Ahmed Yakasai is the new President of Pharmaceutical Society of Nigeria (PSN). In a briefing with some select journalists, recently in Lagos, Yakasai urged the Minister of Health, Prof. Isaac Folorunso Adewole, to facilitate the immediate reconstitution of the Pharmacists Council of Nigeria and appoint at least one pharmacist on each of the Boards of Federal Health Institutions.
The new PSN President said this appeal was part of the highpoints of his presentations to the Minister of Health, during his recent courtesy visit to the Minister’s office. Other issues in his presentations to the Minister were requests for the National Health Act implementation, urgent intervention in critical sector areas like the ECOWAS Common External Tariff (CET), and so on to save the Nigerian pharmaceutical industry.
Yakasai whose formal inauguration as the President of PSN comes February 2016 in Abuja, insists that the Minister should address all pertinent, emerging and contemporary issues critical to healthcare delivery. CHIOMA UMEHA (HEALTH EDITOR) has the excerpts:
Pharmaceutical Society of Nigeria was founded in 1927 and registered under section 21 of the 1922 Companies Act. It is an umbrella body of all the registered pharmacists in Nigeria with a vision to be recognized as a society whose members are accessible healthcare professionals responsible for the provision and rational use of safe, effective and affordable medicines, pharmaceutical care and the promotion of public health and quality of life.
Our stand on some contemporary issues especially as it relates to health care delivery covers the following areas: Drug Distribution Guidelines and Related Matters; Implementation of the National Health Act 2013; Reconstitution of the Pharmacists Council of Nigeria(PCN) and Boards of Teaching/Specialist Hospitals; Continued Instability in the Health Sector; Impact of ECOWAS Common Tariff (CET); Policy Implementation and welfare of workers in Nigeria.
Drug distribution guidelines and related matters
PSN commend the efforts of the Federal Ministry of Health in initiating a Drug Distribution Guideline for the country. Presently, the Federal Ministry of Health through recommendations from the PSN, Pharma stakeholders and the regulatory forum has approved a new drug distribution flow chart for the country.
The new drug distribution flow chart has a slight amendment from the original National Drug Distribution Guidelines which limited choices of prospective wholesalers to State Drug Distribution Centres and Mega Drug Distribution Centres. The concept of Coordinated Wholesale Centres which is now an extra to the wholesalers offers a major opportunity to close down open drug markets in our country once and for all.
The PSN, PCN, NAFDAC and FMOH have worked maximally on this project and we strongly urge the Ministry of Health to sustain this spirit in the current dispensation.
Implementation of the National Health Act 2014
We reiterate our commendations to all those who made it possible for the country to have its first National Health law.
It is important to put on record that the National Health Act is probably the only statute that attracted the attention of a wide spectrum of stakeholders in health and the larger society. There is therefore an urgent need to factor in this broad spectrum solidarity in fashioning the implementation of the National Health Act.
The immediate past dispensation of the Federal Ministry of Health was reported by a section of the media as having sworn in a new Technical Review Committee (TRC) for the National Health Act (NH Act 2014).
The Committee which was said to be “cautiously selected to guarantee representation of the key institutions has a mandate to guide the implementation of the National Health Act.”
Naturally, the PSN accepts the principle of setting up Committees which is also within the powers of the Federal Ministry of Health.
As a follow up to the Technical Review Committee on the National Health Act 2014, a series of other implementation templates of the National Health Act have emerged without representation being sought from PSN and some other professional Associations and Unions in the health sector. We are worried that the members of the 26-man Technical Review Committee and other related committees are unknown to the larger portion of key stakeholders.
Reconstitution of the Pharmacists Council of Nigeria and Boards of teaching/specialist hospitals
We do not wish to bore you with all the tragedies associated with the constitution and operations of the PCN in a particular dispensation, specifically between 2009 and 2011.
In the short time we have had to run without a governing council, we have tried very hard to sustain the ideals of pharmacy practice in Nigeria. Fundamentally, disciplinary matters and accreditation of pharmacy facilities for training suffers in the absence of Council. We urge you to facilitate the immediate reconstitution of the Pharmacists Council of Nigeria.
In the same vein, it is pertinent we inform you about the lopsidedness of appointments on the Board of Teaching and Specialists Hospitals as well as Federal Medical Centres. In the last dispensation pharmacists were represented on only five of the well over 55 Boards of these Federal Health Institutions. Our experience confirms that this lopsided appointment format affects healthcare plans and ultimately overall output. We therefore reiterate our previous appeal that at least one pharmacist be appointed on each of the Boards of our Federal Health Institutions.
Instability in health sector
For a comprehensive, coordinated, safe health system that is responsive to the needs of the population, efficient use of resources, increased job satisfaction, with reduced stress of health professionals, we need collaborative practice based on trust and mutual respect among the health care team.
