COMMUNITY PHARMACISTS IN NIGERIA HEALTH SECTOR: THE COVID – 19 CASE STUDY BY Dr. Samuel Oluwaoromipin Adekola (PharmD.) DSA, MAW ACPN National Chairman
The SGF & Chairman,
Presidential Taskforce on COVID – 19
COMMUNITY PHARMACISTS IN NIGERIA HEALTH SECTOR: THE COVID – 19 CASE STUDY According to the situation report from NCDC as at 27th April 2020, confirmed cases of COVID19 recorded in Nigeria stands at 1273 cases, 239 cases have been discharged and 40 deaths have been recorded. NCDC has adopted diagnostic testing as an essential response strategy to interrupt the transmission for the COVID-19 pandemic by informing patient management and identifying positive cases, which can then be isolated. The Federal ministry of Health has prioritised testing as one of the key interventions to the COVID-19 response in Nigeria. In order to rapidly contain the outbreak, the Government of Nigeria plans to rapidly scale diagnostic testing to cover all 36 States plus the FCT. The NCDC in the National Strategy to Scale Up access to COVID-19 testing in Nigeria stated “ Between May and September 2020; we will roll out mass testing to survey the population, to learn more about this virus and contribute to research and development.”
Unfortunately, Nigeria has lost among many one of her very prominent frontline political leaders, the Chief of Staff to the President of our dear Country to the scourge of COVID 19. Very sad indeed. Mallam Abba Kyari was an unsung hero that can simply be described as gallant soldier who died at his post. May God grant Mr. President, the immediate family and all of us the fortitude to bear this great loss.
The Association of Community Pharmacists of Nigeria (ACPN) is a technical group of the Pharmaceutical Society of Nigeria, the umbrella body of all Pharmacists registered and practicing in Nigeria.
By default world over Community Pharmacies remain the closest and the most accessible primary health-care facilities to the people in cities, communities and villages, hence the first point of call for over 70% of consumers of health in our clime as documented in national studies. Little wonder Community Pharmacists continue to serve the Country as front-line health-care providers even in the face of the current dreaded COVID – 19 pandemic. The latter underscore the continuous risks and potential hazard facing every Community Pharmacist in practice.
Sir, with due respect, the continuous marginalization and outright sidelining of Community Pharmacists by health authorities in Nigeria and now by the Presidential Taskforce on COVID – 19 in all its great initiatives and programmes that include but not limited to both social and economic palliatives is highly dishearten. The current scenario is akin to the consistent exclusion of Community Pharmacists in the Country’s non-performing National Health Insurance Scheme.
For instance, Community Pharmacists who are the first port of call for health interventions of varying depths are not covered by any form of insurance and benefit package in Nigeria, but these same cadre of personnel were singled out for praise by UK Prime Minister Boris Johnson for sustaining services when Doctor’s Clinics (Surgeries) in the private sector were closed in the throes of the plague of COVID-19. The UK Government approved the sum of 300Million Pounds to cushion the welfare and logistics plans for Community Pharmacists in the UK recently because competencies and capacities were attained, apart from regular provision of PPE, masks and medical gloves to the Community Pharmacists and the support staff.
In the USA, Community Pharmacies which already take care of 80% of immunisation activities were officially empowered to carry out COVID-19 testing in their facilities. The UK and the USA have been able to cover more grounds in COVID-19 testing and management of asymptomatic clients simply because it has taken advantage of the proximity of its citizens to Community Pharmacies which will always remain “Grassroots healthcare facilities”.
Community Pharmacists work at the heart of communities to ensure that patients receive their services, treatments and solid information. The role of the community pharmacist is crucial: we are important actors in the healthcare chain and particularly in primary health care. By serving patients with mild or chronic illnesses, giving information and screening them, we continue to ease the burden on hospital doctors, nurses and emergency departments.
The valuable service that Community Pharmacists and their teams provide to communities, and their significant contribution to alleviating the great pressure on health systems during the current coronavirus / COVID-19 pandemic, is now more evident than ever. We do our best and take risks to ensure continuity of care, particularly for vulnerable people, and to maintain a strong and efficient supply chain for medicines and medical products, as well as to provide advice and services. With over 60,000 workforces in the organised Community Pharmacy healthcare sector, a huge center for an overwhelming contagion is established and continuous lack of attention on this sector in curbing the spread of COVID-19 is handling the fight against COVID-19 with a kid glove.
As much as the contribution of community pharmacists is essential to the wellbeing of Nigerians, lack of adequate protection for these personnel is a waiting danger that can eliminate the entire workforce which may not be necessary if government disposition to the safety of Community Pharmacists given higher consideration. The fight against COVID-19 is being championed by the Community Pharmacists through their various efforts of providing personal care remedies, advocating the adherence to the governmental directive for the prevention of the spread and social distancing is being practiced but alas at the greatest risks to their lives.
