‘People should not patronise open drug markets’
Dr Albert Kelong Alkali is the national chairman of the Association of Community Pharmacists of Nigeria (ACPN), the umbrella body of all retail and wholesale pharmacists in the country. In this interview he speaks on effects of drug abuse, inclusion of co
Who really is a community pharmacist?
He or she is a practitioner within the retail pharmacy setting. Pharmacists are the closest to the people in terms of access to health. When people have headache the first place they go to is the pharmacy in the community. The onus is on the pharmacist to assess patients and refer accordingly if it is something beyond his scope.
So the community pharmacists are the practitioners within the pharmacies in the neighbourhood.
What is your assessment of drug abuse in the country?
It is really at an alarming rate. There are a lot of young men abusing drugs these days, and it is necessary for regulatory authorities to ensure that they regulate the sale and distribution of controlled medicines.
On our part, the Association of Community Pharmacists in Nigeria urges our members to make sure they dispense controlled medicines only on prescription, and when they have doubts as to the use of that medicine by a client or patient coming for it, they have to satisfy the extant laws and regulatory requirements before they dispense the controlled medicines.
How does community pharmacists work with the National Health Insurance Scheme (NHIS)?
NHIS is a scheme set up by the federal government to provide access to health for all Nigerians. However, the scheme is still unable to deliver this service to Nigerians because its implementation has been faulty. We are not included in the scheme. Moreso, all professionals have not been carried on board. You cannot operate a health scheme and leave out critical professionals like the community pharmacists.
The scheme is supposed to provide total not half health package to enrollees because that is what they paid for. But a situation where you have an operation called global capitation where funds are deployed to institutions that do not have adequate staff and professionals themselves that are being paid by NHIS to pay other professionals is wrong.
We call on the management of NHIS to scrap the global capitation to ensure that all professionals are adequately paid by the Health Maintenance Organisations (HMOs), and to also ensure that those HMOS perform their roles and not sit on the fence and just spend money that has been put in their custody to ensure that Nigerians enjoy access to health services.
The government promised to close open drug markets this year.What is the situation now?
The open drug market situation is as a result of the poor regulatory environment that we have. For instance, in Kano, Aba, Lagos and so many other major cities we have open drug stores and markets where people sell drugs as if they are selling tomatoes, second hand clothes or spare parts.
Drugs are poisons and should be dispensed by professionals under appropriate conditions. These open drug markets do not have conducive atmosphere for storage. Apart from that the people operating within those environment do not even appreciate that the drugs can be dangerous to the health of the people taking them.
We know that the Pharmacists Council of Nigeria (PCN) has a plan in place and has been advocating that by June this year, open drug markets would be closed down. We hope that this target will be met because that is the least government can do.
Exposing Nigerians to dangerous practices and to drugs that could complicate their situation, is not acceptable at all. So the open drug markets come June should be closed down as proposed by the Pharmacists Council of Nigeria and there should be alterative arrangements. So that Nigerians would not end up having complications because they are taking dangerous drugs, or that would probably be expired because of poor storage in these open drug markets.ss
So we call on government to ensure that the open drug markets in this country are closed down.
Government was also working on the chaotic drug distribution chain, what is the situation now?
The Federal Ministry of Health has been working on the national drug distribution in this country and it is the outcome of this plan that will lead to the closure of the open drug markets. The scheme is still in place but there have been adjustments because of complaints by some stakeholders to accommodate the interest of all. We want government to fully implement this scheme and move us forward so that the practice environment in the country will be better than it is now.
People should not take prescription to open drug markets. Take prescription to a pharmacy and insist on seeing your pharmacist, so that you can be adequately counseled on how to take the drugs, so that you don’t use your money to buy or create problems for yourself.
Our association calls on government to do the right thing by supporting the PCN to ensure that by June this year all the open drug markets are closed down, and to also move all the people within the market to standard settings where products dispensed will be guaranteed, and pharmacists will be available to counsel adequately.
The regulatory agencies need to do more. You cannot get drugs anywhere in small African countries but here in Nigeria it is an all comers affair. In Ghana for example you cannot get drug anywhere except in the pharmacy but here we see them being sold every where even in the Federal Capital Territory and major cities.
Here we have ‘Tokunbo drugs’ that kill Nigerians, so government should look at health and drugs as a very serious matter to tackle the already terrible situation in this country.
The Federal Ministry of Health itself cannot be paying lip service to the health of Nigerians without taking firm action against practice and quackery that has being going on and exposing Nigerians to dangerous drugs.
Recently the association of pharmaceutical importers complained about the increase in import duties, what is your take on this?
That government policy is a misplaced one. You cannot wake up one day and raise duties from zero to 20%. It is unacceptable especially when you don’t have adequate local production in place to close up the gaps.
If you go round the country, the retail pharmacies are already drying up, even where they are, the prices are more than the previous prices so with this 20% increase and the current rate of the dollar, Nigerians are in for a very hard time.
If the government wants to increase tariff, it should ensure that we have the capacity to produce in this country, not subjecting Nigerians to hardship.
Government should reverse that circular. We have made an advocacy visit to the presidency and the Ministry of Health on the issue of tariffs on pharmaceuticals.
The tariff on pharmaceuticals should be zero and that of raw materials too should be zero to encourage local production of drugs. Some of the drugs which these tariffs are increased on include antibiotics and antimalarials, because the major disease burden in this country is malaria and a lot of infection also require antibiotics. It is unfortunate.
When government is making decisions like this all stakeholders within the sector should be consulted. Even the Federal Ministry of Health was not consulted before the increase was made. So we should not make money at the expense of the health of Nigerians. It is not right, it can make some people produce adulterated drugs locally and others will patronise them because of the cheaper cost.
Government should also encourage local production of drugs by providing the necessary infrastructure, among others.
How can Nigerians identify a genuine community pharmacist?
Our association has the green cross emblem which indicates that the pharmacy is registered. I advise Nigerians to always look out for the green cross that is tied with every single pharmacy. There is a number on it and it is unique. If you have a problem with any pharmacy and you take the number on it, the name of the pharmacist will be traced. Any where you see it we can guarantee the pharmacy and that the drugs are from the right source.
Nigerians must take their health seriously. They should stop buying drugs or taking prescriptions from people who hawk drugs in trays, buses and open markets.
Drugs are poisons and are medicines used in therapeautic doses and could have adverse effect that lead to complication when they are not taken properly. Some of these drugs people buy any how could cause serious problems like liver complications, kidney failure and brain damage to mention a few.