– As WAPCP inducts 126 Fellows
With the continued heavy dependence of Nigeria on importation for its drug needs, experts and other stakeholders in the health sector have identified commitment to research as a way out of the quagmire, stressing that such a commitment will not only salvage the country from the risks of excessive importation but will ensure medicine security in the entire West African region.
This was one of the submissions made at the 34th Annual General Meeting and Scientific Symposium of the West African Postgraduate College of Pharmacists (WAPCP) held in Lagos from 16 to 18 May, with the theme, “Medicine Security in the West Africa Region: Matters Arising”.
In his presentation, the Minister of Health, Dr Osagie Emmanuel Ehanire explained that medicine security refers to measures put in place to ensure that quality, safe and efficacious medicines are produced by facilities that meet the right standards and that the integrity of such medicines is not compromised during distribution along the supply chain from the manufacturers down to the consumers. He added that medicine security will ensure that every clinic, health worker and patient has a reliable and equitable access to the medicines and supplies they need to achieve good health.
Ehanire, who was represented by the Director, Food and Drug Services Department, Federal Ministry of Health, Mrs Bunmi Aribeana, pointed out that the emergence of COVID-19 in December 2019 and the subsequent declaration of a pandemic in March 2020 exposed the reliance of most African countries on importation of their medicines. He stated that over 70 percent of the prescribed medications in Nigeria are produced from APIs primarily sourced from firms in China and India.
“More than ever before, it is time to reverse the country’s overdependence on imported medicines. Importation makes the country prone to fake and counterfeit drugs, chaotic drug supply and distribution of drugs, with the resultant effects of increased morbidity, treatment failures, drug resistance and death,” the minister pointed out.
The minister specifically pointed out that absence of quality research in Nigeria and other West African countries was behind the region’s overdependence on importation of essential medicines. He therefore harped on the need to concentrate more effort on research so as to attain drug security.
According to him, “The lack of basic research and development as well as insufficient capacity in pharmaceutical analysis and bio-analytical techniques in the academia and the industry is responsible for Nigeria’s huge dependence on importation. The pandemic has demonstrated that unless our nation is able to determine how to manufacture and distribute its own medicines, we cannot achieve medicine security.”
Restating the commitment of the Federal Government towards ensuring medicine security in country, Ehanire said: “Let me therefore use this medium to charge the WAPCP to live up to expectations and include in its curriculum courses geared towards ensuring the equipping of pharmacists to fill the gap in local production of active pharmaceutical ingredients. We must all collectively change this narrative by making Nigeria self-sufficient in the production of finished Pharmaceuticals and APIs.”
Also speaking at the event, the Governor of Lagos State, Mr Babajide Sanwo-Olu, who was represented by the Chairman, Lagos State Health Commission, Dr Atinuke Onayiga, emphasise the criticality of drug security in the nation, stressing that more efforts should be committed to drug research and development.
The governor said, “One vital thing that is still not enough, if not lacking, in our society is quality research and development. We seem to be running away from research as if it belongs to the white men, whereas, it belongs to all of us. Let us go into research. All the professionals in the health sector need to work together so that we can have a robust health sector. Funding is important and Lagos State is ever ready to provide funding to those who are willing to go into research.”
Chairman of the Nigerian Chapter of WAPCP, Pharm. (Dr) Margaret Obono, had earlier stated that the college chose the theme in consideration of what countries in the region went through at the peak of the COVID-19 pandemic, when all countries that were exporting drugs closed their borders and did not sell drugs to countries in the region for some months. A development, she said, made Nigeria and other countries in Africa to experience scarcity of essential medicines.
In her remarks, President of the college, Distinguished Professor Cecilia Igwilo, lamented that the West African region was becoming a dumping ground for all manner of pharmaceutical products, adding that drug importation had sorrowfully gifted the region with problems of substandard and falsified medicines.
Igwilo noted that the huge dependence on importation which had negatively impacted local drug production was responsible the lack of basic development, including insufficient capacity in pharmaceutical analysis and bio-analytical techniques, in academia and the industry at large.
She added that excessive importation was also responsible for the inadequate training in Current Good Manufacturing Practices (CGMPs) and non-existence of active pharmaceutical ingredients (APIs) or excipients manufacturing facilities in the region. She maintained that a lasting solution was urgently needed to tackle the challenge.
