Thursday, 4 July 2019

Lagos PSN Tells Sanwo-Olu To Reorganise State Healthcare Programme

Chioma Umeha

The Pharmaceutical Society of Nigeria (PSN), Lagos State Branch, has called on Babajide Sanwo-Olu, the governor-elect, to expand the frontiers of health operations to build a virile and productive system that would become a national benchmark in the running of healthcare programmes in the country.
The call was contained in a congratulatory letter Pharm. Adeniran Bolanle, Chairman, and Pharm. Babayemi Oyekunlye, Secretary, of the Lagos PSN sent to the governor-elect over his victory at the just concluded governorship poll in the state.
The duo while alleging that the current managed healthcare programme is ‘haphazard and unduly skewed’ against some prime stakeholders in the state specifically urged the governor-elect to reorganise it.
This, they contended, would guarantee an impactful health insurance programme with commensurate coverage and growth rate.
They further claimed that the challenges of the NHIS are linked to a poor implementation mode and alerted the new governor to avoid replication of the same problem in the implementation of the scheme in the State.
“It is a worrisome commentary to put on record that coverage of the National Health Insurance Scheme (NHIS) at national level since inception in 2006 remains an abysmally woeful less than 2.0 percent (1.72 per cent based on the declaration of the last Executive Secretary of the Scheme). The woes of the NHIS are holistically traceable to a poor implementation mode through and through,” they said.
PSN therefore called on the new governor to urgently open hitherto restricted borders of restriction in benefit packages available to health care providers in terms of privileges and resources. 
They stressed; “The welfare of all health professionals must be grounded on equity, fair play and justice to all concerned. Our Lagos cannot continue to walk on the path of greatness if only a personage as epitomised by dominating the policy direction of the state Ministry of Health in 20 straight years. We at the Pharmaceutical Society of Nigeria (Lagos State Branch) continue to assure Your Excellency of our determination to work with you and in this direction, we declare very boldly that we have a pack of broad spectrum members who can help move your administration to the next level which is the greater Lagos we dream of,” they added.
Other measures they put forward to the governor-elect to build capacity in the march towards the greater Lagos initiative include the establishment of a Faculty of Pharmacy at the Lagos State University (LASU), Ojo, as part of their aspiration and reviving of the dwindling fortunes of the Drug Revolving Fund project as a major tool to ensure availability of drugs in public hospital pharmacies in Lagos State.
“The Pharmaceutical Society of Nigeria (Lagos State Branch) will commit itself to offering advice to the Lagos State Government at no cost on how to achieve zero funding for these projects which only requires sound cost recovery mechanism as bedrock.
“Finally, Your Excellency, we wish to inform you that we are praying for you. You will succeed where others stuttered and you will make manifest the mega city initiative on which Lagos State is inclined. Under your watch, Lagos State as an entity will become Africa’s leading light in the comity of similar entities.
“Please, be assured of the guarantees of our commitment to collaborate with your envisaged dynamic administration always,” the pharmacists said.
They added, “Your victory was obviously a product of hard work, good planning and dedicated track record of service to the people of Lagos State.
“The Pharmaceutical Society of Nigeria (Lagos State Branch) is particularly thrilled that in perfect alignment with your undiluted character of simplicity and humility you have already opened the window of opportunities to all Lagosians including your critical stakeholders like the various professional bodies.”

Tuberculosis: PSN Tasks FG On Community Pharmacists In DOT Programme Implementation

Chioma Umeha

To end tuberculosis, TB, epidemic by 2030 the Pharmaceutical Society of Nigeria (PSN) has urged the federal government to take the advantage of the availability of community Pharmacies from every part of the country to fully implement the Directly Observed Therapy (DOT) programme.
Pharm Mazi Sam Ohuabunwa, the PSN President, made the call in a statement to mark this year’s World Tuberculosis Day at the weekend while commenting on its theme, ‘It’s time to end TB.’
Ohuabunwa pledged that the society would ensure that Nigerians with the disease are provided proper care with simplified medication that would guarantee compliance.
He reasoned that if ending TB Epidemic by 2030 is one of the health targets of the sustainable development goals, “Then prevention, diagnosis and early treatment with first-line TB drugs should be given all the seriousness it requires.”
The PSN President specifically promised that the pharmaceutical body would support the achievement of a TB-free world through one of its technical group, the Association of Community Pharmacists, which is poised to take up the DOT (Directly Observed Therapy) programme and ensure proper pharmaceutical care for patients of TB since chemotherapy remains the main cure.
This includes ensuring proper counselling on the TB regimen and lessening the burden on patients who may need to travel miles to refill a prescription for the long duration of treatment which may be up to six months.
The PSN boss noted that TB incidence is falling globally at about two per cent per year, though multi-drug resistant tuberculosis (MDR –  TB) remains a public health crisis and a global health security threat.
“TB is one of the most killer diseases infecting both young and old. Up to one million children were affected in 2017 and 230, 000 deaths recorded.
In 2017, 10 million people were infected with the diseases and about 1.6 million died from the disease. It is a leading killer of those living with HIV.
The World Health Organisation(WHO) estimates that there were 558,000 new cases with resistance to Rifampicin –  the most effective first-line drug.
According to WHO, about 54 million lives were saved through TB diagnosis and treatment between 2000 and 2017.
Ohubuanwa observed that TB resistance stems from ignorance, poverty and corruption; chemotherapy remains the main cure for TB, adding,  non-compliance to the adequate regimen and duration may lead to resistance to the first line TB drug such as Rifampicin and Isoniazid.
He further said, the second line TB drugs are expensive and have undesirable and debilitating side effects.
However, he assures Nigerians that pharmacist would help in simplifying their TB medications to ensure compliance and total cure.
Stressing on the commitment of the society, Ohuabunwa said; “As the world marks World Tuberculosis (TB) Day on March 24, 2019, with the theme “It’s time to end TB”, the Pharmaceutical Society of Nigeria re-enacts her commitment towards a TB free world.”
Expressing optimism, he noted; “The world can end TB faster than 2030 if all members of the Health care team and our community do their part. PSN says it is possible to end TB before 2030.”

