Pharm. Kennedy Chukwuemeka Izunwa is a Fellow of the Pharmaceutical Society of Nigeria (PSN) and managing director of Foundation Pharmacy and Stores Limited, based in Lagos. In this special interview as chief executive officer (CEO) of the month, Izunwa, who is also the technical director of the Association of Pharmaceutical Importers of Nigeria (APIN) speaks on why access to medicines is a fundamental human right and how his company is working to ensure that the delicate balance between affordability and quality of their products is maintained at all times in the drug distribution chain. He also airs his views on other pertinent issues relating to drug importation, local drug production and so on. Excerpts:
Tell us about Foundation Pharma – its vision and mission in the Nigerian pharmaceutical landscape.
Foundation Pharma Limited is a duly registered pharmaceutical company in Nigeria with interest in importation and distribution of quality pharmaceutical products to serve the Nigerian population. Our mission is to make sure that quality pharmaceutical products are made available to majority of the Nigerian people, if not all. Helping to create greater access to quality medicines at affordable prices is a very important part of our mission as a responsible corporate entity.
Nigeria, as a developing country, has a myriad of tropical diseases and other healthcare issues plaguing its population. What disease area of therapeutic segments are you currently focusing on with a view to bringing lasting relief to the Nigerian populace?
Currently, we have quite a good range of products with emphasis on the cardiovascular area. The focus on the area of cardiovascular drugs is informed by the need to help bring quality relief to patients of cardiovascular illnesses at an affordable cost.
If you check what is happening in the country today and you take a statistics of patients with hypertension or related ailments, such as diabetes, heart disease and so on, you will see that there is so much to do. For that reason, we try to get top range pharmaceutical products that will assist our doctors in handling the challenges posed by these disease conditions. We also have very unique products for the treatment of pains associated with inflammation.
Our range is quite wide. So, we have products for the management of pain, cardiovascular diseases and other conditions. We also have a multivitamin product that is very popular in the market.
Cardiovascular diseases are mostly lifelong conditions that have to be managed with drugs taken at recommended intervals over a long period of the patient’s life. Here in Nigeria, there is the challenge of the cost and affordability of these drugs. As a stakeholder in the pharmaceutical intervention to manage these conditions, what are you doing to ensure that your drugs are not only of top quality but also affordable?
Yes, top quality and affordability is a delicate balance that has to be maintained. Top quality is very important. The issue of affordability is also very important because no matter how good the product is, if it’s not affordable, there is a problem, as people would not be able to access it. So we try as much as possible to make our products affordable, knowing very well that pharmacy practice for us is essential, not only as a business but a humanitarian service.
For us at Foundation Pharma, our joy is not essentially in making huge profits but in the number of persons we are able to give relief from disease conditions or put smile on their faces. To that extent, we derive our joy from the number of persons that are able to derive maximum benefit and relief from our products. Money may not come immediately but we believe that if we continue to do the right thing, then money will come.
What are your thoughts about the COVID-19 pandemic and how it has affected businesses, especially in Nigeria? Do you agree that it has been a period of boom for pharmaceutical and allied businesses?
Diseases or pandemics cannot be a blessing to anyone. To me, the pandemic is a huge disaster to mankind. It is a huge disaster to the economy, and pharmaceutical companies operate within the economy. Pharmaceutical companies will not be happy that people are suffering from sicknesses because they are selling immune boosters, Vitamin C, multivitamins and all other drugs. No, the emphasis should be more on advocacy than pharmaceutical interventions. What do you gain when you make so much profit from pharmaceutical interventions when you are not even exempted from getting the pandemic that other people are contracting and dying of?
As the technical director of the Association of Pharmaceutical Importers of Nigeria (APIN), how can Nigeria attain a healthy balance between local drug production and importation? Is banning importation of a wide range of drugs a solution to issues militating against local drug manufacturing?
People who advocate outright ban on imported products are being rather unrealistic. As an experienced pharmacist, my own position has always been that a holistic approach should be put on ground where you ramp-up factors that will encourage local production.
