Prohibitive Costs of Imported COVID-19 Drugs Call for National Introspection – Ifudu

pharmacy

Professor Ndu David Ifudu is the current Dean, Faculty of Pharmacy, Enugu State University of Science and Technology (ESUT), Agbani, Enugu. The distinguished academic, an alumnus of the University of Ife, now Obafemi Awolowo University (OAU), Ile-Ife, spoke to Pharmanews on sundry issues relating to his early days as a pharmacy student, his career, as well as the ongoing COVID-19 pandemic. At 75, the academic who graduated as the best overall student of his 1972 set, expressed a sense of fulfilment for being instrumental to the establishment of the Faculty of Pharmacy in ESUT. He also urged the authorities to explore the potentials of the country’s local drugs as the fight against COVID-19 rages on. Excerpts:

Sir, you celebrated your 75th birthday last November. How can you describe your life as an academic in the pharmacy profession?

I graduated with B.Pharm. (Hons) degree from the University of Ife (UNIFE) now Obafemi Awolowo University (OAU), in 1972, as the best overall graduating student. Subsequently I was employed as a graduate assistant in the Faculty of Pharmacy, UNIFE, same year.

In 1973, I obtained an American scholarship for postgraduate studies at the University of Connecticut, USA. I successfully defended my PhD thesis on the 20th of May 1979, and by 30 June,  of same year, I was back to UNIFE.

Teaching and research at UNIFE, though exciting, was not fulfilling. By 1984, as a senior lecturer, I was ready to make the desired move to a university based in the industrial city of Lagos, the University of Lagos (UNILAG).

Working in Lagos was very exciting as it was easy for me to relate town and gown. My academic pharmacy career took a turn for the better, with respect to interaction with the pharmaceutical manufacturing companies, NAFDAC (National Agency for Food and Drug Administration and Control) head office (which was then based in Lagos), entrepreneurs, the professional body (Pharmacists Council of Nigeria) and the importers of pharmaceutical products’ raw materials and finished products alike.

This interaction with the private sector made it possible for me to obtain sponsorship to attend pharma conferences all over the globe. These conferences enhanced my outreach to colleagues outside Nigeria and enhanced my research output; hence I earned the chair of professor of Pharmaceutics and Pharmaceutical technology, UNILAG.

This brief resume is necessary for one to appreciate what I mean when I declare that I thoroughly enjoyed my career as an academic pharmacist. The icing on the cake is the fulfillment of my ambition to facilitate the establishment of a state-of-the-art faculty of Pharmaceutical Sciences in my state of origin, Enugu. The faculty building should have been commissioned by June 2020, but for the impact of COVID-19 on the building industry.

What were those values and principles that kept you going against all odds?

My professional oath as a pharmacist was constantly guiding my academic practice. My teaching and research got the better part of my time and were diligently executed. My spare time went into family life, exercising and pharmaceutical consultancy services. I related very well with the head of the university and exchanged regular pleasantries.

I had little or no time left for frivolities hence the odds were hardly noticed. Hard work, dedication, honesty and equity were the guiding principles but, more significantly, I rigidly followed the dictates of my sixth sense, which directed thus: “Love and respect all colleagues while joining hands but trust none.”

Comparatively, how do you see the educational standard of your days as a student and what obtains today in our tertiary institutions?

The quality of education in the 1970s and in the 20th century cannot be compared to what is obtainable today, in the 21st century. A good number of my teachers used or dictated same handwritten lecture materials year after year. Reference materials were extremely limited and often outdated. Today, with the advent of the internet, students have up-to-date reading materials on the move with their computers and phones. Several e-journals and e-books are readily available, leaving current information at the fingertips of students who are anxious or willing to learn.

Your foray into the field of pharmacy must have been a passion you had nurtured from childhood or was it an accidental development?

As a teenager I lived with my older brother, an engineer with the Nigerian railways at Enugu. He had two friends, Mr C.P.O Dike, a pharmacist and Dr D. Ikpeme. Older people in my area called each of them “Doctor”. I simply observed that Dr Ikpeme played tennis with the others only on Saturday, whereas the other two played most evenings. Right away, I disliked Dr Ikpeme’s type of “doctor”. Later, while in secondary school, I got to know the difference between the two professions and swore to be a pharmacist, since I could not stand the sight of blood or a dead person.

How would you assess the current curriculum for pharmacy being taught in Nigerian universities? Do you think it meets the global standard?

Currently our schools of pharmacy offer two different degrees – B.Pharm. and Pharm.D – and as such, run two different curricula. The B.Pharm. curriculum is largely product-oriented, while our Pharm.D  programme has substantial patient-orientation. The B.Pharm. programme will be phased out by 2022, courtesy of the Pharmacists Council of Nigeria (PCN)’s directive. The B.Pharm. curriculum has served the nation well so far and the content of the Pharm.D programme will serve its desired purpose.

