Pharm. N.A.E. Mohammed is the registrar of Pharmacists Council of Nigeria (PCN). In this exclusive interview with Pharmanews, Mohammed, a Fellow of the Nigerian Institute of Management (FNIM), who also recently bagged the fellowship of the Nigeria Academy of Pharmacy, reveals how the four-point agenda he introduced on assumption of office has enhanced PCN’s activities. He also speaks on the council’s plan for the newly approved PharmD programme, as well as the plan to ensure full implementation of the National Drug Distribution Guidelines (NDDGs) by closing down the open drug markets by 1 August, 2017. Excerpts:
On your assumption of office as PCN registrar over two years ago, you announced that you would pursue a four-point agenda. To what extent have the objectives in the four-point agenda been achieved?
I came up with a four-point agenda on my assumption of duty and many of the component objectives have been achieved towards putting in place operating systems to drive the workings of the council. These have resulted in the modest progress made so far by the registry. The extent of accomplishments include: one, repositioning the registry for effective service delivery. To start with, series of trainings and workshops were organised for the management and staff of the PCN registry. The first in the series was a retreat tagged, “A New Mindset for the New Corporate Game”. This was organised for the management staff, which was later followed by the one for the state officers and other senior staff.
In continuation of this, training on Emotional Intelligence (still for the management and other senior staff) was organised in a sequence. To this end, target setting for the registry activities as well as development of a work plan, was put in place to conclude this initial training and re-orientation. Various other workshops and seminars were later organised for the lower cadre of staff. The target of all these efforts was to improve the attitude to work by staff.
Closely linked to these efforts was an attempt at improving the working environment, especially at the headquarters and some zonal and state offices; working tools and incentives were also provided. These have helped to re-orient the entire workforce towards better service delivery. Clients are now being treated as customers, with all due respect and recognition. PCN expects same due respect and recognition from our clients.
Inspection and monitoring, as well as enforcement activities, have been scaled up. PCN has visited 2,349 premises out of which 1,483 were sealed for various offences in eight states of the federation within the first half of 2016 alone. Nine new pharmaceutical manufacturing industries were inspected and added to the pool of manufacturers in 2016 alone.
The various PCN registration software platforms have been upgraded, leading to improved efficiency and early releases of both personal and premises licences for pharmacists, pharmacy technicians and Patent and Proprietary Medicine Vendors (PPMVs). The production and issuance of pharmacists’ customised seals has also added value to service delivery by pharmacists.
In September 2016, the online MCPD programme was launched. So far, the patronage of the online MCPD by pharmacists in the first month surpassed the target set for it. Also, by January 2017, online registration for licenses would come on stream and a seamless and convenient registration process will become operational, most especially for renewal purposes.
The Act setting up the PCN is being reviewed, not only to address the current lapses militating against the operations of the council but also to help bring Nigerian pharmacy practice in tandem with current realities and best global practices.
We are working to ensure the institutionalisation of Good Pharmacy Practice (GPP) in Nigeria. A document on this that cuts across all facets of the practice has been developed and stakeholders meetings are being organised for their buy-in. Full implementation is expected to commence by mid-2017 and we expect that the GPP will bring about improvement in the quality of work at our various workplaces and service delivery points, thereby promoting patients’ health and quality of life.
We are also working to ensure the transformation of career professionals into intellectual practitioners. With this, it is expected that the era of graduating with B. Pharm and retiring with B. Pharm will be 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 practice.
Council has redesigned, restructured and strengthened the MCPD programmes to stimulate interest in continuous self-development and critical thinking for professional and self-growth. The new MCPD modules, starting from January 2017, will be practice–area specific. We believe this will bring about individual empowerment for self-transformation and aspiration to inspire others.
We are also reviewing our curriculum in the faculties of pharmacy to align it with the concept of competency-based training. This is aimed at producing pharmacists that will meet the contemporary healthcare challenges and needs of the patient.
PCN is also reaching out to WAPCP for collaboration in area of certification for pharmacists for specialisation purposes. The current approval of PharmD by the National Universities Commission (NUC) for all Nigerian universities is a welcome development that will help reshape pharmacy education and move the practice from being product-centred to being patient-focused.
