Addressing Impact of Economic Challenges on Drug Procurement

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Against the backdrop of the desire of the Nigeria Academy of Pharmacy to help redress the economic and other challenges in the Nigerian pharmaceutical sector, Kunle Aderinokun ponders the feasibility of such move

Anyone, who has had close dealings with Nigeria’s pharmaceutical industry will realise that it is a sector that is literally gasping for breath. Last week, the council of the Pharmaceutical Society of Nigeria (PSN) released a communiqué in which it warned that the cost of drugs procured at the on-going forex exchange rates might become so prohibitive that it may lead to a massive resurgence of the fake drugs problem. The fake drug problem, though still a big issue in Nigeria has been reined in with some degree of success such that it is not quite as threatening as it was years ago.

PSN therefore warned that the current situation in which drugs are inevitably priced so high that they become unaffordable by the average Nigerian my erode all the gains so far made with regard to the fake drugs problem. This is because when genuine drugs are for some reason, such as the current problems with forex, priced beyond the reach of majority of citizens, manufacturers of fake drugs are often quick to spot the opportunity and flood the country with cheaper though fake and adulterated versions of the drugs. The Pharmaceutical Society asked government to kindly intervene to help make forex more accessible to the pharmaceutical companies.

But why is forex of such importance to the pharmaceutical industry when there are several indigenous and multinational pharmaceutical companies domiciled and operating in Nigeria? The truth, as industry insiders would tell you, is that more than 70 per cent of the drugs on the shelves today are imported. Only some 30 or so percent is manufactured in Nigeria. But even those drugs manufactured in Nigeria rely virtually exclusively on imported materials both for the active components of the drugs as well as the fillers. For instance, a 500 milligrammes tablet of Paracetamol contains 500 milligrammes of Paracetamol as well as other additives such as starch. In the case of Nigeria’s pharmaceutical industry, both the paracetamol and the starch are imported, which essentially means that the industry is bound to catch a cold whenever the forex regime in the country sneezes.

This in part, probably explains why, according to Publisher of Pharmanews, the pharmaceutical newspaper, and Vice President of the Nigeria Academy of Pharmacy, Ifeanyi Atueyi, there is a bit of excitement currently in pharmaceutical and industrial circles on account of the progress being made in the Dangote Refinery. This is because the Dangote Refinery project has announced that the petrochemical segment will be a core part of its focus. This is a marked departure from the approach of the state-owned refineries whose sole interest has been the refining of fuels.

According to Atueyi, the petrochemical industry will help to provide not only for the pharmaceutical industry but other industrial sub-sectors key manufacturing ingredients, many of which are currently imported.

But if lack of a petrochemical industry is blamed for the inability of Nigeria to produce active chemicals like Paracetamol locally, who do we blame for our inability to produce pharmaceutical grade starch locally? Why do we still need to import starch and practically all other drug additives?

Atueyi blamed the current situation on a prolonged systemic lack of focus on research and development. “As a country, our economy has been so import-dependent for so long that we have subordinated even the things we can produce locally to importation especially because we have been too laid-back to embark on aggressive and purposeful research and development.”

Many of those who have embarked on research, he says, have done this at huge cost and inconvenience to themselves because not only is infrastructure lacking, generally, but government support is just not available. Practically all of the research institutes are today, crying for government attention including funding.

This, he said, was one of the reasons that led to the formation of the Nigeria Academy of Pharmacy. “A number of key stakeholders in Pharmacy and the Pharmaceutical Sciences both in Nigeria and elsewhere in the world came together and took a holistic look at the profession and the industry.” Atueyi said stakeholders in the profession sought to take matters into their hands after examining the prevailing state of affairs. “Having thoroughly reflected on the state of research and development in the profession especially in the light of its being a scientific discipline, we resolved to do something tangible to redress its slide.” Scientific research, said Atueyi, was the very basis of the profession itself. “It is through research that medicines are discovered and developed.” The need to encourage research and development was perhaps the most underlying driver for the formation of the Academy which eventually debuted in 2014.

