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COMMUNIQUÉ OF THE 41st ANNUAL NATIONAL SCIENCIFIC CONFERENCE OF THE ASSOCIATION OF COMMUNITY PHARMACISTS OF NIGERIA (ACPN)
Theme: NEVER WASTE A CRISIS: COMMUNITY PHARMACISTS LEARNING FOR FUTURE PREPAREDNESS
The 41st Annual National Scientific Conference of the Association of Community Pharmacists of Nigeria (ACPN), was held at the Festival Hotel, Amuwo-Odofin, Lagos State, Nigeria, from Monday, July 25, to Friday, July 29, 2022 under the theme, "Never waste a crisis: Community Pharmacists learning for future preparedness".
The Special Guest of Honour at the opening ceremony was His Excellency, Mr. Babjide Olusola Sanwo-Olu, the Executive Governor of Lagos State, the Chief host was Prof. Cyril Osifoh FPSN, President Pharmaceutical Society of Nigeria (PSN), while the Royal Father of the day was His Royal highness, Oba (Pharm) Ajibola Ademola Julius, Amuludun Iluyomade 1 (TLK), Olusin of Ijara-isin.
The Conference was graced by other eminent Nigerians including, the Registrar Pharmacists Council of Nigeria (PCN) Pharm. Babashehu Ahmed FPSN, Dr Monica Hemben Eimunjeze FPSN, Director Registration and Regulation Affairs, NAFDAC who represented the Director General NAFDAC, Past President of the PSN and President Nigerian Academy of Pharmacy, Prince Julius Adeluyi Adelusi FPSN, Dr. U.N.O. Uwaga FPSN Past President of PSN and Chairman BOT of ACPN, as well as other Past Presidents including Sir Anthony Akhimien FPSN, Pharm. Azubike Okwor FPSN, Pharm. Olumide Akintayo FPSN and Pharm. Ahmed Yakasai FPSN, the President of Nigerian Association of Pharmacists, Pharmaceutical Scientists and Allied Scientists in the Americas (NAPPSA), Dr. Theresa Pounds, and an assemblage of seasoned speakers and panelists.
Chairman of the Opening ceremony was Pharm. (Hon) Gboluga Ikengboju, Member Federal House of Representatives while the Keynote Address was delivered by Dr. Faisal Shuaib, ED/CEO National Primary Health Care Development Agency (NPHCDA).
Highlights of the conference include:
i. Pharmacists Council of Nigeria certified Vaccination/ Basic Life Support Training for Pharmacists in Partnership with Mercer University, USA,
ii. Ii. The finals of the 2022 ACPN National Anti-Drug Abuse competition (ACPN NADAC) for Secondary School Students nationwide.
iii. Scientific Poster Presentations of Research Conducted at some Community Pharmacies in Nigeria
iv. The launching of Julius Adeluyi Adelusi Community Pharmacy Expansion grant.
Presentations and Topics discussed at the Conference are as follows;
i. Community Pharmacies as Primary Healthcare Centres in Nigeria; What, How and Why?
ii. National Health Insurance and National Emergencies Management; Opportunities and for Community Pharmacists.
iii. Roadmap for Community Pharmacist Certification as Care-Providers for Substance Use Disorder.
iv. Integrating Traditional, Complementary and Alternative Medicines (TCAM) into Community Pharmacy Practice: A Practical Perspective
v. Supply Chain Security for Medicines and Effective inventory Management for Community Pharmacists
After careful evaluation of the presentations at the scientific conference, Conference observed and resolved as follows:
1. Conference recognised the Primary Health Care (PHC) system as the cornerstone of the healthcare delivery, capable of meeting the healthcare needs of the vast majority of the population. It was stressed that the PHC system encompasses a broad mix of promotive, preventive, protective, curative, and palliative care.
2. Conference concurred that all Health systems contain four essential levels of care: lay self- care, primary professional care, general specialist care and super specialist care. Primary health care (PHC) remained the first level of professional contact in the community and forms the corner-stone strategy for the attainment of a level of Health that will permit socially and economically productive life.