We have also introduced what we call New Partnership for Progress Initiative (NP4PI). Over the years, there has been a gap between the regulated stakeholders and the PCN, leading to unwarranted frictions; frivolous court injunctions at the expense of patients’ safety and the general good; and misinterpretations of the functions and responsibilities of the council. These had led to decades of anarchy in some areas of pharmacy practice, mostly in the sales and distribution of drugs.
Council within the two years under review has reached out to various stakeholders, NGOs and other agencies of government to address the various anomalies pervading the landscape of pharmacy practice in Nigeria. Some international organisations are partnering with PCN to assist in achieving this.
It is pertinent to state here, once again, to all concerned that PCN is a federal government agency established by ACT CAP P17, LFN, 2004 and charged with the regulation and control of pharmacy education, training and practice, in all its aspects and ramifications. This law covers all operations and practices involving pharmacists, pharmacy technicians and PPMVs.
I know that the PCN has been very active in clamping down on pharmacy outlets operating illegally; nevertheless, a major illegality in pharmacy practice in this country remains the menace of open drug markets operating in almost all our major cities. What is the council’s plan to deal with this?
Arising from the Ministerial Press Conference on 26 June, 2015, and the ministerial directive thereof, PCN, in conjunction with NAFDAC and the Food and Drugs Department of the Federal Ministry of Health, came up with a framework to address the issue of open drug markets. Several stakeholders meetings were held to allay the fears of extinction by the operators in these open drug markets.
Arising from these engagements with stakeholders, the earlier National Drug Distribution Guidelines (NDDG) flowchart of drug distribution was amended to accommodate the stakeholders in the open drug markets who were hitherto not considered in the earlier NDDG concept. These stakeholders are now to be relocated to Coordinated Wholesale Centres (CWCs) to operate as wholesale centres within the Drug Distribution Network.
These recommendations, as well as a proposed framework of implementation, were forwarded for the consideration and approval of the Federal Ministry of Health (FMoH), which was graciously granted by the then Permanent Secretary, through his letter dated August 3, 2015.
PCN has put in place effective regulatory measures to ensure that every facility complies with prescribed minimum regulatory standards. Standard Operating Procedures (SOPs) have also been developed for CWCs to ensure full compliance of their operators within regulatory requirements.
PCN has also developed an architectural design for CWCs (to maintain uniformity) and shared it with the leadership of the major open drug markets in the country at various town hall meetings with them. Governors of some of the affected states and some leading socio-cultural groups have been written, notifying them of government’s plan to close down these open drug markets.
Further to this effort, PCN put up a public notice in three daily newspapers in June, 2016, to inform all stakeholders in the pharmaceutical sector, particularly the operators of open drug markets, that the deadline for full implementation of NDDG is 1 August, 2017. The PCN is strongly committed to this project. Our ultimate target is to sanitise the drug distribution channels and also ensure that the open drug markets are closed by this date.
What are your thoughts on the recently approved PharmD programme and how can the PCN help ensure more pharmacy schools are able to run it successfully?
The approval of PharmD by NUC is a welcome development, both for pharmacy education and practice in Nigeria after a long-drawn out process spanning a period of about a decade and half. This is what the pharmacy community has been waiting for and it is my belief that it will transform pharmacy education and practice in Nigeria. The patient stands to gain more than any other person.
However, PCN will ensure that we do not lose sight of the traditional concept and practice of Pharmacy that distinguishes the pharmacist from other healthcare providers. It is a six-year programme (five years for direct entry students) that is patient-centred along and product/science–centred. An approved NUC BMAS (Benchmark Minimum Academic Standards) is on ground that was developed by PCN and other stakeholders.
The 17 universities offering Pharmacy in Nigeria and the four undergoing accreditation processes have been contacted on this approval. The various deans have also been invited for a meeting scheduled for November 2016 at Minna to review and adopt the implementation strategy developed by PCN.
PCN has also resolved to give special assistance to faculties of pharmacy to ensure the rapid and successful take-off of the programme. To this end, PCN has put in place some crucial steps.
The first step is to have the first PharmD admission intake. In line with NUC and general university policies, each faculty of pharmacy should request its university management to replace BPharm with PharmD for admission purposes with effect from 2017/18 session. However, any faculty that wishes to defer this for another year or two should notify PCN accordingly.
