How to reduce menace of drug abuse, misuse in Nigeria

The 2018 National Summit of the Association of Community Pharmacists of Nigeria (ACPN) has made recommendations of how to reduce the menace of drug abuse and misuse in Nigeria as well as six recipes to revive the ailing National Health Insurance Scheme (NHIS).

The Summit in its resolutions endorsed by the National Chairman, ACPN, Samuel Adekola, and the National Secretary, Bose Idowu, clamoured for clearly defined boundaries of operations for Patent Medicine Vendors (PMVs) and other members of the healthcare delivery system in the handling of drugs such that, the pharmacist leads drug related decisions due to superior training and knowledge of drug composition and manifestation in the human body.

The pharmacists said the role and rightful place of each health team player should be conceded to them and respected for the benefit of the general public.

The Summit therefore counseled that access to drugs should be restricted and supervised by Community Pharmacists (CPs) in every establishment.

It noted that drugs should be taken off the streets and the efforts towards advocating the prevention of drug abuse and misuse to the public via information, education and communication channels intensified.

The Summit declared that the National Drug Distribution Guidelines (NDDG) should be prioritized through political will based on the perspective that it serves the interest of the Nigerian populace on the long run.

It noted that measures should be put in place to hasten the siting and structural development of coordinated wholesale centres in the priority locations to safeguard the health of Nigerians.

The Summit called for a speedy assent of the Pharmacy Act, which authorizes the establishment of Satellite Pharmacies and the support of pharmacy education in public interest.

There should be a concerted effort to improve the infrastructural amenities in the rural areas to facilitate the motivation of CPs to locate in rural settings.

The Summit critically appraised the NHIS and strongly recommended:

*Fees for services rendered by all providers should be paid directly by Health Maintenance Organisations (HMOs).

*Health insurance should be made compulsory as soon as all existing lapses are redressed.

*Pharmacist Council of Nigeria (PCN) should insist that only registered pharmacies are to be involved in the scheme.

*Fees for services should be unbundles and kept by the HMOs.

*Pharmacists’ seal on prescriptions should be made compulsory to attract payment of all services.

*NHIS should review drug prices annually in consultation with the ACPN.

The Summit encouraged ACPN leadership to continue to work with the National Agency for Food Drug Administration and Control (NAFDAC) to ensure smooth enforcement of regulatory standards in CPs and institute a workable regimen of registering orphan and service drugs using the instrumentality of NAFDAC Automated Production Administration and Monitoring System, called NAPAMS, which aimed at improving registration and monitoring of counterfeit drugs in the country.

The Summit while appreciating the modest strides of NAFDAC urged it to review some of the condition precedent attached to its Mobile Authentication Service (MAS) initiative and other cutting edge technologies.

The Summit suggested the setting up of joint consultation teams from NAFDAC, MAS service providers and ACPN to redress existing challenges and promote collaboration.

The Summit charged the ACPN leadership to further evaluate regulations backing up the setting up the Satellite Pharmacies so as to make the Satellite Pharmacy concept a fruitful venture.

The Summit reasoned that the pharmacist is valuable and his knowledge is valuable.

In the light of the foregoing, CPs must justify the confidence of the consuming public as it oversees the totality of medicine management and make referrals when necessary.

The Summit demanded minimum benchmarks for proper labeling initiatives in the Pharmaceutical Sector with regards to:
*Manufacturers and importers who must ensure that their products bear classification as OTC (Over the Counter) or POM (Prescription only medicines) which will ease regulation of PPMVs who are licensed to carry only OTCS and result in the protection of the patient.

*Engagement in proper labeling of medicines dispensed from Community Pharmacy premises such that the patient has very clear instructions about the dose and frequency of medications on a preprinted label, which will also bear the name of the dispensing Community Pharmacy.

Summit subsequently mandated the ACPN NEC to ensure immediate commencement of labeling initiative in CPs.

The Summit acknowledged the Federal Ministry of Health (FMoH) had resumed work on the abandoned Project of instituting a National Prescription Policy (NPP), a 2013 initiative of the PSN.

This, the pharmacists said had resulted from the unhealthy rivalry among healthcare professionals and the motive to ensure controlled and regulated access to medicines which will reduce the ravaging menace of drug abuse and misuse in Nigeria must always be the guiding light of this endeavour.

The Summit solicited that the constituted National Committee for the NPP should include the national chairmen of ACPN and AGPMPN, to facilitate private sector participation and compliance.

The Summit strongly supported and commended the trans – generational Community Pharmacy Investment agenda of the current leadership of ACPN and agreed that one strategic move to achieve this lofty vision of the Association is by creating structures with supporting systems for collaborations among CP’s that will eventually crystallize to group practice models among the practitioners –a one critical panacea for sustainability.

The Summit adopted in line with International Pharmaceutical Federation (FIP) /World Health Organisation (WHO) policies the expanded roles for CPs, some of which includes point of care testing, non-routine immunization services, non- invasive family planning services, health information and promotions, primary prevention of non-communicable diseases such as cardiovascular disease and diabetes.

The Summit directed the ACPN leadership to foster fresh partnerships with PCN and NAFDAC due to the effect of the inadequacies in the monitoring and control procedures in Nigeria on ACPN members.

“The ACPN must partner with PCN and NAFDAC to boost ethically driven inspectorate activities. This will involve a request for joint inspectorate teams from these agencies to redress our challenges in practice.”