Nigeria’s health sector in bad shape – PSN President

Pharmacist Ahmed Yakasai is the president of Pharmaceutical Society of Nigeria (PSN). In this interview, he speaks on the need to make strategic and deliberate policies that can improve health care in Nigeria and make the country a pharmaceutical hub in Africa. Excerpts:   Daily Trust: What are your thoughts on the ideal medical system […]

Pharmacist Ahmed Yakasai is the president of Pharmaceutical Society of Nigeria (PSN). In this interview, he speaks on the need to make strategic and deliberate policies that can improve health care in Nigeria and make the country a pharmaceutical hub in Africa. Excerpts:

 

Daily Trust: What are your thoughts on the ideal medical system in Nigeria?

Ahmed Yakasai: When some people talk of a medical system they mean pharmacy, nursing, others mean only medical doctors, but I hope this question includes the entire medical sector which talks about the pharmaceutical sector.

Our budget allocation for health should at least be as agreed by Nigeria being a signatory to the convention in Abuja which is 15% for health care. The National Health Care Act if implemented, that is getting the 1% allocation from the consolidated revenue fund, and put in a calabash, the international donors would bring their own, and a method is instituted wherein the primary health care fund is available for emergency situations, the National Health Insurance Scheme fund is accessible, monies are also allocated for pharmaceutical, medicine and consumables. But I do not know what is happening, it seems like leaderships that come and go do not see health as a priority. Our health budget used to be 5.4% to 5.6% but in this regime it reduced from 5.4% to 4. something and this year, it went down to 3.6% which generally is affecting the medical landscape in Nigeria. Nigeria is bedeviled by issues of manpower, all this rivalry among professionals is because of poverty, they are not well paid.

Many have checked out of the country including doctors, nurses, pharmacists, lab scientists in search of greener pastures. I just came back from North Carolina, we have more than 8000 pharmacists in America and the United Kingdom from Nigeria and they are doing well. So, with this kind of attitude definitely to me we are encouraging medical tourism, brain drain, creating more inter-professional rivalry and disharmony in the system.  Health care is in a bad shape in Nigeria, it is a pathetic situation, but of course I always say that one should not bring politics into health care, agriculture or education.

Any government that is successful in agriculture, health and education will get everything right, people will go out and look for whatever they can do to survive, that is how you generate and create employment. In the pharmaceutical sector, if we are encouraged, the about 178 manufacturing outfits can generate almost one million employments, but we are not encouraged.

DT: We are in an election year, what is your advice to Nigerians on choosing leaders that would take some of these issues you have raised to bear in their manifestos?

Yakasai: You see, the way things are going in Nigeria, we have not developed to the point that you cannot vote somebody if he does not have a transparent agenda which shows you the direction, or road map, ideology, or what he can offer.

Just like what Professor Lamuba said, he went round and realized that in Africa, you can only get elected through their stomachs, not through fresh ideas. Because he contested in an election and he organized about 250 town meetings, he went round talking about those ideas, then somebody went and shared money on the day of the elections and he won.  Honestly, anybody that will come with a blueprint on health care as a priority, on agriculture, education should be our leader because he knows what can bring about human development. Of course, the GDP through these areas can easily grow, so in leadership one has to look for those who have fear of God, are ready to be accountable, tested and trusted, not corrupt, but unfortunately the system does not allow honest leaders to emerge. From the primaries up to now I cannot see internal democracy even within the parties.

DT: What intervention do pharmaceutical companies need to make Nigeria a pharmaceutical hub in West Africa?

Yakasai: We have the National Drug Policy in Nigeria which was published in 2005 and it states there every five years, the policy would be reviewed and we are now in 2018, and there has been no revision of the policy. Though I understand a committee was set up to work on the policy. It was clearly stated in the policy that by 2010 we should be able to produce 70% of the medicines we consume and source the other 30% from outside, but the reverse is the case, we are getting 70% from outside and 30% from within. Even with the 30% of the medicines, 98% of the raw materials are imported, so you can see that at the end of the day we are nowhere.

Secondly, the issue of tariff, we have what they call the common external tariff by West African Countries (ECOWAS) which was agreed on and Nigeria signed. Most of the countries do not have industries, they said all imported products should attract 0% but raw materials should attract duties from 5% – 20%, so those countries without manufacturing outfits are happy importing to make medicines accessible at affordable rates because they do not have industries.

We that have industries, we would become a dumping ground, and our local industries would not be able to compete, so we complained and made noise and said that it does not make sense. We visited President Muhammadu Buhari, visited the Minister of Health, and they were able to see through all the points I made. My recommendation then was, let’s make the raw materials 0%, just like what Ghana did just recently, they are not charging interest on raw materials.