Drug Abuse: Pharmacists Should Lead In Drug Management To End Menace – ACPN

Chioma Umeha

Lagos – In view of superior knowledge of drug composition and manifestation in the human body, pharmacists are demanding to be leaders in the handling of drugs and related decisions to end drug menace in the country.

Speaking under the auspices of Association of Community Pharmacists of Nigeria (ACPN), the pharmacists called for clearly defined boundaries of operations for Patent medicine vendors (PMVs) and other members of the healthcare delivery system such that pharmacists would act as their heads.

Their demands came following a recent summit during which ACPN deliberated on a number of issues about the body, resolving that the role and rightful place of each health team player should be conceded to them and respected for the benefit of the general public.

In the resolutions of the summit signed by Samuel Adekola, National Chairman, and Bose Idowu, National Secretary of the body respectively therefore counselled that access to drugs should be restricted and supervised by community pharmacists in every establishment.

It also resolved that drugs should be taken off the streets and the efforts towards advocating the prevention of drug abuse and misuse to the public via information, education and communication (IEC) channels intensified.

The body also advocated that the National Drug Distribution Guidelines (NDDG) should be prioritised through political will to guarantee the interest of the Nigerian populace on the long run.

They further called for measures to be put in place to hasten the citing and structural development of coordinated wholesale centres in the priority locations to safeguard the health of Nigerians.

ACPN also demanded a speedy assent to the Pharmacy Act which authorises the establishment of Satellite Pharmacies and the support of pharmacy education in public interest.

The resolution read; “Summit clamoured for clearly defined boundaries of operations for PMVS and other members of the healthcare delivery system in the handling of drugs such that, the Pharmacist leads drug related decisions due to superior training and knowledge of drug composition and manifestation in the human body.

“The role and rightful place of each health team player should be conceded to them and respected for the benefit of the general public.

“Summit therefore counseled that access to drugs should be restricted and supervised by Community Pharmacists in every establishment. Drugs should be taken off the streets.

“Summit declared that the National Drug Distribution Guidelines (NDDG) should be prioritised through political will based on the perspective that it serves the interest of the Nigerian populace on the long run. Measures should be put in place to hasten the citing and structural development of Coordinated Wholesale Centres(CWCs) in the priority locations to safeguard the health of Nigerians.

“Summit called for a speedy assent of the Pharmacy Act which authorises the establishment of Satellite Pharmacies and the support of Pharmacy education in public interest.”

Speaking on the resolutions, Samuel Adekola, the National Chairman of ACPN, felt that there should be a concerted effort to improve the infrastructural amenities in the rural areas to motivate  community pharmacies to be cited in rural settings.

Following a critical appraisal of the NHIS, Adekola said the body strongly recommended fees for services rendered by all providers to be paid directly by HMOs and the health insurance made compulsory as soon as all existing lapses are addressed.

He said the PCN should insist that only registered Pharmacies are to be involved in the scheme while fees for services should be unbundled and kept by the HMOs.

This is just as he said that Pharmacists’ seal on prescriptions should be made compulsory to attract payment of all services. In addition, he said that the NHIS should review drug prices annually in consultation with the ACPN.

The National Chairman then encouraged ACPN leadership to continue to work with NAFDAC to ensure smooth enforcement of regulatory standards in CPs and institute a workable regime of registering orphan and service drugs using the instrumentality of NAPAMS.

While appreciating the modest strides of NAFDAC, he called for a review of some of the conditions attached to the MAS initiative and other cutting edge technologies. He suggested the setting up of joint consultation teams from NAFDAC, MAS service providers and ACPN to redress existing challenges and promote collaboration.

Adekola charged the ACPN leadership to further evaluate regulations backing up the setting up the Satellite Pharmacies so as to make the Satellite Pharmacy concept a fruitful venture.

He noted that the Pharmacist and his knowledge are valuable. Therefore CPs must justify the confidence of the consuming public as it oversees the totality of medicine management and make referrals when necessary.

He explained that tenets of the incumbent Pharmacy Bill which states that Community Pharmacists should supervise the activities of 20 PPMVs should be implemented to legally authenticate the operation of PPMVs and facilitate their operation as Pharmacists’ assistants in ensuring the delivery of safe and high quality drugs.

Also commenting on the resolutions, Bose Idowu, National Secretary, said that mapping of pharmacies should be completed through fund allocation by the FMoH, for effective distribution of pharmacies and ultimately, the welfare of the populace.

Idowu admonished the ACPN to liaise with all development partners with interest in drug distribution in Nigeria to engage pharmacists as the primary reference points and access other players in the drug supply chain only based on the pharmacist’s supervision as it is obtained in other countries.

She also insisted that representatives of donor agencies in Nigeria must be made to pledge their support to the new operational framework. The ACPN must reinforce the philosophy by adopting Desk Officers to work with PCN, NAFDAC and NDLEA.

The National Secretary demanded minimum benchmarks for proper labeling initiatives in the Pharmaceutical Sector with regards to manufacturers and importers who must ensure that their products bear classification as OTC (Over the Counter) or POM (Prescription only medicines) which would ease regulation of PPMVs who are licensed to carry only OTCS and result in the protection of the patient.

She said engagement in proper labeling of medicines dispensed from community pharmacy premises such that the patient has very clear instructions about the dose and frequency of medications on a pre-printed label which will also bear the name of the dispensing community pharmacy.

The summit subsequently mandated the ACPN NEC to ensure immediate commencement of labeling initiative in CPs.

The summit also acknowledged the Federal Ministry of Health (FMoH) had resumed work on the abandoned project of instituting a NPP, a 2013 initiative of the PSN. This had resulted from the unhealthy rivalry among healthcare professionals. The motive to ensure controlled and regulated access to medicines which would reduce the ravaging menace of drug abuse and misuse in Nigeria must always be the guiding light of this endeavour.

Idowu solicited that the constituted National Committee for the NPP should include the national chairmen of ACPN and AGPMPN to facilitate private sector participation and compliance.

She strongly supported and commended the Trans – generational Community Pharmacy Investment agenda of the current leadership of ACPN and agreed that one strategic move to achieve the lofty vision of the association was by creating structures with supporting systems for collaborations among CPs that will eventually crystallise to group practice models among the practitioners – a one critical panacea for sustainability.

The summit adopted in line with FIP/WHO policies the expanded roles for community pharmacists, some of which include point of care testing, non-routine immunization services, non-invasive family planning services, health information and promotions, primary prevention of non-communicable diseases such as cardiovascular disease and diabetes.

It directed the ACPN leadership to foster fresh partnerships with PCN and NAFDAC due to the effect of the inadequacies in the monitoring and control procedures in Nigeria on ACPN members.

The Summit said the ACPN must partner with PCN and NAFDAC to boost ethically driven inspectorate activities. This will involve a request for joint inspectorate teams from these agencies to redress our challenges in practice.

They specifically requested that the work of the Federal and State Task Forces on Counterfeit and fake drugs must be facilitated. The efforts with PCN and NAFDAC to actualise the NDDG target goals and objectives must be reactivated. In particular, the ACPN must encourage the PCN to take advantage of the manning levels approved for its new Enforcement Department by the Head of Service of the Federation (HOSOF), in a bid for coordinated and effective monitoring and control.

They believed that these efforts, if well managed, would improve the lot of the community pharmacy which in turn would rub off on better quality service to Nigerian consumers of healthcare.