Tuesday, 22 December 2015

Infant HIV Infections, Deaths Threaten Disease Elimination

Experts have warned that the increase in diseases and deaths associated with  HIV infections among infants has virtually eroded most of the previous gains towards elimination of Mother-To-Child Transmission (MTCT)  in Nigeria.

The warnings came during a just concluded two-day meeting at Bayview Hotel, Enugu, which assessed individual and collective efforts towards eMTCT of HIV with emphasis on communications through the mass media. The meeting was organised by members of Journalist Alliance for Prevention of Mother-To-Child Transmission of HIV in Nigeria(JAPiN) with support from United Nations Children Fund(UNICEF). 

A communiqué signed by Sola Ogundipe, National Coordinator, JAPiN said: “An undisputed observations show that the morbidity and mortality associated with pediatrics HIV infection has virtually eroded most of the previous gains towards elimination of MTCT in Nigeria.”

More worrisome is the fact that not less than 60,000 new infections are recorded among children in the country yearly, a situation that has called for aggressive PMTCT intervention, the communiqué said.

According to the communiqué, observations from the various JAPiN zones and states also showed that the progress made in PMTCT towards eMTCT have been grossly inadequate.

Other observations are: “Nigeria has been left behind in efforts to mitigate the burden of HIV and AIDS through PMTCT because of poor aggregation and coordination of efforts,” the communiqué said.

Members of Journalists Alliance for Prevention of Mother-To-Child Transmission of
HIV in Nigeria (JAPiN) at the just concluded meeting in Enugu.

JAPiN further noted that there is significant decline in funding of PMTCT activities and other HIV interventions by international donors in Nigeria.

The group also stated that the huge gap in advocacy due to poor coordination is hurting efforts to redress MTCT situation in Nigeria.

The communiqué added: “JAPiN observes huge communication gap in PMTCT efforts towards eMTCT in Nigeria due to poor cooperation from frontline managers of HIV and AIDS in Nigeria.

“Man-made barriers to efforts of Nigerian journalists (JAPiN members) as communicators/advocates for PMTCT and eMTCT, adding; “Members have been faced with harsh receptions from government agencies, in which case NACA and some SACAs have been found culpable,” it said.

“Poor documentation of cases has beclouded the true situation of MTCT in Nigeria and efforts to prevent and eliminate it. Nigeria still slow at graduating to B+ Option for PMTCT,” the communiqué said.

The group therefore recommended that PMTCT interventions in Nigeria should be guided by the new UNAIDS target of 90:90:90, which is to ensure that 90 per cent of the global population is tested for HIV, 90 per cent of those who test positive have access to treatment and for 90 per cent to be virally suppressed.

Since HIV is not a stand-alone goal under SDGs, JAPiN said; “There is the need to sustain its visibility by prioritising interventions towards meeting related goals and targets, using the broader Maternal Newborn and Child Health (MNCH) scheme.”

It also said that there is need to document milestones, gaps, lessons and prospects towards eMTCT using the mass media as first line approach.

Others are the need to remove bottle-necks to PMTCT coverage by the media; ensure closer relationships between managers of HIV and AIDS control agencies at the national, state and local government levels.

The communiqué insisted that it is important to create strategic local funding initiatives and sound monitoring mechanism for transparency.


This story was published in Newswatch Times on December 17, 2015.

Reconstitute Pharmacists Council of Nigeria – Yakasai tells Minister

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:

Introduction

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.

Policy implementation

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.

NACA takes HIV counseling, testing to Lagos communities

The National Agency for the Control of AIDS (NACA) has commenced a four-day free medical screening programme consisting of HIV Counseling and Testing (HCT), test for diabetes, hypertension and malaria as well as deworming for children in Shomolu Local Government Area of Lagos State.

Over 5,000 residents of Shomolu are expected to benefit from this four-day free medical care programme slated to run from Monday, December 14 till today at strategic locations within the Shomolu Local Government Area.

Speaking at the flag-off of the programme at Olaleye Market, Shomolu, the Principal Programme Officer of NACA, Mrs. Ronke Adeoye noted that the HCT outreach campaign is geared towards making residents to know their HIV status through counseling testing and help achieve the 2030 goal of zero new infection, zero discrimination against people living with HIV as well as zero AIDS related death.

L-R Acting Cheif Executive Officer, Lagos State AIDS Control Agency, Dr Olusegun Ogboye;
Commissioner for Health, Dr Jide Idris; and Executive Secretary, Somolu Local Government,
Mr. Biodun Orekoye during the flag-off of a four-day Free Medical Care & HIV Counselling
and Testing Programme Organised by the National Agency for the Control of AIDS
 in Lagos on Monday.
Said she , “this programme is organized by NACA and MDG; the whole essence is to get people tested and to know their HIV/AIDS status. We found out that people will not ordinarily go to the clinic for testing, so we thought it wise that it is better to bring the testing to their doorstep; as a result of this, we have sensitized the people and the community to come out for testing”.

