Meningitis: Liberalise Importation Of Essential Medicines, Vaccines – PSN

By Chioma Umeha

Following the outbreak of Cerebrospinal Meningitis (CSM) which is spreading like wildfire across the country, experts have said that collaboration is critical to ensure available and affordable safe as well as effective medicines and vaccines to tackle the menace.

Stating this on Monday were pharmacists who spoke under the platform of Pharmaceutical Society of Nigeria (PSN) who regretted that the persistent fatalities from outbreak of Meningitis is a preventable one.

Specifically, PSN blamed the recurring epidemics in the country to improper medicine management and protocols especially in the area of immunisation.

According to them, a well-structured and lawfully constituted regulatory agencies involved in drug distribution would address the improper medicine management and protocols especially in the area of immunisation.

The agencies which are critical in the drug distribution network, PSN said are mainly, National Agency for Food and Drug Administration and Control (NAFDAC) and Pharmacists Council of Nigeria (PCN).

Pharm. Ahmed Yakasai, the President of PSN, in a release said that pharmacists as medicine experts have a professional responsibility to ensure the wellness of Nigerians and assure consumers of medicines that “we shall not shirk in our responsibility in this regard.”

Yakasai said: “Our observation is that the avoidable fatalities in the vicious cycle of meningitis fatality over the years are fallouts of wretched medicine management and protocols especially in the area of immunisation.

Globally, pharmacists as medicine experts are trained to handle advice and deal with all categories of medicines and biological preparations.

“Given the scenario of a well-structured and lawfully constituted regulatory agencies involved in drug distribution especially NAFDAC and PCN, the PSN submits that a more robust collaboration of efforts would ensure the availability, affordability of safe and efficacious medicines and vaccines in our nation to redress the anxiety and concerns the perennial meningitis epidemics continues to inflict on our stressed health system.”

Proposing a viable ameliorating balm experientially, the PSN called on the Federal Government to adopt routine immunisation as the panacea to the tragedy meningitis continues to epitomise in our borders.

“Since the 80s a lot of countries have adopted immunisation against haemophilus influenza Type B in their routine childhood vaccination protocols. This practically facilitates the elimination of this pathogen in such countries.

“The current epidemic is traceable to the more deadly and often times resistant Type C variety, so logically the way forward is to introduce the vaccine for meningococcus group C as it has proved clinically effective to substantially decrease this pathogen. Quadrivalent vaccines which combine four vaccines with the exception of B specie now exists with some countries even placing premium on evidence of vaccination with them as entry requirement into their country.”

Yakasai explained that the approach for prevention and control of meningococcal epidemics based on early detection followed by massive vaccination of the vulnerable population with vaccines though has shown some effectiveness especially in young people, it is still perceived as a model for product development partnership in resource limited settings. “This is the norm in Nigeria and most African nations,” he said.

“Moving forward as a fortified health system, Nigeria must change its approach to the totality of immunisation procedures by opening its borders of restrictions to permit Community Pharmacists to conduct routine immunisation against all killer childhood diseases in public interest,” the PSN said.

The PSN President observed that the resort to emergency import of vaccines every year we record epidemics is certainly not good enough, as it remains a panic measure at best.

“Government must liberalise the importation of essential medicines and vaccines which the local pharmaceutical industry has not shown proven capacity to produce. Perhaps once again the PSN must appeal to the Federal Government to follow the dictates and spirit of the PSN position paper on the implementation of the recent 20 percent Import Adjustment Tax (IAT).

“A 20 percent IAT on medicines and vaccines which are life saving only exposes consumers of medicines to avoidable death sentence. Our resolve as responsible health providers who embrace a connectivity of empathy seriously forbids jostling along this less than noble route.

“The Pharmaceutical Society of Nigeria apart from canvassing routine immunisation by community pharmacists and other competent health workers wishes to advise the public to keep faith with the reflected tips to prevent meningitis: ‘Eat only properly and well-cooked meals. Meat, fish and poultry products must be cooked at high temperature to eliminate bacteria. A balanced diet, adequate rest and sleep in addition to moderate exercise will ultimately help to maintain a strong immune system while multivitamin supplements with doses of Vitamin A, C, E and D are helpful in maintaining good health as well as reduce the chances of inflammation around the brain and spinal cord.’”

The PSN also recommended hand washing after exposure to dirt or toilets remains essential. Those who harbour or play with pets need to maintain high sanitary conditions. It also said that health workers who manage meningitis patients might consider wearing face masks to protect themselves especially if their patients are coughing or sneezing while environmental sanitation is germane to maintain germ free enclave.

The Nigerian Government has confirmed the death of over 336 people in the latest meningitis outbreak in the country.

In a statement issued on Tuesday, the Federal Government said it has also activated an Emergency Operations Centre to manage the epidemic.

The government further said that a total of $1.1 billion was needed to tackle the outbreak of Cerebrospinal Meningitis in five states of the north.

The disclosure came as the Senate President, Dr Bukola Saraki, said the Senate under his leadership, was prepared to accord government all necessary support towards tackling the disease headlong.

The amount, according to Dr Emmanuel Odu, Acting Director-General,National Primary Health Care Development Agency, NPHCDA, is needed to vaccinate an estimated 22 million people in the affected states of Zamfara, Sokoto, Kebbi, Katsina and Niger, which has resulted in the death of 336 people so far.

“As of April 3, 2017, a total of 2,997 cases with 336 deaths have been reported with 146 of cases being laboratory confirmed,” Lawal Bakare, a spokesman for NCDC said.

According to the Dr. Chikezie Ihekweazu, the Chief Executive Officer of the National Centre for Disease Control (NCDC), the most affected were Zamfara, Sokoto, Katsina and Niger states. Other states affected are Kebbi, Nassarawa, Jigawa, FCT, Gombe, Taraba, Yobe, Kano, Osun, Cross Rivers, Lagos and Plateau.

Neighbouring countries within the African Meningitis Belt that are having similar experience are Niger, Chad, Cameroun, Togo, and Burkina Faso.

Records have it that the worst CSM epidemics in the country occurred in 1996 when it claimed 11,717 lives out of 109,580 cases. And in 2003 it claimed 401 lives from the 4,130 cases reported. In 2008, it was 562 deaths out of 9,086 cases and in 2009, 9086 cases were reported out of which 562 lost their lives.

The Federal Ministry of Health source said the current the epidemic is different from the previous ones caused by Neisseria Meningitides Type ‘A’.

It said the current one is Neisseria Meningitides Type C and in epidemic proportion for the first time.