Professor Ezekiel Olugbenga Akinkunmi is the immediate past Chairman of the Nigerian Association of Pharmacists in Academia (NAPA). He is also a Professor of Pharmacy, Microbiology and Biotechnology at the Obafemi Awolowo University (OAU), Ile Ife, Osun State. At the just concluded National Scientific Conference of the association held at the Olabisi Onabanjo University (OOU), Ogun State, he spoke on the challenges facing the healthcare delivery system, underfunding of the sector among other salient challenges bedeviling healthcare delivery system in the country.
The NAPA’s National Scientific Conference has just been concluded. What’s the take away from this conference?
Our 22 conference was tagged: Gateway 2024. The theme was “Pharmacy Education, Research and Practice: Towards Global Relevance.” Global to us means being relevant globally and locally. As Nigerian pharmacists in academia, though we originated locally, but we are global citizens. The globe is our market. We are hot-cakes. We are intellectuals of repute and international experts. We are a city set on a hill that cannot be hidden. We are the very best of the very best!
There are greater benefits from this conference. The conference was a call to the fact that our researches, education and practices must be locally and globally relevant for us to contribute meaningfully to the goal of Universal Health Coverage.
In the conference, we emphasised that our researches must of necessity be geared towards addressing first the basic needs of our local community, in this case, we are talking about Nigerians, but then, it must also have a global appeal. We must train our students in the context of local patriotism as global citizens.
Without mincing words, we noted at the conference that while the Nigeria pharmacy students are being trained to serve their world, they must not forget their indebtedness to the community that raised them.
This year’s conference can also be safely tagged a Conference of empowerment. For these reasons therefore, we had a mentorship class meant mainly for the younger colleagues with the title: “How to make a success of your academic Pharmacy career,” in addition to this, we also had an Academic Pharmacy Practice Class titled: “Building a sustainable Academic and Professional Journal to global standard.”
To round up our training, we had a third sub-theme with the topic: “Nigerian Research Institutions: Strategies for Productive Collaborations.” All these themes were taken by erudite scholars and professors.
What would you describe as your achievements and specific challenges during the period of your stay in office?
Concerning achievements, I would have loved it if this answer is given by another person, especially one of the esteemed and distinguished members of our association and indeed any member of our prestigious Pharmaceutical Society of Nigeria (PSN). This is because by the grace of God we were able to cross so many landscapes in the period of our stewardship.
We were able to do a lot with the support of those who gave us this opportunity of service, the National Executive Council (NEC) of NAPA, as well as chairmen and members of various committees.
Firstly, we were able to produce a revised workable bye-law for the association, which commenced from August 2023. We also produced the Academic Pharmacy Practice documents, which was a major document used to develop the Minimum Standard for Academic Pharmacy Practice in the Compendium of Minimum Standards of Pharmacy Practice in Nigeria by the Pharmacy Council of Nigeria in May 2023.
We established the NAPA Consulting Services platform for those who were interested in consulting the expertise of Pharmacy intellectuals and researchers. This is more related to colleagues in other technical arms of our profession – hospitals, community, industry, and administrative, but also extended to the public, including technocrats, non-governmental organisations and governmental agencies, including media houses like yours.
We also started the NAPA Awards for Outstanding Pharmacy Students. The award is for any graduating pharmacy student who has excelled academically, behaviorally and in community services.
The award is to be presented during the professional induction ceremony at the various schools of Pharmacy and all award winners will also enjoy free registration and participation at the NAPA National Conference. 17 of such beneficiaries from all over the country participated in this last conference.
We also established the NAPA Intellectual Property Rights Committee. The coverage of this committee extends to all members of PSN including non-pharmacists. Again, we were able to coin a motto or slogan for our association – ‘Joining hands to produce men of honour.’ This was derived from the PSN motto – As men of honour, we join hands.
We were able to sustain the continuation and institutionalisation of the NAPA-NAIP Collaboration and also commenced the NAPA-ACPN Collaboration. NAIP is the Association of Industrial Pharmacists of Nigeria, while ACPN is the Association of Community Pharmacists of Nigeria. We also continued to enjoy collaboration with our hospitals and administrative pharmacists’ counterpart, the AHAPN, who are involved with the training of our students in clinical skills during their clerkships.
The third award of the NAPA-NAIP Collaboration grant for the development of an indigenous medicinal product for the industry was awarded during our tenure.
These various collaborations have much more varied and wide scopes that I cannot cover here now. We established a regular Webinar titled: Experts In Pharmaceutical Value Chain (EIPVC) Webinar Series, where issues and topics of relevance to members were discussed.
We also established the NAPA YouTube channel called NAPATv. We conducted pre-conference Webinars before our Annual Conference in 2023. We were also able to continue and maintain good working relationship with the PCN; National Agency for Food and Drug Administration and Control (NAFDAC); Nigeria Academy of Pharmacy (NAPHARM) and West Africa Post Graduate College of Pharmacy (WAPCP) and participated in several of their programmes, giving adequate representations on behalf of NAPA.
We have good working relationship with the Registrar of PCN, Pharm. Ibrahim Babashehu Ahmed and the heads of all other affiliated organizations, including all present and past leaders of PSN.
We participated fully and actively in all PSN NEC and Council meetings, as well as in their conferences, technical and interest groups. We tried to instill necessary disciplines in our practices among members, while upholding members’ welfare.
In the past three years, there was no single case brought to our notice that did not receive adequate attention. We supported our elderly professors as we participated and contributed fully in their valedictory and retirement programmes, while giving them opportunity for free participation in our Conferences.
