Chijioke Iremeka
One year ago, precisely on May 29, 2023, Senator Bola Ahmed Tinubu was sworn in as Nigeria’s democratically elected president, and with him taking over the reins of power, stakeholders in the pharmaceutical sector were optimistic that things would turn around for good.
However, reflecting on President Tinubu’s first anniversary in office, members of the Pharmaceutical Society of Nigeria, Community Pharmacists of Nigeria, and the Pharmaceutical Manufacturers Group of the Manufacturers Association of Nigeria said his administration is not getting it right in addressing key issues in the pharmaceutical sector.
According to them, among many factors, Tinubu’s appointments of non-pharmaceutical professionals is causing more harm to the health sector.
They emphasised the importance of appropriate appointments to propel the sector forward and urged the President to take deliberate actions to bolster the industry by ensuring that the sector reaches its full potential to contribute significantly to the well-being of the populace and the economy.
Pharmacists and local drug manufacturers, who spoke with PUNCH Healthwise in different interviews said that health funding is still a major challenge in Nigeria and urged the president to reduce the cost of diesel, fuel, and electricity to make locally manufactured drugs available and affordable to the poor.
The immediate past President of the Pharmaceutical Society of Nigeria, Olumide Akintayo said health funding in Nigeria is still a major challenge and has not improved in the last one year.
He said the country needs to enact laws and have them implemented to strengthen the healthcare provision and make drugs available for the masses, including the vaccine.
Akintayo said, “There is an Abuja Declaration, where 15 per cent of the national budget should go to the health sector but this has not been implemented. Even when Tinubu went online to say that his administration has the highest budget allocation to health, it is just not enough.
“The President created a lot of gaps in the healthcare sector with his appointments. The two Health Ministers are all physicians and this is a misnomer. Having physicians in all the appointments in the major health positions is a recipe for tragedy.
“When you use physicians as the Health Minister and Minister of State, it can’t work because you are getting opinions from one sector. Prof Ali Pate is a good, well-seasoned professional but he may not be getting the desired result because of the president’s lopsided appointments.
“Tinuba is not getting it right and will not get the right result because he does not allow the requisite professional to run the pharmaceutical sector. The pharmaceutical sector is very essential in running the health sector and if you want to improve the Gross Domestic Product of the country, the pharmacists and this sector are well positioned to do this.
“He may have improved in some areas, but not in this sector. Except you allow experienced pharmacists, who understand this sector and the problem with drug manufacturing and distribution to handle certain positions, he will not improve at all.”
According to him, the President called for cooperation among various sectors, yet all his appointments, from special advisers to the Director General of the Nigeria Centre for Disease Control and Prevention, and the Chief Executive Officer of the National Primary Health Care Development Agency, are physicians.
Akintayo said, “The signal of this is that you are telling others to go to hell. The treatment is not healthy for the unity and development of the health sector because there is a need for a pharmacist who can tell what to do in the area of drug manufacturing and distribution.
“That is why the Minister of Health for State and Social Welfare, Dr Tunji Alausa issued a circular that was a major tragedy without carrying out the necessary assessment to know the capacity and the type of syringes that could be produced in the country and banned importation of syringes, creating a serious monopoly.
“You don’t just ban things at face value. You have to ensure that the manufacturers can produce what the country needs before making such a costly pronouncement so that it doesn’t boomerang.
“With this, you are now referring people to the open drugs market that the government and other stakeholders are trying to close to buy essential drugs and syringes. You listed an open drug market where people should go and source them.”
Akintayo noted that the PSN and other professional bodies have told the President to establish a presidential committee to regulate and ensure that drug circulation in the country is done smoothly and professionally without going to the open drug market.
He stressed that when the wrong people are in place and all the right components are lacking, Nigeria will continue to have a poor health sector with all the negative indices.
The pharmacist insisted that Nigeria should have the best pharmacists and physicians but due to poor welfare, they are leaving the country.
He said, “There is no policy or law you will enact to keep the people in the country without treating them well. That is why we talk about the welfare of the people. The President said all the outstanding allowance and benefits accruing to these healthcare professionals would be paid immediately during his inaugural speech but one year after; he has not fulfilled that promise.
“It is not good enough for the country that the President will say something and will not do it. It destroys the confidence and trust people have in him.
“During the COVID-19 pandemic, the CEO of the Primary Health Care Development Agency took the bold step and allowed community pharmacists to vaccinate people. Over 243 community pharmacists signed a Memorandum of Understanding and in less than one year, they vaccinated over 76, 000 people.
