Sir Ifeanyi Ayueyi, a fellow of the Pharmaceutical Society of Nigeria and Managing Director, Pharmanews, a pharmaceutical publication, in this interview with SADE OGUNTOLA, explains why curtailing fake drug in circulation is difficult and how to solve the internal acrimony in the health sector, among other issues.

As a pharmacist of long standing, what areas of pharmacy practice would you say need to be changed to ensure better outcomes for the profession?

Change is constant, hence the need for improvement also in pharmacy practices. Take, for example, the area of drugs. Research is done on a daily basis and so older drugs are being discarded, just as new ones are coming in. Due to this, the professionals must be on their toes because things are changing; they must keep learning about medicines.

Emphasis must also be on changing the drug distribution network. It is a crucial factor. In fact, at the last Pharmaceutical Society of Nigeria conference, the need for this was discussed. The problem of fake drugs could be linked to how drugs are distributed in the country. Distribution of medicines is not in the hands of professionals and this has created a lot of problems.

In the university, there is a need to improve the quality and the level of education of trainee pharmacists so that, after their training, they will be useful to the community they are serving.

Are quality drugs accessible and affordable in Nigeria?

Talking about quality, there are some companies in Nigeria that the quality of what they produce is guaranteed anywhere in the world today. Four companies have been approved by the World Health Organisation; their laboratories can manufacture medicines that can be sold even in US and UK markets. So, in terms of quality, their medicines are guaranteed.

Many more companies are also producing quality drugs and are equally aspiring to be WHO-prequalified like others. So, in terms of drug quality, Nigeria is doing well.

In terms of affordability, due to prevailing economic conditions, drugs may not be affordable to everybody. This is why some governments are offering free health services and promoting national health insurance so that people could have access to the medicines even when they don’t have money.

But many people are complaining of being given generic drugs, which they believe are of lower quality than branded drugs?

Sometimes people think that a generic drug is inferior to the branded one. This is not true. Even drug companies that have WHO certification can produce generic products. When you say a product is generic, it means that it is given the standard official name rather than a brand name. The manufacturing process of the two is the same, but the packaging may be different.

However, this does not mean that you cannot have low quality generic medicines. But I can assure you that most of the substandard or fake generic products are imported mainly from India and China.

Moreover, fake or substandard medicines sometimes may be branded because their importers have asked that they should be produced that way. But NAFDAC is working very hard on checking this. Recently a drug faker was jailed for six months, though he had the option of a fine.

But the law was lenient on that drug faker?

Before, there was very light punishment for drug fakers. The law was weak and the prescribed punishment was very mild. NAFDAC is just reversing this so that people caught can be dealt with in a more deterrent way. If they had been doing that, I’m sure that people would have learnt their lessons. Indeed, the law itself was a big issue in curtailing fake and substandard drugs. So we are now having stricter laws and more persons will be persecuted and so people will dread going to jail.

Is it possible for consumers to be able to differentiate substandard medicine in the pharmacy?

Well, it is very difficult to know the difference between substandard, fake and good quality medicines. Even pharmacists and doctors themselves sometimes find it difficult differentiating one from the other. For consumers, the advice that is usually given is to always buy drugs from authorised distributors. By doing so, one is fairly confident of buying a good product.

Many Nigerians living in the suburbs rely on patent medicine dealers. Will their health not be jeopardised by substandard drugs? How relevant are these group of people?

Talking about the patent medicine dealers, this is an aberration. They are found only in Nigeria and the group was created because of the shortage of pharmacists. Anybody who is above 18 and can read and write can be a patent medicine dealer. They are not trained.

What they are supposed to do is to sell packs of over-the-counter (OTC) medicines. They are supposed to know only the names and prices of OTC medicines, but not to count tablets or dispense medicines. Unfortunately, many patent medicine dealers do all they are not supposed to do. People patronising them also must know they are non-professionals.

Patent medicine dealers were just to fill a gap; once we have adequate number of pharmacists as it is the case in the advanced countries, all these will change.

What is your assessment of the health sector?

First, health is a personal responsibility. If you renege on that responsibility, you have nobody to blame. Each individual needs to endeavour to live a healthy life. If this is done, this over-dependence on government and other caregivers will reduce.

People cannot continue smoking cigarettes, drinking alcohol, involving in illicit sex, eating junks and doing all sort of things and then want the healthcare providers to take responsibility for their health. It does not work that way. Individuals have to be responsible for their health.

The government’s responsibility to take care of the health of the citizens is somehow related to the prevailing economic situation. When there is poverty, it affects everything, including health.

So, government has the responsibility to provide the infrastructure and environment that will be conducive to health. It is not just consuming drugs; it is a total environment that will make people healthy. When talking about improvement, there is no area that does not require improvement, but government is trying with the available resources and human capacity.

Internal acrimony in the health sector, the competition in its rank and file, what is the solution?

One basic understanding which some people do not have is that when it comes to taking care of people’s health, it is a team work. This is fundamental and that is why in developed countries, they fare better.

But in Nigeria, many are concerned with their ego, forgetting that hospitals exist because of patients. Attention is drawn away from patients to individuals. Where there is rancour among the health team, there is no way good results will be possible. No single group can take care of people’s health. In advanced countries, they have realised that and they do not behave as we do.

Second, we encourage “bring others down” and that is part of ego. A major grouse of the medical doctor is that they see pharmacists as coming up in education, knowledge and practice. The impression they have is that pharmacists want to overtake them by bearing the title “doctor” and being addressed as “consultants”. But in the US today, all pharmacists are doctors. They are no more studying a bachelor’s degree in pharmacy in the USA.

So, hospitals are full of doctors whether you are a pharmacist or a medical doctor. This is the trend and we have to know what is happening in the world today. We cannot be going backward when the world is moving forward.

Pharmacists now go on to specialise in different aspects such as orthopaedics and even diseases such as diabetes or hypertension. So when they are working with medical experts, it is a wonderful match, since the pharmacist will support the doctor in discussing the therapy and everything to the benefit of the patient.

Knowledge is growing, nurses are advancing. Today, you have nurse practitioners that attend to patients and prescribe drugs because they have undergone training on diagnosis and treatment. Even though they are still limited in what they can do, you find them every useful in communities. They still refer some cases to specialists but the law allows them to attend to patients and prescribe.

All these misunderstandings should not be there if there is no selfishness. One is only a leader when there are followers. Who are you leading? If you do not have their cooperation, they will revolt. Health is a team work. Nature has made it so.

Cases of people getting sick or even dying as a result of negligence in the hands of doctors through wrong prescriptions abound but they are not usually well documented. Even a pharmacist that dispenses a wrong drug, nobody questions him. But abroad, the case is not so. We are walking blindly here, especially in health, and that is why there must be the malpractice insurance cover.

You are running Pharmanews, whose motto is to inform the public about pharmacy profession and so on? Why this?

In Pharmanews, we are not informing the public because it is not a link between the profession and the public. It is a professional paper to keep health professionals informed. That is why you do not see Pharmanews at the newsstands; it circulates among health professionals, primarily pharmacists, doctors, nurses, hospitals and the health institutions. Pharmanews started in 1979, and we thank God because we have published every month from 1979 without interruption. It is West Africa’s foremost health journal.

http://swankpharm.com/2014/11/27/even-a-pharmacist-may-not-be-able-to-identify-fake-medicine-sir-ifeanyi-atueyi-rxchatng-johesustrike/

Original Source: Nigerian Tribune

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