No nation is completely self–sufficient in local drug production. If you are into drug importation, you know you should be aiming at local drug production but you don’t just do that. You need to adopt a well-calculated approach. You start by putting infrastructures in place and start producing at least the non-active pharmaceutical components, such as pharmaceutical grade starch and others in sufficient quantity locally. These are areas in which we have strong capacity. We can get sufficient binders locally. From there, you now move to the production of petrochemical products to see if we can get raw materials.
As we are scaling up our local inputs, we begin scaling down on importation so that there will be a seamless transition from importation to local production. Gradually, you turn the table around but it has to be a careful and well-calculated approach with a reasonable timeline. It is not something you do by fiat. If you do it by fiat, you cut people’s access to essential medicines and at the end of the day, the patients will suffer.
So at every point in time, we must look at the accessibility of medicines to the patients’ population whose wellbeing is paramount in this whole discussion. Access to medicine is a fundamental human right. So it’s a crime to inhibit access to medicines to people that need them.
At the same time, an economy that depends fully on importation will never grow. Nigeria is endowed with rich natural and human resources. We can make good use of these resources from God and gradually grow them to turn the table around from an importing country to a country with sufficiency in drug production. We always believe that this is the path to follow and not by fiat. If you do it by fiat, you will hurt the drugs distribution chain and the patients will suffer.
There are quite a litany of issues facing the pharmaceutical industry in Nigeria, ranging from infrastructural problems to power issues, high cost of foreign exchange and the rest. Which of these issues do you think should be tackled mainly by government?
All of them are very serious issues. If you talk about infrastructure – if I tell you how long it takes to get a container out of the wharf, you would be surprised. It takes a lot of time because of the problem of access to the ports. The longer it takes, the more expensive it becomes to get the container out and this cost is eventually passed to the end users of the products.
What about power? There is now way you can successfully run a pharmaceutical company without producing your own electricity. The cost of running your generator is sometimes twice the cost of every other thing. Then we talk about the high cost of foreign exchange. That one has has a direct impact because it’s like garbage in, garbage out. The high cost of foreign exchange affects even local manufacturers because they import raw materials, machineries and some other inputs also. Even water that some people claim is sourced locally, is treated with materials and machineries that are also imported. Again, all the active pharmaceutical inputs are also.
The local manufacturer who imports everything he needs to produce locally is affected as much as the pharmaceutical importer by the high cost of foreign exchange. This also affects costs of drugs to the patients and their access to the drugs. Therefore, I will advocate for a special window for pharmaceutical companies especially those who are bringing in essential medicines. Government should help create a special window, where they will be able to access foreign exchange at a concessionary rate. That, to me, will impact positively on the lives of Nigerians
Do you have plans for local drugs production?
There is already a solid arrangement waiting to manifest. It is a given. I have always said that every pharmaceutical importer is a local manufacturer in disguise. When you start importing, you should be encouraged to bring in your foreign partners to set up local plants in Nigeria.
Pharmaceutical importation in Nigeria is not pure importation per se; it’s contract manufacturing because what happens is that the brands belong to us but you outsource the manufacturing. The same way you would have outsourced to local plants but because of infrastructural deficits.
While you are importing, you will need to work towards collaborating with your foreign partners to try and set up even if it’s a small plant to handle some productions locally. That is the way to go. Local drug production is good but it has to be done systematically and orderly. While you are importing, always have it in mind to make efforts towards producing locally because that is the way to go.
What’s your advice to the younger generation of pharmacists on how to take the pharmacy profession to greater heights?
I will always advise the younger ones to learn from the older colleagues. Experience is never purchased in the market. I even wish there is a better organised scheme in which the older ones can mentor directly the younger ones in terms of education, practice, ethics and so on. Mentorship is good if it’s done in such a way that somebody who has knowledge, experience, expertise and is of a very dependable character mentors a younger person.
Another thing I want pharmacists to remember is that the life of a patient is affected by our practice. Therefore, we have to be disciplined and careful without too much emphasis on money or monetary profits.