Internationally, the World Health Professions Alliance (WHPA) is a body which unites the International Pharmaceutical Federation, World Medical Association, International Council of Nurses, World Dental Federation and World Confederation for Physical Therapy for collaborative practice. There is therefore the need to have a Nigerian replica of WHPA and work harmoniously as a team. It is possible.
Some pressing challenges in the health sector which have lingered for so long compel a dire need to appeal to the Minister to urgently look into the problems.
The issue of Federal Medical Centre (FMC) Owerri
For over three months, health professionals and workers, members of our associations and unions at the FMC, Owerri, were on strike, practically closing down the hospital for the entire period, subjecting patients and members of the public to untold hardship. It is hoped that the Fact Finding Committee that was constituted on this challenge would carry out her assignment expeditiously.
Non-employment of graduates of pharmacy
Non-employment of graduates of pharmacy into the Federal tertiary hospitals as intern pharmacists or as registered pharmacists even Federal Health Institutions in the catchment areas where pharmacy graduates were trained does not employ them.
The attitude of management in some of the Federal Health Institutions is a major let down. Often times the Drug Revolving Funds are decapitated because the funds are diverted to other endeavours which is a violation of the Drug Revolving Funds manuals and guidelines in the enabling statute.
PSN deems it necessary to inform you on the viability of well managed Drug Revolving Funds in public health institutions.
The issue of commercialization or privatization of health facilities which cannot be in tandem with global best practice which is different from a public private partnership (PPP) concept.
However, there is also need for health system audit and general overhaul for efficiency, therefore some services like catering, security, mortuary services and general maintenance can be totally privatised.
Impact of ECOWAS Common External Tariff (CET)
The Implementation of ECOWAS CET which allows finished Pharmaceutical products to be imported at zero percentage duty is a good gesture and same should be extended to raw and packaging materials which now attract a duty percentage ranging from five per cent to 20 per cent. This simply means that locally manufactured pharmaceutical products have become uncompetitive. The fall out is an imminent closure of all Nigerian Pharmaceutical plants. Also, many pharmaceutical manufacturers are running out of raw materials due to lack of response from banks on the letter of credit requests and is likely that many will close shop in the next two months. We urge you to intervene on this critical issue.
The Nigeria Drug Policy provides that 70 per cent of government purchase should be sourced from local manufacturers. I think the time has come for this policy to be implemented at all levels of government. It will boost internal capacity utilization and make local manufacturing more attractive. With the opportunity of new government and new way of doing things and from your character and characteristics, I have no doubt in my mind that you will provide a strategic direction, develop and implement policies that will see the Pharmaceutical sector become globally attractive and competitive
Welfare of health workers in Nigeria
There is need for implementation of the spirit of the existing circular on promotion of our members from CONHESS 14 to 15 as directors which places premium on the need to sanction defaulting hospital managements.
Specific steps must be taken by the Head of Service of the Federation to ensure the expedited issuance of an enabling circular authorizing consultancy cadre for health professionals that have adhered to due process, to be vested with consultancy status as a prelude to inculcating this cadre into the schemes of service of these health professionals.
This must be worked out with the Federal Ministry of Health in line with the spirit of the circular on consultancy and specialist allowances Ref. SMH.491/S.2/VOL II.221 of March 29, 1976, which authorizes consultancy status for all health professionals, and the condition precedent of the National Industrial Court of Nigeria (NICN) that provides for a nod of the Federal Ministry of Health for the appointment of consultants.
Payment of arrears of specialist allowances to qualified hospital based health professionals with effect from January 1, 2010, should be ensured. So also, we request for payment of arrears of the skipping of CONHESS 10 which remains outstanding the same period.
We further request the release of the circular on adjustment of salary since January 2014 and immediate payment of at least two months arrears, while the balance is accommodated with proven evidence in the 2016 budget.
We further demand sponsorship of an amendment bill to correct the anomalies in Decree10 of 1985 (CAP U15 463) LFN 2004, especially in the following areas: Lopsided composition of the Board of management; appointment of chief executive officers (CEOs) of federal health institutions; appointment of Chairman Medical Advisory Committee (C-MAC); Appointment of Deputy Chairman Medical Advisory Committee (C-MAC); Training of health professionals; Removal of the borders of restriction on permanent staff of federal health institutions; National Health Insurance Scheme (NHIS)
In the spirit of the broad spectrum of reforms, there is no reason why for six years now the NHIS encourages unlawful payment mechanisms dubbed global capitation, while HMOs also capitates secondary and tertiary facilities which completely disrupts the equilibrium of the health system.
We demand that the Federal Government direct the board and management of the NHIS to immediately adopt lawful payment mechanism to wit, capitation for primary providers and fee for service for secondary and tertiary providers.
Government must also redress the capitation modes by embracing international global best practices on what constitutes a primary facility for capitation in Nigeria.
This story was published in Newswatch Times on December 17, 2015.