Pharmaceutical Society of Nigeria (PSN) has applauded the National Assembly (NASS) for adopting a motion to resuscitate the Drug Revolving Fund (DRF) in Federal Health Institutions (FHIs).
It called for an Act of Parliament to strengthen the supply and quality assurance of essential drugs at affordable costs for Nigerians.
PSN recounted how the DRF project, created by the Essential Drug Decree 43 of 1989 and entrenched in the statutes as Cap 252 LFN 2004, was truncated because various FHIs mismanaged the scheme.
DRF scheme is a scheme where drugs and medical consumables are sold at cost price plus a markup, and the revenue is used to replenish stocks while ensuring that drugs remain affordable to those who need them.
The president of PSN, Professor Cyril Usifoh, said the DRF initiative was a well-thought-out contingency solution to end perennial out-of-stock syndromes in the nation’s health institutions by ensuring uninterrupted access to essential medications for the public and addressing indebtedness to pharmaceutical companies and manufacturers.
He lamented the scheme’s scuttling because the hospitals’ management introduced a strange control mechanism.
In a statement he made available to journalists in Abuja, Usifoh commended the House Committee on Health Institutions for the motion on the collapse of DRF, saying it would restore the scheme’s main objectives, which included effective control and management of drug procurement, quantification, and quality assurance in the country’s health system.
Usifoh said the creation of DRF under the old Essential Drug Decree 43 of 1989, which is now entrenched in the statutes as Cap 252 LFN 2004, ordinarily, ‘’should compel all health institutions to embrace the concept which, according to him, was working very well up to the mid-nineties before the major tenets of the scheme as spelt out in the DRF manuals were truncated by the various hospital management.’’
He explained, ‘’Some of the major highlights of the DRF scheme compel operators to guarantee Cost Recovery Mechanisms, which is the philosophy behind a revolving fund regarding basic norms in resource management. It was also established to ensure cost recovery in DRF. The enabling manuals prescribe that the DRF Committee must have a Project Manager, who is usually the HoD/director of pharmacy in the FHIs, and an accountant who will be co-signatories to insist that DRF is not diverted from the core responsibility of making drugs available in public health facilities.
‘’Over the years, the PSN has observed a systematic debasement of the DRF concept by the different hospital managements, mainly because they romanced fatalistic foreign spirits that were antithetical to the growth of the DRF schemes.
‘’The PSN puts on record that in a well-advertised memorandum signed by Mr. Linus Awute, the then permanent secretary, the Federal Ministry of Health in 2010 on the directive of former President Goodluck Jonathan, the FMoH directed the FHIs to appreciate that the basic tenets of drug procurement including drug quantification, quality assurance and sources of drugs used in the health system were the professional prerogative of the Pharmacists which were validated in existing Pharmacy laws.”
He said, ‘’It is salient to note that well-run DRF schemes are a major panacea to out-of-stock syndromes. The Orthopaedic Hospital (NOH), Igbobi was a benchmark at some point as it remains one of the major FHIs which built a functional Pharmacy House complete with compounding facilities and a well-run Information Centre with the proceeds of DRF without decapitating the DRF as normal procurement was sustained with payment schedules maintained as at when due.’’
Citing a deviation from the original guidelines on the management of the DRF as reason for the collapse of the initiative, Usifoh noted that the PSN and the Joint Health Sector Union (JOHESU) had raised the alarm over the distortions in the management of the scheme and demanded an audit of the project at the National Orthopaedic Hospital, Igbobi, Lagos to stem the tide.
‘’The dubiety which was incorporated into the defective PPP models adopted when the management of the hospital began to tinker with the supply chain of the logistics of moving drugs from the public window to the pharmacies in the privately managed amenity wards compelled outcries from the PSN and JOHESU which drew the attention of the FMoH to this flawed practice by seeking an audit of the DRF at Igbobi.”
According to him, pharmacists who aided desperate health institution CEOs in scuttling the DRF may face disciplinary action by the PSN.
‘’In some other scenarios desperate CEOs of the FHIs short-circuit the pharmacy ecosystem by jeopardising the career path of experienced Pharmacists and using vulnerable Pharmacy practitioners who cringe and allow them to dominate the procurement process with their cronies. The PSN may be forced to sanction such erring Pharmacists in the foreseeable future.”
Usifoh recalled the PSN’s efforts to draw the FMoH’s attention to the need to revive the DRF and thanked the Ministry and the House of Representatives for taking action.
‘’Consequent to these developments, the PSN has been inundating the FMoH with proposals on resuscitating the DRF as a sustainable procurement methodology to eliminate out-of-stock syndrome in the FHIs. The FMoH, in a landmark development of its National Council meeting in December 2023, held in Ado-Ekiti, Ekiti State, resolved that all FHIs must adopt the DRF in the procurement of drugs.
‘’The resolve of the FMoH on this matter amplified the lawful mandate of the National Council by threatening sanctions on those management teams in the FHIs which failed to implement the DRF scheme,” he said.