However, no deferment should exceed two years. faculties should note that the first four years of both the BPharm and PharmD BMAS/MAS are largely similar. Thus, faculties have at least three years to put in place structures and resources for the clinical/practice training years (500 and 600 Levels) of the first PharmD intake.
The second step is on the PharmD curriculum. Each faculty of pharmacy shall proceed immediately to draw up its own PharmD curriculum for processing through the usual university organs for approval not later than March 2017. Both NUC’s BMAS and PCN’s Minimum Academic Requirements (MAR) should serve as templates for the curricula to be drawn up.
The third step is on resource verification and accreditation. Each faculty shall immediately and vigorously pursue efforts to secure resources and put in place structures required for the successful running of the PharmD programme. The target should be to achieve successful resource verification by NUC on or before June 2018 and accreditation by the end of 2019.
In view of the newness and special nature of the PharmD programme, PCN will be willing to mount pressure on various university managements to provide the necessary support for resource verification and accreditation. If necessary, PCN will also approach NUC and other appropriate government organs in this regard. Faculties must seek PCN visitation/accreditation after successful NUC accreditation.
The fourth step is to have a crash PharmD capacity building programme. Perhaps, the most critical and urgent preparation for PharmD implementation is capacity building, especially in terms of academic content and professional/practice/clinical orientation. In most faculties of pharmacy, the staff that will drive PharmD need to be properly and adequately equipped to do so.
PCN is aware that a few faculties of pharmacy have mounted training workshops in the past or are in the process of mounting one. While these training efforts are laudable and helpful, there is a strong need for a centrally coordinated and standardised effort that will easily be recognised nationally and internationally.
To this end, PCN is proposing to mount a special, intensive, fast-tracked PharmD conversion programme for interested academic pharmacists only in faculties of pharmacy.
Pharmacists, in recent times, are being urged to show interest in specialty pharmacy services and become experts in the use of specialty drugs used to treat complex/chronic conditions. What are your thoughts on this?
Pharmacy as a profession has both philosophical and practice model dimensions. To bring about changes in their practice, pharmacists must not only change the way they think and act; their mode of service delivery must also change. They must move from “LPO” pharmacist mentality or product-only-centred practice to patient-centered care.
To this end, pharmacists should be directed towards a change in attitude before they are expected to develop innovative practices and offer new services. This attitudinal change involves intensive product/practice knowledge specialisation, good communications skills and a cordial relationship with other health professionals.
Pharmacists need to understand this concept of having a “practice”. They need to understand that a “practice” relies on practitioners and is not dependent on a place or setting. As practitioners, their inclination is to care for the patients’ needs using quality assurance tools analogous.
You were reported to be coming up with proactive measures to tackle the challenges some pharmacy students face while trying to access opportunity for internship. Tell us about these measures. Also, what is the long-term solution to this challenge?
One of the measures that PCN has put in place to tackle the internship challenges is the accreditation of more sites for the internship programme. PCN is also talking with the training institutions to take some of their students.
For a long-term solution, the Honourabe Minister of Health has been sent a memo on the way forward and a committee is working on it. It is expected that the strategy proposed to the ministry, if adopted, will cater for other healthcare workers.
What has been your greatest challenge so far as the PCN registrar?
Human beings are difficult to manage and this calls for God’s grace. This grace has been quite sufficient for me so far. The repositioning of Pharmacy in public domain has been my greatest challenge so far as the PCN registrar.
Over the years pharmacists and indeed pharmacy in Nigeria have been ‘legislated’ out of the public domain, with other stakeholders – mostly patent and proprietary medicines vendors licence-holders ravaging the nooks and crannies of the nation without control. Leadership in Pharmacy over time has been encumbered with issues concerning dysfunctional practice in the country. This has indeed swerved their attention off the need to undertake long-term developmental programmes. This trend is changing with the current leadership of PCN that is presently working out a long-term developmental programme with PSN, NAFDAC and FMOH, and other stakeholders on drug distribution and related issues in Nigeria.
Finally, there is need to keep in perspective the fact that the wrong positioning of Pharmacy as a profession has continued to deny it public sympathy and support, and this has in turn impacted negatively on the prospects of the profession in Nigeria. And this must change. As men of honour, let us join hands to bring about the change!