Sterling Bank Partners Foundation, Others On Digital Health Summit

Chioma Umeha

Sterling Bank Plc, one of the leading commercial bank, has said it is collaborating with Premier Medical Systems (PMS) and PharmAccess Foundation to host a digital health summit aimed at transforming Nigeria’s health care sector for better service delivery.
Speaking at a press conference in Lagos recently, Mr. Abubakar Suleiman, Chief Executive Officer (CEO), Sterling Bank, noted that although thousands of people are making individual efforts to lift Nigeria’s health care sector, such efforts are not enough to take the industry to the next level.
He said, “Our approach is to use our influence and resources to bring all collaborators in the sector together to brainstorm on the way forward through a sustainable collaboration that is digital based.”
Abubakar said, “Our operations are based on three pillars. We have an agile mind, we have a digital platform and we also have specialist skills. We are bringing the specialist skills we have to the health care sector using the digital platform. So we will find the parties that can make it digital.
“We cannot use traditional methods to catch up. We want to use the technology that is now available to leapfrog the sector. If we are to solve the problems in the health care sector in Nigeria, the solution cannot be provided by doctors, nurses, pharmacists, hospital administrators or even partners that are providing financial support.
“It can only happen when these parties come together and work out the issues. We want to be known for bringing people together to find the solution,” Abubakar said.
The CEO also noted that stakeholders in the health care sector cannot find a solution to the problem without adequate and reliable information, remarking that the current state of affairs in the sector is pitiable because anyone looking to get information about the sector will get contradictory statements from different sources.
He said the bank wants to work with digital partners to get reliable data that stakeholders in the health care sector would be able to use in their work.
Also speaking Dr. Niyi Osamiluyi of Premier Medical Systems said the Digital Health Summit would bring together stakeholders in the Nigerian digital health space. He said the theme of the summit would be, “Leveraging mobile technology for Health: Progress and Challenges.”
He said the summit would have stakeholders such as the Federal Ministry of Health, the Federal Ministry of Communication, NITDA, NHIS, the World Health Organisation (WHO), the World Bank and Mobile Network Operators (MNOs), among others, in attendance.
The summit aims to encourage collaboration and create connections between investors, development partners, government agencies, other stakeholders and startups.
In her remarks, Ms. Njide Ndili, Country Director of PharmAccess Foundation, noted that the summit would bring people together to solve the problems of the sector as well as provide finance that would take it to the next level.
She said PharmAccess is an entrepreneurial organization with a digital agenda dedicated to connecting more people to better healthcare in Africa. It employs a multidisciplinary team of professionals in Kenya, Tanzania, Ghana, Nigeria and the Netherlands. The Dutch Ministry of Foreign Affairs is a committed and long-term funder of the organisation’s activity.

Making Healthcare Accessible At Grassroots Through Insurance

Chioma Umeha

With the poverty level of Nigerians which is put at 70 per cent, reducing out-of-pocket payments for healthcare and making it accessible to all, especially, the indigent at the grassroots has remained a huge challenge to the country. However, health insurance provides financial protection for the poor spreading risks and pooling funds makes healthcare affordable and accessible to Oyo state indigenes, writes CHIOMA UMEHA.

To ensure universal access to quality health delivery by protecting Nigerian families from financial barriers to health care, and ensuring availability of funds to the health sector the National Health Insurance Scheme (NHIS) was launched 14 years ago.
However, less than two decades after its launch, experts have lamented on its slow implementation as only five per cent coverage has been achieved by the scheme.
It is instructive to note that the NHIS was established under Act 35 of 1999 by the Federal Government and  is expected to improve access to health services and bring overall development of the country
To ensure that residents in Oyo state enjoy the NHIS, the state recently introduced a new premium payment for its insurance scheme.
According to Dr Olusola Akande, the Executive Secretary of the agency, Oyo State Health Insurance Agency(OYSHIA) farmers are now allowed to pay premium with farm produce.
Speaking recently during a media visit facilitated by United Nations Children’s Fund, (UNICEF) and Oyo State Health Insurance Agency, Akande said;“Many people who would have loved to enroll in our health insurance programme but lack the financial capacity to pay the premium voluntarily agreed to give us yams and palm oil and other farm produce in lieu of cash to be paid for the premium.” He further noted that even farmers and others who cannot afford to pay the N8, 000 are encouraged to pay with their farm produce to the agency in lieu of cash.
“In the agency, we have set up a marketing section that is aiding us to sell the yams and palm oil and other farm produce and when we sell them, we help the owners to keep the money until it is enough to pay the premium and enroll them.”
Akande said the goal of health insurance was to provide quality healthcare services for the people of the state without experiencing catastrophic health expenditure.
He expressed worry that many people are still not aware of the activities of OYSHIA and required the support of the media to propagate the importance of health insurance to the people so that more people would enroll.
“OYSHIA has been rated very high in terms of performance. We will not relent in making sure that the people of the state enjoy quality healthcare without expending their entire savings on medical bills,” he stressed.
Akande, revealed that under two years, the scheme has made amazing achievements which include over 80,000 enrollees from 33 LGAs, 350 vaginal deliveries and 78 caesarian sessions (CS), over 10,000 children under five years and pregnant women covered, creating employment opportunities for residents, upgrade of three fully upgraded OYSHIA accredited PHCs and seven others at various stages of completion, as well as institutionalisation of engagement platforms for various stakeholders.
Affirming that 100,000 civil servants had been captured, but the target is 400 to 450,000. Akande regretted that in spite of the success so far, there are still challenges such as beliefs, attitudes and customs of people on insurance policies, adverse selection, attitude of health-workers and enrollees, sponsorship and cross-subsidy for the vulnerable groups and the poor, limited resources for advocacy, publicity and enlightenment, and inadequate and untrained manpower logistics.
To him, it has become imperative for people to visit their doctors as occasion demands with the aim of determining their health status. According to him, health insurance remains protection against financial hazards, spreading of risks and pooling of risk to ensure that people remain healthy with a little financial resource.
Olufemi, Abimbola and Adebayo, who are also among the 100,000 beneficiaries covered under the Oyo state health scheme, shared their experiences during a media field trip to the Agbongbon Primary Health Centre.
Olufemi, a teacher, like many other Oyo residents, had prayed for stress-free access to healthcare even before he got married. Like a dream come true, he was fortunate to be enrolled into the scheme a few months after he got married. At first, he never believed that with just N8, 000 per annum, his wife could have a successful caesarean section without paying through his nose.
“I registered about two months after I got married and the first payment was made two months after. Luckily, my wife got pregnant and gave birth and since then, I have been paying less to nothing. It may not be 100 per cent success but I am happy with the programme.”
Also, five months old pregnant mother, Abimbola Ahmed, could not help but express her joy. Ahmed says, “I paid only N2, 400 the first time I came and since then, I have not paid any other money. I am happy with the scheme. “You see many women in our community don’t have money but since the government presented free delivery, many of us have been coming. You can see that many people are here now. “I joined the scheme in March last year.
This programme is very good and beneficial because they take care of us. They give pregnant women all the attention they need. After your delivery, you would be given a bed for free”.
He also appreciated the UNICEF, for sponsoring and financing the programme.
Another beneficiary, Mr. Adebayo, said that his wife was on admission for two weeks after major surgery and was treated free, without any charge.
“My wife did not pay a kobo in this place, all tests and surgery were treated free. If they write drugs, I will go to the pharmacy and they will give me free without any charge. When it was time for us to be discharged, I was expecting to be given a bill but I did not get one. The programme is really good and live saving”, he said.
Affirming the increase in the number of patients, Assistant Record Attendant, Health Records at the Agbongbon PHC, Mrs. Adekola Atinuke, made it known to DAILY INDEPENDENT that, every month, the Centre takes 40 deliveries a month and can be more sometimes.

