Pharm. Nurudeen Aimanekhi Mohammed, popularly known as NAE Mohammed, is the registrar, Pharmacists Council of Nigeria (PCN). In this exclusive interview with Pharmanews, Mohammed who emerged PCN registrar in June 2014 speaks on how the four-point agenda he unveiled when he assumed office has positively impacted on the Registry and helped institutionalised Good Pharmacy Practice (GPP) among others. He also outlined the efforts of the PCN in providing a level playing field to players in the pharmaceutical industry and how the satellite pharmacy initiative will address the short supply of professional service to underserved areas in Nigeria. Excerpts:
It’s almost four years since your assumption of office as registrar. You mentioned right from inception that you would be working on a four-point agenda. How much success have you recorded with this?
The four-point agenda is anchored on four themes, namely: Repositioning of the Registry for effective service delivery; institutionalisation of Good Pharmacy Practice (GPP); transformation of career professionals to intellectual practitioners; and new partnership for progress initiative.
The impacts have been far-reaching and manifold. The repositioning has brought about online registration for pharmacists and premises; online Mandatory Continuing Professional Development (MCPD), Post Registration Examinations for Pharmacy graduates (PEP), Pharmacy Technicians’ Pre-certificate Examination (NPCE); registrar’s monthly update; indexing of pharmacy students in universities; and facilitation of two streams of foreign pharmacy graduate orientation programmes, instead of one (as in the past) among various other innovations. The online registration has ensured prompt licensure, while the online MCPD has afforded pharmacists the opportunity of choosing practice-specific modules, as well as access the MCPD programme from the comfort of their homes, offices and even on the move.
Institutionalisation of GPP has heightened enforcement activities by the PCN in sanitising the practice environment, as well as the comprehensive review of existing laws and the drafting of new regulations to strengthen regulatory oversight and improve the practice environment for pharmaceutical service providers, among others.
As regards the open drug markets in the country, council, in conjunction with Federal Ministry of Health and NAFDAC, has worked out a relocation plan with the stakeholders in these markets and by 31 December, 2017, these markets would have been shut down. Council is, once again, appealing to the various state governments to assist in fast-tracking the relocation of these stakeholders from these markets.
Transformation of career professionals to intellectual practitioners has seen to the expansion of frontiers for pharmacists to enable them fit into other areas of practice by building their capacity. Many pharmacists are now into public health, telecommunications, security, food and beverages, banking/finance and a whole lot of other areas.
At the Registry of the PCN, improved staff training and provision of working tools have helped to build the morale of staff. The staff are now highly motivated and their work output and responses to clients needs have greatly improved. Pharmacists are going for higher degrees in clinical pharmacy, public health, industrial pharmacy, even security studies while in-house training programmes also complement the capacity building efforts.
New partnership for progress initiative has seen to various collaborations between PCN and Howard University Global Initiative in Nigeria (HUGIN), Management Sciences for Health (MSH), Society for Family Health (SFH), UN Office on Drugs and Crime (UNODC), Clinton Health Access Initiative (CHAI), USAID, PSN/PACFaH, etc, in an effort to expand access to essential medicines and improve universal health coverage.
Constructive engagement and collaboration with PSN has also brought about peaceful atmosphere in the pharmaceutical landscape and in PCN-PSN relationship. During the period under review, Council, with the support of stakeholders, has secured the approval of PharmD as the minimum degree for pharmacy education in Nigeria. To address the shortfall in human resource, Council, in conjunction with Faculty of Pharmacy, University of Benin and NAPPSA, has put in place a special PharmD programme.
In our quest as a nation to ensure the growth of the local pharmaceutical manufacturing sector, PCN and even NAFDAC as regulatory agencies are crucial in not just regulating companies but also facilitating businesses for players in this sector. What has the PCN done in this direction and what more could be done?
