Mr. Ibeabuchi Ekere is a US-based Pharmacist; and has practiced pharmacy for 42 years. In this interview with Senior Correspondent Amos Anwule, he examines the limitations in the practice of Pharmacy in Nigeria; the quality of Nigerian-trained Pharmacists; the presence of fake drugs in the Nigeria market amongst other issues. Excerpts:
How has science and technology helped in the manufacturing of drugs?
The use of the word “drug” most times connotes illegal or hard drugs; I will prefer using the word medications or pharmaceuticals. For the past 50 years or more, technology in this sector has been static in the sense that many manufacturing outfits have continued with the batch manufacturing process instead of the more efficient continuous process. The batch process has many intervals of human input which introduces errors and contaminants that have resulted in many recalls and its attendant financial losses. It is also a longer and costlier process, whereas the continuous process is faster with minimal inbuilt human errors.
Can you explain the difference between the batch manufacturing process and the continuous manufacturing process?
Batch manufacturing process in pharmaceutical industries involves braking the process of manufacturing into stages; in production of tablets for instance, weighing and mixing, granulation and drying of granules, punching the granules into tablets, then blistering if desired and packaging. Each stage requires human attention and input to progress to another stage resulting in the introduction of errors and contaminants which may results in recalls of products and losses. The products come out in batches with assigned batch numbers and expiry dates. The continuous process has an initial high cost of installation but is more efficient and cuts production time into a quarter because there is no break from measuring of raw materials to packaging. Since there is minimal human input, minimal errors are introduced resulting in purer products, fewer recalls and higher profit margins.
What limitations do the Nigerian Pharmacists face?
Pharmacists practicing in Nigeria are faced with many limitations that prevent them from practicing to the full extent of their professional training. I will itemise the source of these limitations as follows: one: ineffective enforcement of existing laws designed to regulate the pharmaceutical industry due to lack of political will by the leaders; two: the massive influx of non-professionals from all walks of life into the pharmaceutical business of production, importation, distribution, and dispensing; three: the loose control systems due to a massively corrupted personnel entrusted with the control processes; you can buy even controlled substances and poisons from the lowliest patent medicine dealer. Another one is the high cost of medications due to poor infrastructure; manufacturers are saddled with the provision of electricity, water, road, and security. These are things taken for granted in other parts of the world and they add to cost of production which is passed down to the end users. The issue of greed is also there. I cannot put a handle on why Nigerians are very greedy, but it is messing things up in governance at all levels, messing things up in commerce at all levels from the wharf to the warehouse. Then the ignorance of the populace due to low literacy levels has rendered many susceptible to manipulations by those trading in medications.
You said that the greed of Nigerians is one of the limitations in pharmacy practice. How?
Greed generates corruption in people. It is greed that escalates the cost of clearing pharmaceuticals at the wharf and airport; that makes the law enforcement agencies to look the other way while the laws regulating pharmaceutical practice are broken with impunity by all-comers. Greed is the bane of our society.
Can you suggest any law(s) that could take care of the limitations?
I have talked about the ineffective enforcement of existing laws. Our problem is not the absence of regulatory laws, but the lack of will to enforce the existing ones. For instance, we have such laws as: Food and drugs Act Cap 150 of 1990; Poisons and Pharmacy Act Cap 366 of 1990; Counterfeit and Fake drugs (miscellaneous provisions) Act Cap 73 of 1990; Pharmacists Council of Nigeria Decree 91 of 1992 – prescribing the skills and competencies required of a pharmacist; but anyone can become a “pharmacist” today in Nigeria. Then you have the National Agency for Food and Drug Administration and Control (NAFDAC), decree no. 15 of 1993; and the Drugs and related Products (registration) Decree No. 19 of 1993. All these laws have not deterred Nigerians from making a mess of the pharmaceutical business, so drafting more laws will be unrewarding.
What is your assessment of the quality of the Nigeria-trained Pharmacists?
Nigerian-trained Pharmacists are among the best trained and highest grade in the world. It is an acclaimed fact outside the shores of Nigeria that they have always shown as we say that “the difference is clear” between them and others from other parts of the world, in academics, pharmacy business, and human relations; they have always excelled.
Why do we have so many fake drugs in the Nigerian market?
The answer is not far-fetched. Nigerians are very greedy to the point that they do not care who the end-user would be. My people have a saying that: “When one throws a pebble into a busy market, the pebble might land on his relative’s head.” The perception of importers and manufacturers of fake medications as to the nature of pharmaceuticals is that they are mere commodities as shoes, nails, sun glasses etc. They look at medicines as ordinary commodities with no regard to its storage requirements, expiry dates etc.
Why do we have many imported drugs in the Nigerian market?
Lack of infrastructural support leads to high cost of manufacturing which in turn makes the finished product costly and non-competitive with the imported products. It therefore makes business sense to import than to manufacture and incur losses.
Can we use modern science and technology to reverse the trend?
No. Science and technology are not the answer to the in-built/acquired structural/behavioral problem of non-compliance to rules and regulations that govern human interactions that is inherent in the ways we do business in Nigeria.
Can you compare pharmacy practice in the US with the practice in Nigeria?
The practice of Pharmacy in Nigeria is still evolving; I believe the USA was at this level at some point in the past. The systems and climate of practice are very different and does not yield to comparisons. Most muddles as the presence of patent medicine dealers, open-market merchandising of medications, and open disobedience to laws are not present in the USA. We shall get there someday; no matter how slow we seem to be going now.
Nigeria is not yet there scientifically. How does this affect the practice of pharmacy in the country?
Without a sound technological base, pharmacy practice will always lag behind in what is current in developed countries. Without strong scientific structures, our research and development will continue to suffer. A situation where every instrument in the laboratory and every needed raw material is imported can only inhibit smooth research.
What is the difficulty in producing medicines for some terminal diseases such as cancer?
There are no really no difficulties in manufacturing medicines in organized economies where pharmaceutical industries invest a high proportion of their revenue in research and development (R&D) of medicinal products, for a country like Nigeria where due to lack of funds and infrastructure, there is virtually no R&D base except perhaps in universities, development of new drugs is not given any prominence. Developing new medicines targeted on a particular disease is possible when driven by an urgent need and funding from governments and organizations.
What is your advice to young pharmacists in Nigeria?
Pharmacy is a noble and honorable profession and no one should regret being a pharmacist. I will
advise that young pharmacists choose an area of pharmacy in which to specialise in order to carve a niche and minimise competition.