“In the past, we used to have 20 to 22 deliveries a month, but last month alone, we had 36 deliveries”, Atinuke said. “Last year, we had 905 pregnant women in our record. But in the first five weeks of this year alone, we have over 108 on the list already. “Although some women are still going to Traditional Birth Attendants, TBAs, the introduction of OYSIA has continued to increase antenatal uptake here and the number of other patients at the Health Centre. More women are now delivering here since they know they will not pay. At times, money can keep them away”.
Speaking, Fasan Desimola, a member of the medical team said she has 600 enrollees in her care out of which government caters for 400 while the remaining 200 are private enrollees. “It has not been easy getting people out to come and enjoy this programme, but it has given more people the opportunity to access health care,” Desimola said. “I also have a lot of pregnant women and children under five who registered free and they are being catered for by the state government. “Also, many elderly ones are here. It is easier for them to access health care here because their children can pay from wherever they are. “I have a lot of hypertensive and diabetic patients. I have never had any reason to complain. There is nothing more troubling than when you manage a patient that cannot afford the cost of treatment, as a doctor you cannot be happy.”

NMA Tasks Nigerians On Regular Eye Screening To Prevent Glaucoma

Chioma Umeha

To mark this year’s World Glaucoma Week, the Nigeria Medical Association (NMA), has tasked Nigerians from age 40 and above to go for regular eye screening at least once a year as part of strategies to prevent glaucoma disease.
According to a statement issued weekend and signed by Dr Biyi Kufo, Chairman, Committee on Eye Health, the disease has become a public health concern.
Noting that cases of glaucoma are on the rise in the country, Kufo said regular screening of the eyes by a qualified ophthalmologist once a year would help people with the disease access treatment early and prevent blindness.
He said surgery has been found to be more effective in the treatment of glaucoma than medical management alone.
Kufo added that glaucoma remains a leading cause of blindness worldwide and in Nigeria, with a national prevalence of blindness of 4.2 percent; glaucoma contributes 16.7 percent of that figure.
Decrying poor management of the disease Kufo said more awareness on glaucoma is needed.
“Glaucoma consists of a group of diseases that affect the optic nerve which connects the eye to the area of the brain responsible for the sensation of sight, and glaucoma if untreated, results in loss of optic nerve function, and irreversible blindness.
“Most often, when we talk about glaucoma, we are referring to its most common form, primary open-angle glaucoma, which is also sometimes called chronic open angle glaucoma. It is referred to as open angle because in this condition, the angle between the transparent cornea in front of the eye and the iris, which is usually seen as dark brown inside the eye remains open.
“In most cases glaucoma does not present with any symptoms, until the late stages of the disease, meaning that people who have the disease often do not know until it is advanced and the vision is seriously affected. They usually then experience cloudiness which gradually worsens vision deteriorates,” he explained.
“When an ophthalmologist examines patients with glaucoma, the signs of glaucoma can be seen. When glaucoma is suspect, there are a number of tests that can be done to establish the diagnosis.

Presidential Assent To PCN Bill Will Address Challenges Of Fake Drug, Abuse – Adeniran

With 15 years of service, Bola Adeniran, the Chairman, Pharmaceutical Society of Nigeria (PSN), Lagos State Branch, is a seasoned pharmacist who has served PSN in various capacities including, past Vice Chairman, Secretary, Social Secretary, Unofficial Member of the Executive Committee at the State level.  In this interview with CHIOMA UMEHA ahead of the March 14, 2019 Annual General Meeting (AGM) of the branch, the Adeniran examines contemporary issues in the health sector with particular reference to pharmacy. Excerpts:

The assent of the Pharmacy Council of Nigeria (PCN) Bill appears to be a dominant issue in your sector in recent times, why is this bill so important?

