The Future of Pharmacy in Nigeria

pharmacy

There seems to be an enormous gap between what pharmacists actually do and what the public perceive them to do. Despite their immense potentials and actual contributions to healthcare in our country, they are usually faced with an unfortunate, huge lack of recognition and appreciation for their roles within the healthcare system.

A consulting room with its restricted access and privacy provides a distraction-free environment for patients to build up a relationship with their doctors. The public perception however is that because pharmacists work in a shops (majority of which have private consulting areas now), they are less important, less professional with some even not realizing that Pharmacy is a profession. I often hear some people remark that anyone can practice as a pharmacist, provided you have worked in a pharmacy long enough, irrespective of your level of education.

The public need to acknowledge that pharmacists work in different work environments: academia, research, regulatory, drug discovery, drug manufacture, clinical settings, among others. It is difficult for me to imagine a world without pharmacists. Can you?

Today’s world faces problems that are complex and complicated. Too often the debate over health outcomes and managed care has glossed over a series of complex social, political, and ethical issues. The field of Pharmacy in developing and developed countries is showing rapid progress with new discoveries, policies and paradigms and seeing new challenges which require new and rapid responses.

How can we leverage this in Nigeria? Policy or politics? Political decisions have strong influence which in turn affect other policies and political initiatives around the economic growth. If there’s anything the noble profession of Pharmacy in Nigeria requires more than everything else, it is involvement in politics and policy making.

Given the prevailing trend in Nigeria today, pharmacists especially community pharmacists are seen more as businessmen/women than healthcare providers. With this widespread notion, community pharmacies need to win over the hearts of the public over their roles through policies that put them as first destination for patients.

This explains the community pharmacy involvement and underutilization in the National Health Insurance Scheme for the control of infectious diseases like tuberculosis, HIV, and AIDS in provision of effective interventions such as family planning/child spacing, which will assist in moving the country closer to achieving Universal Health Coverage (UHC). Adolescent reproductive health, health screening, disease prevention and health promotion, reduce maternal and perinatal morbidity and mortality, Malaria and HIV related mortality, are some of the interventions where pharmacists can be very useful considering the expansive and intensive nature of their training.

In the hospital setting, the responsibility of many pharmacists are obscured within a dispensary where patients may not even have a glance at the pharmacist. It is only in few hospital settings he is involved on the clinical reviews and evaluation. Pharmacists can increase their research base and start clinical trials of novel drugs and head such panels, set up researches into post marketing survey that would earn them a place and listening ears by the clinical team. As for the issue of dispensing drugs today, auxiliary nurses and doctors can now do as well as what pharmacists can do. Patent stores can (illegally) conveniently carry that out as well as open stores. Without a strong professional voice and participation in the national policy making, the profession will be unable to lobby for and meet the business demand outlined above.

Another reason is that pharmacists are largely marginalized in the clinical drug selection process; a sharp contrast to the situation in developing/developed countries. Where is the National Drug Distribution Guidelines, implementation strategy? In 2015, the Federal Government, under its National Drug Distribution Guidelines, directed that all open drug shops in market places should be shut down by July 1, 2015, shifted to 2018, yet they are still in existence.

Again, drug production and discovery; policy reversals, poor infrastructure, lack of patronage for local products and inconsistency in government policies and funding have been a challenge with only less than 40-45% essential drug production in the country. We still import APIs that we have the capacity to not only produce but to help other countries’ economy to boost and develop our economy. Policy support will help in patronizing made-in-Nigeria pharmaceutical products and domestic innovation in building capacity to produce novel and affordable medicines for local health problems; which in turn will stimulate economic development, decrease dependence on international donor programmes, and contribute to improving global health in Nigeria.

Social media also has become a forum for political discourse, a means for political engagement. Although, there is an increasing tide of awareness from young pharmacists lending a voice. We must use the media of our creative works to address the problems of our political environment. Technology has transformed the way millennials participate in politics and furthermore, it has changed the way we shape policy.

Pharmacists should be advocates and resource persons for health information. Your patients could get information through different channels and platforms. It could be written materials. It could be an app that connects patients to online health information. It could be face-to-face counseling with patients on things like smoking cessation, nutrition or fitness. The trick is making it convenient for patients.

If this is the case, why won’t as men of honor join the national politics? How will pharmacists continue to change policy if they are not in the vital decision- making positions to do so? As a consequence, there is a gap between those governing us and what we believe. Advocacy, especially political advocacy, is often viewed as a form of persuasion or influence, but it is also a form of education. A shift to a healthcare system where pharmacists are routinely reimbursed for providing medication therapy management would require policy change at the national level.

One of the penalties for refusing to participate in politics is that you end up being governed by your inferiors –Plato (427 BC – 347 BC). As men of honour, we need to do as much as possible to ensure the relevance of the profession in Nigeria’s political scene. Let's take care of the pennies and the pounds would take care of themselves.

Yusuf Hassan Wada wrote this from Usmanu Danfodiyo University Sokoto. He can be reached on hasawa2011@gmail.com