Government has not thought it needful to capture the contribution of Community Pharmacists in the ongoing fight against COVID-19 and this has been demonstrated by the exemption of Community Pharmacists from among the healthcare practitioners to receive personal protective equipment in rendering their services to the citizenry.
The community pharmacists have been rendering their services with the greatest risks to their lives and to their immediate family members because of their daily exposure to potential COVID-19 carriers. The news of Pharmacists across the globe becoming exposed to COVID-19 and subsequently succumbing to the disease in line of their practice is noteworthy.
As an association, we are no longer comfortable seeing our members risking their lives without adequate protection and serving the general public who are still not convinced of the veracity of the claims of the spread of COVID-19 in Nigeria. The daily tally of the confirmed cases is scary and the inherent danger of current phase of established community transmission in Nigeria, can better be imagined.
Personal protective equipment are not within the purview of our what Community Pharmacists can provide because of its global scarcity. Only the government have the access to this right now and must necessarily capture the community pharmacies in the distribution of these equipment. A whooping 60,000 workforce in the community pharmacy sector with daily exposure to potential COVID-19 patients is a huge figure begging the attention of the government right now.
As law abiding citizens and professionals who swore oath of allegiance to care and support human healthcare needs, we will continue to render our services even in the face of this intimidation and marginalization. However, we would not shirk to call out our members to withdraw their services if it becomes obvious that continuing rendering our services would be detrimental to our personal health and that of our family members without adequate attention from the government.
In the face of the reality we have presented, there is no health system that can thrive when it ignores the Community Pharmacy workforce because of the peculiar proximity to consumers of health. This is what will continue to position Community Pharmacists as the most accessible healthcare professional in every health system albeit globally.
Your Excellency, the immediate engagement of Community Pharmacists in community data gathering and eventual COVID – 19 testing with Rapid Molecular Diagnostic strips in Nigeria will necessarily become a game changer as currently being observed in other more serious economics. Today in Africa, Nigeria have conducted less than 15,000 tests in compares to Ghana our close neighbor with close to 70,000 tests, South Africa have done over 100,000 tests and even Egypt with close to 60,000 conducted tests. But in our Country Nigeria, because government is not engaging private sector, particularly community pharmacies and the pond ponderance of private laboratories.
As a responsible Association, we hereby calling on the government of the Federal Republic of Nigeria to immediately capture Community Pharmacists as part of the healthcare practitioners to benefit from the distribution of the personal protective equipment and every other palliatives being designed for the healthcare sector at this time of unrelenting fight against COVID-19.
The healthcare sector especially in the downstream prominently positioned Community Pharmacies as a veritable instrument for positive healthcare interventions in our nation just as in other advanced economies. As SMEs, they are in line with the government’s mandate in providing healthcare service as a social responsibility to the populace.
However, finding a favorable and low-priced funding have been a big barrier to the growth and continuous existence of Community Pharmacy endeavors in Nigeria, worse still is the challenge of products prices astronomical increase that has characterized the COVID-19 era across the globe.
While appreciating the recent Federal Government intervention through Central Bank of Nigeria for the N100b intervention fund established for essential services and including pharmacies in the bracket as a major engagement that hopes to turn around the fortune and the impact of the sector for the overall good of our Country, we seriously call on the federal government to prevail on the Central Bank of Nigeria to forthwith establish special fund in the like manner as done during this COVID-19 intervention as a permanent platform for the growth of Community Pharmacy in Nigeria with the understanding that Community Pharmacy segment of the pharmaceutical value chain is pivotal as the major link between the manufacturing and consumers of health with huge potential of gainful employment generation.
We equally expect that a special committee of the CBN be established to appraise and measure the impact of this intervention fund to the sector at regular intervals. Representatives of the Association of Community Pharmacists of Nigeria (ACPN) would be willing to be part of the committee to advance current realities of the funding amongst her members.
We therefore request the leadership of CBN to deeply consider the extension of the current programme of financial intervention for critical and essential services with Pharmacies prominently and continuously benefiting from this platform going forward.
We are sure many of our young pharmacy graduates would be encouraged to increase their capacity and the contribution of pharmacy profession in tackling the healthcare challenges in our nation. The future feedbacks would also be jumpstarting a somewhat less productive pharmaceutical industry to advanced grades competing with India and China in years to come if this funding is sustained for the downstream sector of the healthcare industry.
ACPN continue to pledge her commitment to protect the good people of Nigeria and empowering the Community Pharmacists as our motto implies.