The main problem with the Pharm.D is not the content, which is in line with universal best practices, but in training the trainers. You can only give what you have in terms of knowledge. Most of the teachers in clinical pharmacy departments obtained their training in part-time one-year crash programmes with very limited hospital exposure. Moreover, while a Pharm.D graduate in the US undergoes 30 hours of hospital posting per week for two years, some of our Pharm.D recipients – future or current teachers- hardly can boast of a total of 60 hours of clinical clerkship in a  50-bed hospital throughout their training period..

Of all the schools in which you have taught, which inspires more nostalgic memories in terms of intellectual labour and social life?

Of all the schools of pharmacy in which I have taught, University of Lagos conjures the most nostalgic memories in terms of academic work and social life. As dean or head of department, substantial financial provision was voted for effectively running the unit. Interestingly, too, there were enough pharmaceutical establishments in Lagos and its environs for adequate financial town and gown interactions!

As a pharmacist, what do you think can be done to decisively halt the spread of the coronavirus, especially in Africa where the healthcare delivery system is largely in shambles?

COVID-19 remains an enigma worldwide. The World Health Organization (WHO) and the Centre for Disease Control (CDC) of the US, as well as the entire world scientific communities, are understanding the biology of the virus more and more on a daily basis. Our best bet will be to follow the guidelines provided by WHO, with some modifications, as may be necessary.

According to WHO head, Dr Tedros A. Gebreyesus, the virus would infect many more people if governments do not start to implement the right policies. His message remains, “Test, trace, isolate and quarantine.”

In addition, the following are highly recommended: Disciplined hand washing, use of face covers or masks, social or physical distancing, staying at home if sick or isolating the sick, getting tested if in contact with a sick person, and of course, praying.

Recently, a group of 239 scientists from 32 countries around the world provided practical advice to WHO on how to avoid coronavirus transmission, because of its airborne nature. These include: Provision of sufficient and effective ventilation – that is, supplying of clean outdoor air and minimising recirculating air – particularly in public building, workplace environments, hospitals and age care homes; supplementing of general ventilation with airborne infection control such as local exhaust, high efficiency air filtration and germicidal UV lights placed up in ceiling to avoid damage to people’s eyes and skin; avoiding overcrowding, particularly in public transport and public building; and when in a vehicle, opening windows and making sure the air conditioning or heat is not recirculated but set to include outside air.

Such measures are practical and often can be easily implemented; many are not costly”, they wrote.

Some Nigerian scientists and researchers have come up with claims that they have developed drugs which can cure COVID-19. In your view, what should the federal government do about these people and their claims?

NAFDAC should have a guideline in place for evaluating antiviral therapies. Hopefully, NAFDAC or NIPRD has the facilities and expertise to handle antiviral screening projects. All these claimants should be received with open hands and have their products subjected to at least, preliminary antiviral screening.

An herbal medicine practitioner, Dr Paul Ojeih of Iris Medical Foundation, has recently claimed that he has a drug that can cure COVID-19. Don’t you think the government should evaluate his claim by asking NAFDAC to carry out checks on the efficacy or otherwise of the drug called Venedi Elixir?

New antiviral therapies are urgently needed to fight the spread of this coronavirus infection, despite safety concerns. According to Dr Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases (NIAID), USA, there is “no guarantee for safe and effective vaccines against COVID-19 anytime soon.”

The cost of buying some of the touted  remedies, such as Remedesivir, the first drug shown to be  effective against the coronavirus, is about  $2340  US dollars (about a million naira ) for a patient requiring the shortest treatment course; and  $4290  US dollars (about  2 million naira ) for a longer treatment course.

The prohibitive costs of such imported anti-COVID drugs should make any local drug like Dr  Paul Ojeih’s Venedi Elixir attractive and a great candidate for antiviral screening. My belief is that Nigeria has the expertise locally in antiviral studies. NAFDAC, NIPRD, as well as other research institutes and universities should take up the challenge of screening and verifying the antiviral claims. The new viral study centre   in Ebonyi State should be checked out.

The need for a local antiviral remedy is so dire that, in the worst case scenario, antiviral screening services should be sought outside Nigeria. NAFDAC, on its part, should exert flexible administrative regulations while maintaining standards.

Pharmanews recently celebrated 41 years of uninterrupted monthly publication since 1979. What impression does this feat give you, especially about the publisher, his leadership orientation and potentials for the future?

Pharmanews continues to break new grounds in health reportage and has established an enviable reputation in the healthcare sector and in the pharmaceutical industry. The leadership of Pharmanews with Pharm. Sir Ifeanyi Atueyi at the helm of affairs has ensured that West Africa’s biggest online health news portal attracts thousands of global visitors, especially healthcare professionals, on daily basis – hence a reflection of his doggedness, and unflinching commitment to pharmacy journalism.

This feat also speaks volume of the quality of staff and leadership at Pharmanews. Only a hardworking, strong, exceptional and truly committed team could maintain such an enviable record. It has been a great “family” affair.

The future, though very bright, will depend on how Sir Atueyi plans the line of succession. May God Almighty grant Sir Atueyi the wisdom to appoint a worthy successor.