With the current pharmacist-to-patient ratio in the country estimated at one pharmacist to about 15,000 people, Nigeria risks a progressive collapse of pharmaceutical care services unless urgent structural reforms are implemented, particularly in rural areas and public tertiary institutions, the Association of Hospital and Administrative Pharmacists of Nigeria (AHAPN) has warned.
The National Chairman of AHAPN, Pharm. Oyim Elechi, in an exclusive interview with Pharmanews, lamented the widening gap in healthcare services due to the mass emigration of practitioners, commonly referred to as “japa.” He warned that unless urgent steps are taken to reverse the trend, poor health indices and high mortality rates will remain defining features of the nation’s healthcare system.
While the World Health Organisation (WHO) recommends a ratio of one pharmacist to 2,000 people, he noted with concern that Nigeria’s current reality falls far short of this benchmark, with an estimated ratio of one pharmacist to between 10,000 and 15,000 people, a situation that continues to worsen due to migration.
According to him, the migration of pharmacists has reached a critical level, with direct implications for patient safety and service delivery. To reverse the trend, AHAPN, he said, has continued to advocate aggressive workforce expansion and equitable distribution policies.
He acknowledged that the crisis did not arise in isolation, identifying the major factors driving the mass emigration of pharmacists and other healthcare professionals, including poor remuneration, unconducive working environments, inadequate modern equipment, excessive workload, and discriminatory policies within the health system, among others.
He noted that patients ultimately bear the brunt of these structural deficiencies, leading to increased medication errors, inadequate patient counselling, and weakened pharmaceutical care services.
In a bid to address the situation, he proposed both short- and long-term strategies to correct the system’s anomalies.
For immediate intervention, he recommended improved welfare packages, advocacy for hazard and call-duty allowances, and a review of the CONHESS salary structure. He also called for workforce stabilisation through engagement with the government to lift embargoes on recruitment, emergency hiring in underserved facilities, task-shifting with appropriate safeguards, and temporary redistribution of responsibilities while maintaining quality standards.
He further addressed the unresolved status of the consultant pharmacist cadre in many states, insisting that its full implementation is non-negotiable for improving pharmaceutical care outcomes. At the same time, advocacy efforts continue at both legislative and executive levels.
He identified major barriers to full implementation, including fiscal constraints, as many state governments are reluctant due to the perceived increase in wage bills.
Other factors slowing progress, he said, include policy inertia and bureaucracy, weak political will in some regions, inter-professional resistance, misconceptions about role overlap with other healthcare professionals, lack of a uniform implementation framework, and the absence of a binding national enforcement mechanism for states.
Asked about the association’s position on pharmacist consultant allowances and the four per cent call-duty allowance, he said negotiations are ongoing at various levels. However, the association has issued a 12- to 24-month ultimatum for a conclusive decision, stressing that these allowances are earned entitlements, not privileges, and are critical for motivation, retention, and recognition of clinical responsibilities.
With the Pharmacy Council of Nigeria’s transition to the PharmD as the entry-level qualification in the profession, Elechi described the change as a significant paradigm shift, with greater emphasis on clinical specialisation, patient-centred care, pharmacy subspecialties, and evidence-based research.
He assured that existing pharmacists will not be displaced but will be integrated through structured professional development pathways.
