‘Why government should improve investment in healthcare’

As COVID-19 continues to disrupt the medical services, President, Pharmaceutical Society of Nigeria (PSN) Mazi Sam Ohuabunwa in this interview with STANLEY AKPUNONU stressed the role of digital technology and why there should be more investment in the healthcare industry.

What’s your take on the funding of the health sector and the role of technology in improving the industry?
The country has failed to understand why it is important to make investments in healthcare. In the last couple of years, it was never like this; the Nigerian government post-independence invested in healthcare. As a pupil going to school one day, while my uncle gave me a lift in Port Harcourt, I sustained an injury. He took me to the health centre near my school; I was treated and he dropped me at school. I went for constant dressing and given medicine, my parents did not come; nobody asked me any question, just my name and I was treated. That was the country we had then.

I also can remember my brother having an appendix and was rushed to the hospital; my parents did not pay a dime, but he was treated. It did not matter whether we had money or not.

In the sixties and seventies, Nigeria set up a vaccine laboratory plant in Yaba, Lagos; we were making a yellow fever vaccine. But in the last 25 years, the laboratory went down and not much has happened. Recently, the government said they are doing Public-Private Partnership (PPP) with a pharmaceutical company, but it is not up on stage. We abandoned investment; vaccines are very delicate and you need the highest level of technology to be able to it. The point is that the country does not have the technology; we have not made the right investment in anything relating to the vaccine. We are not even able to resuscitate the old one we had, even if the lab was existing now, it is of no use because technology has changed.

The country is facing revenue challenges; it is over-borrowing, almost going beyond its limit. There is a physical responsibility act that states that country cannot borrow more than 3 per cent of GDP; we are almost there if not slightly above. We have borrowed so much that our debt payment provision in the budget is almost higher than the capital budget; such a country cannot invest much in this area. Human Immunodeficiency Virus (HIV) is funded by donor agencies, likewise vaccination, tuberculosis, and malaria. So, what are we funding? The challenges are many. The major issue is that we do not have the technology, funding and we do not even have the right leadership. The donor agencies are even getting tired; they are getting tired of even the one they are giving us, they are not even sure we are using it well.

How would you rate the government response to healthcare challenges?
We have found a change in attitude now; the government has begun to do things differently, and the National Assembly is making money available for research. The Central Bank of Nigeria (CBN) is making money available for research, giving grants, aids, and soft loans to researchers and institutions. That is the hope and that is why I believe we can come out with therapeutics, especially in the area of comparative advantage, which is in the area of phytochemicals, herbal medicine, and traditional pharmaceutical medicine. We can produce something that is useful in the management of COVID-19.

The Central Bank of Nigerian released 100billion for pharmaceutical health companies, how would you rate access to the fund?
Many of the companies that applied, a significant number of them have received, especially the well-established pharmaceutical manufacturing companies. Let’s say 60 to 70 per cent of the applicants have received the funds. However, almost all of them are facing the problem of foreign exchange because the money is essential for building capacity; either building new plants or expanding the old one and they cannot get foreign exchange. That is where they are having a problem. The allocation in the bank is limited and they have to go outside to sources and that increases the exchange rate with which they made their plan. That is the greatest problem and we have made a request that the CBN should make a special provision for these companies so the money does not lose value because if it does it would create a problem during repayment.

The N100 billion is for pharmaceutical health companies for capacity development, building new plants, and expanding both in products and technology. There is also a different allocation for research for individuals, universities, research institutes. Both funds are stepping in the right direction and they are things that we have been begging to happen and we are happy they are happening, though we still need more.

Recent reports show an increase in adulterated and illicit drugs in the market, what went wrong?
It is the issue of disruption in global supply chain logistics. When things could not come out from China, India too stopped, and many countries banned both raw materials and finished goods. So, people took advantage and fill the gap; it was a good opportunity for fake and substandard drugs to come in. Soon, the incident would reduce once things come back to normal. The problem will not be long-lasting.

What is the update on the pharmacy bill and what problems will it address?
The pharmacy bill is in the Senate, it has been passed in the House of Reps; the senate is working on it. When I visited the National Assembly last week, I was told it has been listed a number of times, but because they are so busy with too many things, and are yet to place it.

The bill is to broaden the spectrum of regulation, what we have now is the Pharmacist Council of Nigerian law; that is what is subsisting today. But what we have now is the Pharmacy Council so that it covers every aspect of pharmacy. Some of these miscreants selling drugs call themselves all kinds of names, say the existing law is for pharmacists and since they are not pharmacists, the law does not cover them. This one covers everything about pharmacy, which is one major change. It also gives a greater spectrum for regulation and providing additional funding opportunities to PCN. It would also reduce costs because the current council is unyielding; the new law will save costs.

If you are coming to a council meeting and you have like 100 or 200 people in a meeting, it does not make sense, so the new law reduces it. Instead of having the director of pharmaceutical services from all the states, they bring representation from geopolitical zones. First to make the meeting manageable and reduce cost because the government has been talking about reducing cost. We are consuming 70 per cent of the budget on recurrent expenditures; the government is looking for a way to reduce cost and that is it. Though some self-thinking individuals are not okay with it, that is the way to go.

How did the protest that rocked the country recently affect the pharmacy industry?
About 11 to 13 companies were affected; there was one that was completely razed, and other vandalized. The loss would be not less than 5billion. I do not have any record of any pharmaceutical company being vandalized; we are only talking about the community pharmacies. The immediate effect is that people they are serving have lost the opportunity to be served. Again, they have put off work and destroyed wealth; people working there have no work. This is the issue we are dealing with; there is the loss of manpower, loss of labour, income, and overall loss of service and contribution to the economy. Our hope is that the Lagos State Government said they would help and we also hope some of them have insurance.

What is your reaction to the 2021 proposed budget for health?
The budget shows we are still not ready to invest in healthcare; I do not know when we will be. If COVID-19 has not shocked us enough to put more investment in healthcare, I do not know what will make us do so. We hope the shortfalls would come from the private sector and of course we have a large chunk from donor agencies; we hope they would continue to support us.