Antimicrobial resistance is one of the most pressing public health challenges of our time, with inappropriate use of antibiotics continuing to fuel the emergence of drug-resistant infections. According to Dr George Orisile, a UK-trained pharmacist and PhD researcher specialising in antimicrobial stewardship, reversing the trend will require more than professional awareness; it will demand stronger regulation, better governance and stricter enforcement of existing standards. In this interview with Temitope Obayendo, he examines the systemic issues affecting antimicrobial stewardship in Nigeria, the importance of robust pharmaceutical governance and the opportunities for responsible healthcare investment. Excerpts:
As a pharmacist and researcher specialising in antimicrobial stewardship, how has your academic work shaped your approach to healthcare systems in Nigeria?
My PhD research has made me look beyond individual practice and focus more on the systems that shape professional practice. In Nigeria, many healthcare professionals understand what good practice should look like, but they often operate within weak enforcement systems, fragmented supply chains, patient pressure and commercial realities.
My approach has therefore become more systems-focused. I see antimicrobial stewardship not simply as telling pharmacists not to dispense antibiotics without appropriate checks, but as creating an environment where professional practice, regulation, public education and access to medicines work together.
Your work combines regulation, supply chain integrity and investment. Why do you believe governance should be the starting point rather than an afterthought in Nigeria’s pharmaceutical sector?
Because in healthcare, demand is rarely the problem. Nigeria has a large population, high demand for medicines and enormous market potential. The real issue is governance.
Without sound governance, investment can quickly become risky. You may have products, capital and customers, but if regulation, documentation, quality assurance and accountability are weak, the entire business model becomes vulnerable.
For me, governance is not merely paperwork. It is the foundation that protects patients, safeguards investors and preserves the long-term credibility of the pharmaceutical sector.
Through AGORIS Consulting Nigeria, you focus on building regulated pharmaceutical importation and distribution platforms. What are the most critical compliance risks investors often underestimate when entering this space?
Many investors focus on sales projections and profit margins but underestimate regulatory exposure.
The major risks include product registration requirements, NAFDAC compliance, sourcing from properly audited Good Manufacturing Practice (GMP)-certified manufacturers, documentation gaps, cold-chain or storage failures, labelling issues, import permits, pharmacovigilance obligations and traceability throughout the distribution chain. This is where AGORIS Consulting Nigeria intends to make its greatest impact.
Another common misconception is the assumption that because a product is available abroad, it can simply be imported and sold in Nigeria. Healthcare products must be treated differently from ordinary consumer goods.
Antimicrobial resistance remains a growing global concern. Based on your research, what are the key drivers of inappropriate antimicrobial use in community pharmacy settings in low- and middle-income countries?
From my research and broader professional experience, the drivers are both social and structural.
Patients often seek quick relief and may request antibiotics based on previous experience, advice from family members or what worked for them in the past. Cost is also a major factor, particularly where people avoid hospital consultations because of affordability or access barriers.
At the practice level, pharmacists may face commercial pressure, competition from informal medicine vendors, weak enforcement of prescription regulations and limited integration into national antimicrobial stewardship programmes.
Inappropriate antibiotic use is therefore not simply a knowledge problem. It is also driven by access, affordability, public behaviour, regulation and market forces.
How can stronger regulatory enforcement and professional practice standards realistically improve antimicrobial stewardship at the retail pharmacy level in Nigeria?
Stronger enforcement can establish clearer boundaries around acceptable professional practice. When regulations are applied consistently, pharmacists are better supported in declining inappropriate requests for antibiotics.
However, enforcement alone is insufficient. It must be complemented by practical professional standards, public education, better referral pathways and greater recognition of community pharmacists as integral members of the wider antimicrobial stewardship system.
Retail pharmacies are often the first point of contact for many patients. With the right support, they can become important centres for patient education, early triage, responsible medicine use and appropriate referral.
You work closely with UK and diaspora investors. What distinguishes a well-structured, sustainable healthcare investment from a speculative one in emerging markets such as Nigeria?
A sustainable healthcare investment is built on compliance, patient safety, quality assurance, sound operations and long-term value.
A speculative investment, on the other hand, is driven primarily by market size, quick returns and assumptions about demand.
Nigeria presents enormous opportunities, but healthcare investments must be properly structured. Investors need clear regulatory pathways, audited suppliers, sound governance structures, accountable management, financial discipline and business models that address genuine healthcare needs. The best healthcare investments are not only profitable but also trusted.
Nigeria’s pharmaceutical supply chain has long faced challenges relating to quality assurance and distribution inefficiencies. What structural reforms do you believe are most urgent to restore trust and system integrity?
The most urgent reforms include stronger quality assurance, improved product traceability, better regulation of distribution channels and stricter control of the informal medicine market.
Nigeria also needs stronger collaboration among regulators, manufacturers, importers, wholesalers, pharmacists and healthcare institutions. Digital tracking systems, more robust inspections, stricter enforcement of storage standards and transparent licensing processes would all help restore confidence.
Ultimately, the public must be assured that the medicines they purchase are genuine, safe, effective and properly handled throughout the supply chain, from manufacturer to patient.
Looking ahead, what role do you see pharmacist-led enterprises like AGORIS playing in strengthening healthcare systems and improving access to safe, high-quality medicines?
Pharmacist-led enterprises can bridge the gap between commercial investment and professional healthcare responsibility.
AGORIS Consulting Nigeria is built on that principle: developing pharmaceutical business models that are investment-ready and regulation-ready, patient-centred and quality-driven.
I believe pharmacists should not only work within healthcare systems but should also help design better systems and contribute to national policy frameworks centred on patient safety.
Enterprises such as AGORIS Consulting Nigeria can support safer access to medicines, responsible importation, stronger distribution governance, greater investor confidence and improved public health outcomes.
For me, the future of pharmacy in Nigeria must extend beyond dispensing medicines in retail pharmacies. It should encompass leadership in healthcare systems, regulation, investment and medicine safety.
