Olumide Akintayo, the immediate past President of
Pharmaceutical Society of Nigeria (PSN) recently, delivered the 2017 Marquis
Annual Memorial Lecture at the Faculty of Pharmacy, Obafemi Awolowo University,
Ile-Ife, entitled, “Leadership and Excellence In Pharmacy Practice.” In this
interview with CHIOMA UMEHA, he reviews pharmacy profession in Nigeria and
advocates reforms that would engender effective leadership and excellent
pharmacy practice. Excerpts:
Can you take a holistic look at the state of pharmacy
practice in Nigeria; how would you rate it?
To declare that pharmacy practice in Nigeria sometimes
thrives in an atmosphere of confusion is an understatement. Prevarications and
vacillations have become the unenviable cross of the Nigerian Pharmacist. An
evaluation of the various sectors of our practice reveals that it is still not
uhuru.
In academic pharmacy, you are witnesses to the unending
tales of woes that have manifested in lack of teaching aids and research grants
for the academic pharmacist. The dearth of chemicals, well-equipped
laboratories absence of conducive teaching environment characterise the
darkness, which has of late enveloped this important sector of the practice.
Even when hospital and administrative pharmacists have
enjoyed pay increases like other health personnel, all is still not well in
relative terms because the era of discriminatory salary wages in the health
sector ensures that a young medical graduate earns more money than a senior
pharmacist who is a top officer in the public sector making the professional
life frustrating.
Industrial Pharmacy is not to be spared of the rotten basket
of fruits because sharp practices in the manufacture and sales of drugs have
destroyed have destroyed a sector which used to be buoyant.
General or Community Pharmacy Practice which embraces drug
distribution from the manufacturer to the consumer is ravaged to a great extent
by the fake drug syndrome.
It is indeed sad and worrisome that a profession which
should be a celebration of excellence sometimes does not live up to this
billing. However, pharmacists still maintain their potentials despite all odds.
What key
reforms do you think could revolutionisethe sector, including the practice
settings in Pharmacy?
Pharmacy practice has its peculiarities as a profession with
substantial commercial plenitude. This makes it prone to ubiquitous exploiters
both within and outside the profession. This lingered for many years before we
challenged the status-quo. At a time, narcissism was the order of generations
of colleagues who found themselves at the hierarchy of the profession in the
public sector to the detriment of others.
I will prescribe key reforms in the practice areas
including, Community, Hospital and Administrative, Academic as well as
Industrial Pharmacy.
Mention challenges facing community pharmacy in the country
and reforms you expect in this area?
Perhaps the most fundamental of the problems in contemporary
community pharmacy practice in Nigeria is the insanity that pervades drug
distribution in Nigeria.
The ‘Frankenstein Monster,’ called unregistered or illegal
premises remains the most challenging affliction of practitioners and by
extension the citizenry, yet it is often ignored. It all started in the Second
Republic when entrepreneurs motivated by purely profit motives invaded pharmacy
in the import licence era. This invasion marked the advent of sales and
manufacturing of spurious and fake drugs. The leadership of the Pharmaceutical
Society of Nigeria of that era protested this unpalatable situation. Government
had also shown its concern by placing drug matters on the Exclusive list for
legislation and responded by promulgating Decree 21 of 1988 as amended by
Decree 17 of 1989. This Decree has since metamorphosed to Act 25 of 1999. Specifically,
Section 2 of Act 25 of 1999 is aimed at ameliorating the problems of illegal
drug sales points which remain the crux of the matter in drug distribution.
Listed in this category are drug markets, kiosks, buses, ferries, train etc.
Section 6 of this same law vests the legal authority to deal with this retinue
of illegal sales points on the Federal Task Forces and its allies in the 36
States. After29 years the first set of laws on illegal sales points and the
establishment of task forces were put in place; it is a matter of historical
importance to document that they have not succeeded.
This is manifest by the birth of new breed drug markets in
all Nigerian cities today despite that we had only those in Lagos, Onitsha, Aba
and Kano at the advent of the Task Forces in 1988.
The Olusegun Obasanjo Presidency set up a Presidential
Committee on reforms in the drug distribution sector. One salient
recommendation of the Committee was the decision to prescribe the concept of
Mega wholesaling in drug distribution.
Further experiment with the concept after consultations with
major stakeholders has today given birth to recommendation for Coordinated
Wholesale Centres (CWCs) in four major cities – Lagos, Onitsha, Aba and Kano.
