on him the title of emeritus professor of the university and presenting him the certificate, during the 44th convocation ceremony of the university, held on 24 of January, 2015. Next to Prof. Akubue on his right is his wife, Associate Professor Felicia N. Akubue.

I’m set for ACPN national chairmanship – Pharm. Alkali

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Pharm Alkali

In this exclusive interview with Pharmanews, current national vice-chairman of the Association of Community Pharmacists of Nigeria (ACPN) Pharm. Albert Kelong Alkali Pharm. spoke on some of the achievements of the present administration under the leadership of Pharm. (Alh) Olufemi Ismail Adebayo, as well as his aspiration to become the next national chairman. Excerpts:

 

Briefly tell us about yourself, especially your academic background

I am Albert Kelong Alkali, a community pharmacist and managing director, Medisal Pharmacy, Abuja. I graduated from Ahmadu Bello University, Zaria, Kaduna State, in 1991, after which I went into the industry as medical representative for Roche Pharmaceuticals Nigeria Limited (before they changed to Swipha), covering the north/east zone. Since leaving Rochi in 1999, I have been in community practice. I am currently a final year student in Pharm. D conversion, and in some couple of months, I will be Pharm. Doctor Alkali Albert Kelong.

Our pharmacy, Medisal Pharmacy, Abuja, has two premises – one in the National Assembly’s Quarters and the other at Wuse Zone 6.

 

How do you combine running a community pharmacy in Abuja with the responsibility of being a national vice-chairman of ACPN?

It all depends on planning.It also boils down to the fact that I have had enough experience, being a former chairman of ACPN, before becoming the national vice-chairman.So, I have mastered my planning and I know the way I plan my activities, so that my personal business and the national assignment do notdisturb each other. I am the superintendent pharmacy for one of the outlets, while the other one is being superintended by another pharmacist. Although it is not an easy task as it entails a lot of sacrifices, but with God, we are doing well and this has inspired me to go a step higher – I am hoping to become the next national chairman of the ACPN by the grace of God.

 

Why did you choose community pharmacy practice ahead of other aspects of the practice?

Let me be sincere with you, community pharmacy practice is very interesting. I started with the industry as a young man because the industry had prestige then, and you were also well-remunerated and well-trained. As medical reps then, we could do presentation and we underwent series of trainings that were quite interesting.Meanwhile, hospital practice was the least interesting then because the environment was not conducive. But I want to tell you that community practice is an embodiment of both the hospital practice and the industrial, because you combine all. Some people come with prescriptions, while others come without any. I think it has been the most interesting as it affords you the opportunity to meet people, solvetheir problems, put smiles on their faces, while you also make money.

 

Why do you intend to vie for the office of national chairman of ACPN?

I know I am capable to be the national chairman after having understudied my present chairman, Pharm. Olufemi Ismail Adebayo from day one in office. I have also been in the Council as the state chairman, FCT branch, in the past.So I know some of the challenges that we are facing and I have the pedigree to be able to lead the association well and achieve greatness for the association.

I also have deep passion for this association and I’m glad that I’m a pharmacist because it has improved and equipped me with a lot of knowledge. With vision and focus, I am ready to steer the association to the next level. Also, with the calibre of chairmen we have had and the wealth of knowledge of the outgoing chairman, coupled with the direction I have set for myself, I think I will be able to, at least, match or supersede what the outgoing chairman has done because I am one of his loyal students (Laughs).

 

What gives you confidence that you can lead an association as complex as the ACPN?

As the national vice-chairman, I have worked closely with my chairman and whenever I advise and he feels the advice is useful, he takes it.Also, from the experience I have garnered working with him, I have developed many ideas for projects and programmes for the advancement of the profession and the association which I would love to implement when I emerge the national chairman of our association.

This administration, under the able leadership of Alh. Ismail has done its best and I am hoping to continue wherever it stops. At the end of the day, I would love to see community pharmacy practice members that are doing well, giving back to the society and providing the public with the needed therapeutic attention, as well ridding the society of fake and counterfeit medicines.

With 23 years’ post-graduation experience and having been a Fellow of the WAPCP since 2005, state chairman and member, National Executive Council (NEC) for five years, and being a national vice-chairman for three years or so, I am quite mature for the job, and I am willing to take this association to the next level by the grace of God.

 

Tell us some of the achievements and challenges as of the present administration in the last three years in office.

 

Well, under the able leadership of my national chairman, Pharm. (Alh) Olufemi Ismail Adebayo, we have been able to come up with the mission and vision statements for the association which have defined our focus and goals from inception. The association now has a new logo and, of course, the public is now better enlightened on whom a qualified and registered community pharmacist is compared to those days when quacks and charlatans almost took over the practice from the professionals.

In addition, we have done enough to improve the welfare of our members and also enhance their practice. However there is still much to be done because we cannot work in isolation. The regulatory agencies also have to do their work so that the practice can be better than it is now. I am very happy that we have a new registrar at the level of PCN and the new board of council. From the way they are going, they are charting a new course for the profession, and if things continue this way, I think pharmacy practice will be much better than what it is now.

 

How do you see pharmacy practice today compared to what it used to be?

It is getting a lot better and I will also like to say that my own pharmacy practice has been enhanced by the fact that I enrolled in the Pharm. D conversion programme, which, to me, is the best thing that has ever happened to pharmacy in Nigeria. I am saying this because, by the time you graduate as a Pharm. D holder, you become well-grounded. The University of Benin that is presently doing the conversion is doing well. Today, I have patients who come to my premises for immunisation, some for counselling, some with chronic ailments such as hypertension, diabetes and others; while some come specifically because they want to see and talk to the pharmacist. This can only be possible when they have confidence in you. So, in a nutshell, pharmacy practice, from my point of view, is now better practised than what it used to be.

 

Are you suggesting that all pharmacists who have B.Pharm. should also go for Pharm. D?

Definitely yes, that is the way forward. All pharmacists should go for Pharm. D, while those who already have B.Pharm. should go for conversion. This doesn’t mean it’s a must for everybody but all those intending to be pharmacists should go for the Pharm. D because it is a unique degree that brings one closer to the patient.

The reason some set of people are trying to take away the practice from us is because we are not close to the patients. So, if we are close to the patients as well as the molecules, other healthcare professionals will respect us as being important in healthcare delivery.

 

As someone who has been in the practice for a while, how would you assess pharmacy practice in the country?

Pharmacy is a profession that is highly specialised and thrives well in a properly regulated society and that is why in the US and the UK, pharmacists are in the top class of society. However, in our country today, the practice environment needs to be sanitised and that is why we have so many of our colleagues not doing too well.

However, despite the chaotic situation we find ourselves, if, as a pharmacist, you are able to define yourself and do what you are supposed to do in your practice area, you will realise that your community will appreciate what you are doing and you will be popular in their midst. So, the practice is highly rewarding for those who know what to do, in terms of pharmaceutical care and others.

 

As one of the stakeholders, what is your view on the happenings in the healthcare sector in the country?

The healthcare sector today, to me, leaves much to be desired. We are supposed to do better than we are doing now, but some doctors (don’t let me say all) continue to see pharmacists as rivals in the industry. I know that it’s just specialisation that separated the two because pharmacy and medicine are the same as they aim at achieving the same result, which is healthcare provision. Also, none of the healthcare providers can work in isolation, because the physician may not be able to work effectively without the pharmacists, while the same applies to others. So, as far as I am concerned, it is just ego problem, which is not good for the sector. Healthcare provision should be about patients.

