Wednesday, 18 March 2020

COVID-19: Increase Funding In Drug Research, PSN President Urges Govts

Following Coronavirus, COVID-19 pandemic and the fact that sizeable proportion of the drugs used in Nigeria come from China and India, and the difficulty in trading with these countries, Mazi Sam Ohuabunwa, President, Pharmaceutical Society of Nigeria (PSN) has urged the Nigerian governments to see the imperative of investing heavily in research and production of local drugs. She spoke with our source on the deadly disease ravaging countries of the world. Excerpts:
 Are we well prepared to contain the menace of Coronanvirus now threatening humanity including Nigeria? Will you say we are much better prepared with regards to the case of Ebola virus?

I believe that the level of preparedness should have been better than it is now. The saving grace that we have is that we have had an experience in managing crisis like this, which is the Ebola crisis. That has given us residual experience, but beyond that we ought to have done a lot better. I believe that when the first signs came, when the first news broke, I expected that efforts should have been made especially with acquiring medical equipment that would have been used for managing the illness.
We were certain that if such an epidemic had opened the world that Nigeria was going to be part of it, given our level of interaction with China. In fact, given our involvement with global trade and the fact that Nigerians travel all over the world our level of preparedness should have been better.
We need to be more proactive than we have been but I think that the Ebola and some of the residual incidences have been helpful here.

What is your reaction to the FG’s clamping down of some pharmacy outlets, accusing them of hiking prices of hand sanitisers and all that?

It doesn’t make sense; we are not a country with controlled price regime. It is a free market and there is a natural market response to scarcity, you can’t dictate it. When there is a high demand for any product the price would change. It is standard; not only would it change from the retail point, it would also change from the source, the producers, manufacturers and even distributors.

So it is not the right thing to do to pursue people and all that. We are not in a price controlled regime. Of course, as pharmacists we have already advised our colleagues to do the utmost they can to ensure that they do not profiteer from the misery and problem we are facing in the country. The much we can do is moral persuasion. We cannot legislate it because the response to demand everywhere in the world is that prices change when the demand changes. So using consumer protection agency is very primitive in this circumstance; you might even cause more problems.
Suppose the guys don’t even bring it to sell at all because they are afraid you are going to come and hold them. We shouldn’t add salt to injury. I think the issue is about increasing availability of the product and this is why I said part of our preparation was lackluster.
We ought to have anticipated this. In America, they have everything on ground; they didn’t wait for the issue to arise before buying the masks and gloves.
So government ought to have anticipated this. The pharmaceutical companies are primes right now as I speak to you based on advice to increase production of these things but some of them don’t happen overnight. What is worse is that the sizeable proportion of the materials we need come from China and the counry has become a difficult place to trade and that has complicated the issue a little bit.
What role should the pharmaceutical companies play in providing some sort of moral support?

I think that is the role all the professional pharmacists should play. They should appreciate the fact that there are some of the closest neighbours, first line of touch to many people who need medical help and advice in many climes, not just in Nigeria. Therefore they take that responsibility seriously. So one of the first advice we issued when I became president was that no patient should be coming to your pharmacy without getting an opportunity to interact with you. You shouldn’t sell a medicine because someone asked for it. You must find out why the person needs the medicine and know if it is OTC medicine. Even for OTC medicine, doctors may not prescribe the medicine but you must talk to your pharmacist for every medicine, whether it is ethical or OTC; you need the counseling for each one of them.

We have also asked them to get flyers that people can take away so that they can be educated, even if what they came for didn’t have to do with any infections at all. It is part of the primary duties, because that pharmacist is the first line especially in primary health care.
There are serious concerns globally about finding a cure for Coronavirus. Here in Nigeria, Prof. Umaru who is a virologist and head of the BIO Resources Centre, claims that he has found a cure for it and I saw a picture showing his meeting with the Minister of State for Health, the Minister of Science and Technology and some other federal officials. Is the PSN involved in this process of finding a cure?

First, with due respect, research is slow in our country and it is an expensive thing to do. Nigeria governments have not come to the full realisation of the need to invest in research in our country.
How do I know? I have served on the board of several types of research in Nigeria including the National Institution of Research and Development. 

If you walk into that place, you will be sorry for the institution because the walls are broken, not to talk of equipment or funding. It is a shame. Go to our universities; there is not enough in research and development and so we have to depend on the rest of the world; what a shame! But having said that, there are a few pharmaceutical companies with due respect and modesty, mine included, doing research and development.

NEIMETH was the first pharmaceutical company to come up with a local remedy for sickle cell anaemia which is one of the neglected diseases of the black man. And in this other area we are in, Professor Maurice Iwu who is in the board of NEIMETH Pharmaceuticals right from when he was in the universities and after we have related to him because he is a research guy and even when he was in the United States we have tried to develop some of his work to bring them to market. 
So we are working with him on these other areas and we are asking that the government should show more interest because investment in research is a long term. And what does it take, first is that for every product that comes to the market, you have spent about 500 million dollars to get a product to the market; 10 others have failed after you spent so much money on them.

The reason is that, first you have to go through several trials, Phase 1 and Phase 2 etc. The moment you realise that the product is effective you then have to prove its effectiveness. You then have to prove it effectively. If it is very effective and unsafe then you can’t use. There must be a balance where the effectiveness of overrides safety. So you do Phase 1 to Phase 4, starting from lower animals like rats and cats and then you move to a human being. When you get to human being you do trials, controlled clinical trials, no matter how good the medication is.

The product can be useful on day one but on day 50 it could cause you problem. You will have to allow the product a number of days to see its shorter and longer medium toxicity. Even when a product is in the market, there is what we call post long surveillance pharmaceutical vigilance. You are still monitoring the efficacy and side effects because some of them show up at chronic injection, not at acute injection and that is why National Agency for Food and Drug Administration and Control (NAFDAC) and those agencies set up surveillance for these things.

Many of world, ingredients came from China. Now India is saying they may not be able to serve more export, what does that portend for Nigeria?

Well, it is a wake-up call for us. I just wish that Nigeria will just listen and take a cue. In this country where there is a lot of flora and fauna that have pharmaceutical uses; indeed what they bring out of China exists here. It a matter of processing them and put them in a manner that they can be marketed.

We have the potential to build up a formidable pharmaceutical subsector, building from areas of competence and areas of endowment that is manufacture medicines from things that are available in our clime. We don’t need to go to China, but the point is that pharmaceutical companies need to go to the bank to borrow money at double-digit. 
Then you invest it in ten years or five years of research and the research is not bringing in money; it may even fail. So part of the reason why our companies with due modesty haven’t done as well as others are that we are investing in research. You take short term money and put in long term investment, it doesn’t work like that.

So every once in a while you feel like you are burning your fingers. The sustainability of every pharmaceutical anywhere in the world is innovation, research and development. So, I think that our Nigeria should take a decision now because there will be another virus. I don’t know the name and I am not prophesying. 
Why don’t we start preparing now, get the pharmaceuticals and give them a mandate, get the teaching hospitals, industries and give them a mandate so that by the time the next illness breaks we would have got some level of preparedness of what medications to use?

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