Dr Leo Egbujiobi is the immediate past president of the Nigerian Association of Pharmacists and Pharmaceutical Scientists in the Americas (NAPPSA). In this exclusive interview with Pharmanews, he highlights the notable achievements, legacies and challenges of his tenure. Excerpts:
Congratulations on your successful tenure as president of NAPPSA. You previously listed some objectives you intended to focus on during your administration. What would you consider as your major achievements?
First, let me congratulate Pharmanews – the publisher and the staff – for the excellent service you have rendered to pharmaceutical science and the pharmaceutical industry in the past 41 years. It is overwhelming and humbling to see the significant number of awards that the organisation has garnered.
I am very proud that Sir Ifeanyi Atueyi and his staff members have done a great job. It is indeed a remarkable achievement for the management of Pharmanews to have attained this height. Thank you for the excellent job that you have done and continue to do.
Coming to NAPPSA, I don’t want to see what was done while I was president as my achievements. As the president of NAPPSA, I only helped to build the second layer of the foundation. My executives and I charted a course to fortify the foundation in the area of communication, pharmacy education and alliances. Our discussions also covered making Pharmacy in Nigeria a respected profession. What we have done was to usher NAPPSA to the third layer of its existence.
It was really interesting that the NAPPSA forum, which is now a widely used platform of communication, came out of frustration when our last convention was frustrated by cancellations due to crisis in the hotel where we were supposed to hold the conference in Atlanta. Several phone calls were made but we had difficulties communicating about the event. Then, Mrs Emelia Orubele, who was my chief coordinator for the Atlanta convention, advised that we open an online platform. That was how people came across the NAPSSA forum, which is now a big WhatsApp group.
I really had problems communicating with the members, because a lot of people don’t read their emails or even visit the NAPPSA website; but they go to the NAPPSA forum to join conversations. The forum has really bridged the communication gap among members. It is a good network opportunity for members to know what is going on and to discuss issues.
Prior to the creation of that platform, communication was not easy among NAPPSA members. You could write letters to 200 persons but only 10 would respond. It is different now with the forum. And, obviously, the current leadership of Dr Tony Ikeme is taking it to a higher level.
Looking at our achievements in terms of the groups and organisations we were affiliated with, I think our greatest impact was in communicating with the Nigerian Medical Association (NMA), and jointly with the Pharmaceutical Society of Nigeria (PSN) and the Pharmacists Council of Nigeria (PCN), along with the Medical and Dental Council of Nigeria (MDCN). All these organisations have a similar goal, which is patient-centered approach and they also have a lot of joint conferences. Right now, I know that the PSN, PCN, and NMA are in constant communication to define the role of a pharmacist, a medical doctor, and a nurse, while the NMCN gets involved in taking care of the patient.
We all know that when these three entities work together, the patient outcome is improved. So I would like to say that this is a significant measure that will yield fruit down the road. It is not about what we have done today. It is about what we have left behind that will continue to grow, because a society does better when their old folks plant trees, which they themselves may not benefit from. It is not what I benefit from; it is what will benefit the organisation in the future.
You also mentioned in a previous interview that you were going to find a way of making it easier for Nigerian pharmacists in diaspora that were interested in coming home to practise to do the necessary qualifying examinations and get the certification they needed with the PCN. How much of this was achieved?
It was huge, and it came to fruition. My biggest thanks to the PCN registrar, Pharmacist Elijah Mohammed; and his assistant, Dr Anthony Idoko. We actually had the first group of NAPPSA members in Nigeria for three weeks for certification. They did three weeks online and in Lagos they had their first inaugural training. I came in for one day for the opening ceremony.
From what you’ve observed about the batch of pharmacists that came for the PCN certification last year, how impactful would you say the certification has been on their practice?
The certification serves two purposes. One, they can go home and practise. And two, it allows them to have dual practice; they can practise in Nigeria and also in America. The Association of Community Pharmacists of Nigeria (ACPN) which is the section for retail pharmacists now relate with the counterparts of NAPPSA, and we believe that, with that synergy, there will be exchange of skills and transfer of technology.
Definitely, leading an association like NAPPSA comes with some challenges. Looking back at your tenure, what could you identify as your toughest challenge?
The main challenge was communication, because you can have big dreams, but without communication, you can’t get anywhere. Also, the rapidity with which we wanted to change things was there, but people were slow at adapting to changes; so, the intersection of rapid change and time caused a lot of difficulties.
As a physician, my job is almost 24/7. I wake at six in the morning and I go to bed at 2.00am; so every hour is accounted for. But that is not how everybody else works. So, whenever I was ready to talk to NAPPSA members then, they would have already gone to sleep. That break in the communication channel led to a lot of challenges.
Again, the formation of an NGO in Nigeria to help NAPPSA was a great idea. It went fast but we were held back by the “Nigerian factor”. The joint exercise of Association of Nigerian Physicians in Americas (ANPA) was another thing that moved very fast, but the major challenge was communication.
Having joined the respectable league of past NAPPSA presidents, what is your advice to the new NAPPSA leadership?
It is actually simple because I am the immediate past president; so I am still part of the leadership. The greatest way to advise is to work with and behind the president. Advice made in the open can be seen to be selfish. The current president of NAPPSA is a very meticulous person, with excellent communication skills.
As a pharmacist and cardiologist, would you say your knowledge of Pharmacy has improved or impacted your practice as a cardiologist?
The wonderful thing about being trained as a medical doctor, especially in the US, is the ability to be allowed to have diverse training and experience. For instance, only about 30 per cent of patients I see need drugs, and I see about 3000 patients a year. I spend hours going through psychological and psychosocial counselling with about 10 per cent.
Now, the pharmaceutical knowledge makes me more effective and appreciative. It makes me appreciate the role of pharmacists in the care of my patients. I have a better understanding than an average physician. I see my two years as the president of NAPPSA as very helpful because when I discuss with doctors about Pharmacy, they wonder where I got the knowledge.
You are a cardiologist, and I know you are aware of this wave of heart-related issues in Nigeria. What should we be doing as a nation to help improve heart health?
The whole thing starts from parents. You see, if your parents had heart problem or high blood pressure, you are going to have it, unless you make some lifestyle changes. The truth is that heart disease is a combination of slowly and accumulating factors that could have been interrupted if primary care and attention were given.
The nurse, pharmacist, and the doctor are obligated to discuss the role of hypertension, diabetes, smoking, excess cholesterol, obesity and lack of exercise in sudden death, stroke, heart attack, and kidney failure.
There are four major causes of sudden death – though 60 per cent of it is due to immediate blockage of the artery in the heart. The four of them are stroke, blockage of the lungs, irregular heart structure due to child birth deformity, and disease in the muscle of the heart due to cancer. It still goes back to identifying these factors and dealing with them.
In spite of that, people still die suddenly, even in the United States. But from the time I qualified as a cardiologist till now, the number of people dying suddenly has gone down by 60 per cent, because we are now able to identify them; and even though we know they may die suddenly, we put a device in them and monitor their lives.
For those whose cases we cannot predict, we create an environment where there is increased chance of resuscitation. It goes back to constant power and management of high blood pressure, diabetes, smoking and cholesterol.
If we are able to provide clean water and 80 per cent of electricity to the average Nigerian, disease process and death will go down by 30 per cent; people will live longer by five years. Clean water and constant power are major challenges in Nigeria, because we have not given appropriate attention that they deserve. It is because we, as a nation, have not realised the importance. We still see them as a luxury.