 

Re: Now that ACTs appear to be failing

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 Below is an insightful rejoinder I received from Professor David T. Okpako on my article, “Now that ACTs appear to be failing.

 

The article in the January 2015 issue of Pharmanews, page 46, with the above title, written by Pharm. Nelson Okwonna, caught my attention and compelled me to write this brief response.

The article dealt with the important issue of emerging Plasmodium falciparum resistance to the artemisinin-based combination therapies (ACTs), now the drugs of choice for the treatment of malaria disease throughout Nigeria. The author raised the apocalyptic scenario of an ‘epidemic of monumental proportions’ for Nigeria, the epicentre of malaria disease, in the event of resistance to ACTs.

I have also raised such alarm before and, again, in a forthcoming book, where I drew attention to modern medicine’s historical experience with the disease caused by tubercle bacillus (TB) which was treated successfully with effective affordable drugs in the 1950s, but which later developed resistance to such drugs, and then to every generation of anti-TB drug that science could invent. Today there are some strains of TB (extensively resistant TB) which do not respond to chemotherapy –a nightmare scenario and one of today’s most intractable chemotherapeutic problems, even in the western world.

Among Nelson’s recommended solutions is a most telling point, i.e., “heading home for answers” -where he suggests that, in our attempt to tackle the problem of multi-drug resistance in malaria,we should look at the possibility of combining our local herbs with known existing therapies. This is a most insightful suggestion for which there is strong scientific evidence, which I may very briefly point to. Basically, malaria is a disease whose pathology is underpinned by inflammatory mechanisms triggered by the presence of the plasmodium parasite.The evidence that malaria is an inflammatory disease is now overwhelmingly incontrovertible. And the herbal remedies used by various indigenous communities in Nigeria to treat fever, aches and pains (FAP), the quintessential manifestations of the inflammatory reaction, have been shown by Nigeria scientists in the last 30 to 40 years to possess anti-inflammatory pharmacological properties.

We can thus say with confidence that ancient Nigerians, in their malaria endemic zones, evolved a rational method of treating what must have been a common ailment, malaria fever,with herbs, that worked.There is no evidence that Africans were near extinction due to malaria disease, before modern chemotherapy came to the rescue.

The ancients were ignorant of the mosquito/parasite origin of the disease, but they treated the symptoms (many people in Nigeria still do).I argue that such successful treatment of malaria-induced FAP is tantamount to cure in Africans living continuously in contact with the anopheles mosquito.This is because the people have partial immunity conferred on them by anti-plasmodium antibodies and numerous genetic protective adaptations e.g., sickle cell gene and glucoe-6-phosphate dehydrogenase enzyme deficiency; their immune system was primed ready to deal with the plasmodiumparasite whenever it showed its presence. In such people, all that is needed is a successful amelioration of the malaria-induced inflammation (some mediators of inflammation, e. g., the cytokine, tumour necrosis factor, TNF, actually suppress immune activity in the sufferer); the resulting surge in anti-plasmodium immune activity in such people would eliminate the parasite, resulting in a cure of the disease. Moreover, the immune status of the individual against the plasmodium was strengthened after every bout of malaria-induced FAP, and successive attacks would be less severe in a process of natural attenuation of the parasite. This was how Africans living in malaria endemic areas came to attain a state of biological equilibrium with the disease before European introduction of modern chemotherapy with plasmodicidal drugs less than 500 years ago.As we now know, the use of plasmodicidal drugs in the treatment of malaria runs against the grain of that age-old biological equilibrium.

An important advantage of herbal treatment is that the parasite is not provoked into mobilising its considerable arsenal of resistance mechanisms, which is what happens when we use plasmodicidal anti-malaria drugs such as chloroquine and the ACTs whose aim is to kill the plasmodium.The malaria multi-drug drug resistance that we see in Plasmodium falciparum is a defence reflex against extinction by an ancient parasite that sees itself threatened.

Drug resistance was an unknown phenomenon in Africa before the extensive use and abuse of anti-malarial drugs, following the introduction of modern chemotherapy. Even when fully fleshed out, this hypothesis is, at best, a most plausible hypothesis; but it can be tested and represents a challenge to the Nigerian medical community which, up till now, seems to accept foreign prescriptions on malaria without question.

Pharmacists and doctors and all who are familiar with this science must work together and pressurise the government to fund concerted research into traditional anti-FAP herbal remedies for development as anti-malaria therapies, or as adjunct to conventional therapies, as Nelson wisely suggested in his article. This is to ensure that not every adult otherwise healthy Nigerian with a competent immune status and partial immunity should have to take powerful resistance-provoking plasmodicidal drugs such as the ACTs for the treatment of FAP that has not been diagnosed as malaria disease. This, plus other smart designs in the use of effective plasmodicidal drugs, will increase their life-span by minimising the chances of drug resistance.

I am thus in full agreement with Nelson Okwonna that we should head home for answers by turning to indigenous herbal remedies. The world is turning to plants for anti-inflammatory medicines because the array of anti-inflammatory chemical entities present in plants is mind-boggling and cannot be matched by non-steroidal anti-inflammatory drugs produced by synthetic chemists in the pharmaceutical industry.

All in all, the time has come (aided by science!) for us in West Africa to begin to see malaria disease as our ancestors understood it – that is, a common ailment treatable with available herbal remedies, not a deadly disease of epidemic proportions as we have been conditioned to perceive it by international experts guided by a persisting fear of the disease; a fear reinforced by their memory of numerous malaria deaths of non-immune Europeans in their first encounter with the disease in West Africa in the 19th century.

David T. Okpako, FPS, FAS.

Quality measurement and management in health care systems

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Maintaining leadership in health care management is unachievable if the quality of health care cannot be measured. A good health care system allows for effective evaluation in order to know what exactly the quality of care is, and how well it is delivered.

Sadly, in most developing countries, there is no mandatory national healthcare system to track the quality of care delivered to the citizens. Much of what is done is spontaneous delivery of health care within an existing cyclic health structure that has existed for many years without recourse to change.

On the other hand, in developed countries, interest in measuring quality of health care has initiated dramatic transformations of health care systems, accompanied by new organisational structures and reimbursement strategies that could affect quality of care.

Why is the measurement of quality in health care difficult in the developing ones? Apart from a lack of documentation about how major illnesses are treated in most health care systems, there are other factors, which include:

  1. A lack of systematic outcome assessment.
  2. A lack of resource evaluation related to quality for specific diseases.
  3. Persisting variations among providers in care for similar patients.
  4. Paucity of formal monitoring systems by health care providers or regulators.

 Assessing quality care

Understanding quality of care is quintessential to effective leadership in health care management. Quality carecan be defined as the degree to which health services for individuals and populations increase the likelihood of desired health outcomes, become consistent with current professional knowledge, and divided into different dimensions according to the aspects of care being assessed. This cannot be achieved without effective management; in fact, management is the commitment required to achieve quality health care objectives. It involves coordinating, leading and motivating people in order to achieve a set objective. It entails the efficient use of all available resources.

Our focus here is the measurement of the quality of health care. How do we know how well we are doing? Are there precise measurement tools for measuring an existing health care system?

