How I plan to transform pharmacy practice in Nigeria – Pharm. Mohammed
In this interview with Pharmanews, Pharm. Nurudeen Aimanekhi Elijah Mohammed, who emerged as registrar of the Pharmacists Council of Nigeria (PCN) in June 2014, explains how his four-point agenda for the PCN registry will enhance the pharmacy profession in Nigeria. He also spoke on the imbalance in the pharmacist-patient ratio in Nigeria and what the PCN is doing to solve the problem. Excerpts:
You took up your new assignment as PCN Registrar after spending several years in the private sector. How will your private sector experience impact on your new public sector assignment?
My private sector experience is an added advantage to my present assignment. This is so because the PCN, as a professional regulatory body with most of the professionals in the private and public sectors, needs an administrator with experience in the private sector to be able to strike a balance in its operations.
I was fortunate to have worked closely with the public sector as a consultant in policy making and implementation, as well as serving as member of the PCN Governing Council, during which I served in the different committees of the Council. This gave me more opportunities to have a level of understanding of the workings of public service.
Also, as a certified professional manager and Fellow of the Nigerian Institute of Management (Chartered), I intend to bring to bear on PCN activities my private sector experience. I will and mesh its market culture concept of high focus on client’s needs, productivity, clients’ satisfaction, competiveness and result-oriented activities with the clan culture of the public service sector that focuses on collaboration and teamwork. In doing this, we shall be focusing more on effective and efficient service delivery and clients’ satisfaction. The era of “we are here and you are there” will no longer be the case; rather, we shall be working as partners with the overall goal of delivering quality pharmaceutical services to Nigerians.
You recently announced a four-point agenda for the PCN registry. Tell us about this agenda. What prompted it?
I was inspired to put forward this agenda when I sat down “by the River of Babylon”, meditating on the general state of affairs of pharmacy profession in Nigeria. This was several months before becoming the PCN Registrar. The practice, we all know, is faced with moral and ethical issues that have assumed a crisis status – decades of neglect and uncoordinated regulation, disobedience to pharmacy laws and ethics, and passivity by stakeholders, which have produced various cultures of pharmacy practice with various appellations (handshake marketing, register & go, heredity marketing, ‘Almajiri’ professionals of various dimensions etc.) that are devoid of self-actualisation or true commitment to the ethics of the profession.
The reasons for these are obvious: Legalisation of illegality and removal of the essence of pharmacy practice from the public domain; lack of culture of respect, appreciation, understanding and co-operation among the older, middle and younger generation of pharmacists; and lack of common vision, a unified sense of purpose, and recognition of mutual interdependence.
Indeed, a lack of coordinated regulation and control has turned the practice into Pharmaceutical Nollywood, with all shades of actors acting various scripts to suit an assortment of owners, producers and directors alike. What an interesting film show!
My four-point agenda for the PCN registry is derived from my vision and mission for the upliftment of the pharmacy profession and practice in Nigeria. Before I applied for the job of registrar, I developed the four-point agenda as my working tool to move the profession forward, if appointed. I am happy that, today, I am the registrar and the four-point agenda has come to stay as our working tool in the registry. And I count on all stakeholders to join hands with us in ensuring improved pharmacy practice in Nigeria.
The components of the four-point agenda are: Firstly, repositioning the registry for effective service delivery – by this, we mean that the PCN should be more visible and align to the yearnings of Nigerians on quality pharmaceutical service delivery. We are focusing on creating I.T.-driven pharmacy regulation with result-oriented inspectorate activities and e-practice in all its ramifications. To achieve this, we need, in addition to other activities, to review and possibly harmonise the pharmacy laws that will not only address the current lapses but be in tandem with current realities and best global practices.
Secondly, institutionalising Good Pharmacy Practice (GPP) in Nigeria. The World Health Organisation’s seven-star pharmacist concept is all-encompassing. We want Nigerian pharmacists to imbibe this concept, especially now that we are all yearning for pharmaceutical care. This will engender improved visibility and image for pharmacy practice in the eyes of the public. We expect that the GPP will bring about great improvement in the quality of work at our various workplaces, thereby promoting patients’ health and quality of life.
Thirdly, transforming career professionals into intellectual practitioners. What this means is that the era of graduating with B.Pharm. and retiring with B.Pharm. is over. Pharmacists are life-long learners and this must reflect in our professional practice. We must continuously develop and improve ourselves, irrespective of where we practise. We are redesigning, restructuring and strengthening the MCPD programmes to stimulate interest in continuous self-development and critical thinking for professionalism and self-growth. We believe this will bring about individual empowerment for self-transformation and inspiration to inspire others. We are also reviewing our curriculum in the faculties of pharmacy to produce pharmacists that will meet the contemporary health care challenges and needs of the patient.