“Imagine what would be its multiplier effect if 10, 000 community pharmacists were given that chance to vaccinate. Maybe they would do so much to reduce maternal mortality in the country.
“I believe that Nigeria has great potential. We don’t have another country. I hope President Tinubu proves me wrong. Minister of Interior, Olubunmi Tunji-Ojo is doing well. Festus Keyamo is doing well in Aviation. I hope Ali Pate will do the same and improve the health system. He seemed to have good ideas but we need translation of those ideas.”
Speaking further, the former Secretary of the Association of Community Pharmacists of Nigeria, Lagos State chapter, Okotie Jonah, said there has not been improvement in the sector but people have adjusted to available alternatives.
He explained, “In the pharmaceutical sector, I won’t say there is an improvement, but we are just adjusting and people are looking for cheaper alternative drugs to stay alive.
“As it is now, ventolin inhalers are not still available but people are now adjusting to the alternatives. However, there were a lot of things happening before Tinubu came in. So they were ongoing but it is manifesting in the present day.
“COVID-19 and its effects are still not over because the system was shut down for over a year and some countries have not recovered. We don’t have any system. We still import raw materials and finished products.
“We are not deliberate about empowering local manufacturers. In some other countries, the local drug manufacturers were given money to improve their capacity. The US, for instance, gave them money to increase their capacity. But we don’t have that here.
“Until government officials understand that we are in this together, we will not make any progress. These big companies we hear their names don’t get to where they are without support. The government gave them money and they are global players today.
“You can’t empower the people without empowering the system to get to the international standard. These are the things that make the system archaic.”
Okotie noted that one year is short but long enough to know the direction of the government and health sector.
He said Pate seemed to have started on a good note by getting the stakeholders to identify the problems.
Okotie lamented that the lack of a justice system in the country is affecting the sector, saying that health facilities are threatening to stop offering services to people with health insurance policies as the government does not pay them.
He added, “This explains why health facilities treat people with insurance policies without seriousness because the government is not paying them for their services. You said emergency cases should not be turned down or rejected, that they should be treated but who will pay them for their services?
“We need to get a feedback system that ensures that all the participants know what the problems are. The government said it wants to improve local manufacturing in the country, yet the National Agency for Food and Drug Administration and Control wants to compare and burden a starter business with international standards roles.
“If we sincerely want to produce drugs in this country, the government must give some support and incentive. This is the time for the government to support financially and when the business gets to the point of profitability, it can take the funds and give to another.
“Also, if we must get this process right, we must stop comparing a backyard producer with others producing in America because they are starters, and there is no sense in compelling them to do so with international standard roles.
“Those firms you are comparing them with started little like them but supported by their respective countries to get to where they are today. That is what we need to do and not overburden them. That is what China does too.”
On his part, a member of PMG-MAN, and the Chief Executive Officer of Mopson Pharmaceutical Limited, Lagos, Dr Michael Paul, said that the health sector in the country is not functional and the mood of the economy is being affected by the exchange rate.
He noted that the exchange rate is also affected by several factors, stressing that when the exchange rate is high, it affects the economy.
Paul added, “For instance, if you take a loan for five years at the rate of N750 per dollar and the exchange rate goes up, you are not repaying the same amount because the dollar has gone up.
“As the dollar goes up, it will affect the amount you pay. So when you talk about the economy, you do so in relation to people and the resources around them.
“The health sector in Nigeria is a foreigner. Everything about medicine in Nigeria is imported, starting from machinery, to raw materials, finished goods and drugs.
“When you touch the dollar, you have touched the people, and consumers’ participation will drop. If the dollar is good, it will be an achievement for this regime but the exchange rate, electricity tariff and removal of fuel subsidy affected the larger number of consumers.
“The health sector is not performing as the manufacturing capital is dwindling. Tinubu can still do something to restore the naira to a certain level where it would enhance production.”
Paul urged the President to bring down fuel prices to at least N300 and see how the economy would pick up and poor masses would have access to essential drugs.
He added, “Anything that affects the dollar and naira, affects the price of soap, clothes, food, and everything you can think of.
“So, let Tinubu do that magic he did when he was a governor. Let the Central Bank of Nigeria and Tinubu bring down the exchange rate and make naira at least N300 per dollar and see what the economy will become.
“Our leaders need to show some sense of self-denial to make the people happy and not spend on exotic cars at the expense of the poor masses. Come and do the same magic again; reduce the cost of diesel, fuel, and electricity among others and people will be happy with you.”
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