There are quantitative measures that can be used to monitor and evaluate the quality of important governance, management, clinical, and support functions that affect patient outcomes. These quantitative measures are carried out using indicators.Indicators aremeasures that assess a particular health care process. They provide a quantitative basis for clinicians, organisations and planners aiming to achieve improvement in care, and the processes by which patient care are provided. Indicators are a form of clinical quality measures (CQMs).

 About clinical quality measures

      Clinical quality measures(CQMs) are tools that help measure and track the quality of health care services provided by eligible professionals, eligible hospitals and critical access hospitals (CAHs) within a health care system. These measures use data associated with providers’ ability to deliver high-quality care or relate to long term goals for quality health care.

CQMs measure many aspects of patient care, including, health outcomes, clinical processes, patient safety, efficient use of health care resources, care coordination, patient engagements, population and public health, and adherence to clinical guidelines.

The importance of using an effective indicator cannot be overemphasised. Indicators serve crucial purposes. They make it possible to:

  1. Document the quality of care;
  2. Make comparisons (benchmarking) over time between places (e.g. hospitals);
  3. Make judgements and set priorities (e.g. choosing a hospital or surgery, or organising medical care);
  4. Support accountability, regulation, and accreditation;
  5. Support quality improvement; and
  6. Support patient choice of providers

Also,the use of indicators enables professionals and organisations to monitor and evaluate what happens to patients as a consequence of how well professionals and organisational systems function to provide for the needs of patients.

However, indicators are not a direct measure of quality. This is because quality is multidimensional; hence, in order to understand and measure quality, different measures must be employed. Although indicators are not sole determinants of measuring quality, they must be ideal indicators. They are said to be ideal if they are based on standards of care. These ideal indicators can be evidence-based and derived from the academic literature. Where scientific evidence is lacking, it can be determined by an expert panel of health professionals in a consensus process, based on their wealth of experience. Thus, indicators and standards can be described according to the strength of scientific evidence for their ability to predict outcomes

 Characteristics of an ideal indicator

An ideal indicator:

* Is based on agreed definitions, and described exhaustively and exclusively;

* Is highly or optimally specific and sensitive; that is, it detects few false positives and false negatives;

* Is valid and reliable;

* Discriminates appropriately;

* Relates to clearly identifiable events for the user (e.g. if meant for clinical providers, it is relevant to clinical practice);

* Permits useful comparisons; and

* Is evidence-based. Each indicator must be defined in detail, with explicit data specifications in order to be specific and sensitive.

It is important to know that indicators may vary in their validity and reliability. Validity is the degree to which the indicator measures what it is intended to measure. This means the result of a measurement corresponds to the true state of the phenomenon being measured. A valid indicator discriminates between cares, otherwise known to be of good or bad quality, and concurs with other measures that are intended to measure the same dimension of quality.

Reliability, on the other hand, is the extent to which repeated measurements of a stable phenomenon by different data collectors, judges, or instruments, at different times and places, get similar results. Reliability is important when using an indicator to make comparisons among groups or within groups over time. These two qualities must be considered when choosing an indicator.

Types of indicators

There are different classifications of indicators that may be useful when considering which should be used for a given purpose in an organisation. An indicator can be any of the following:

* Rate-based or sentinel;

* Structure/process/outcome-related; and

* Generic or disease-specific.

* Type of care, function, and modality-related

Rate-based and sentinel indicators

A rate-based indicator uses data about events that are expected to occur with some frequency. These can be expressed as proportions or rates (proportions within a given time period), ratios, or mean values for a sample population.

To permit comparisons among providers or trends over time, proportion- or rate-based indicators need both a numerator and a denominator, specifying the population at risk for an event and the period of time over which the event may take place. An example of rate-based indicator is: “clean and contaminated wound infection” where the numerator is the number of patients who develop wound infection from fifth post-operative day after clean surgery and the denominator is the total number of patients undergoing clean surgery within the time period under study who have a post-operative length of stay for five days.

Moreover, a sentinel indicator identifies individual events or phenomena that are intrinsically undesirable, and always triggers further analysis and investigation. Each incident would trigger an investigation. Sentinel events represent the extreme of poor performance and they are generally used for risk management. Example is the number of patients who die during surgery.

2.Indicators related to structure, process and outcomes

There are indicators that can be related to structure, process and outcome of health care. ‘Process’ denotes what is actually done in giving and receiving care; that is, the practitioner’s activities in making a diagnosis, recommending or implementing treatment, or other interaction with the patient.

On the other hand, ‘outcome’ measures attempt to describe the effects of care on the health status of patients and populations. Improvements in the patient’s knowledge and salutary changes in the patient’s behavior may be included under a broad definition of outcome and, so, may represent the degree of the patient’s satisfaction with care.

Further,‘structure’ refers to health system characteristics that affect the system’s ability to meet the health care needs of individual patients or a community. Structural indicators describe the type and amount of resources used by a health system or organiSation to deliver programmes and services, and they relate to the presence or number of staff, clients, money, beds, supplies, and buildings.It is important to note that the assessment of structure is a judgement on whether care is being provided under conditions that are either conducive or inimical to the provision of good care.

* Process indicators: Process indicators assess what the provider did for the patient and how well it was done. Processes are a series of inter-related activities undertaken to achieve objectives. Process indicators measure the activities and tasks in patient episodes of care. An example of process indicator is the proportionof patients treated according to clinical guidelines. Some authors include the patient’s activities in seeking care and carrying it out in their definition of the health care process; others limit this term to the care that health care providers are giving. It may be argued that providers are not accountable for the patient’s activities and these, therefore, do not constitute part of the quality of care, but rather fall into the realm of patients’ characteristics and behaviour that influence patients’ health outcomes.

* Outcome indicators: Outcomes are states of health or events that follow care and that may be affected by health care. An ideal outcome indicator would capture the effect of care processes on the health and wellbeing of patients and populations. Outcomes can be expressed as ‘The Five Ds’: (i) Death – a bad outcome if untimely; (ii) Disease – symptoms, physical signs, and laboratory abnormalities; (iii) Discomfort – symptoms such as pain, nausea, or dyspnea; (iv) Disability – impaired ability connected to usual activities at home, work, or in recreation; and (v) Dissatisfaction – emotional reactions to disease and its care, such as sadness and anger.

It should be noted that intermediate outcome indicators reflect changes in biological status that affect subsequent health outcomes. Some outcomes can only be assessed after years, for example, five-year cancer survival. It is, therefore, important to assess intermediate outcome indicators. They should be evidence-based and reflect the outcome (e.g. HbA1c in diabetes). They can be regarded as short-term outcomes.

Therefore, outcome measures must be adjusted for factors outside the health system, if fair comparisons are to be made. In quality assessment, components that relate to the medical care system should be isolated, which is accomplished by controlling for significant confounding factors that contribute to the outcome.

 

  1. Generic and disease-specific indicators

Generic indicators measure aspects of care that are relevant to most patients, while disease-specific indicators are diagnosis-specific and measure particular aspects of care related to specific diseases. Both generic and disease-specific indicators can focus on structure, process, or outcome.

Generic indicators may be difficult to interpret, especially when making comparisons among hospitals or providers, because there may be profound differences in patient mix. Examples of generic indicators are proportion of specialists to other doctors, registered patients in the emergency department, unscheduled returns to the operating room and in-patient mortality.