Conference posited that PHC is a community-oriented model, for the discharge of health care services to the population in their communities, in a way that is easy and acceptable to them. Conference relied on WHO declaration that Community Pharmacists are the Health Professionals most accessible to the public, who render services such as
i. Prevention of diseases and health promotion programs.
ii. Screening, Identification and classification of non-communicable diseases e.g., hypertension, diabetes.
iii. Dispensing of medicines in accordance with nationally agreed protocols
iv. Ensuring accurate supply of medicinal products through a quality process.
v. Patient counselling as well as care and support for those who are ill.
vi. Provision of Drug information to health professionals, patients and the general public.
vii. Maintaining links with other health professionals to support referral.
vii. Detection of drug therapy problems and resolution of such in collaboration with other health care professionals
Conference took a position that achieving Universal Health Coverage (UHC) is a responsibility for all, especially in these times of expanding population and limited human resources for health. Inclusion of Community Pharmacies as Primary Healthcare Centers in Nigeria will propel improved quality of life which translates to decrease burden of healthcare on the Government because PHCs in existence are too few to serve the populace and are often under-resourced and lacking in skilled manpower; a depletion resulting from relocation and retirement of trained personnel. Conference critically appraised the totality of the expertise of Community Pharmacists and summarised the output as including but not limited to the reflected:
i. Provision of some level of Primary Care Services.
ii. Rendition of professional intervention to relieve the burden of Health Care borne by the Government.
iii. Serve as a buffer in providing some services in order to reach more people in receiving quality healthcare thereby improving health indices.
iv. Support Government efforts in increasing uptake of health interventions in the state (Covid-19 vaccination, HIV management and Family planning procedures).
Conference therefore strongly urged Government to utilise the peculiar advantage of the network of Community Pharmacists in rural and urban centres to drive its agenda of UCH.
3. Conference reckoned that the National Primary Health Care Development Agency (NPHCDA) is responsible for ensuring the right policies with pragmatic and technical support are put in place. These services are made available, accessible and affordable to the population especially at community level. Conference commended the NPHCDA for reaching out to all pharmaceutical entities in the country for sensitization at the peak of the COVID-19 pandemic in 2021 which is a laudable example of “NOT WASTING A CRISIS” as the pandemic provided an opportunity to involve Community Pharmacists in PHC service delivery. This led to a partnership with the ACPN for COVID-19 vaccination at Community Pharmacies, a partnership which is very strategic to achieving the goal of Primary Health Care development in Nigeria. Conference emphasized that Pharmacists being an integral part of the health care system in any country, must take advantage such that Community Pharmacists will compliment efforts at bringing quality health services closer to the people through the PHC system. Consequently, the ongoing national effort to revitalize the country’s PHC system will only be complete, with the Community Pharmacy component fully incorporated. Conference informed Government that the quality of every healthcare system is grounded in its PHC system as well as a credible drug distribution system because 62% to 75% of every healthcare cost has drugs at its heart. In addition, people die more from a poorly managed drug therapy than diseases.
4. Conference lamented for the umpteenth time that the supply chain system for drugs distribution in Nigeria was faulty and ACPN had started a supply chain platform that interconnects all pharmaceutical entities in Nigeria. The Premises to Premises or Pharmacy to Pharmacy (P2P) platform is a Pharmaceutical Ecosystem to make sure medicines ordering in Nigeria is from, and through PCN-registered facilities only. The P2P platform is now operational to strengthen the supply chain system, reduce the prevalence of fake medicines and reduce the scare concerns associated with our industry. Thus, products available at Community Pharmacies will be those without untoward supply chain excursions.
5. Conference put on record that Community Pharmacists are well trained and equipped with great skills to champion a healthier nation as attributed to by exploits in their professional space nationwide.
Conference therefore implored Government at State and Federal level as well as the private sector to utillise the depth of knowledge as well as broad spectrum skills of Pharmacists in all key Health programmes including Primary Healthcare endeavours, Social Health Insurance and Managed Healthcare Schemes in the bid to ensure access to affordable and qualitative Healthcare services.
6. Conference recalled the unfruitful Health Service Delivery System which compelled the enactment of the NHIS Act to facilitate access to efficacious, affordable and accessible Healthcare.
Conference decried the operational modalities of the NHIS which has consistently deviated from the set goals, targets and objectives of a well-coordinated Social Health Insurance agenda, a major reason for the unacceptable and disappointing coverage rate of less than 5% for over 15 years.
Conference applauded the decision of the FG to repeal the NHIS Act on May 19th 2022. A new law, National Health Insurance Authority (NHIA), 2022 was enacted mainly to promote, integrate and regulate all health insurance schemes in Nigeria. The goal of reducing out -of- pocket expenditure on health to less than 30% will be easily achieved and, expanding health coverage will favourably cause a decline in Maternal Mortality Rate (MMR) and Under 5 Mortality Rate (U5MR).
7. The New Act 2022 was rejigged to propel Social Health Insurance through specific interventions including:
i. Capturing the roles of States in jump-starting the State Health Insurance Scheme.
ii. Ensuring the implementation and utilisation of the Basic National Healthcare Provision Fund.
iii. Providing for the Basic Healthcare needs of the indigents and vulnerable groups which constitute about 40% of the population i.e., 70-80million people.