Pharmacy is a unique profession compared to many careers as it goes beyond service provision to being a commercial venture which involves a special commodity, drugs.
Often, once you identify yourself as a pharmacist in Nigeria, the most likely question that follows is, what are you people doing about fake drugs? The modern day sobriquet as rationalised by WHO brands fake drugs as falsified medicines. Whichever nomenclature you choose to call it, this is an issue that constitutes huge public health menace to all consumers of health.
There is also the dimension of drug abuse and misuse which is seriously ravaging our youths, even women especially in Northern Nigeria today.
Critical evaluation has confirmed that the challenges of growing incidences of fake drug and drug abuse are due to extreme poor management of the drug distribution channels.
This is exactly what the PCN Bill seeks to redress. It is probably the most important piece of pharmacy legislation in recent times.
For the records, there are many benefits to be derived from a speedy assent of the PCN Bill by President Muhammadu Buhari. First, the new Pharmacy Council Bill is consistent with pharmacy regulatory laws in other Commonwealth Countries.
Second, the PCN Bill has provisions to improve access to quality, effective and affordable medicines, which is a cardinal responsibility of every government to her citizens. This is also the main goal of the National Drug Policy, 2005.
Next, it makes explicit provisions on the prohibition of sale of drugs in unauthorised places as provided for in the National Drug Distribution Guidelines (NDDG). This will further strengthen the fight against drug abuse.
Also, the Bill has addressed gaps inherent in the current law which are being exploited to institute litigation against the Minister of Health and PCN to restrain government from regulating illegal sales of drug by unlicensed persons and premises.
Further, the bill stipulates stiffer penalties for offenders to serve as deterrent.
It also strengthened professional discipline for the pharmacists and is all-encompassing and had brought all players in the pharmaceutical sector under proper regulation.
Conclusively, it will protect and promote public health.
The monitoring and control procedures in the regulation of pharmaceutical still appear inadequate given the huge number of unlicensed premises. How do we redress this unwholesome development?
I am glad you appear to have a grasp of the challenges. In Nigeria today, we have barely 6,000 registered pharmaceutical premises in retail, distribution, importation and manufacturing cadres. In the patent and proprietary medicines vendors licence (PPMVL) holders segment there are probably less than 20,000 players.
As far back as 2002, the PSN, Lagos State Branch had alerted the government over a million unlicensed pharma premises in the erstwhile 20 Local Government Areas in Lagos State. This was a time Lagos had just 800 licensed premises. So if the ratio in Nigeria’s Centre of Excellence was 1:112 in favour of unlicensed premises 18 years ago, you can imagine the dangerous implications. The situation poses many questions.
If the most cosmopolitan state had such preponderance of unlawful premises, what will be the situation in the far North territories which are not under more serious regulatory searchlight? What is the number of registered premises in each state of the Federation? The last time I checked Jigawa and Yobe states each had less than five premises respectively.
In the face of these challenges, how do we modulate the perennial problem of easy access to drugs in Nigeria? I must say that the PCN continues to make some strides. Recently, the Office of Head of Service of the Federation approved new manning levels for the inspectorate department at PCN which is a major boost in the quest to ensure better monitoring and control of pharmaceutical premises in Nigeria.
The Satellite Pharmacy concept entrenched in the PCN Bill will consolidate and validate credible professional services by registered pharmacists in very substantial as well as potentially impactful number in Nigeria. For once the PCN would be able to function as a regulatory agency with full complement of statutory powers to rescue the ailing drug distribution channels.
Mr. President needs to help the health system by responding to the will of the stakeholders in the pharmaceutical sector by assenting to the PCN Bill which has the propensities to fast track a new cycle of productivity in the totality of pharmacy practice as well as specifically the monitoring and control procedures in pharmaceutical premises in Nigeria.
The health sector is becoming notorious for disruptions and strikes detrimental to public health. What is the way out of this mess?
Perhaps, I should start by congratulating President Muhammadu Buhari on his re-election as President on behalf of our teeming membership in Lagos State which accounts for over 45 per cent of the total membership of pharmacists in Nigeria.

In his first tenure, Mr. President repeated the dreadful error first committed by erstwhile President Goodluck Jonathan by appointing the two Ministers in Charge of the Federal Ministry of Health (FMOH) from one profession.
The Health Sector is a multi-disciplinary sector comprising an array of high profile professionals. Other appointments in Federal Health Institutions (FHIs), National Health Insurance Scheme (NHIS), National Primary Healthcare Agency (NPHCA), National AIDS Control Agency (NACA) and others are all unduly skewed in favour of the medical profession. The tragedy inherent in the output of the incumbent leadership of the FMOH is too grave to ignore. It is on record that it is the most insensitive, wicked and despicable administration in the annals of FMOH.
The minister openly became spokesman of NMA, violated the rights and denied other health workers their welfare packages including salaries when on strike, despite court orders and valid Memorandum of Understandings (MOUs) with the trade union in the Health Sector.
The liability created by the ministers in charge of FMOH for this government was enormous, but for the goodwill enjoyed by Buhari all would probably have been lost.
Can you imagine Prof. Adewole inaugurated the Medical and Dental Council of Nigeria (MDCN), but refused to do same with PCN, Nursing and Midwifery Council of Nigeria and Medical Laboratory Science Council of Nigeria? It was most shameful that the leadership of FMOH could not pretend or disguise its obvious bias for a chosen and favoured profession.
The way forward therefore is for President Buhari to right the wrongs in the health sector by appointing a seasoned administrator in charge of the FMOH; otherwise, it would continue to be a volatile sector. For the records, in the Obasanjo era, Prof. Eyitayo Lambo, a health economist, was in charge of the FMOH for almost five of the eight years with remarkable success.
President Buhari must support comprehensive reforms which would liberalise all the myriad of health professions in line with global best practices. This can be practically demonstrated through the President’s support for Federal Medical Centres Bill which opens the space in the Healthcare for the first time.
What is your take on Joint Health Sector Union (JOHESU) agitations for adjustment of CONHESS salary scale?
Of course, it is a struggle grounded in fair play and justice. You are aware of the MoUs in respect of CONHESS and the salient conditionality that once you adjust any of the scale it becomes imperative to do same with the other.
Today, apart from the antagonism of Adewole-led FMOH, another medical doctor, Dr. Chris Ngige who ideally is the Chief Conciliator on labour matters in Nigeria remains another stumbling block in the quest for fulfillment in the JOHESU agitations.
Let me say with a deep conviction that after following the recent national and zonal rallies of Health workers under the auspices of JOHESU, I have no doubt that danger and uncertainty would continue to loom over the health sector. The dark clouds that have gathered in our sector can be dealt a decisive blow by President Buhari only through the appointment of a sound manager of cognate experience in charge of the FMOH.
I have continued to evaluate the Secretariat of PSN, Lagos State Branch, in terms of amenities and physical expansion compared to what it was a few years ago. How did you manage it?
We must thank God for His provisions and mercies. Our Exco has completed the second phase of the Secretariat which the Anthony Oyawole leadership started in 2008. We bought a befitting bus last year which cost us some modest tens of millions of Naira. We have also improved on our I.T. gadgetry and boosted our power supply capacity with new generating sets.
Our progress is due to our very supportive membership and, of course, our ever dependable Board of Trustees of the branch.  To His glory, we have a fully functional Secretariat and in a few weeks, we should be able to dedicate a wing of the facility to events management.