Disease-specific outcome indicators can be used to compare hospitals and plans, when data are risk-adjusted. Confounding factors, such as prognostic factors for specific diseases, are likely to be found in the scientific literature for these diseases, thereby, indicating the need for risk adjustment. Example of this type of indicator is the proportion of cardiologists to other doctors treating patients with heart failure at the department of cardiology.

  1. Indicators related to type of care, function, and modality

There are indicators that can be classified according to type of care, function, and modality. These set of indicators, classified by type of care, may be preventive, acute, or chronic.Also, quality measurement can be done based on health care functions such as screening, diagnosis, treatment and follow-up. This must be done alongside the modalities through which the health care process is done. Modalities in the health care process includehistory, physical examination, laboratory/radiology study, medication, and other interventions.

It is critical to evaluate and re-evaluate healthcare performance among professionals and organisations. These indicators can serve as a plumb line if indeed we seek leadership in health care management.

The table below captures this group of indicators and illustrates how they can be classified in quality of care measurement systems, especially in multiple clinical topics. The table displays examples of indicators classified according to type of care, function and modality

Indicator Type of Care Function Modality
Sickle cell disease: children with a positive sickle cell    Chronic Treatment Medication screen of children suspected of being positive for sickle cell disease should be placed on daily penicillin prophylaxis from at least 6 months of age until at least 5 years of age
Urinary tract infection: children with a diagnosed urinary tract infection should be reassessed at 48hours to determine if there is clinical improvement Acute Follow-up Other contact
Well-child care: the child’s weight should be measured at least four times during the first year of life. This information must either be plotted on a growth curve or be recorded with the age/gender percentile Preventive Screening Physical Examination

 

As always, our passion at the Pharmanews Centre for Health Care Management Development is to drive effective leadership through qualitative healthcare management. It is crucial to know that the measurement of health care quality is greatly aided by the use of relevant quantitative indicators, supplementing other approaches that may include qualitative analyses of specific events or processes. For a healthier Nigeria, indicators can also be important with regard to prevention, quality of life, and satisfaction with health care.

We believe that a more effective health care system is possible with the continuous education of health care personnel and the design of an effective platform for discourse among health care professionals. This explains the reason for our aggressive 2015 training campaigns across Nigeria and beyond.Join us as we advance the development of health care management around the globe.

Mentorship in health care leadership

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In health care, leadership positions are continually emerging. There is someone rising to a new position somewhere; at another place, someone is just being replaced, while some others have initiated leadership by creating a position that was previously not in existence, either by a new discovery or leadership simply initiated by knowledge. Though leaders are daily emerging, no one seems to be asking: who is mentoring these neophyte leaders?

Pharmanews Dudai workshop
Participants on a facility tour of the Medcare Hospital during the Health Care Financing and Innovation Workshop held in Dubai last year

Mentorship is principal in ensuring effective and continuous leadership in health care. No other system requires more precision and less error than health care; hence, the need for workers, even leaders, to seek mentorship. Sadly, mentoring in health care is not deliberately carried out, especially in most countries in Africa, where workers or new leaders are thrown in the wild to survive. In fact, there are only a few health mentorship programmes in Nigeria. Many health care organisations do not pay close attention to deliberate mentorship or other leadership development initiatives.

There are those who believe that a mentor-mentee relationship should occur naturally,rather than being a planned programme of action. As Byrne describes it, “mentorship though appears ubiquitous, yet elusive, not deliberately initiated but left to chance.”Developed countries like the United States of America have planned mentorship programmes. For example, the USACentre for Disease Control and Prevention sponsors a formal mentorship programme for Public health advisors – a strategy for developing new managers. So also does the American Dental Education Association (ADEA). Recognising the dearth of women in executive positions and serving as deans of dental schools, ADEA, in 1992, created a programme for women liaison officers (WLOs) appointed by dental school deans.The purpose of the programme was simple: to develop new women leaders.

According to Hawkins and Fontenot (2010), an important gift health leaders can give to their professions is to serve as mentors to those who will lead health care organisations and institutions into the next decades.

 

Requisite skills

Mentors in health care should possess certain qualities for effective mentorship. First, they should be highly cognisant of the professional landscape. They should not only be experienced, but should be fully aware of how the health system works – they should be abreast of long-standing structures and cultures.

Second, mentors should be visionary; they should have strategic insight into events that will later shape the climate of most circumstances in their chosen fields. They need this to provide direction for new leaders. In addition, mentors should be creative, risk-takers, inspirational and possess good communication skills.

Hawkins and Fontenot further add that mentors should be politically astute, sensitive to ebbs and flows of human life, and should possess self-knowledge.

Though these qualities are attractive,the style employed by a mentor can affect the quality of leadership he provides for a mentee in health care.

 

Relevant styles

There are different styles of mentorship adopted by mentors.Mentors’ styles are as varied as the persons who choose careers as health professionals.

According to Hawkins and Fontenot, some mentors appear to have a philosophy of mentoring that one can best characterise as trial by fire or critical, and others appear to have more nurturing styles. Both styles can either be effective or a hindrance for a mentee. The key is to discover the right match between mentor and mentee that will be beneficial to both parties.

Mentors who are toxic can do more harm than good for their mentees. They (Hawkins and Fontenot) quoted Darling (1985) as saying there are four categories of toxic mentors: avoiders who are seldom, if ever available and impossible to reach; dumpers, who believe in the sink or swim approach to surviving as professionals; blockers, who either micromanage or withhold information; and destroyers whose goal seems to be to undermine anything and everything the mentee proposes.

The trial-by-fire mentors may bombard their mentees with criticisms of their work in the extreme. The underlying philosophy appears to be that such hazing will toughen the mentees up for the real world of academia or clinical practice or whatever the field and role for which the mentee is preparing.

The nurturing style of mentoring is one in which the mentor assumes more of a parental role, creating a safe, open environment that allows the mentee to both learn and try new ideas and methods by himself. It is a more participatory style of leadership.

 

Rational strategies

Mentorship can be done in two forms. Byrne (1991), as quoted by Ehrich (1999), says mentoring can be traditional or formal. Under the traditional mentoring system, mentors employ their personal resources to assist their mentees to develop their career. The senior member in the organisation initiates a relationship with young members who he recognises as having certain potentials that could be developed. In this case, the mentor chooses his mentee. This form of mentorship is left to happen naturally, and though it appears sentimental, some best mentor-mentee relationships have been produced by this “natural selection” process.

In the twilight of the twentieth century, Byrne notes, mentorship became formal. Under formal mentorship, raising new leaders is a systemic policy issue and a standard part of management practice. Most times, the effectiveness of the policy rests on the following factors: mentor’s commitment to the programme, mentor’s compatibility with mentees, and mentor’s competences in terms of technicality and interpersonal skills. This type of mentorship is not voluntary.

Additionally, there is the professional mentorship system. This form of mentorship is voluntary. It is a process which is promoted and encouraged by top leadership as part of mainstream staff development. Leaders are simply encouraged to mentor young managers.

 

Resultant success

Studies conducted among health care leaders proved that those who have mentors were more likely to succeed than those who were not on any form of mentorship programme. In other words, mentorship, no matter the form, provides the mentee, as well as the mentor, with immense benefits.

First, the mentee enjoys rapid career advancement. Mentoring helps mentees navigate through the career path because they are being guided by those who have been there. They also enjoy personal support in carrying out their duties as they work under the supervision of a mentor. Mentees in a mentorship programme have the chance of increasing in learning and personal development.The strong sense of being under supervision can also help to increase mentee’s confidence.