Adeoye stated that residents will also be opportuned to do blood pressure test, blood sugar test and malaria test in addition to HIV counseling and testing adding that children will also have the opportunity to be dewormed while people also have access to free medications.

“This outreach is very important because as a nation, we want to get to zero level by 2030; which means that by 2030 we want to have zero new infection, zero discrimination against people living with HIV as well as zero AIDS related deaths”, the programme officer said.

She expressed optimism that the 2030 target is possible if only people can come out and know their status stressing that the only way this can be done is through counseling and testing.

“This is why we have brought the HIV counseling and testing to their door-step in the community where the people reside to help them in the quest to get counseled and tested; it is our belief that if we do this, we will actually get to our target by 2030”, Adeoye said.

She noted that most important prevention against HIV/AIDS is for people to abstain from risky behaviours and use protection like condoms. She added that prevention-of-mother-to-child transmission of HIV is possible, stressing that pregnant women who are HIV-positive can actually give birth to HIV- negative children.

“This outreach is actually going on in other states and the Federal Capital Territory including 12 states that are HIV- positive endemic states; the essence is to make people come out to get tested; that is why we are taking the campaign to them”.

“We do not want a situation where people will be down with the sickness before they go to the hospital; we want to forestall this scenario by bringing the service to their door-step and this is why we are using market spaces and bus-stops where people can easily access HCT services”, Adeoye noted.

Earlier, the State Commissioner for Health, Dr. Jide Idris, noted that HIV burden has gone down nationally, but stressed that the state government is still working assiduously to improve access to HCT activities.

Said he, “as a responsible government, it is our duty to ensure that we prevent our people from contacting HIV/AIDS and that is why we have started this programme with our national body; NACA, so that everybody will understand what HIV/AIDS is all about, how it is spread and how we can prevent ourselves from contacting it”.

The Commissioner noted however, there are behaviours that one can adopt to prevent HIV infection like the practice safe sex by abstaining, if not married; sticking to one faithful, uninfected partner if married and using condom appropriately if you must have casual sex.

He listed other preventive behaviours to include avoiding the use of unsterilized skin-piercing instruments, ensuring that only screened blood are transfused or received and infected mothers should seek advice before getting pregnant so that all steps will be taken to ensure that the baby is not infected.

Idris enjoined every pregnant woman to make sure that they undertake the test so that the health workers can help her protect the unborn baby from HIV infection noting that all government hospitals offers HIV counseling and testing services and some selected Primary Health Centres.


This story was published in Newswatch Times on December 17, 2015.

FrieslandCampina WAMCO closes with 13 awards

FrieslandCampina WAMCO, one of the   foremost dairy companies, garnered 13 awards in 2015 ranging from ‘Most Improved’ and ‘Most Respected’ to one of the ‘Best Three Tax Compliant Companies in Nigeria’ awards recipient. FrieslandCampina WAMCO emerged, “Most Improved Company in CSR” at the 2015 SERAs – Social Enterprise Report and Awards – in recognition of its remarkable corporate social responsibility strides, especially with its Dairy Development Programme (DDP).

Mr. Rahul Colaco, Managing Director/CEO, FrieslandCampina WAMCO Nigeria Plc 
The Dairy Development Programme that earned FrieslandCampina WAMCO the “Most Improved Company in CSR 2015” award enables dairy farmers to run their businesses optimally and bring dairy production to higher volumes and quality. To facilitate this programme, FrieslandCampina WAMCO setup four milk collection centres (MCCs) in Fasola, Alaga, Maya and Iseyin as well as a milk bulking centre (MBC) in Iseyin, Oyo State.

BusinessDay Media Ltd, publishers of BusinessDay daily newspapers, also gave FrieslandCampina WAMCO an award as one of Nigeria’s Top 100 Most Respected Companies in 2015.

For unfailing compliance in tax remittances, FrieslandCampina WAMCO received a Chartered Institute of Taxation, Nigeria (CITN) Merit Award in the Corporate – Private Sector category as one of the best three tax compliant companies in Nigeria.   FrieslandCampina WAMCO’s 2015 awards include the LCCI Commerce and Industry Award, NECA/NSTIF Ambulance Award, Iconic Brand of the Year (Peak) Award from Marketing World Magazine, Nutrition Society of Nigeria Award of Excellence, and Sales Excellence Award for Distribution by the Institute of Certified Sales Professionals.

Others are the University of Ibadan (Food Technology) Social Responsibility Award, NASD-OTC Securities Award of Excellence & Special Recognition, Brand Africa 100 Best Brands Award, the Manufacturers Association of Nigeria’s Total Compliance Award and the Gold Winner TVC Award (Peak) by the Association of Advertising Agencies of Nigeria (AAAN).

For over 60 years, FrieslandCampina WAMCO has deliberately positioned itself as a provider of branded high quality dairy nutrition throughout Nigeria and West Africa. With a clear strategy of providing affordable nutrition through a range of low unit portion packs (LUPP) of its premium brands – Peak and Three Crowns evaporated and powdered milk – consumers can access quality dairy with as low as 10 naira.



This story was published in Newswatch Times on December 17, 2015.

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