Lassa Fever: Nigeria To Participate In Clinical Trials Of Vaccine Development – NCDC

•As Disease Cases Decline With Intensive Response

Chioma Umeha
Over the last five weeks, there has been a decline in the number of new cases of Lassa fever reported in Nigeria. In addition, the country has witnessed a reduction in the number of people who have died from the disease, compared to 2018, Dr. Chikwe Ihekweazu, the Director General of the Nigeria Centre for Disease Control (NCDC), said.
Dr. Chikwe Ihekweazu who said this while interacting with members of the press at a briefing held on today, revealed that the NCDC and partners have continued to sustain response activities in states across the country, despite progress made so far.
According to him; “An outbreak of Lassa fever was declared in Nigeria on January 21 2019. Since then, 420 confirmed cases and 93 deaths have been reported in 21 States. The national response is being coordinated by the national, multi-sectoral, multi-partner Emergency Operations Centre (EOC) led by NCDC.
“In addition, NCDC has supported Ebonyi, Edo, Ondo, Plateau and Kebbi states in activating sub-national level EOCs for coordination.
“Following the large Lassa fever outbreak in 2018, the NCDC together with partners instituted five key measures to ensure improved preparedness in 2019.
“These include; Trained over one thousand health care workers in the six zones in the country on Lassa fever management, diagnosis and surveillance, together with the Irrua Specialist Teaching Hospital; Prepositioning of treatment and diagnostic supplies to the 21 states that recorded cases in 2018, treatment centres and laboratories.
“Others are; Publication of Lassa fever messages on three major newspapers, weekly radio shows on Radio Nigeria, and intensive community engagement; High level advocacy visits to State Governments, encouraging them to do more to prevent and respond to cases of Lassa fever.
“The rest are; Developed new case management guidelines, initiated a Lassa fever Research Consortium and hosted and International Conference on Lassa Fever to share knowledge.”
Following the declaration of the 2019 outbreak, the Director General, NCDC said that a Rapid Response Teams (RRTs) comprising officers from the NCDC, Federal Ministry of Agriculture and Rural Development and Federal Ministry of Environment have supported the response in the high burden states of Edo, Ondo, Ebonyi, Plateau, Bauchi and Taraba states.
In these states, NCDC has also supported full availability of drugs, personal protective equipment, laboratory reagents and other supplies required for case management and diagnosis of Lassa fever. This year, there has been no single stock-out reported in any state.
In January 2019, NCDC hosted the first Lassa fever International Conference. This brought together the largest gathering of researchers and professionals to discuss progress on Lassa fever. Importantly, Nigeria introduced her national Lassa fever research plan and has been recognised as one of the leading stakeholders in global Lassa fever research. Over the last six months, progress has been made in this area especially in discussions around Lassa fever vaccines.
In the next one year, Nigeria is expected to be part of clinical trials towards the development of Lassa fever vaccines.
In 2018, genetic sequencing carried out at the Irrua Specialist Teaching Hospital showed that the virus circulating originated from the pool of lineages that have been in Nigeria since the first discovery.
This year, early sequencing result shows similar findings. The preliminary results of 42 Lassa fever virus sequences indicate that rodent to human transmission, as observed in 2018, is still the dominant route of transmission. Therefore, there is a strong need to improve prevention measures especially around environmental sanitation.
The progress recorded in the response to the 2019 Lassa fever outbreak including an early decline in the number of new cases and reduced case fatality have been attributed to various factors.
This includes the early deployment of One-Health national RRTs, improvement of functions in Lassa fever treatment centres, revision of case management guidelines, enforcement of environmental sanitation in some states, introduction of the Infection Prevention and Control (IPC) ring strategy, targeted intensified risk communications activities, high level advocacy visits, operational research into response activities, among others.
Dr Ihekweazu  said; “We are grateful to our partners including the World Health Organization, UK Public Health Rapid Support Team, Medecins Sans Frontiers, World Bank, ALIMA, African Field Epidemiology Network. We also applaud the efforts of state epidemiologists, treatment centres and laboratories in the country, especially the Irrua Specialist Teaching Hospital Edo, Federal Medical Centre Owo, Ondo and Federal Teaching Hospital Abakaliki, Ebonyi.
It is very important that Nigerians continue to practice preventive measures to avoid infection. Prevention of Lassa fever relies on promoting good community hygiene to discourage rodents from entering homes.
Other effective measures include storing grains and other foodstuff in rodent-proof containers, proper disposal of garbage far from the home, maintaining clean households and frequent hand hygiene.
All food should be well prepared, and family members should always be careful to avoid contact with blood and body fluids while caring for sick persons.
Healthcare workers are urged to maintain a high index of suspicion for Lassa fever when handling patients, irrespective of their health status.
Lassa fever should be considered in patients with fever, headache, sore throat and malaise, in whom Malaria has been ruled out with a rapid diagnostic test (RDT), especially when patients are not getting better.
Health workers should adhere to standard precautions including wearing protective apparels when handling suspected Lassa fever patients. The revised Lassa fever case management guidelines are available on the NCDC website,

Lassa fever is a viral infection caused by the Lassa fever virus, primarily transmitted to humans through direct contact, eating food or drinking water contaminated with urine, faeces, saliva or blood of infected rats.
Person-to-person transmission is through contact with blood, urine, saliva, throat secretion or semen of an infected person.
The disease can be treated, with early presentation to a healthcare facility greatly increasing the chances of survival. Early signs of the disease include sudden fever, sore throat and general body weakness.

Violence Against Children Cost Nigeria $6.1 Billion – UNICEF

Chioma Umeha

The high economic cost of violence against children in Nigeria has been revealed in an unprecedented report, launched jointly by UNICEF and the Federal Government, under the leadership of the Ministry of Budget and National Planning and the Federal Ministry of Women Affairs and Social Development.
According to the report, the economic impact of the violence against children in Nigeria is estimated to be about USD$6.1 billion, which is equivalent to about 1.07 per cent of the country’s GDP, a statement signed by Oluwatosin Akingbulu, Communication Officer, United Nations Children’s Fund (UNICEF), said weekend.
This financial loss is from the cumulative loss of earnings due to loss of productivity, stemming from suffering associated with different degrees of violence, over time.
“The cost of inaction is high, when it comes to violence against children,” said Mrs. Ifeoma Anagbogu, Permanent Secretary of the Federal Ministry of Women Affairs and Social Development.
“Violence affects children’s health, education, and productivity. It is clear that we need to eliminate any form of violence against children    both from a moral perspective and an economic perspective.”
The report revealed that about half of the Nigerian children surveyed experienced physical violence by parents, adult relatives, direct or indirect caregivers or community members, before they reached 18.
“The findings of this study point to the strong need for increased funding of interventions by government to reduce violence against children in Nigeria,” said Mr Olajide S. Odewale, Permanent Secretary of the Ministry of Budget and National Planning.
It was noted that the study may actually underestimate the economic burden of violence against children, as several serious consequences of such violence were not included, due to a current lack of data.
The evidence presented in the report indicates an urgent need to provide child protection services in Nigeria and prioritise the elimination of violence against children, which can ensure the country’s human capital has the mental, physical, and emotional stability needed to boost its social and economic development.
“This year marks the 30th anniversary of the Convention of the Rights of the Child, giving us an opportunity to join our collective efforts to protecting children from violence, abuse and neglect. This includes a re-commitment to increase investment in child protection services,” said Mohamed Malick Fall, UNICEF’s Country Representative in Nigeria.
The research on violence against children was led by the Government of Nigeria, in collaboration with UNICEF, and with funding from the US President’s Emergency Plan for AIDS Relief (PEPFAR), through USAID, the EU and the Ministry of Foreign Affairs and International Cooperation.