We engaged in strong advocacies and strengthening of branches and also visited many of our branches across the country and paid courtesy calls on their Vice-Chancellors with continued advocacies.
We had a NAPA Pharmily meeting in February 2023 and we successfully hosted all our annual conferences. We encouraged mentorship by the establishment of Chairman’s Mentors Award and the sustenance of the already established Award for younger colleagues through essay writing on relevant topics. Our tenure was laced with promotions, elevations, appointments, wining of prestigious grants, as well as local and international awards by members.
We had the pronouncement of so many Associate Professors and Professors from all our branches. I cannot give more details here. Many of our branches have started benefiting from some aspects of the professional allowances and more are in the way to.
Unfortunately, despite all our efforts we could not arrive at the desired ends on the issue of professional allowance at the National level. However, we are still proud to say that the issue presently is not where we met it. We have moved very close to the Promised Land. We maintained total integrity in our financial records and we were as frugal as possible, while attending to all necessary issues.
The icing of the cake was the election of a distinguished NAPA member, erudite scholar and a past National Chairman of our association, as the President of the PSN, during our tenure. He is Professor Cyril Odianose Usifoh, the current President of the PSN. The last time it happened was over two decades ago. It was such a privilege to work with him.
Lastly, as I speak to you, there is presently an ongoing writing of NAPA Textbooks with titles in all areas of Pharmacy profession. Through this, we seek to provide contextually balanced and relevant textbooks for Pharmacy students and practitioners in Nigeria, the West Africa sub-region and beyond. It is expected that it will also help to save Nigeria lots of foreign exchange over time, while helping towards the realisation of the Sustainable Development Goals (SDG) of education and health for all, in our region. On this particular project, we will appreciate all the support we can get from all stakeholders in the country. Above all we give God all the glory for our modest achievements.
What would be your advice to the new executives?
Incidentally, I am part of the new executive as the immediate past Chairman. My role is more of advisory. I can tell you that, in the history of our association, new leaders have always been building on the legacies they found on ground because we believe it can only be better. I enjoyed fully the support and guidance of those who gave me the baton. I am sure that the new executive will do well. I therefore urge them to consolidate effectively on what has been done while they break new frontiers for the benefit of us all. I can assure them that we are in the journey together.
What role is NAPA playing in the success of the National Healthcare delivery system?
Asking this particular question is like asking what role pharmacists are playing in the success of the National Healthcare delivery system. We are the trainers of pharmacists. Our responsibility is to produce experts that the country can be proud of. And we are glad to beat our chest and tell you that the professionals we trained are second to none globally.
We are training professionals with local and global appeal. We are training patriotic citizens of this country. You can see them in the hospitals, community and the various industries championing the course of not only national healthcare delivery, but universal healthcare delivery.
Also, the topic of National Healthcare delivery is well situated in the Pharmacy curriculum and we are delivering on our mandate through appropriate researches, teaching and community services. We need the support of government to be able to do more.
What do you think the government can do to make healthcare delivery in Nigeria more effective and efficient?
Commitment is the word. Government at all levels needs to show adequate, continuous and trustworthy commitment. Improving healthcare delivery means getting capable hands, capable equipment and encouraging environment for it to happen. Cost of healthcare has to be made low, so that it can get within the reach of the most vulnerable among us.
Local production of essential medicines for the management of at least those common ailments among us, have to be encouraged. We should consistently work towards improving access and medicine security. I think presently government is working in that direction and I want to encourage them to keep it up. We have pointed this out in several fora.
Our faculties need to be given adequate resources and support for teaching and research into local resources for disease management. Hospitals need to be equipped. As I talk to you this is not the case in many of our public hospitals and laboratories. There is a dire need to appoint and employ able and capable experts for the training of healthcare personnel and also capable experts in our healthcare facilities at the primary, secondary and tertiary levels. This invariably means that all the three tiers of government are involved.
We should do everything to curtail the pervasive brain drain that has become a norm among health care personnel. I can tell you that this has become an emergency and we plead with government to have a look to it.
What percentage of the Federal Government’s budgetary allocation would you advocate for the health sector?
According to a World Health Organisation (WHO) 2018 report, the Nigeria health outcome indicators are still unacceptably high in spite of modest improvements. Maternal mortality ratio is 814 per 100,000. Mortality rate for infants and children under five years is between 70 and 104 per 1000 live births, respectively, while neonatal mortality rate per 1000 live birth was projected at 34.1.
Communicable diseases still constitute major public health problems. Tuberculosis prevalence was at 323 per 100,000, Malaria accounted for 27 per cent global burden, malnutrition is common with stunting rate at 43.6 per cent. Non-communicable diseases burden such as hypertension, diabetes and neurological disorder are on the rise. Poverty is still pervasive with 53.5 per cent of the population living at less than $1.9 a day. Achieving the Sustainable Development Goals (SDGs) therefore remains a challenge.
The approach of the government to embark on the domestication of the SDGs is a welcome development. There is a need to emphasise the implementation of the Primary Health Care Revitalisation Programme as a key strategy for the attainment of Universal Health Coverage. Talking of primary healthcare, the integration and institutionalisation of community pharmacy in the Nigeria Primary Healthcare (PHC) system is a critical and readily available avenue in our desire to drive necessary positive changes.
Hence, adequate budgetary allocation is the way to go. The present value of total expenditure on health as a percentage of Gross Domestic Product (GDP), which was put at 3.67 does not look okay. Also the allocation of just about five per cent of the 2024 budget to health cannot even begin to address these precarious indices. I will rather recommend a budgetary allocation of nothing less than 15 per cent as indicated in the April 2001 ‘Abuja Declaration’ by heads of state and governments in the African Union.
