ADDRESS BY THE PRESIDENT OF THE PHARMACEUTICAL SOCIETY OF NIGERIA (PSN) PHARM. AHMED I. YAKASAI, FPSN, FNAPharm, FNIM ON THE OCCASION OF A COURTESY VISIT TO THE HON. MINISTER OF HEALTH, PROF. ISAAC FOLORUNSO ADEWOLE ON TUESDAY, DECEMBER 15, 2015
It is my pleasure and honour to lead this delegation of the Pharmaceutical Society of Nigeria to your office on this auspicious occasion. On behalf of my colleagues, I wish to congratulate the Honourable Minister once again for your appointment and thank you immensely for granting us this audience.
Pharmaceutical Society of Nigeria was founded in 1927 and registered under section 21 of the 1922 Companies Act. It is an umbrella body of all the registered pharmacists in Nigeria with a vision to be recognized as a society whose members are accessible healthcare professionals responsible for the provision and rational use of safe, effective and affordable medicines, pharmaceutical care and the promotion of public health and quality of life.
This visit affords us an opportunity to interact with you and share our humble perspectives on the role that the Pharmaceutical Sector can play in national development when carefully, harnessed.
We shall also bring to your notice our thoughts on some contemporary issues especially as it relates to Healthcare delivery. This includes:
1. Drug Distribution Guidelines and Related Matters
2. Implementation of the National Health Act 2013
3. Reconstitution of the Pharmacists Council of Nigeria and Boards of Teaching/Specialist Hospitals
4. The Continued Instability in the Health Sector
5. Impact of ECOWAS Common Tariff (CET)
6. Policy Implementation
7. Welfare of Workers in Nigeria
1. DRUG DISTRIBUTION GUIDELINES AND RELATED MATTERS
The Pharmaceutical Society of Nigeria wishes to commend the efforts of the Federal Ministry of Health in initiating a Drug Distribution Guideline for the country. As it stands presently the Federal Ministry of Health through recommendations from the PSN, Pharma stakeholders and the regulatory forum has approved a new drug distribution flow chart for the country.
This slight amendment from the original National Drug Distribution Guidelines which limited choices of prospective wholesalers to State Drug Distribution Centres and Mega Drug Distribution Centres. The concept of Coordinated Wholesale Centres which is now an added leg to the wholesalers offers a major opportunity to close down open drug markets in our country once and for all.
The PSN, PCN, NAFDAC and FMOH have worked maximally on this project and we strongly urge the Honourable Ministry to sustain this spirit in the current dispensation.
2. IMPLEMENTATION OF THE NATIONAL HEALTH ACT 2014
The PSN has in recent times continually paid glowing tributes to all those who made possible for Nigeria to have its first ever National Health law.
It is important to put on record that the National Health Act is probably the only statute that attracted the attention of a wide spectrum of stakeholders in health and the larger society. There is therefore an urgent need to factor in this broad spectrum solidarity in fashioning the implementation of the National Health Act.
In the immediate past dispensation, the Federal Ministry of Health was reported by a section of the media as having sworn in a new Technical Review Committee (TRC) for the National Health Act (NH Act 2014).
The Committee which was said to be “cautiously selected to guarantee representation of the key institutions has a mandate to guide the implementation of the National Health Act”.
Naturally, the PSNaccepts the principle of setting up Committees which is also within the powers of the Federal Ministry of Health.
As a follow up to the Technical Review Committee on the National Health Act 2014, a series of other implementation templates of the National Health Act have emerged without representation being sought from Pharmaceutical Society of Nigeria and some other professional Associations and Unions in the health sector.
We are worried that the members of the 26-man Technical Review Committee and other related committees are unknown to the larger portion of key stakeholders.
3. RECONSTITUTION OF THE PHARMACISTS COUNCIL OF NIGERIA AND BOARDS OF TEACHING/SPECIALIST HOSPITALS
Honourable Minister, we do not wish to bore you with all the tragedies associated with the constitution and operations of the Pharmacists Council of Nigeria in a particular dispensation, specifically between 2009 and 2011.
In the short time we have had to run without a governing council, we have tried very hard to sustain the ideals of pharmacy practice in Nigeria. Fundamentally, disciplinary matters and accreditation of pharmacy facilities for training suffers in the absence of Council.
We urge you to facilitate the immediate reconstitution of the Pharmacists Council of Nigeria.
In the same vein, it is pertinent we inform the Honourable Minister about the lopsidedness of appointments on the Board of Teaching and Specialists Hospitals as well as Federal Medical Centres. In the last dispensation pharmacists were represented on only five (5) of the well over fifty five (55) Boards of these Federal Health Institutions. Our experience confirms that this lopsided appointment format affects healthcare plans and ultimately overall output. We therefore reiterate our previous appeal that at least one pharmacist be appointed on each of the Boards of our Federal Health Institutions.
4. THE CONTINUED INSTABILITY IN THE HEALTH SECTOR
For a comprehensive, coordinated, safe health system that is responsive to the needs of the population, efficient use of resources, increased job satisfaction, with reduced stress and burnout of health professionals, we need collaborative practice based on trust and mutual respect amongst the health care team. Internationally, the World Health Professions Alliance WHPA brought together the International Pharmaceutical Federation, the World Medical Association, the International Council of Nurses, the World Dental Federation and the World Confederation for Physical Therapy for collaborative practice, hence the need to replicate it and work harmoniously as a team. It is possible.
Some pressing challenges in the health sector which have lingered for so long compel a dire need to appeal to the Hon. Minister to urgently look into the problems.