Achieving HIV-Free Babies Through Adherence To HIV Treatment

Chioma Umeha
Nigeria contributes 12.4 percent of the global burden of HIV infected children with an estimated number of 267,000 living with the virus, says 2017 Joint United Nations Programme on HIV/AIDS, (UNAIDS) report.
The report also states that Nigeria has the second largest burden of Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome, (HIV/AIDS) and also contributes the largest proportion of new vertically acquired HIV infection among children.
With 95 percent of the National HIV response driven by donor partners, including Prevention from Mother To Child Transmission of HIV, (PMTCT), and pediatric treatment services, experts say it is important that mothers adhere to treatment in order to eliminate Mother To Child Transmission Of HIV (eMTCT).
According to research, drugs adherence requires 95 per cent to achieve viral suppression and reduce Mother To Child Transmission of HIV, (MTCT). By viral suppression, the HIV virus loses its ability of being transmitted to another person.
To ensure drugs adherence and achieve the ‘Goal of eMTCT by 2020,’ Nigeria has initiated strategies to curb HIV transmission from mothers to their children.
Dr. Ijaodola Olugbenga, the Assistant Director and Head of PMTCT of the National AIDS And STIs Control Programme, (NASCP), Federal Ministry of Health,  said that the strategy  entails ensuring that at least 90 per cent of infected women have access to comprehensive prevention of mother-to-child transmission of HIV services, including, antiretroviral drugs, (ARVs), during pregnancy, labour, delivery and breastfeeding period.
Dr Olugbenga listed comprehensive intervention package to PMTCT which includes; HIV Testing Services, (HTS), Provider Initiated Testing and Counselling, (PITC), Infant Feeding Counseling, family planning counselling and services, ARV and Cotrimoxazole prophylaxis for mother -infant pairs, early infant diagnosis and linkage to treatment.
Others are; screening of all pregnant women for hepatitis, syphillis and other Sexually Transmitted Infection, (STIs), screening of the mother for cervical cancer as well as eligibility assessment for lifelong anti retroviral therapy.
Currently, there are essential activities to ensuring that women living with HIV do not have babies with the virus, the Assistant Director, NASCP added that these efforts are geared towards women giving birth to HIV-free babies.
The Head of PMTCT said the on-going activities includes; Routine HIV testing services for all pregnant women attending ante natal care, labour and postnatal with appropriate documentation.
He added that there is “Initiation of all newly identified positive pregnant women on Anti Retroviral Therapy, (ART) with referral to adult ART clinic after PMTCT. Appropriate classification of HIV Exposed Infant, (HEI) risk and initiation on recommended ARV prophylaxis -viral load for all pregnant women 32 to 36 weeks gestational age.
The rest according to him is; “Testing of all HEI at two months, using early infant diagnosis from two to18 months and rapid test at 18 months and documented referral of all HIV positive infants to pediatric ART.”
Presenting the 2017 Maternal PMTCT Cascade, at a media dialogue, recently organised by the Child Right Information Bureau, (CRIB), Federal Ministry of Information with support from United Nations Children’s Fund, (UNICEF) held in Calabar, Cross River State, Dr Olugbenga noted that 165,474 are estimated mothers needing PMTCT.
The cascade shows that 64,811 women tested HIV positive (old and new in ANC), while 50,890 are HIV positive mothers on ART, even as 24,026 are HIV positive mothers who delivered at the health facility booked and unbooked.
It further estimated that in 2017, 221,729 children aged zero to14 were living with HIV; the number of those currently on ART were put at 54,167; children with viral load test result were 10,464 while those with viral load suppression 4,699.
Dr Olugbenga also said NASCP has put up some strategy focused on saving children from HIV as follows; increase ANC uptake and improving facility based delivery, increase HIV testing coverage among pregnant women, provision of ARVs for the positive pregnant women during delivery and breastfeeding period.
“Increase Dried Blood Spot, (DBS) and early infant diagnosis testing coverage, improving the pediatric ART management, coordination and harmonization of efforts, improving data harvesting and management.”
However, there are limitations in carrying out these ongoing strategic efforts as well as full implementation of these plans, Olugbenga revealed that; there is inadequate proportion for HIV programme in National and State budget, dwindling support from partners, socio- economic challenges, poor health seeking behavior, culture, myths, misconceptions, stigmatisation.
He further said there are laudable plans to sustain the efforts thus far by partners and such plans are; sustaining the drive, improve collaboration, more granular level effort to identify priority States, LGAs, wards that can achieve eMTCT with minimal efforts.
To ensure effective integration of PMTCT in the Maternal and Newborn Child Health (MNCH) platform, there is need for high level advocacy for eMTCT and pediatric ART as well as resource mobilization, he said.
Earlier in his speech, Mr. Olumide Osanyinpeju, the Deputy Director and Head, Child Rights Information Bureau, showed concern over the large number of children in the country at risk of contacting the HIV from their mother adding that proactive measures should be taken by all stakeholders to save the children from the imminent danger.
Osanyinpeju however said that the Federal Government is working relentlessly with relevant stakeholders to achieve an HIV/AIDS free nation, stressing that journalists should champion the course of the realisation of the rights of children to live free from the disease.
He said; “it is worthy to note that it has been a difficult task propagating that children reserve the rights to issues affecting them, the right to live free from diseases, HIV/AIDS in focus. May we not lose sight of the fact that a large number of Nigerian children are still at risk of this infection, a host of them living in our communities under emergencies and insurgencies.
“We must understand that the deprivation of the foregoing is an infringement on the rights of a child. There is need for all to rise up against this menace as routine transmission may leave life-long scars that may affect the child emotionally and psychologically.
“As you know, government alone cannot fight this cause, hence, the need to collaborate with Agencies, Non-Governmental Organisations and other line partners and Organisations to advocate on how best to address the issue.
“We need the media to start making the Nigerian people think in the interest of the Nigerian child, to tackle the low level of awareness that exists amongst our people towards the realisation of the health needs of children within the framework of child’s right, and obtaining the desired support from government and institutions,” Osanyinpeju added.
He enjoined the media to strive and develop clear messages that will sensitise and inspire the Nigerian people and use stories, reports to create massive awareness as well as enlighten the people, duty bearers, and indeed all levels of government on the need for prevention and elimination of Mother To Child Transmission of HIV.
Osanyinpeju further tasked journalists to mainstream the issue so as to increase the knowledge among spouses, partners and family members, as well as addressing HIV-related stigma and deep gender inequalities in decision making.
“By so doing, it will go a long way in realizing the objective of UNICEF at advancing Children’s rights and enhancing their well being. We must work in line with the United Nations General Assembly Resolution to intensify global efforts to eliminate this menace.”
Similarly, in a recent report  dissemination, Mr. Greg Ashefor, the Ag.Director, Research Monitoring and Evaluation Directorate, National Agency for the Control of HIV/AIDS, (NACA), corroborated; “Based on our data, only 1, 090,233 persons (747, 853 females and 342, 380 males) are currently on HIV treatment in Nigeria as at June 2018.”
This number, he said includes all persons on treatment programmes supported by the President’s Emergency Plan For AIDS Relief, (PEPFAR), Global Fund and the Federal Government.
PEPFAR is the United States government initiative to address the global HIV/AIDS epidemic and help save the lives of those living with the disease, primarily in Africa,