8. Conference opined that the role of Community Pharmacists in ensuring the delivery of quality healthcare services to the Nigerian populace has become more crucial than ever. It is important, in the best interest of the Nigerian citizenry that CPs are;
i. Accredited for Pharmaceutical Services.
ii. Recognised as Primary Health Care service providers.
iii. Allowed to mobilize grassroots participation as the first point of contact with organized health service.
iv. Included in the Drug Management Organizations (DMO) Program as the last operators in the value chain of drug distribution.
v. Allowed to expand pharmaceutical coverage through Satellite Pharmacies as provided for in the Pharmacy Council of Nigeria Bill.
Flowing from the above, Conference evaluated the draft PCN Bill and concluded that it provided the enabling template to achieve the agenda items listed above.
Conference therefore called on President Muhammadu Buhari to immediately give assent to the PCN Bill in the ultimate public interest.
9. Conference submitted that particular attention be paid to the shortcomings of the NHIS which could limit the success of the NHIA Act such as;
i. Sidetracking of Community Pharmacists and other secondary providers in the Global capitation payment which adversely affected trust. Thus, payment mechanisms must be right and premised on the lawful precept which prescribes fee for service for CPs and other Secondary as well as Tertiary providers.
ii. Sub-optimal tariff management under NHIS, though entrenched in the New Act, however calls for review of drug prices every three years which is too long and impractical due to the rate of inflation in frequency and proportion.
iii. Capacity Development; a need for reawakening and continuing education of the different cadres of Health Practitioners. iv. The engagement of licensed Actuaries, who monitor the implementation of the operational guidelines, ensuring equity (in fees for service, distribution of enrollees to providers, effective tariff management amongst other things) and proper risk management for all parties involved, is fundamental to effective implementation of this new NHIA Act of 2022, as provided for, in section 38 of the Act.
10. The conference inferred that no matter the illness, drugs are the last resort of disease. The proper use of drugs, in the right combination, quantity, frequency, with suitable diet, liquids, through the proper route, is very critical to the efficacy of therapy as well as and the duration of convalescence and the economics of therapy. These values captured in Medication Therapy Management (MTM), a service unique to Pharmacists, must be recognised and accorded a service charge in the NHIA. Without a doubt, healthcare without assured quality Pharmaceutical Services is built on defective foundation. Conference reminded the general public that, when drugs of any sort are used outside the recommended indication, dose or duration, the consumer is taking a conscious risk towards self-poisoning. Thus, no drug of any description should be taken without the intervention of a Pharmacist.
11. Conference committed itself to the commissioning of the initiative of a unique labeling model for Community Pharmacists to distinguish professional handling of medications with regards to appropriate counselling, medications review (MTM), and instruction. Conference seized the discourse to call on the National Human Rights Commission to live up to its mandate of ensuring access to genuine drugs as a right of citizens of the Federal Republic of Nigeria in furtherance of its pact with the PSN in previous dispensations.
12. Conference recognised the importance of creating a scientific database of herbal products of primary health indications and called for a policy reform towards greater incorporation of herbal medicines in healthcare delivery as well as the identification of Community Pharmacists as care providers for substance use disorders and mental health screening.
13. Conference adopted the launching of the Julius Adelusi Community Pharmacy Expansion Grant to improve the access of 230 Million Nigerians to Community Pharmacists. In similar spirit, the Conference approved of future plans to immortalise the late Pharm. Jimi Adesanya FPSN the former National Chairman of the Nigeria Association of General Practice Pharmacists (now ACPN) for meritorious services
14. At the end of the Conference, the following Pharmacists were elected to pilot the affairs of the Association for the next one year:
National Chairman, Pharm. Adewale Oladigbolu, FPSN; National Vice Chairman, Pharm. (Mrs.) Bridget Otote Aladi, FPSN; National Secretary, Pharm. Ezeh Ambrose Sunday MAW; National Assistant Secretary, Pharm. Nkiru Chuka-Okoye; National Treasurer, Pharm. Omokhafe Ashore MAW; National Financial Secretary, Pharm. Babatunde Samuel; National Publicity Secretary, Pharm. Keneth Ujah MAW; National Editor-in-Chief, Pharm. Giwa Babajide; Internal Auditor, Pharm. Ikechukwu Okwor, MAW; Immediate Past National Chairman, Pharm. (Dr) Adekola O. Samuel, MAW, DSA.
Pharm. Adewale Oladigbolu, FPSN
Pharm. Ezeh Ambrose Sunday, MAW