Second, those who volunteer to or participate in mentorship programmes enjoy personal fulfilment. Mentors in health care, as in other fields, derive a sense of satisfaction for providing guidance to emerging leaders. This state, psychologists say, is a major motivation for mentors’ participation in a training programme. Also, they getassistance on projects as neophyte leaders can serve as research fellows and help to manage projects.

Third, a well- planned mentorship programme can befinancially rewarding for the mentor. Health care organisation may pay those who get involved in a mentorship programme, as it requires extra work and effort to successfully guide emerging leaders. In the same vein, coaches enjoy increased confidence. Success recorded from a mentorship programme will spur mentors to adopt more protégés and re-vitalise their interest in work.In addition, there are immense benefits for organisations that organise a mentorship programme.

 

Result-oriented structures

As earlier discussed, health care organisations in Africa need to plan, prepare and adopt monthly or yearly mentorship programmes for staff members. These mentorship programmes can be organised in-house or outsourced to health care training providers.

However, there are factors that influence the success of mentoring programmes.First, is the availability of time for mentoring. This often constitutes a major setback in mentoring, as those who should mentor sometimes complain of being short of time. Mentoring leaders require time, attention and a close follow-up on the activities of the mentee. For effective mentoring to take place, senior health executives should be ready to give their time, which in most cases, is very limited.

Second, is the training of mentors. Mentorship can only be as effective as the skills and personality of the mentor. For effective mentoring to happen, mentors must be thoroughly and continuously trained to be able to succeed in both group and individual coaching. A good mentoring programme is designed to train mentors to communicate with rather than talking to the mentee, andto network with other mentors.

Third, matching mentors and mentees can be a challenge to effective mentoring. Issues such as ethnicity, gender, and religion can influence a mentorship process. A good mentorship programme is planned to discourage outright rejection of any mentee or overly sentimental displays by senior executives in the choice of those to mentor.

Other factors include overdependence of mentee on the mentor, possibility of sexual attraction and clash between mentors and chief executives.

Despite all these, organisations still benefit greatly from mentorship programmes in that they lead to the development of their staff. According to Hawkins and Fontenot, physicians, nurses, physical and occupational therapists, dieticians, veterinarians, dentists, pharmacists, psychologists, social workers, and other health professionals assume their first leadership positions often with some trepidation. With formal mentoring, however, the confidence of such personnel is bolstered.

Similarly, mentoring increases staff commitment to the organisation. By enrolling a staff for leadership training, the employee views his organisation as committed to his welfare, and will in turn give away heartily his loyalty. Leadership programmes for mentors and mentees are cost effective, especially, on the long run. A lot is saved by encouraging mentorship among senior executives. Neophyte leaders, entrepreneurs and managers need to embrace mentorship programmes.

 

Recap/summary

In order for organisations to stay ahead in health care, there should be a constant improvement in leadership. The Pharmanews Centre for Health Care Management Development, for over 20 years, has continued to provide relevant and qualitative leadership training for mentors, managers and emerging leaders in the health care system. It is Nigeria’s leading healthcare platform for developing and networking health care leaders. Our leadership development programmes run for different months in the year, each designed to meet specific leadership and management objectives.

We believe that a more effective health care system is possible with a deliberate and well-planned programme of action for emerging leaders in the Nigerian health care industry. Attention needs to be paid to effective leadership through the discourse and implementation of pragmatic leadership models. Our trainings are not just events but well thought-out campaigns designed to initiate change in participating organisations and the health care industry.

We sustain a strong trainer-trainee network as well as promote open channels for mentor-mentee relationships. You can send nominations for any of our 2015 health leadership workshops, starting with the Health Care Entrepreneurship Workshop,scheduled for 24–25 March in Lagos.

Stay on this page, as we begin, from the next edition, a panorama of distinguished leaders in the Nigerian health care Industry.

 

References

Hawkins J. and Fontenot,H. Mentorship: The heart and Soul of health care Leadership. Journal of Healthcare Leadership. 2010: (2) 31-34

Naicker, I.; Chikoko, V. and Mthyiance, S. Does Mentorship Add Value to In-Service Leadership Development for School Principals? Evidence from South Africa.Anthropologist 2014, 17(2) 421-431

Ehrrich, L. Mentoring: Pros and Cons for HRM. Asian Pacific Journal of Human Resources. 1999: 37 (3) 92-107

Colgate Palmolive launches MCP toothpaste

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In its efforts to combat dental cavity and enhance oral health in the country, Colgate Palmolive Nigeria has introduced new toothpaste, Colgate Maximum Cavity Protection (MCP), produced with Pro-Argin Technology, a new anti-cavity technology.

The new toothpaste, which is also a sugar acid neutraliser, was recently presented to dental care professionals at the Sheraton Hotels and Towers, Lagos.

Colgate
L-R: Dr(Mrs) Bimpe Adebiyi, head, dentistry, Federal Ministry of Health (FMOH) and Mrs Hannah Oyebanjo, marketing director, Colgate Palmolive Nigeria during the event.

In its efforts to combat dental cavity and enhance oral health in the country, Colgate Palmolive Nigeria has introduced new toothpaste, Colgate Maximum Cavity Protection (MCP), produced with Pro-Argin Technology, a new anti-cavity technology.

The new toothpaste, which is also a sugar acid neutraliser, was recently presented to dental care professionals at the Sheraton Hotels and Towers, Lagos.

Speaking at the event, Dr Olabode Ijarogbe, president, Nigeria Dental Association (NDA), commended Colgate Palmolive for first introducing the product to dental care professionals before releasing it to the general public. He noted that what the company was introducing to the experts was revolutionary for oral health care.

Dr (Mrs) Bimpe Adebiyi, head, dentistry, Federal Ministry of Health, in her remarks, also commended the company’s initiative, noting that the successful convergence of NDA and other dental care professionals was a proof that the oral health community in Nigeria was united.

In her welcome address, Mrs Hannah Oyebanjo, marketing director, Colgate Palmolive Nigeria, said that the company had a lot of initiative for the country, adding that the introduction of Colgate MCP was just one of such.

Presenting the new product to the professionals at the event, Dr Ogechukwu Mac-Johnson, oral consultant, Colgate Palmolive Nigeria, said Colgate MCP was the first and only family toothpaste with a unique sugar acid neutraliser technology and fluoride.

She said the company was introducing the best cavity-protection toothpaste to the professionals, adding that research had shown that the product was so advanced that it decreased early decay by half.

Fluoride, she added, does not neutralise sugar or prevent cavity, unlike Colgate MCP, which is the future of cavity protection and would make things easy for the dentists.

Colgate MCP, Dr Mac-Johnson said, neutralises acids before they can harm the teeth, strengthens enamel with fluoride and calcium to prevent cavities from forming, decreases early teeth decay by half and reduces new cavity formation by 20 per cent.