The emphasis on pharmaceutical research by the Academy, Atueyi said, was multipronged. “We want to elicit more attention towards the funding of scientific research whether in the universities or the research institutes by government. We know that government is grappling with several issues at the same time but we believe that from a futuristic point of view, every forward-looking country must take research and development seriously.” Enhanced understanding by government of the imperative of better funding for research and improved funding will lead to better quality researches from the universities and research institutes, he says. “Imagine the cost-savings to Nigeria for instance, if all of the additives used in drug manufacture were locally made, if for instance we didn’t need to import corn-starch.”

He added that the cost savings could have been deployed to other vital areas of the economy. Besides, the task of providing these drug additives could have created a massive industry that would have generated thousands of jobs for Nigerians.

Atueyi added that besides the economic aspect which could have been of a huge benefit to Nigerians, there is also the health benefit. “Perhaps, a lot more progress could have been made in our quest to find newer and better remedies for diseases if we paid more attention to scientific research.” He adds that interestingly there are several disease conditions that are predominant in this part of the world and which Africans are best positioned to find solutions to. “Sickle cell disease for instance, is peculiar to black people. Malaria is endemic in Africa. Even HIV/AIDS is more prevalent in developing countries like ours whereas in developed regions of the world, prevalence is gradually on the decline,” said Atueyi.

The Nigeria Academy of Pharmacy is therefore not only providing specialist advocacy for the revival of scientific and pharmaceutical research in particular, but also encouraging wealthy individuals and public-spirited foundations to fund research and even endow professorial chairs in these areas. According to Prof. Fola Tayo, Pro Chancellor and Chairman of the Governing Council of Caleb University who also serves as General Secretary of the Academy, “endowments of professorial chairs in our universities is a key area we are looking at because we recognise that typically, a well-endowed professorial chair in the sciences can be very productive because it would usually lack only very little.” With adequate resources to carry out researches, impact could be very dramatic, he said.

Another key area of concern for the Academy said Prof. Tayo was the curriculum for the training of pharmacists and pharmaceutical scientists in Nigeria’s universities. “Considering that the profession of Pharmacy is very dynamic, the Academy has been very concerned that such training must continue to be in line with evolving trends in the larger society such that the pharmacist continues to deliver optimal value to Nigerians.” Doing this, he said, had led the Academy to engage all of the universities in Nigeria with accredited Faculties of Pharmacy, in conjunction with the Pharmacists Council of Nigeria and consultants from the UK and the United States among others with a view to reviewing the curriculum. “This is not to say that there is anything fundamentally wrong with the current Pharmacy curriculum.” Rather he said, “All we are doing is searching for maximum value. We want the training to be as dynamic as it is in the developed countries of the world and the products of such training to deliver just as much value to society as they deliver in developed countries.”

Tayo said one of the fallouts of this focus on the training of pharmacists, was that the National Universities Commission (NUC) has approved a clinically-focussed degree, the Doctor of Pharmacy, or Pharm.D for the profession. “Training of pharmacists used to be centrally focused on drugs and medications, but today, that focus has shifted. Across the world, the patient rather than the drug is now the centrepiece of the training of pharmacists.” The shift of focus from drug to patient, according to Tayo, also implied that the training would have a far more clinical focus than hitherto. “It means that pharmacists will have to spend more time engaging doctors and nurses and other members of the clinical team than they used to.” The benefits to society of this enhanced engagement among these professional groups are huge. It means that rather than practice in isolation as was the case in the past, the pharmacist is now in a better possession to avail other healthcare professionals of his specialist knowledge even while learning more about diseases and their manifestations from his doctor colleagues. Such engagement, Tayo pointed out, could only mean better quality care for the patient and of course better inter-professional harmony.

Membership of the Academy, Tayo noted, comprises “Fellows” who have gone through a rigorous selection progress and found to have distinguished themselves in their areas of practice while also possessing the enthusiasm to contribute to helping the Academy achieve its mission. According to him, on September 15, six additional fellows will be inducted to join the ranks of the current ones. “We are confident that this addition will even further vitalise our efforts at the Academy at creating real value for Nigerians and mankind in general using science.”

For an Academy that is barely two years old, the sound bites from the professionals are inspiring and reflect a commitment to dramatically impact the country in the both the economic and health spheres. It remains to be seen if the Academy will stand the test of time and by how much it will indeed, achieve its objectives in the years to come.