Fidson Healthcare Plc Receives ISO 14001:2015 EMS Certification

Chioma Umeha
Fidson Healthcare Plc,  one of the leading pharmaceutical company in Nigeria has received the Environmental Management System (EMS) certification, in compliance with the International Organisation for Standardization (ISO) 14001:2015, the world’s most widely recognized standard for Environmental Management Systems which minimises the impact of the company’s operations, activities, products and services on the environment.
EMS is intended for utilisation by organisations seeking to manage their environmental responsibilities in a systematic manner that contributes to the environmental pillar of sustainability while maintaining an eco-friendly environment.
Presenting the certificate at Fidson’s corporate head office in Lagos, Samuel Sawah, CEO & Managing Partner – 4 Quarters Consultancy Limited (a support firm on EMS Certification),  noted that Fidson received this certification having met all specified requirements that must be deployed in enhancing environmental performance.
Sawah said ISO 14001:2015 ensures an organization achieves the intended outcomes of its environmental management system, which provide value for the environment, the organization itself and other interested parties in consistency with the organisation’s environmental policy. These management systems include the enhancement of environmental performance, fulfilment of compliance obligations and achievement of environmental objectives.
Responding to Sawah’s remarks, Dr Fidelis Ayebae, Managing Director, Fidson Healthcare Plc, thanked the body for the certification and noted that the company’s commitment to maintaining the EMS standards, is not only to enhance its environmental performance and manage legal compliance to environmental responsibilities, but also to set the pace for other manufacturing companies by demonstrating its commitment to humanity and environmental preservation.
“In a society where organisations and even the citizens pays less attention to the impact of their operations and activities to the environment, we at FIDSON choose to set the pace for others to follow because as an indigenous manufacturer of pharmaceutical products, we say that ‘We Value Life’ and this implies that we must truly show that we value life by strictly adhering to environmental policies and regulations”, he added.
The EMS certification, which is one of the many feats achieved by the company in recent times, is another demonstration of the company’s commitment to positively impacting humanity as parts of its Corporate Social Responsibilities (CSR) initiative, focused on Children’s education, health and environment.

Insurgency: German Contributes 15m Euros To UNICEF For Children Education

Chioma Umeha

The German Government has announced a new contribution of 15 million euros to UNICEF Nigeria to support the provision of quality and equitable basic education and strengthen the resilience of the most vulnerable communities, especially children, in Adamawa and Yobe states.
A statement signed by Oluwatosin Akingbulu, Communication Officer, United Nations Children’s Fund (UNICEF) said the new contribution was provided through the German Government’s Development Bank – Kreditanstalt für Wiederaufbau (KfW).
The statement further said that the fund will enable UNICEF to support the Government of Nigeria to provide 1,060,000 conflict-affected children and adolescents with increased access to quality education in a safe and healthy learning environment.
It will also provide 8,200 teachers with increased capacity to deliver quality learning at pre-primary and primary levels and support 500 school-based management committees to plan and maintain a safe and healthy learning environment in schools, with increased community participation.
“All children, regardless of their situation, must be supported to access all their basic rights.
Investing in education is perhaps the best investment any nation can make for its children,” said UNICEF Representative Mohamed Fall. “This investment is timely, as it comes at a moment when we are redoubling our efforts to improve both access and quality of education for conflict-affected children.”
The KfW contribution will also support UNICEF’s work to link humanitarian needs and long-term development opportunities in target conflict-affected communities in north-east Nigeria.
The German Government is a long-standing partner of UNICEF Nigeria, having contributed over 21 million euros towards the humanitarian and development response in Nigeria since 2016.
Prior to the crisis, the North East had the highest percentage (52 per cent) of children who never attended schools, with at least 17.1 per cent in Adamawa state and 73 per cent in Yobe state. Moreover, the North East had the highest children drop-out rates, at 3.2 per cent (4.4 for Adamawa and 1.6 for Yobe). The current situation shows a decline in the total number of schools by 22 per cent and a decline in total enrolment by 38 per cent.