Fourthly, the New Partnership for Progress Initiative (NP4PI). In this area, we are looking at partnering with stakeholders that will speed up our processes and practices. Such stakeholders include MDAs, Customs Service, CBN, international organisations, etc. We are also looking inward for cross fertilisation of ideas between the regulated stakeholders and the regulators. This way, we can be sure of common focus on issues and ideas with the aim of drastically reducing friction and legal tussles.
The Governing Council of the PCN was inoperative for a number of years. What were the effects of the absence of this important Council and what are the lessons to be learnt from that unfortunate vacuum?
The Governing Council of a regulatory body like the PCN is key to its effective operations. The Governing Council fashions out the policies that drive the day-to-day activities. So, absence of the Governing Council will naturally impact negatively on the activities of an agency like PCN. We have witnessed this in the past and we do not pray to have such vacuum again.
The major effect of the absence of the PCN Governing Council in the past is that the registry was left to carry out routine activities. This, in effect, means that when there were critical and challenging issues to be addressed, it became difficult to urgently apply necessary measures. A case in point here is the review of the PCN Act, which has been on the drawing board of the PCN for over ten years without much progress.
The key lesson to be learnt from this absence of the Governing Council is that it retards progress in regulatory activities. It is advisable that government considers the statutory boards/councils whenever dissolution is to be effected.
There is still a great imbalance in the pharmacist-patient ratio in Nigeria. What is the PCN doing to tackle this challenge? How can it help boost the quality of pharmacy education and number of practising pharmacists in Nigeria?
The imbalance in the pharmacist-patient ratio in Nigeria is disturbing. While the WHO recommended ratio is 1:5000 pharmacist-to-patient ratio, as at today in Nigeria, the ratio of practising pharmacists to patients is 1:15,000 (based on estimated population of 150m).
The associated problem of brain drain is not helping matters in addressing this problem. The PCN has done quite well in trying to bridge the gap, considering the number of accredited pharmacy schools in Nigeria. As at today, we have 17 accredited pharmacy schools; and about four others are at various stages of accreditation.
The PCN is doing quite well in accrediting eligible schools for training of pharmacists, and this is one of the ways of addressing the challenge. The PCN is also carrying out advocacy visits/appeals to state governments to sponsor their indigent students to study Pharmacy in Nigeria and abroad.
In terms of the quality of pharmacy education, the PCN is working on reviewing the pharmacy curriculum and enhancing the pharmaceutical care content. We are not only working on the quality of education but on the quality of pharmaceutical service delivery by creating enabling environment for the practitioners.
What are your thoughts on the theme of the 87th PSN Conference, “Transforming Pharmacy Practice for Better Outcomes”?
The conference is in line with my four-point agenda and the overall focus of the current Governing Council of the PSN, under the chairmanship of Pharm. Bruno Nwankwo and, indeed, the spirit of transformation of the Federal Government of Nigeria. We need transformation of pharmacy practice, prompted by ‘zeal to lessen the burden of the sick’ and there cannot be a better time to start it than now.
Critical times call for a radical response from the people of conscience. Traditional means, methods and modes of thoughts are insufficient to meet the needs of the present hour! A more drastic approach is required.
In every generation, people of conscience usually come forth from within the people to bring about a change for good. They are ‘separated’ men and women who are satisfied with nothing less than undivided devotion to the good of humanity, uncompromising obedience to the will of doing what is right, and unflinching engagement with a culture that is hostile to all things of good conscience.
Revolution rarely begins suddenly. Instead it grows up over time as people become less and less satisfied with conditions as they are. One incident leads to another and tensions mount until, finally, one catalytic event becomes the flashpoint that propels them into action. As a ‘professional nation’ must we wait for this to happen before we know that things must change for good?
The pharmacy profession and indeed many practitioners have watched – mostly in silence – as the voice of reasoning and the laws of the practice were progressively ‘legislated’ out of the public arena, as the gladiators ‘worshipped’ at the altars of greed, materialism and selfishness to perpetuate the malevolent deeds.
A revolution, not of violence and destruction, but of love, professional sanctification and radical devotion to what is good, can bring us out of the woods. This is only achievable through a process of self and systemic transformation and actualisation.