It is noteworthy to say that these cities hosted prominent drug markets at
Idumota in Lagos, Head Bridge in Onitsha, Ariaria in Aba and Sabongeri in Kano.
This chain of events is meant to pave way for the sealing of drug markets in
Nigeria.
We must follow this to a logical conclusion in the interest
of consumers of medicine in Nigeria and most importantly send the right signal
to the global community that we do not endorse a Nigerian style of pharmacy
practice.
The priorities must be to open the space, particularly to
allow Academic Pharmacists who teach upcoming pharmacists to develop an ethical
context and dimension in Community Pharmacy Practice.
The proposed ‘Satellite Pharmacy Concept’ approved in 2014
by the Annual General Meeting of the PSN would energiseindustrial, hospital and
academic pharmacists to polish their skills in retail of medicines and provide
the required counseling component.
What about Hospital and Administrative Pharmacy.
We have had some positive movement in streamlining the
career stratum of our hospital pharmacists in the last few years.
First, is in the area of the obnoxious Teaching Hospital Act
which was first promulgated in 1985concerning the status for our colleagues in
Federal Health Institutions.
The Federal Ministry of Health has been forced through
unorthodox methods to issue circulars authorising promotion of pharmacists and
others to CONHESS 15 as directors.
In 2015, the first Director of Pharmacy emerged in a
teaching hospital in Nigeria at the University College Hospital (UCH) Ibadan.
At the last count, over 20 pharmacists have now emerged as
directors of pharmacy in the 55 Federal Health Institutions (FHIs) in Nigeria.
We must continueto pursue with vigourour determined bid for
consultancy status.
Hospital and Administrative Pharmacists can put an end to
lingering retrogression with regards to the consultancy status by leveraging on
the residency training circular issued by the Federal Ministry of Health in
July 2015.
Today, approval has been given at the Federal Medical
Centre, Owo, for resident pharmacists to have access to training facilities by
the Minister for Health, Prof. Isaac Adewole.
It is logical to think that the residency training remains
the precursor of the consultancy cadre itself and therefore would speed up
agitations for the consultancy grade.
We must clamour for adequate reward for labour through an
equitable CONHESS – CONMESS Salary ratio which factors the new Pharm. D
curriculum recently approved by the NUC.
I specially appeal to all Faculties of Pharmacy to bear in mind
that we can only run our races in tandem with the realities of the operating
environment. From the political, intellectual, social and financial
perspectives, a six-year Pharm. D programme structured as a home grown
initiative is what will best serve the pharmaceutical interest in contemporary
nation building.
What is your assessment of Academic Pharmacy?
Our academic pharmacists are not rewarded for clinical
services because the templates for these provisions are informal.
Academics in Pharmacy must work with the PSN leadership to
work out the recognition of the Fellowship of the WAPCP in the academic wall as
we have seen in same healthcare callings. Once this is worked out, we can begin
to network with the universities and other regulators to fast-track Masters
Degrees and Ph.D status for holders of the Fellowship of the WAPCP.
The added impetus this arrangement guarantees is that we can
begin to breed a new generation of academic pharmacists who are grounded in
post-graduate professional and academic qualifications. I foresee benefit-
packages which would celebrate true excellence in our practice on account of
this arrangement.
Can you take a look at Industrial Pharmacy?
The Pharmaceutical Industry is still largely at infant level
in Nigeria. It is obvious that our operations are still at the stage of
tertiary manufacturing because we import everything from equipment to packaging
materials, APIs and excipients.
Investments in Research and Development are unavailable and
the poor financial base of the manufacturing entities makes growth and
development of the industry a herculean task. To trigger an industrial
revolution in Nigeria, we must actualise the existence of petrochemical plants
where a plethora of chemical needs can be synthesised.
The inherent advantage with this is that we can become an
Africa’s hub for finished drug product, APIs, excipents and chemical needs of
other nations.
At a time we need to diversify the economic base of Nigeria,
this is certainly imperative as it compels a positive rise of the Gross
Domestic Product of the nation.
Still in the search for excellence, the PSN leadership
should mobilise working agreements between the faculties of Pharmacy (Drug
Research and Production Units), National Institute for Pharmaceutical Research
and Development (NIPRD) and Pharmaceutical Manufacturers Group of Manufacturers
Association of Nigeria (PMG-MAN) which is the umbrella template of
pharmaceutical manufacturers in Nigeria.