In the same vein, President of the Nigeria Academy of Pharmacy (NAPharm.), who is also a former Minister of Health, Prince Julius Adelusi-Adeluyi, stated that the West African region can indeed achieve medicine security if all stakeholders in the health sector support one another and work together.
Adelusi-Adeluyi who was the event’s father-of-the-day, said: “I want to urge the WAPCP to improve quantitatively and qualitatively across the entire West African region. There are 16 countries in West Africa. I have moved around and found out that we are the same; we can help one another, if we form a team, supporting one another.”
The Chairman of the occasion, Dr (Mrs) Dere Awosika, who is the current Chairman of Access Bank PLC, wondered why Nigeria should fret over medicine insecurity if a country such as the U.S. that is bigger than Nigeria can achieve medicine security.
She said the West African region can achieve medicine security once there is cooperation. She therefore called on all stakeholders in the West African pharmaceutical sector to work together, saying one person cannot score a goal but a team can score goals.
The President, Pharmaceutical Society of Nigeria, Professor Cyril Usifoh, in his welcome address warned that the West African region has made itself very vulnerable by its reliance on importation of pharmaceutical and medical devices. “Posterity will hold us accountable if we do not at this time come up with a practical solution”, Usifoh said.
Presenting the keynote address, Pharm. (Dr) Okey Akpa said the argument for medicine security hinges on the need for countries or regions to have reasonable control and access to medicines at all times, stressing that medicine security is critical to the survival of any country or region.
Akpa, who is the managing director of SKG Pharma Limited, as well as president of West African Pharmaceutical Manufacturers Association (WAPMA), pointed out that medicine security is aimed at achieving self-sufficiency in critical supplies of essential medicines.
He said supply of medicines to West Africa is largely dependent on importation, noting that, on the average, only 30 percent of medicines supply in West Africa is from local production, while 70 percent of the supply is imported.
“An import dependency level of 70 percent in the West African region is a real danger to the population of the region. This calls for action, and urgent action for that matter, not just rhetoric,” Akpa said.
The SKG Pharma boss explained that there are three options for achieving medicine security which are importation, donation and local production, stressing that local production, is the most attractive and most reliable of the options. He however added that local production is the most challenging in providing medicines that are effective, safe, affordable and of good quality.
“The question often asked is can Africa make its medicines? My answer is yes, Africa and West Africa for that matter, can and has demonstrated that it can make its medicines – at least, the essential ones – to the level that will guarantee security of her population with adequate cover of essential medicine, if the right things are done”, he said.
Akpa also pointed out the need for purposeful research to attain medicine security, saying one of the biggest challenges hindering local medicine production and consequently medicine security in the West African region is dearth of research.
In his words: “There is Research and Development (R&D) gap. The industry cannot grow without R&D to back it up. In this regard, such agencies as the Nigerian Institute for Pharmaceutical Research and Development (NIPRD) and the Centre for Plant Medicine Research Ghana must be adequately supported. Only two R&D institutions are grossly inadequate for the region. More pharmaceutical and vaccine R&D institutions need to be established to focus on different aspects of drug medicines and vaccines research and development. The various faculties of pharmacy and pharmaceutical sciences in the universities also need to be supported to contribute to Research and Development.”
Akpa further said that, aside from research and development, other challenges facing local drug production include government policies, access to market, regulatory challenges, poor return on investment, limited availability or lack of skilled manpower, medicine distribution channel challenges, overdependence on imports for production inputs, weak healthcare system, poor infrastructure, lack of finance, high cost of finance, and lack of government incentives.
He emphasised the need to grow the number of pharmaceutical manufacturers in the region and also grow the industry in overall capacity, scope of production, quality standards and capacity to meet growing demands, in terms of therapeutic areas. He also harped on the need for political will and commitment from the government within the region.
Citing India, Brazil China, Malaysia Indonesia, and Bangladesh as examples, Akpa stated that their current status of medicine sufficiency is driven by political will.
“Medicine security drives health security; health security drives economic security, economic security drives national security. In this sense, medicines must be treated as one of the key components of the regions (and countries)’ security architecture”, he said.
The WAPCP also used the occasion to induct 126 Fellows into its fold, following their success in the 2021 part two Fellowship exam of the college. The new inducted fellows cut across all the specialised areas in the five faculties of the college, namely Clinical Pharmacy, Community Pharmacy, Drug Production & Quality Assurance, Public Health Pharmacy and Social & Administrative Pharmacy.