 

The Living Sacrifice

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My friend, Ralph, drove some miles to my area of residence in Lagos one Saturday morning, some years ago. He was invited to the wedding ceremony of his nephew and was to serve as the chairman of the wedding reception after the church programme. Ralph drove round, looking for the church but could not locate it. Therefore, he decided to stop over at my house to help him locate the church. I was glad to see him but was not sure of the particular church he was looking for because there were many small churches in the area. I took him to one I suspected to be his target. However, on getting there, there was no life in the premises. The building was not impressive and the entire compound was deserted and unkempt that Saturday morning. Ralph looked around with disappointment and impulsively uttered, “Ifeanyi, let’s leave this place. God cannot be in this kind of place.”
Obviously, Ralph’s understanding was that God would only reside in well-built and attractive churches and would be uncomfortable in poorly maintained and dirty ones. He is not alone in this thinking. Some people still believe that the church is where God lives and you need to go there to meet Him. This is the reason we invest heavily on churches to make them habitable for God and provide conducive environment for the worshippers.
The truth is that, historically, God has always sought to dwell with His people. In the Garden of Eden, He had fellowship with Adam. After Israel left Egypt, He instructed them to build a portable tabernacle where His presence would dwell. In the land of Canaan, God dwelt with His people in the Ark of Covenant. The temple was built in Jerusalem under King Solomon.
However, the coming of Jesus Christ has changed this situation. God now dwells in us and not in buildings made by man. His children and not structures are now the temples or sanctuaries or churches. This truth can only be revealed to us by the Holy Spirit.
There are inherent responsibilities in God taking up His residency in us. God is holy and perfect, and, therefore, His presence demands a particular atmosphere in which to dwell. The totality of our being is to be presented as living sacrifices, holy and pleasing to God (Romans 12:1).
Romans 6:12-13 says, “Let not sin therefore reign in your mortal body, that ye should obey it in the lusts thereof. Neither yield ye your members as instruments of unrighteousness unto sin: but yield yourselves unto God, as those that are alive from the dead, and your members as instruments of righteousness unto God.” Our total being is for serving God. Our hands, eyes, feet, lips, mind and so on are for the service of God. The tragedy is that some people use these organs to work against Him and serve the devil. Being temples of God demands that we guard ourselves against the defilement of the world.
We are temples of God because when Christ saved us, He purchased us as a dwelling place. 1 Corinthians 6:19-20 says, “What? know ye not that your body is the temple of the Holy Ghost which is in you, which ye have of God, and ye are not your own? For ye are bought with a price: therefore glorify God in your body, and in your spirit, which are God’s.” This implies that we have lost the ownership of our bodies. We are merely stewards or caretakers of the dwelling-place of God.
It is indeed a great honour and privilege to be a dwelling place of God. I met one colleague during a conference I attended in Finland some years ago. He was the President of a large pharmaceutical company and he invited me for a tour of his facility. The report was published in Pharmanews. We exchanged phone calls a few times and then stopped. Surprisingly, he phoned me last year to inform me that he was visiting Nigeria for a few days and would like to spend the first one night with my family and then check into a hotel to receive his business associates. He told me to ask my wife to prepare local dishes for him to enjoy. As soon I got this message we started cleaning every part of our house and planning for the type of food to serve him. We purchased some fresh local fruits and also invited two family friends for dinner with our guest. We did all these because he was actually honouring us by spending one night with us.
Now I compare the visit of my friend with God coming to reside in our body. The body must be made ready, fit and pleasing to Him. This implies that we must keep the body clean. The type of clothes we put on the body matters to God. What we eat and drink is important to Him. The exercise we give to the body, the sleep we have, the medicines we take and the general care we give to the body are all important to God, who is the owner of the body.

Prof. Okogun tasks scientists on drug production from plant extracts

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Emeritus professor of Chemistry, Joseph I. Okogun, has said that for Nigeria’s indigenous herbals to be fully harnessed for the improvement of health care delivery, production of drugs from active principles is no longer an option but a necessity.

HERBALS
Okogun, who spoke extensively during the public lecture organised by the Nigerian Academy of Science (NAS), held at the Nigerian Institute of Medical Research, Yaba, on 28 January, 2015, called on all scientists, including biologists, chemists, pharmacologists and clinicians in the country to form a formidable team for the formulation of drugs from active principles on a large scale.
Speaking on the topic, “Drug Production Efforts in Nigeria 2: Anti-Cancer Remedies Emerge through Herbs, Chemistry and Biology”, the erudite don asserted that a smooth collaboration could enhance the development of some natural drugs as well as their formulation into prescribed drugs, with the use of the country’s plant extracts.
Okogu chided Nigerian scientists for their negative behaviour towards the efforts of herbal practitioners in the country, noting that such actions would not lead to the development of the health care sector.
He said it was high time researchers supported traditional practice by assisting in standardising the practice through clinical trials and other activities that would promote indigenous plants resources.
Analysing the manufacturing capabilities of the country, the renowned scholar said the country had, among other things, availability of human resources; presence of active principle isolation in over 99 per cent purity; extensive documentation by FDA and NAFDAC; as well as intellectual property protection and maintenance, which make the formulation of local herbal drugs a huge possibility.
He explained further that local manufacturers would be doing themselves and the nation a great disservice, if they persist in importing active principles, rather than utilising local medicinal plants, which can play better roles in the body chemistry of the populace.
Citing the example of a medicinal plant in Nigeria called gedunin, as published in Research Gate with the title: “An unprecedented gedunin rearrangement reaction converts a methyl group into the methylene group of a cyclopropyl ring”, he said the plant has several medicinal and commercial values, as indicated by the publication.
“Some of the activities of gedunin, when tested in the laboratory showed the following medicinal activities: anti-ovarian cancer, anti-colon cancer, anti-malaria, anti-allergy, and insecticides”, he listed.
In his own remarks at the event, Prof. Oyewale Tomori, President of the Nigerian Academy of Science, urged the federal government to give science the priority it deserves in the country. He said there was need to fund and develop drug researches, to reduce the burden of diseases and save many Nigerians.
“With the significant changes taking place in the country, science has not fared well, even with all the steps taken,” he observed. “The federal government should invest in basic science and drug researches to support the growth of the drug industry and other manufacturing industries. This initiative will encourage indigenous drug makers to take bold, strategic steps in local drug production and, in effect, spur the growth of the industry in Nigeria,”
President of the National Association of Nigeria Traditional Medicine Practitioners (NANTMP) Chief Omon Oleabhiele, also contributed by making a comparison between China and Nigeria, stating that if the Chinese could succeed on their native medicine of Acupuncture, which was initially kicked against by the World Health Organisation, then Nigerian scientists were inexcusable for not harnessing their local herbs for the development of drugs for their citizens.
He further mentioned that if government could allow traditional doctors to record the experiences of patients who were successfully treated with native herbs and became well, it would serve as a good platform for clinical trials, a development that would accord local traditional medicines global recognition.

Fever has benefits, says medical expert

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….. as GSK unveils Panadol Suspension, Scott’s Emulsion for kids

In an apparent bid to quell the fears often associated with fever, a consultant neonatologist has hinted that the health challenge is not as serious as many believe.

