Saturday letter 1
The World Pharmacists’ Day is celebrated every year on September 25th under the sponsorship of the International Pharmaceutical Federation (FIP). The theme of this year’s Annual Pharmacists Day is “Safe and effective medicines for all” which aims to promote pharmacists’ crucial role in safeguarding patient safety through improving medicines’ use and reducing medication errors by policy attention, political consideration and administrative frameworks.
The role of pharmacists’ in safeguarding patient safety through improving medicine use and reducing medication errors has increasingly been seen in introduction of a variety of measures designed to strengthen drug safety and to increase patient safety thereby reducing medication-related errors.
In Nigeria, like other countries of the world, it is a study in contrasts. An ambitious middle-income country and Africa’s largest economy, it also struggles to provide some of the most basic of services to its residents. Access to essential medicines is yet threatened by high poverty rate. Affordability declines drastically down the population profile of poverty line; an anti-diabetics drug costs N1500 for a 30-day supply of drugs, thus costing a minimum wage worker two days’ worth of work; cancer care costs about five times the monthly minimum wage for a government employee and an anti-hypertensives costs about half a day’s work for a month course of treatment in Nigeria.
It is disheartening that out-of-pocket health service and detaining patients to pay their bills are a reality. There is great disparity in the availability of health services between urban and rural areas. Some years ago, all African countries met, and agreed in Abuja to give at least 15 per cent of their entire national budget to health. Unfortunately, Nigeria’s health budget is hovering between five and nine per cent annually.
The state of Pharmacy Practice in the country poses a public health crisis mainly with access to medicine, weak standard of practices and a weak regulatory of medicines in Nigeria. It is no coincidence that Nigeria currently has one of the worst drug market controls in the world, a high rate of medication resistance and one of the worst cases of drug abuse.
In order to fulfill the declaration “Health for All” which encompasses “Safe and Effective Medicine for All” the WHO presented the concept of ‘universal health coverage’ (UHC), which is defined as “all people receiving quality health services that meet their needs without exposing them to financial hardship”.
Research has also shown an existing data indicating a shortage of pharmacists necessary to achieving safe and effective medicine in Nigeria. This is supported by a research being done by Aniekan etal, “Analysis of pharmacy workforce capacity in Nigeria” that suggests that only 12,807 pharmacist are in active professional practice as indicated by the number of licensed pharmacists in 2016 which represent 1:15,000 of the country population.
Restructuring the drug distribution sector is key to achieving safe and effective medicine for all. Distribution of drugs requires efficient supply chain systems and appropriate regulation to ensure that the medicines that reach the consumers are in their intended qualitative state, ensure that the medicine that gets to the consumers are qualitative, effective, affordable, safe and supported with the required instructor to ensure rational use in entrenching a distribution system that drug and related facilities must be well-managed to ensure they can deliver quality service.
Today, we are talking about the spread of chronic illnesses like kidney and liver problems. A lot of these problems could be traced to the uncontrolled proliferation of medicine stores in Nigeria. When medicines are available everywhere, people tend to abuse them.
Even so, the inability to effectively address the country’s numerous challenges on open drug market has contributed to the persistent barrier towards achieving the safe and effective medicine for all. The production, distribution and consumption of fake and sub-standard drugs no matter the form, reason or quantity, approach taken should not be condoned or trivialized which happens a lot in open drug market. Most of the occurrences of fake drug dealings go unrecorded which has contributed tremendously to untimely and avoidable deaths especially among the uneducated.
The quality of health care services on medicines delivered is poor and remains a huge source of concern. The private sector remains the main hub for counterfeits and substandard low-price product and main source of medicine for many Nigerians with over 10,000 unregistered patent and proprietary drug stores dominating the sector.
Information and communication technology offers the opportunity for tremendous innovation in medicine access with rigorous citizen education and sensitization, especially of the uneducated with regard to the what, how, when and where to use drugs. While mobile technology is essential to the medicine for all efforts, data coverage towards getting a central database for prescription, over- the-counter (OTC) and controlled drugs which are abused will go a long way toward reducing abuse, resistance, misuse and dependence on the negative data to the region.
Yusuf Hassan Wada, Usmanu Danfodiyo University Sokoto