Exactly one year ago, on May 29, 2023, Senator Bola Ahmed Tinubu was inaugurated as Nigeria’s democratically elected president, sparking optimism among stakeholders in the pharmaceutical sector for positive transformations under his leadership.

Yet, as President Tinubu marks his first year in office, members of key pharmaceutical organizations such as the Pharmaceutical Society of Nigeria, Community Pharmacists of Nigeria, and the Pharmaceutical Manufacturers Group of the Manufacturers Association of Nigeria have expressed reservations about his administration’s approach to vital issues within the pharmaceutical industry.

A notable concern raised by these stakeholders is Tinubu’s appointment of non-pharmaceutical professionals to key roles, which they believe is adversely affecting the healthcare sector. They underscored the significance of appointing individuals with relevant expertise to propel advancements in the industry and called on the President to implement effective measures that would enhance the sector’s capacity to make a meaningful contribution to public health and the economy.

Reports from Wakadaily revealed that pharmacists and local drug manufacturers highlighted the ongoing challenge of inadequate health funding in Nigeria. They urged the President to address this issue by reducing the costs of diesel, fuel, and electricity to facilitate the affordability and accessibility of locally produced medications for underserved populations.

In light of these concerns, Olumide Akintayo, the immediate past President of the Pharmaceutical Society of Nigeria, emphasized that health funding remains a critical obstacle in Nigeria and has shown limited improvement over the past year. He stressed the urgent need for legislative measures to be enacted and effectively implemented to fortify healthcare services and ensure the availability of essential medications, including vaccines, for the general populace.

Akintayo highlighted, “There is an Abuja Declaration, where 15 per cent of the national budget should go to the health sector but this has not been implemented. Even when Tinubu went online to say that his administration has the highest budget allocation to health, it is just not enough.

“The President created a lot of gaps in the healthcare sector with his appointments.  The two Health Ministers are all physicians and this is a misnomer. Having physicians in all the appointments in the major health positions is a recipe for tragedy.

“When you use physicians as the Health Minister and Minister of State, it can’t work because you are getting opinions from one sector. Prof Ali Pate is a good, well-seasoned professional but he may not be getting the desired result because of the president’s lopsided appointments.

“Tinuba is not getting it right and will not get the right result because he does not allow the requisite professional to run the pharmaceutical sector. The pharmaceutical sector is very essential in running the health sector and if you want to improve the Gross Domestic Product of the country, the pharmacists and this sector are well positioned to do this.

“He may have improved in some areas, but not in this sector. Except you allow experienced pharmacists, who understand this sector and the problem with drug manufacturing and distribution to handle certain positions, he will not improve at all.”

He further emphasized that , the President called for cooperation among various sectors, yet all his appointments, from special advisers to the Director General of the Nigeria Centre for Disease Control and Prevention, and the Chief Executive Officer of the National Primary Health Care Development Agency, are physicians.

Akintayo stated, “The signal of this is that you are telling others to go to hell. The treatment is not healthy for the unity and development of the health sector because there is a need for a pharmacist who can tell what to do in the area of drug manufacturing and distribution.

“That is why the Minister of Health for State and Social Welfare, Dr Tunji Alausa issued a circular that was a major tragedy without carrying out the necessary assessment to know the capacity and the type of syringes that could be produced in the country and banned importation of syringes, creating a serious monopoly.

“You don’t just ban things at face value.  You have to ensure that the manufacturers can produce what the country needs before making such a costly pronouncement so that it doesn’t boomerang.

“With this, you are now referring people to the open drugs market that the government and other stakeholders are trying to close to buy essential drugs and syringes. You listed an open drug market where people should go and source them.”

Akintayo emphasized that the Pharmaceutical Society of Nigeria (PSN) and other professional organizations have urged the President to establish a presidential committee to oversee and ensure the smooth and professional distribution of drugs in the country, avoiding the unregulated open drug market.

He pointed out that with incompetent individuals in key positions and a lack of essential resources, Nigeria’s healthcare system will continue to struggle with subpar performance and unfavorable outcomes.