L-R: Dr Dorothy Esangbedo, president, Union of National African Paediatric Societies and Associations (UNAPSA); Prof. Oluyinka Ogundipe (retired), formerly in charge of paediatrics and child health in Lagos University Teaching Hospital (LUTH); Kerry Alexander, marketing director, GlaxoSmithKline (Consumer) and Dr Bode Adesoji, GSK’s medical director for Anglophone West Africa, during the unveiling of two brands Panadol Suspension and Scotts’ Emulsion, at Oriental Hotel, Victoria Island, Lagos, on 15 January
L-R: Dr Dorothy Esangbedo, president, Union of National African Paediatric Societies and Associations (UNAPSA); Prof. Oluyinka Ogundipe (retired), formerly in charge of paediatrics and child health in Lagos University Teaching Hospital (LUTH); Kerry Alexander, marketing director, GlaxoSmithKline (Consumer) and Dr Bode Adesoji, GSK’s medical director for Anglophone West Africa, during the unveiling of two brands Panadol Suspension and Scotts’ Emulsion, at Oriental Hotel, Victoria Island, Lagos, on 15 January

Addressing participants during GlaxoSmithKline (Consumer) Nigeria Plc’s launch of two new brands – Scott’s Emulsion Cod Liver Oil and Panadol Suspension for Children, which took place at Oriental Hotel, Victoria Island, Lagos on 15 January, 2015, Dr (Mrs) Mariya Mukhtar-Yola, a consultant neonatologist with the National Hospital, Abuja, said there was no universal definition for fever.
She added, in her presentation on “Management of Pain and Fever in Children,” that unlike what many people think, fever is a neurochemical response common to many animals.
“If this definition appears complex, perhaps, we should take that of English physician, Thomas Sydenham which states that ‘fever is nature’s engine which she brings into the field to remove her enemy.’ Isn’t it funny to note that, until recently, I never knew that even cats develop fever?” she quipped.
While attributing the major causes of fever to infection, vaccines, biologic agents, trauma, rheumatic disorder and genetic disorder, Mukhtar Yola disclosed that it was also pertinent to consider its benefits.
“For those who don’t know, fever has its own merits in the sense that it plays a protective role on the immune system, inhibits growth and replication of micro-organisms, and aids in acute body reaction,” she said.
Buttressing Mukhtar-Yola’s claims, Dr Yinka Osho, GlaxoSmithKline’s expert detailing manager, remarked that this is one area Panadol suspension (for children) is different.
“Panadol suspension provides fast and effective relief from pain and fever. It is also gentle on tiny tummies, easier to administer and has a pleasant strawberry-flavoured taste,” he said.
While appreciating the efforts of the key speakers, Dr Bode Adesoji, GSK’s medical director (Anglophone West Africa), said the presentations bordered on three domains, namely pharmacovigilance, clinical research and medical information.
In terms of pharmacovigilance, Adesoji said that today GSK’s products are notable for their robust link to the concept.
“Also, when we talk about clinical research, GSK is ahead. We are different from the kind of people you meet in Molue (Lagos commercial shuttle) who sell all-in-one products (that cure diarrhea, headache, fever etc). Our brands come with quality you can trust.
“Finally, in the third domain where we have medical information and promotional practice. It might interest you to know that GSK has moved from the old practice of paying speakers to participate in our programmes. As part of our transparency policy, we believe that once you have something genuine and important to present to the public, the speakers will willingly agree to participate,” he stressed.
Speaking on Scott’s Emulsion Cod Liver Oil, D. Chikara Nwoke, another GSK’s expert detailing manager said that the product was a brainchild of Scott and Bowne Company, established in 1876 in New York City.
Labelled as “Scott’s Emulsion Cod Liver Oil,” it is said to be rich in cod liver oil, which is a natural source of Omega-3 Vitamin A & D, calcium and phosphorus. It is also said to help children to build their natural body resistance to infections like coughs and colds and develop strong bones and teeth during their growing years.
Nwoke described the product as a brand trusted by mothers for generations to help protect their children from coughs and colds, so that they will grow strong and healthy.
The products’ unveiling had several pediatricians, pharmacists, physicians, neonatologists and nurses in attendance. Notable among them were Prof. Olowu Adebiyi, president, Paediatric Association of Nigeria (PAN); Pharm. Olumide Akintayo, president, Pharmaceutical Society of Nigeria (PSN), Pharm. Ismail Adebayo, chairman, Association of Community Pharmacists of Nigeria (ACPN) and T. S. Dayanand, managing director, GlaxoSmithKline (Consumer).
Others were Dr Dorothy Esangbedo, president, Union of National African Paediatric Societies and Associations (UNAPSA); Prof. Oluyinka Ogundipe (retired), formerly in charge of paediatrics and child health in Lagos University Teaching Hospital (LUTH); Dr Olufemi Dosunmu, managing director, Bomi Clinics, Sango-Ota; and Kerry Alexander, marketing director, GlaxoSmithKline (Consumer).

Dons, pharmacists mourn Prof. Sofowora

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UntitledDistinguished pharmacist, scholar and researcher, Prof. Abayomi Sofowora, former Chairman of WHO Regional Expert Committee on Traditional Medicine is dead.

Sofowora died on 22 January, 2015 after a brief illness. Prior to his death, the erudite pharmacist had lectured Pharmacognosy for over 45 years. He spent 40 year in the Department of Pharmacognosy, Faculty of Pharmacy, Obafemi Awolowo University, Ile-Ife (October 1967–December 2007). He was head of the Drug Research Unit; Head of Department of Pharmacognosy and dean of the Faculty of Pharmacy. He also served as consultant to WHO, OAU (now AU), UNDP, UNIDO, ADB, ECA and TCDC.

From February 2010 to January 2013, Sofowora was visiting professor to the University of Maiduguri. He spent another two years as adjunct professor in the Department of Pharmacognosy, Delta State University, Abraka.

Speaking on his passing, Prof. Fola Tayo, pro-chancellor, Caleb University described the late don as a luminary and great teacher of Pharmacognosy.

“He came back very active after his training at University of Nottingham. Sofowora was a frontliner in the 1970s. In Ife (OAU), he remained committed and trained quite a number of students,” Prof. Tayo said, adding that, “Sofowora represented so many things – from Fagara project to his mark in sickle cell treatment.”

Prof. Paul Akubue, retired vice chancellor of Madonna University, Port Harcourt, Anambra State told Pharmanews that the news came to him as a shock.

“Honestly, I am still in shock. He was such an active researcher, very much involved in traditional research. Even though I wouldn’t be able to say much about him, I can tell you that we were contemporaries and travelled together on a couple of occasions. This is quite painful!” he lamented.

In his own remarks, Pharm. (Sir) Ifeanyi Atueyi, publisher of Pharmanews, described the death of the celebrated don as a great loss to the pharmacy profession and the entire academic community.

“Professor Sofowora devoted his life to academic pursuit and fully served at the Obafemi Awolowo University, Ile-Ife,” Atueyi said.”The inauguration of the Nigeria Academy of Pharmacy last year offered him the opportunity to share his wealth of experience on academies and constitutional issues. His exit reminds us that death is the lot of mortals and all we need to do is live right while there is life and fulfill our destiny.”

Also commenting on the sad event, veteran pharmacist and Fellow of the Nigeria Academy of Pharmacy, Pharm. Godfrey Obiaga, noted that Sofowora would be greatly missed by the scientific community and the nation as a whole.

“He was a great teacher. Many students of Pharmacy passed through him, one way or the other. He will be greatly missed, but we cannot question God,” he stated.

While praying for the family of the deceased for consolation and fortitude, Obiaga equally challenged fellow pharmacists to sustain the legacies of the departed icon.

“Pharmacists must honour him greatly and do what we can to build upon what this great pharmacist started,” Obiaga enthused.

