How to avert looming scarcity of safe, cheap drugs

*PSN appeals to government to ensure lawful, befitting appointments in pharmaceutical sector

Ahmed I. Yakasai is the President of the Pharmaceutical Society of Nigeria (PSN). A veteran practitioner of almost 35 years experience, Yakasai is a former Chairman of the PSN (Kano State Branch), first Deputy President at national level and two-time past commissioner in Kano State for eight years.
Yakasai in this interview with The Guardian ahead of the 89th Annual National Conference of the Society in Minna, Niger State, scheduled from November 7 to 12, 2016, shared perspectives in pharmacy and health
management in Nigeria. CHUKWUMA MUANYA writes.

The scarcity of forex must be affecting pharmaceutical sector like other sectors of Nigerian economy. How is the PSN managing this situation in conjunction with the federal government?
After a careful evaluation of the impact of the current paucity of forex in the country which is gradually grinding operations in drug manufacturing and importation outlets to a halt in the days ahead, I appeal to President Muhammadu Buhari, to urgently intervene to prevent an impending national calamity which will lead to morbidity and outright mortality of consumers of health in Nigeria.

We reason that empty warehouses of a plethora of the pharmaceutical companies due to inaccessibility to forex to directly source finished products, active pharmaceutical ingredients (APIs) and other excipients will naturally breed out of stock syndrome in the inventory of life saving drugs with obvious consequences in the days and weeks ahead, as most companies will exhaust the leftover stocks from last year.

We further posit that it is impossible to transact pharmaceutical inclined business at the rate of $1 to N400 as the drug products from such transactions will be completely unaffordable thus defeating the goal of our National Drug Policy which advocates the availability of safe, efficacious and affordable drugs in the health system at all times. Flowing from the above, we call on the Federal Government to facilitate better access to forex to pharmaceutical companies as a matter of priority in view of the security dimensions of the out of stock syndrome which has a propensity to boost the fake drug syndrome as charlatans will certainly exploit the vacuum created by a lack of basic drugs.

What are you doing to stem the tide of the renewed influx of fake drugs in Nigeria?
The sale of drugs in open markets is a despicable act, which the law forbids. Unfortunately we did not manage a few things well in the past. In the immediate past dispensation Pharma stakeholders including operators in open markets resolved to restructure the entire drug distribution chain to provide for Mega Drug Distribution Centres (MDDCs), State Drug Distribution Centres (SDDCs), regular wholesalers and coordinated wholesale centres (CWC) which will be a metamorphosis and complete transformation of market structures to neat enclaves which PCN and NAFDAC can regulate. We are working on this and the major players in markets are making progress to meet the August 2017 deadline set by Government. In a nutshell open markets will be closed after this deadline and drug distribution endeavours will be professionalized in this clime.

Do you believe that government will abide by July 2017 commencement date of the implementation of amended National Drug Distribution Guideline (NDDG).
In this regard we are on course absolutely. The Pharmacists Council of Nigeria (PCN), National Agency for Food Drug Administration and Control (NAFDAC), Federal Ministry of Health (FMoH) and pharma stakeholders including Pharmaceutical Manufacturers Group of Manufacturers Association of Nigeria (PMG-MAN), Association of Nigerian Representatives of Overseas Pharmaceutical Manufacturers (NIROPHARM), Association of Pharmaceutical Importers of Nigeria (APIN), Association of Community Pharmacists of Nigeria (ACPN) and representative of non-pharmacist wholesalers who are expected to move to the proposed Coordinated Wholesale Centres (CWCs) are in one accord to change the unhealthy status quo we have allowed in the country.

The Coordinated Wholesale Centres are already being constructed in some parts of the country. You will agree with me this is very strategic to our overall success. It is my belief that when PCN and NAFDAC structure are fully established, we shall mobilize to consolidate our present level of commitment and gains.

The PSN remains committed to decorous drug distribution channels and I assure the consuming public we shall not fail in this regards.

We have had appointments in most parastatals including some in the health sector, when and what do you expect with notable appointments in the pharmaceutical sector?
You must continue to reckon and remember that it is the prerogative of the federal government to carry out these appointments whether at PCN, NAFDAC or Nigerian Institute for Pharmaceutical Research and Development (NIPRD), which I believe you are referring to. I however presume that your interest is predicated in public interest especially in the value such appointments can bring to bear on public health endeavours.

Our first priority is to ensure lawful appointments on all pharmaceutical platforms because we certainly do not envisage or pray for the disruption in equilibrium we experienced at PCN when representatives of PSN was compromised due to a distasteful manipulation by an interested party. We once had the same scenario at NAFDAC, which degenerated to a court action in another dispensation.

To avoid an unpalatable discourse the PSN has since recommended its representatives to the Honourable Minister for Health as provided for in Section 3 (1) F of the PCN Act. The federal government is also familiar more than ever before with the condition precedent to appoint substantive Director Generals (DGs)/Chief Executive Officers (CEOs) for NAFDAC and NIPRD.

We shall continue to believe that an administration that abhors corruption like the incumbent government has practically demonstrated will be seriously mindful of appointing elements who have antecedents that are tainted with corruption or other negative vices in previous positions they held in public or private sector. It is instructive to put on record too that to appoint regulators especially in our sector, such must be premised or built around persons who are conversant with the terrain to be regulated. I therefore appeal to the federal government to give us lawful and befitting appointments in the pharmaceutical sector in the days and months ahead.

The 89th Annual National Conference of PSN holds in Minna from November 7 to 12, 2016. What do we expect?
This conference has as its theme “Pharmaceutical Industry Contributions to National Development”. The Vice President His Excellency, Prof. Yemi Osinbajo, is expected to declare it open as a Special Guest of Honour, while the Governor of Niger State is Chief Host and the Honourable Minister for Health will be the Guest of Honour. Our nation needs to develop an efficient manpower base in the quest for self sufficiency and economic growth. This unique conference will therefore exploit avenues for this much sought after maxims as it concerns the Pharmaceutical Sector of the economy.

It is a peculiar gathering of pharmacists and other scientists nationwide as well as the diaspora, so you can only expect us a new positive force to emerge pharmaceutically speaking after November 12, 2016.

Do you have any update in the quest to improve welfare of health workers in Nigeria?
We wish to appeal to the President Muhammadu Buhari led federal government to give immediate attention to the clamours of health workers including pharmacists to redress some pressing welfare demands.