Dr. Kingsley Chiedu Amibor is the National Chairman, Association of Hospital and Administrative Pharmacists of Nigeria. In this interview he ex-rayed the challenges faced by pharmacists and what the government must do to win the war against COVID-19. Martins Ifijeh brings excerpts:
How would you assess the contribution of hospital pharmacists in the fight against COVID-19?
Pharmacists as frontline healthcare workers have made huge contributions towards the curtailment of the spread of COVID-19 in Nigeria. This ranges from the production of hand sanitisers, provision of medications used in managing COVID-19 to making face masks and other personal protective equipment available to those that need them. Our members also offer pharmaceutical care and medication therapy management. In collaboration with other healthcare professionals, hospital pharmacists are ensuring that there is improvement in quality of life of patients as well as reduction in hospital stay. Pharmacists in virtually all hospitals (federal and state) with the exception of few, have been involved in producing millions of litres of hand sanitisers in both single packs for individual use and large packs for use in wards, clinics and so on.
What challenges are your members facing in curbing COVID-19?
The biggest challenge confronting our members right now is inadequate personal protective equipment which is in short supply. In particular, the N95 Face masks which to some extent can prevent the healthcare worker from being infected with the virus are in short supply. Even the surgical face mask is equally not adequate. This is a major source of discouragement to our members.
Why are health professionals opposed to the importation of Madagascar COVID-Organics into Nigeria?
There have been several controversies around the importation of COVID-Organics into Nigeria. One of the grounds for opposition is that for a long time, Nigerian scientists have been proclaiming that they have herbal cure for COVID -19. But, nobody seemed to give them a chance, in terms of inviting them for clarifications.
At the same time, many universities and research institutes have been crying for funding to enable them carry out research into cure for various ailments. And then all of a sudden, Madagascar, a third world country just like Nigeria came out to say, oh we have discovered a herbal cure for COVID-19 and then the government now begins to show interest and say, okay bring this product into Nigeria and lets use it on our people. Don’t forget that the World Health Organisation (WHO) had warned that clinical trials have not been conducted on COVID-Organics to establish its safety and efficacy profiles. Moreover, in the country where it was produced, the product was only used on few people, the results obtained with those few people could have been subjective, in other words, it may or may not have been due to the COVID-Organics.
Another reason for the opposition is that the parent plant from which COVID-Organics is produced Artemisua annua grows here in Nigeria. Nigerian pharmacists have the potential and wherewithal to extract the active ingredient which is artemisine from the parent plant if given adequate support.
What is your take on the use of herbal remedies in the treatment of COVID-19?
Herbal products generally find use in the treatment of many diseases including infections. These products are believed to be generally safe and of low toxicity, compared to most orthodox medicines. One challenge with their use is that herbal products are not standardised, and so you find one herbalist will tell you to drink two glasses morning and evening for example to achieve laxative effect with a particular herbal product. Another herbalist will produce his own from the same leaves and tell you to drink half glass may be three times daily to achieve the same effect.
What kind of motivation do your members need to perform optimally?
There are many challenges confronting our practice as hospital pharmacists. First is our work environment. There is hardly enough space in most pharmacy departments. Some do not have counseling rooms to ensure patient’s confidentiality. We are asking that pharmacy departments in various hospitals be restructured to make room for offices, patient counseling rooms and so on. The existing pharmacies that still have some space can be restructured to provide for counseling rooms. The Pharmacists Council of Nigeria (PCN) has a prototype of what each pharmacy department in our hospitals should look like. All hospitals are encouraged to key into the PCN model.
Second, is that the out-of-stock syndrome is gradually creeping back to our hospitals because the Drug Revolving Fund which was put in place by government to guarantee continuous medicines availability in hospitals is being mismanaged by most hospital’s top management. You collect medicines from a drug manufacturer on credit, promise to pay within 60 days, the medicines are sold and rather than settle the supplier, such monies are diverted to meet other hospital needs. This practice is rampart in virtually all the hospitals in the country. The result is that as at today, most tertiary institutions owe drug manufacturers close to N3 billion from unpaid drug purchases.