The PCN, in its effort to provide a level playing field for players in the pharmaceutical industry, has been in the forefront of advocacies to governors, traditional rulers and opinion leaders on the issue of facilitating acquisition of land for the states and mega drug distribution centres (SDDCs & MDDCs) and Coordinated Wholesale Centres (CWCs) in Lagos, Anambra Abia, and Kano States. This is part of the efforts aimed at the smooth implementation of the National Drug Distribution Guidelines (NDDC) so that all players will have a serene, well-structured and business-friendly but well-regulated environment. The PCN inspection and monitoring department is also prompt with manufacturing inspections, while the Registrar does not delay approvals, once factories are recommended for licensure.
What more could be done is for the federal government to summon enough political will to declare zero import tariff on pharmaceutical raw materials like Active Pharmaceutical Ingredients (API), packaging raw materials, as well as improve power generation, so that the overhead cost of doing pharmaceutical manufacturing is reduced to tolerable levels. This in turn will bring down the cost of medicines as well as increase capacity in local pharma manufacturing.
You are a strong advocate of the satellite pharmacy initiative. However, these pharmacies (satellite pharmacies) will still have to contend with the present environmental challenges, especially that of infrastructural deficit facing community pharmacy entrepreneurs right now. How can the satellite pharmacies thrive, in spite of these challenges, and what are your thoughts on how operators of satellite pharmacy can mitigate the challenges?
The satellite pharmacy concept is to help address the short supply of professional services in underserved and hard-to-reach areas, mostly in our rural areas. This is an opportunity for pharmacists that are not engaged in the conventional community practice on a full time basis to be engaged in community practice in their areas of abode that are underserved.
The very concept of satellite pharmacy has inbuilt cost-saving measures. Do not forget that they will operate in underserved or hard-to-reach areas; so there are concessions as to premises size and the use of lower level and untapped pharmaceutical manpower to reduce cost.
Additionally, PCN will be doing advocacy to government agencies in the areas of power, road construction, as well as security in order to ensure that the cost of running satellite pharmacies is low enough to encourage participation.
My thought on how to mitigate the challenges is to be innovative and creative – to have a change of mindset. Necessity it is said to be the mother of invention. Somewhere in East Africa, a simple but innovative water sanitisation/purification process was introduced and that protected the people from guinea worm infestation. Here in Nigeria, there are abundant innovations in water sanitisation, power, buildings, etc, for operators of satellite pharmacy to key into.
For instance, in a community called Paipe in Abuja, near the Idu Railway Station, an innovative and revolutionary prototype building, made of pet bottles of soft drinks filled with sandcreet and powered by a simple solar system with rain water harvesting component, has been successfully built at a very low cost. This can be multiplied. The pet bottles hitherto constituted environmental nuisance.
There is still a wide gap in pharmacist-patient ratio in Nigeria. Tell us what has been done to expand access to pharmacy education and what more we can do as a nation to ensure we have enough pharmacists to serve our huge population?
Even in countries of the Organisation for Economic Cooperation and Development (OECD) where the ratio is high, it is still not optimal. OECD countries have between 60 and 100 pharmacists per 100,000, which gives 0.6 – 1 pharmacist per thousand population, and these are among the most prosperous countries in the world. The whole of USA has about 250,000 pharmacists! This amounts to about 50 per state. Quite a shock, isn’t it?
In Nigeria, the ratio is even worse. But the problem with Nigeria is not that we don’t produce enough pharmacists; rather, a large number of young pharmacists that we produce leave the country in their quest for greener pastures. However, decaying and shrinking infrastructures in the existing Faculties of Pharmacy in Nigerian universities are militating against the number that can be admitted to study Pharmacy.
In addition, the high cost of establishing a Faculty of Pharmacy is preventing many universities from establishing it. Strictly speaking, expansion of access to pharmacy education is outside the purview of the PCN. PCN cannot decree an increase in pharmacy students intake nor can it decree the establishment of Faculties of Pharmacy in universities. We can only advocate and solicit for government and private entities to establish more pharmacy schools and appeal to young pharmacists to be patient enough and stay back. Nigeria will get better.
The pharmacy technician programme has been improved upon and that now enables qualified pharmacy technicians to gain admission into Faculties of Pharmacy in our universities as direct entry level. This will also help to address the shortage of pharmacists in the country.