As reward for his selfless service to pharma research and the community at large, he was honoured with special recognitions, including Fellow of the Nigeria Academy of Pharmacy (FNAP), Fellow of the Pharmaceutical Society of Nigeria (FPSN), Fellow of the West African College of Pharmacy, Great Achievers Award of Obafemi Awolowo University, Fellow of the Nigerian Society of Pharmacognosy (FNSP) and an award by the Sickle Cell Association of Nigeria, Ibadan.Untitled

ACPN cautions against self-medication during strikes

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

L-R: Pharm. Christy Ediomo, ACPN national treasurer; and Pharm. (Alhaji) Ismail Adebayo, ACPN chairman at a recent event
L-R: Pharm. Christy Ediomo, ACPN national treasurer; and Pharm. (Alhaji) Ismail Adebayo, ACPN chairman at a recent event.

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

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

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

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

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

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

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

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

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

5,000 underage girls give birth Everyday- UN reports

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pregnant-girls

February 12 of every year is set aside as world sexual and reproductive health day, when nations and organizations discuss issues on teenage pregnancy, and enlighten both parents and teenagers why they should shun the habit.

According to a director at the United Nations Population Fund (UNFPA) Werner Haug, “some 7.3 million teen women give birth every year. 2 million of these are under 15 years of age, and every day, roughly 5,000 girls give birth. Yearly, 70 million young women lose their lives during pregnancy and childbirth”.

In his report,Motherhood in Childhood, released two years back, he said it shows that adolescent pregnancy perpetuates poverty and hampers development in poor countries.

He further noted that adolescent pregnancy is related to a “whole string of human rights violations” and so it must gain more attention in global development policy.

 

 

How daily consumption of coffee reduces cancer risk from the National Cancer Institute.

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Cup-with-full-of-coffeeHere’s one more reason to feel good rather than guilty about your near-religious java habit: Drinking coffee may lower your risk for melanoma, the deadliest form of skin cancer, suggests new research from the National Cancer Institute.

For 10 years, researchers tracked the coffee-drinking habits and skin cancer rates of nearly 450,000 adults over age 50. After adjusting for factors like UV exposure, age, BMI, physical activity, smoking history, and alcohol intake, they found that coffee drinkers were less likely to be diagnosed with malignant melanoma than coffee skippers. In fact, those who drank four cups of caffeinated coffee per day had a 20% lower risk of skin cancer. Decaf didn’t offer any significant benefit.

What’s the connection? Previous studies show that the morning mud is loaded with compounds like caffeine and polyphenols that appear to suppress UV-induced tumor growth. The bean roasting process, too, spurs the formation of B vitamins that might offer another layer of protection against tumor formation, researchers say.

Still, all that caffeine can come with a cost. Guzzling more than 400 mg of the stimulant can lead to anxiety, restlessness, irritability, headaches, and more. Too much caffeine can also amp up your body’s production of the stress hormone cortisol, which can lead to weight gain (especially around your middle), digestive issues, and even heart disease.

Since an eight-ounce cup of coffee can pack anywhere from 95 to 200 mg of the stuff, it’s smart to stick with just one or two cups per day, says Jacqui Justice, MS, CNS, nutrition director at New York Health & Wellness Center. Drink 12 ounces of water before and after each cup, to counteract caffeine’s dehydrating effects, she says. Once you’ve hit your limit, switch to green tea: A serving maxes out at 45 mg caffeine, and is packed with some of the same skin-saving antioxidants as coffee. Plus, studies show that three cups of green tea a day can increase your metabolism and lead to weight loss.

prevention.com

 

 

 

 

 

Job vacancy for Operations Manager

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Pharmanews Limited requires the services of an Operations Manager.

Job Title: Operations Manager
Location: Lagos

Job Description

  • Coordinate, manage and monitor the workings of various departments
  • Design training programmes and manage training workshops
  • Prepare and control operational budgets; plan effective strategies for the financial wellbeing of the company
  • Develop operation policies and ensure their adequate execution
  • Plan and support sales and marketing activities
  • Assist in the development of strategic plans for operational activity

 Qualifications

  • Minimum of Bachelors in Pharmaceutical Sciences.
  • A post graduate qualification would be an advantage.
  • Excellent written and verbal communication skills, including technical writing skills.
  • Understanding of business processes.
  • Computer literacy
  • Managerial experience
  • Age: 25-40 yearsRemuneration: Attractive

    Application Closing Date: 27th February, 2015
    Method of Application
    Interested candidates should send their CVs and application letters to: jobs@pharmanewsonline.com by Friday 27th February, 2015

    Only shortlisted candidates will be contacted.

Pharmanews Workshop on HEALTH CARE ENTREPRENEURSHIP

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          A capacity development workshop that inspires and equips health professionals for efficient and productive service delivery is essential in achieving sustainable outcomes. For 21 years now, Pharmanews Ltd has offered training and consult ancy services to health care personnel in Nigeria. The company is accredited by the Centre for Management Development (CMD) as a management training institution. Our programmes have benefited pharmacists, doctors, nurses, medical laboratory technicians, pharmacy technicians, distribution managers, store officers, and other health care practitioners.

We do request that you nominate/participate in the upcoming training workshop for the course below.

COURSE:         HEALTH CARE ENTREPRENEURSHIP

Date:                 Tuesday 24 – Wednesday 25 March, 2015

Time:                 9:00am – 4:00pm

Venue:            Pharmanews Training Centre, 8, Akinwunmi Street, Mende, Maryland, Lagos

Target Participants: Health care entrepreneurs, community pharmacists, doctors, managers and executives of NGOs and HMOs.

Course Contents:

  • Elements of Business Plan Development
  • Business Financing and Cash Management
  • Elements of the Emerging Wellness Industry
  • Essentials of Health Care Marketing
  • Leading Effective Organizational Development Strategies
  • Comparative Study of Global Health Care Entrepreneurship Models

Course Objectives:

At the end of the workshop, participants will be able to:

  • Understand the processes and considerations involved in developing a viable business plan for a health care organisation.
  • Identify and apply strategies for achieving effective business financing and cash management.
  • Understand the emerging wellness industry and position their organisation for optimum contribution and profitability.
  • Understand the elements of health care marketing, ethical issues in health care entrepreneurship and modalities for an effective marketing drive.
  • Develop the necessary skill-set and attitude required to lead an effective organisational renewal and development strategy.
  • Learn global best-case models for driving health care entrepreneurship ventures.

Registration:

Registration fee is N50, 000 per participant before 24/02/2015 and N55, 000 after 24/02/2015. On-site registration of N55, 000 could also be made at the workshop venue.

Registration fee covers tea break, lunch, workshop materials and certificates ONLY.

Group discounts: 3 – 5 participants: 10%,   6 and above participants: 15%

 Cancellation: For cancellation of registration fee, 90% of the fee will be refunded, if cancelled at least seven (7) days to the workshop and this information communicated to us by sms or email, using: info@pharmanewsonline.com. There will be no refund if cancelled thereafter.

Method of Payment:

Participants should pay into Pharmanews Ltd account in Zenith Bank Plc (A/c No. 1010701673) or Access Bank Plc (A/c No. 0035976695) and send their full names and bank deposit slip numbers by sms or email to Pharmanews Ltd.

For further information, please contact:

Cyril Mbata                                –  +234 706 812 9728

Nelson Okwonna                         –  +234 803 956 9184

Ernest Salami                           –   +234 703 986 8837

Elizabeth Amuneke                     –   +234 805 723 5128