Why FG Should Prioritise Assent To Pharmacy Council Of Nigeria Bill – ACPN

Chioma Umeha

It is nearly one year since the United Nations Office on Drugs and Crime (UNODC) called on the Nigerian government to arrest the increasingly widespread use of pharmaceutical drugs among the country’s youths, in which time it is expected to have strengthened existing legal framework to bring the menace under control.
The expectation became rife barely one month ago with the subsequent release of the National Drug Use Survey in Abuja, which provided a snapshot of the ongoing opioid epidemic and mental health update across the country.
Specifically, the survey found that the number of drug users in Nigeria which is estimated at 14.4 per cent or 14.3 million people aged between 15 and 64 years. The data suggests that the prevalence of past year drug use in Nigeria is more than twice the global average of 5.6 per cent.
It is not therefore surprising that the Association of Community Pharmacists of Nigeria (ACPN) has sent an urgent plea to the Federal Government to facilitate the assent of Pharmacy Council of Nigeria Bill which it said would address health concerns with regards to the increasing challenges of drug abuse and misuse in the country.
Pharm. Samuel Adekola, the ACPN National Chairman, and Pharm. (Mrs.) Abosede Idowu, the National Secretary, who made the plea on behalf of the association in a statement lamented that the development obviously further complicates the perennial woes of fake as well as falsified drugs in the country, adding that it naturally should bother all promoters of good pharmacy practice in Nigeria.
Pharm. Adekola said, “We as part of a global community will continue to collaborate and strategise along the lines of global best practices particularly with alliance partners including International Pharmaceutical Federation (FIP), World Health Organisation (WHO), African Pharmaceutical Forum (APF) and the West African Postgraduate College of Pharmacists (WAPCP) to clamour for standards and ideals that would ultimately boost consumerism as well as professionalism in Nigeria.”
For emphasis, he said the bill should be assented to for a number of reasons which include that the Pharmacy Council of Nigeria (PCN) Bill 2017 is very consistent with similar laws in the Commonwealth League of Nations, where regulatory laws and statutes have become very sacred in keeping pace with the norms and ethos of public health.
He gave examples of such pharmacy regulatory laws in some Commonwealth nations comprising General Pharmaceutical Council of Great Britain, Pharmacy Council of Ghana, Tanzania, Kenya, South Africa. Others are National Association of Boards of Pharmacy in United States of America (a wholly Government owned pharmacy regulatory body) and Pharmacy Council of Canada, among others.
“It is a statement of fact that many less endowed African nations have today polished their pharmacy laws to meet global best practices such that the terminal consequences of poor statutes, weak enforcement, and so on which engender easy access to drugs to promote the vicious cycle of drug abuse and misuse, falsified drug syndrome etc are gradually being eliminated in these climes. This is the same purpose the new Pharmacy Council Bill is intended to achieve,” he stated.
Pharm. Adekola explained that one of the philosophies of the National Drug Policy 2005 is to guarantee that Nigerians have access to safe, efficacious and affordable medicines.
“This is a cardinal responsibility of every government to its citizenry. One of the major benefit packages of PCN Bill is that it opens a unique window of competence-driven service rendition at all levels. The new Satellite Pharmacy concept gives us the prospects of additional pharmaceutical premises in hundreds of thousands range manned by registered pharmacist,” he said.
Furthermore, he explained that the Bill provides that any pharmacist who has over 10 years post-qualification experience can own a satellite pharmacy not withstanding his primary practice option.
“What this does is that professional service points in pharmacy will increase from about 5,000 we currently have to over 100,000 in Nigeria. These satellite Pharmacies in turn have mandate to provide oversight in a manner of hub and spoke model over the Patent and Proprietary Medicines Vendors thereby improving their regulation.
“The enforcement of sales of medicines in only registered pharmacies and patent medicines stores by the PCN is the only way to permanently redress the menace of drug abuse and falsified drug syndrome in Nigeria. This has been prescribed by the Poison and Pharmacy Act,” he said.
Adekola said that the PCN Bill 2017 clearly prohibits sale of drugs in authorised places such as open drug markets, this in essence is in tandem with the National Drug Distribution Guidelines (NDDG) which is the official government tool structured to impose decorum in the unwieldy drug distribution channels which Nigeria currently contends with. He added; “Today as it stands government moves to replace the unlawful open market structures with Coordinated Wholesale Centers (CWC) need to be grounded in lawful templates which the PCN bill guarantees.”
He said that the responsibilities of the critical stakeholders and in particular regulators like PCN, NAFDAC, NDLEA as well as police would automatically be enhanced once all the necessary reforms are formalised.
Pharm. (Mrs.) Abosede Idowu on her part explained that the Pharmacy Laws are laced with very substantial antiquity because the first Pharmacy Ordinance was enacted in 1887. This, she said, had been tinkered with severally through a series of metamorphosis in evolving Acts till the modern day variants like the PCN Cap 17 LFN 2004 and the PPA Cap 535 LFN 1990.
“The consequences of these acts of negligence remain the vulnerability of the PCN and Federal Government and the Honorable Minister of Health to unending litigations which reduces the efficiency of the PCN in carrying out its statutory mandate.
“The PCN bill in question has also removed all ambiguities with regards to offences and relevant commensurate sanctions applicable to all players. This is particularly significant because owners of unregistered premises, those who sell products they are not legally licensed to sell and those who violate the condition precedence attached to their licensure will better appreciate the consequences of their unlawful endeavors and acts,” she explained.

Idowu contended that flowing directly from the foregoing the PCN Bill particularly compels pharmacists to show more responsibility in their professional practice, adding that the need for discipline is showcased at greater heights because the Disciplinary Tribunal is geared towards wielding the big stick on erring pharmacists and pharmaceutical premises in the best interest of consumers of health.
“The PCN bill also has the unique feature of unhindered empowerment as all professionals and their cadres of practice are registered as distinct legal entities. The PCN bill will therefore feature for public consumption a gazette of registered pharmacists, pharmacy technicians, registered retail, wholesale, importation, manufacturing, CWC and satellite pharmacies. The peculiar registration format would also highlight all patent and proprietary medicines vendors licence holders in Nigeria for proper scrutiny,” she explained.
According to the ACPN Secretary, the PCN Bill has also taken care of effective management of resources by presenting a robust yet broad spectrum structure that can work maximally in the interest of the pharma-sector to enhance service delivery at all times.
Finally, the Association of Community Pharmacists of Nigeria appealed to the Federal Government to heed this clarion call to engender a new agenda of productivity, professionalism, self-sufficiency in local production and regulatory excellence in the pharma-sector.
The association reasoned  that the achievements would change the narratives and place the pharma-sector in good stead to contribute to National Gross Domestic Products (GDP).

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