How government aided proliferation of patent medicine dealers – Sir Chukwumerije
In this interview with Adebayo Folorunsho-Francis, Sir Anthony Azubuike Chukwumerije, a Fellow of the Pharmaceutical Society of Nigeria (FPSN) and first president of the Pharmaceutical Association of Nigeria Students (PANS), revealed how government encouraged proliferation of patent medicine dealers. He also disclosed the reason pharmacy students went on hunger strike in the 1960s and why he thinks pharmacists are the most suited for public offices. Excerpts:
Tell us a little about your educational background
I gained admission into Government Secondary School, Afikpo (now in Ebonyi State) in 1953 and I went to the Nigerian College of Arts, Science and Technology, Enugu,for my G.C.E. Advanced Level studies in Physics, Chemistry and Biology In 1958. I also attended the Nigerian College of Arts, Science and Technology, Ibadan (Oyo State), for my diploma studies in Pharmacy, and the University of Ife, Ile-Ife (now Obafemi Awolowo University) in Osun State, for a degree in Pharmacy.
Would you say studying Pharmacy was a good decision for you?
Pharmacy was a wise choice, even though there were occasions when one had one’s doubts. For example, while at school, we learnt that despite the fact that we entered pharmacy school with G.C.E. A Level papers in three core science subjects, we were,on graduation,to be placed at a grade level in the civil service that was lower than that of other graduates. At that time, we went on hunger strike and the school authorities had to beg us to call off the strike after nearly four days. This, notwithstanding, pharmacy students were still the busiest, the happiest and the most sought after in the campus.
How does the pharmacy profession in your day compare to today’s practice?
Pharmacy practice was characterised by fighting within and fighting without (in the civil service). We contended with low salary grading and unfavourable practice environment. There was no job satisfaction, and all the years spent at school seemed wasted. Many left for Medicine and others for Law. Community pharmacy practice was fully rewarding and the few who were in it prospered financially and in health. Quackery was minimal and proliferation of adulterated and fake drugs was not common.
What about the problem of drug counterfeiting?
Dealers incounterfeit drugs could easily be traced and dealt with;while multinational drug companies who dared sell prohibited drugs to the open market were easily identified and their parent companies in Europe queried and admonished. There was strict adherence to discounts to pharmacies, hospitals and doctors. Indigenous drug manufacturing was at its incipient stages and only multinational companies imported drugs and medicinal products.
Soon after, drug detailing started and the early pharmacists who were in it had chauffeur-driven flashy cars and enjoyed bountiful allowances. Then the civil war set in and, after it, every person became a drug seller and governments introduced import licences for importation of drugs, even to moneybags who never went to school. Abuse inevitably set in and remains uncontrollable.
Did you also contend with the issue of multiple registration of premises?
The Supreme Court’s interpretation of “in continuous supervision” of a premises has finally settled that (the issue of multiple premises for practitioners) and considerably reduced the takehome income of our members, while medical practitioners got away with multiple clinics.
As I earlier mentioned, counterfeit, sub-standard and adulterated drugs are still everywhere. When Chief Akuneme (now late) was the Chief Inspector in Eastern Nigeria, he would trace any drug classified as poison found in any marketplace to its original manufacturer in Europe or anywhere and inquire why such a drug should be found in the shop of a person not licensed to practise as a pharmacist. Any dealer in counterfeit, sub-standard or adulterated drug was promptly prosecuted.
Some state governments themselves encouraged sale of drugs in open markets by issuing drug importation licences to unqualified persons. Pharmaceutical inspectors were few and could not cope with the problem. Schools of pharmacy were few and only a few pharmacists could be produced. Consequently, community pharmacists already restricted by law to one premises each,could not cope with the expanding population, and colluding governments seized the opportunity to proliferate patent and proprietary medicine stores.
Predictably, in a very short time, the patent medicine dealers outnumbered qualified pharmacists and having saturated the towns, they invaded the open markets, formed very strong unions, and overwhelmed the few fearless pharmacists who wanted to do honest business. The situation has persisted even though the late Director-General of NAFDAC, Dora Akunyili, dealt severe blows on counterfeiters, open market drug dealers and importers of fake and sub-standard drugs.
What is your view about pharmacists in politics?
I have always advocated that pharmacists should be in politics. We are the only health professionals properly trained to handle men, money and materials. Remember that pharmacy is a profession, a science and a business. Tell me of any business that is more complex than politics and government? If pharmacists are in government, they will correctly interpret the pharmaceutical component of any health bill to their colleagues and be in a position to challenge assaults on pharmacists in any area of practice.
How best do you think the issue of fake drugs and counterfeit medicines can be curbed?
I have earlier suggested that to curb fake drugs and counterfeit medicines, a competent and incorrupt pharmacist should head NAFDAC. Some state directors of pharmacy are also corrupt and issue patent and proprietary medicine licences recklessly; andthey hardly go oninspection nor have a strong inspectorate division.
In our time, part-time inspectors were appointed from practitioners to complement the scarcity in government. Even though governments in Nigeria pay lip service to local manufacturing, I have not seen any incentive to local manufacturers of anything. All sorts of things are imported freely into this country; and these include drugs.
To what extent did you participate in pharmaceutical activities?
I was the first president of the Pharmaceutical Association of Nigeria Students (PANS). We started fighting for pharmacy while at the university and I remember being called to the office of the then Vice Chancellor, the Late Prof. Oluwasanmi, to be persuaded to ask pharmacy students to call off their strike and go back to the classroom.
At the end of the Nigerian civil war, I found myself in Enugu. I enrolled with the Enugu State branch of the PSN, became its Assistant Secretary, then Secretary, then Assistant Chairman and finally, Chairman. I was member of council for several years and served in various committees both at the state and national levels. This culminated in my award of the Fellowship (FPSN) in 1985.
What is your impression about the annual PSN national conferences?
The annual PSN conference was instituted in our time and pharmacists generally loved it. I remember that as a younger man, I never missed any PSN or FIP conferences but age has many limitations including less travelling and limited resources. These conferences afford opportunities for interaction, fellowship, updates in scientific advances, getting to know places and asking questions on confusing issues. Branches and more affluent members should occasionally sponsor older colleagues to some of these conferences.
Should an active pharmacist be made to retire?
My answer is yes when he can no longer understand advances in the profession and would therefore not counsel properly on the correct and safe use of drugs. In my opinion, all professionals should retire at the age of 80 and like the psalmist, number their days to apply their hearts unto wisdom.
What is your advice to young pharmacists?
Young pharmacists should learn to appreciate their profession and do whatever they can in their practice area to adhere to good and ethical practice. The present acquisitive proclivity of the youth is condemnable. Wealth comes through hard work and faith in God whose wish is that we should prosper and be in health, even as our souls prosper. If we all practise ethically and not abet quacks and counterfeiters, no pharmacist has business with poverty.