Dr (Mrs) Angela Ogo Kanu, a Nigerian pharmacist with over three decades of practice in the United States of America, has urged the federal government to fund more research in natural products as a means of tackling the global pandemic of coronavirus.
Speaking in an exclusive interview with Pharmanews, Kanu, who is the founder/managing director of Healthy Therapy Management LLC, based in the US, also critically examined issues bordering on regulation of community pharmacies and relevant training for pharmacists, especially in this COVID-19 era.
Below is the full text of the interview:
Tell us a little about your early life and educational background.
I was born in Arochukwu in Abia State, where my parents lived at the time, on 27 March, 1959. My late father was the vice principal of the only secondary school in the town, Aggrey Memorial College.
When I was about six years old, my family moved to Lagos. My father took a lecturing appointment at University of Lagos. I started school at Our Lady of Apostles Primary School, Yaba. Shortly after, because of the civil war, we relocated to Nsukka, where my father took a lecturing appointment at University of Nigeria and I continued my primary school.
Soon after, at the outset of the civil war in 1967, my family moved to Arochukwu and moved again back to Nsukka in 1970, when the war ended. I completed my primary education in 1972 at the University Primary School, as the Head Girl. I attended Cornelia Connelly College (CCC), Uyo (now in Akwa-Ibom State) for my secondary education from 1972 to 1976.
I gained admission to study Pharmacy at the University of Nigeria, Nsukka in 1976. There, I earned my bachelor’s degree in Pharmacy in 1981, master’s degree in Pharmacy in 1984 and Ph.D in Pharmacognosy in 1987.
Why and when did you relocate to the USA?
Most of my childhood and adolescent years were spent at Nsukka, where my family lived.
As an adult, after my master’s degree programme, I got a lecturing appointment in the department of Pharmacognosy, while studying for my Ph.D. I also had the privilege of working in a general hospital and a catholic hospital during my internship and National Youth Service Corps, respectively.
When a job opportunity became available in Canada in 1987, I was very willing to seize the opportunity to broaden my horizon. I felt that diversifying my knowledge-base would put me in a stronger position to impact any aspect of the profession I chose. I practised Pharmacy in Canada from 1988 to 1990, when I moved to the USA as a result of my marriage.
Healthcare delivery in Nigeria has always been of interest to me. Anytime I travelled out of Nigeria as a young adult and had the opportunity to witness a different style or standard of healthcare practice, I always desired to use any acquired knowledge to benefit patients in Nigeria. I came to the US with that mindset.
I have lived and practised Pharmacy in the US for 30 years, while married and raising three sons. I am still very committed to contributing to the wellbeing of patients in Nigeria. I am affiliated to professional groups devoted to ways that will benefit the Nigerian healthcare system.
Harvesting from greener pastures to benefit the less-privileged remains my desire. I have co-led two medical missions back to Nigeria and have contributed to many other similar medical missions.
How can Nigeria harness herbal remedies for therapeutic purposes, especially in this COVID-19 period?
I have always maintained that the continent of Africa (particularly Nigeria as a country) is endowed with many medicinal plants and natural products. I have no doubt in my mind that what nature embedded in that part of the world has not yet been fully harnessed.
To elucidate the active medicinal compounds surrounding us, significant attention needs to be paid to research and development. While I am not currently on any team researching the constituents of Garcinia kola or other medicinal products for activities against Coronavirus, I recommend that Nigeria, like most other countries, encourage an enabling work environment. This will be a step in the right direction both for the current pandemic and for the future.
How would you compare pharmacy regulations in Nigeria with that of the US?
Laws and regulations that guide pharmacy practice in the US are usually well-defined and the consequences for non-compliance are clearly spelt out. The individuals charged with upholding these rules and regulations are never left in doubt of the expectations.
Accountability is usually key. Mechanisms are put in place at numerous points for checks and balances, to facilitate compliance. I have not practised in Nigeria in a long time. So without specifically discussing the issues in the Nigeria setting, I can share my knowledge on what I think works in the US.
All practitioners are held to the same standards. The boards of pharmacy are firm and consistent with oversight. Annual renewal of licences/registrations are denied or suspended, in cases of violations. Licences/registrations are revoked if the offence warrants revocation. Frequent inventory and records of controlled substances are taken and maintained. Legend drugs are dispensed by prescription only.
Is there provision for patent medicine dealers in the US?
I am not aware of a provision for patent medicine dealers in the US. As stated earlier, laws governing the dispensing and sale of medications are usually clearly defined. The roles of pharmacy cashiers, technicians, interns, staff pharmacists, pharmacy managers etc. are often explicit.
It is uncommon for healthcare providers at this level, to fight each other. Groups know the scope of their practice and abide by the laws. Non-pharmacy outlets that sell medications may only sell non-prescription, over the counter (OTC) items, like common analgesics. Non pharmacy facilities that dispense medications only do so upon approval and registration from the board of pharmacy. No pharmacy may be open or operate without a licensed/registered pharmacist on the premises.
How can community pharmacists improve their practice?
The community pharmacist is strategically placed in every corner of the society. They are the “go to” people for most patients’ medication needs and drug information. Pharmacists will be better served to stay up-to-date on accurate drug information. All pharmacists should acquire training in medication therapy management, comprehensive medication review and reconciliation of patients’ profiles.
Therapeutic intervention programmes by pharmacists should be offered to patients when indicated. These services will attract and retain patients/customers, while serving a most critical need. A satisfied customer is a return customer. Customer service therefore cannot be overemphasised in community practice.
A strong control of inventory is also a key item in growing gross margin. A good system of inventory ordering and replenishment will ease smooth operations. Frequent reconciliation of inventory will consistently maintain checks and balances and portray transparency.
In what specific ways can community pharmacists contribute in curbing COVID-19?
As healthcare providers, we have to lead by example. Luckily, safety standard recommendations are quite public and worldwide. They include: Wearing masks, social distancing, hand washing with soap and running water, as well as using hand sanitizers with the right concentration of alcohol.
Also, where possible, pharmacies/pharmacists should engage in testing and contact tracing.
Are there aspects of practice that Nigerian pharmacists can emulate from their American counterparts?
Year after year in the US, pharmacists are voted one of the most trusted professionals. There is a reason for that. I would like to see practice by Nigerian pharmacists modelled more towards service-based than product-based approach. Such compassionate care, if adopted, will go a long way.
The patient is the core factor binding the various groups of healthcare providers and interest groups. Optimum attention ought to be paid to patients’ therapy management and outcomes.