1. The issue of Federal Medical Centre, Owerri. For over three months, health professionals and workers, members of our Associations and Unions at the Federal Medical Centre Owerri were on strike, practically closing down the hospital for the entire period, subjecting patients and members of the public to untold hardship. It is hoped that the Fact Finding Committee that was constituted on this challenge would carry out her assignment expeditiously.
2. Non employment of graduates of pharmacy into the Federal tertiary hospitals as intern pharmacists or as registered pharmacists even Federal Health Institutions in the catchment areas where pharmacy graduates were trained do not employ them.
3. The attitude of management in some of the Federal Health Institutions is a major let down. Often times the Drug Revolving Funds are decapitated because the funds are diverted to other endeavours which is a violation of the Drug Revolving Funds manuals and guidelines in the enabling statute.
The Pharmaceutical Society of Nigeria finds it necessary to inform you on the viability of well managed Drug Revolving Funds in public health institutions.
4. The issue of commercialization or privatization of health facilities which cannot be in tandem with global best practice and is different from a public private partnership (PPP) concept.
5. However, there is also need for health system audit and general overhaul for efficiency, therefore some services like catering, security, mortuary services and general maintenance can be totally privatised.
5. Impact of ECOWAS Common External Tariff (CET)
The Implementation of ECOWAS CET which allows finished Pharmaceutical products to be imported at zero percentage duty is a good gesture and same should be extended to raw and packaging materials which now attract a duty percentage ranging from 5% to 20%. This simply means that locally manufactured pharmaceutical products have become uncompetitive. The fall out is an eminent closure of all Nigerian Pharmaceutical plants. Again many Pharmaceutical Manufacturers are running out of raw materials due to lack of response from banks on the letter of credit requests and is likely that many will close shop in the next two months. We urge you to intervene on this critical issue.
The Nigeria Drug Policy provides that 70% of government purchase should be sourced from local manufacturers. I think the time has come for this policy to be implemented at all levels of government. It will boost internal capacity utilization and make local manufacturing more attractive. With the new opportunity for new government and new way of doing things and from your character and characteristics, I have no doubt in my mind that you will provide a strategic direction, develop and implement policies that will see the Pharmaceutical sector become globally attractive and competitive
7. WELFARE OF HEALTH WORKERS IN NIGERIA
It is pertinent to mention that we have valid court judgments, collectively bargained Agreements, Memoranda of Understanding (MOUs) and even circulars signed with government which have remained implemented on a haphazard or discretionary basis by the Federal Health Institutions, such as the following:
i. Implementation of the spirit of the existing circular on promotion of our members from CONHESS 14 to 15 as directors which places premium on the need to sanction defaulting hospital managements.
ii. Specific steps must be taken by the Head of Service of the Federation to ensure the expedited issuance of an enabling circular authorizing consultancy cadre for health professionals that have adhered to due process, to be vested with consultancy status as a prelude to inculcating this cadre into the schemes of service of these health professionals. This must be worked out with the Federal Ministry of Health in line with the spirit of the circular on consultancy and specialist allowances Ref. SMH.491/S.2/VOL II.221 of 29th March, 1976, which authorizes consultancy status for all health professionals, and the condition precedent of the National Industrial Court of Nigeria (NICN) that provides for a nod of the Federal Ministry of Health for the appointment of consultants.
iii. Payment of arrears of specialist allowances to qualified hospital based health professionals with effect from January 1, 2010, should be ensured.
iv. Full payment of arrears of the skipping of CONHESS 10 which remains outstanding since the year 2010.
v. Release of the circular on adjustment of salary since January 2014 and immediate payment of at least 2 months arrears, while the balance is accommodated with proven evidence in the 2016 budget.
vi. Sponsoring an amendment bill to correct the anomalies in Decree 10 of 1985 (CAP U15 463) LFN 2004, especially in the following areas:
(a) LOPSIDED COMPOSITION OF THE BOARD OF MANAGEMENT
(b) APPOINTMENT OF CHIEF EXECUTIVE OFFERS (CEOs) OF FEDERAL HEALTH INSTITUTIONS
(c) APPOINTMENT OF CHAIRMAN MEDICAL ADVISORY COMMITTEE (C-MAC)
(d) APPOINTMENT OF DEPUTY CHAIRMAN MEDICAL ADVISORY COMMITTEE (C-MAC)
(e) TRAINING OF HEALTH PROFESSIONALS
(f) REMOVAL OF THE BORDERS OF RESTRICTION ON PERMANENT STAFF OF FEDERAL HEALTH INSTITUTIONS
vii. NATIONAL HEALTH INSURANCE SCHEME (NHIS)
In the spirit of the broad spectrum of reforms, there is no reason why for 6 years now the NHIS encourages unlawful payment mechanisms dubbed global capitation, while HMOs also capitate secondary and tertiary facilities which out rightly disrupts the equilibrium of the health system.
We demand that the Federal Government direct the board and management of the NHIS to immediately adopt lawful payment mechanism to wit, capitation for primary providers and fee for service for secondary and tertiary providers.
Government must also redress the capitation modes by embracing international global best practices on what constitutes a primary facility for capitation in Nigeria.
Honourable Minister, we wish to convey our appreciation for your approval of this courtesy call and humbly invite you to my formal inauguration as the President of PSN and investiture of our new Fellows on the 18th of February 2016 at Congress Hall, Transcorp Hilton, Abuja.
PHARM. AHMED I. YAKASAI, FPSN, FNAPharm , FNIM.