Akintayo stressed that Nigeria should be staffed with top-notch pharmacists and physicians, but unfortunately, they are leaving the country due to poor working conditions and welfare.

He mentioned, “There is no policy or law you will enact to keep the people in the country without treating them well. That is why we talk about the welfare of the people. The President said all the outstanding allowance and benefits accruing to these healthcare professionals would be paid immediately during his inaugural speech but one year after; he has not fulfilled that promise.

“It is not good enough for the country that the President will say something and will not do it. It destroys the confidence and trust people have in him.

“During the COVID-19 pandemic, the CEO of the Primary Health Care Development Agency took the bold step and allowed community pharmacists to vaccinate people. Over 243 community pharmacists signed a Memorandum of Understanding and in less than one year, they vaccinated over 76, 000 people.

“Imagine what would be its multiplier effect if 10, 000 community pharmacists were given that chance to vaccinate. Maybe they would do so much to reduce maternal mortality in the country.

“I believe that Nigeria has great potential. We don’t have another country. I hope President Tinubu proves me wrong. Minister of Interior, Olubunmi Tunji-Ojo is doing well. Festus Keyamo is doing well in Aviation. I hope Ali Pate will do the same and improve the health system. He seemed to have good ideas but we need translation of those ideas.”

Further more , the former Secretary of the Association of Community Pharmacists of Nigeria, Lagos State chapter, Okotie Jonah, stated there has not been improvement in the sector but people have adjusted to available alternatives.

He elaborated, “In the pharmaceutical sector, I won’t say there is an improvement, but we are just adjusting and people are looking for cheaper alternative drugs to stay alive.

“As it is now, ventolin inhalers are not still available but people are now adjusting to the alternatives. However, there were a lot of things happening before Tinubu came in. So they were ongoing but it is manifesting in the present day.

“COVID-19 and its effects are still not over because the system was shut down for over a year and some countries have not recovered. We don’t have any system. We still import raw materials and finished products.

“We are not deliberate about empowering local manufacturers. In some other countries, the local drug manufacturers were given money to improve their capacity. The US, for instance, gave them money to increase their capacity. But we don’t have that here.

“Until government officials understand that we are in this together, we will not make any progress. These big companies we hear their names don’t get to where they are without support. The government gave them money and they are global players today.

“You can’t empower the people without empowering the system to get to the international standard. These are the things that make the system archaic.”

Okotie observed that while one year may seem brief, it’s sufficient to gauge the government’s direction and healthcare sector’s trajectory.

He acknowledged that Pate had made a promising start by engaging stakeholders to pinpoint the sector’s challenges.

However, Okotie expressed concern that the absence of an effective justice system in the country is hindering the healthcare sector’s progress, citing the example of health facilities threatening to discontinue services to patients with health insurance policies due to the government’s failure to settle its debts.

He added, “This explains why health facilities treat people with insurance policies without seriousness because the government is not paying them for their services. You said emergency cases should not be turned down or rejected, that they should be treated but who will pay them for their services?

“We need to get a feedback system that ensures that all the participants know what the problems are. The government said it wants to improve local manufacturing in the country, yet the National Agency for Food and Drug Administration and Control wants to compare and burden a starter business with international standards roles.

“If we sincerely want to produce drugs in this country, the government must give some support and incentive. This is the time for the government to support financially and when the business gets to the point of profitability, it can take the funds and give to another.

“Also, if we must get this process right, we must stop comparing a backyard producer with others producing in America because they are starters, and there is no sense in compelling them to do so with international standard roles.

“Those firms you are comparing them with started little like them but supported by their respective countries to get to where they are today. That is what we need to do and not overburden them. That is what China does too.”

Dr. Michael Paul, a member of PMG-MAN and CEO of Mopson Pharmaceutical Limited, Lagos, expressed his concerns about the health sector in Nigeria, stating that it is not functioning effectively.

He also highlighted the impact of the exchange rate on the economy, noting that it is influenced by multiple factors and that a high exchange rate has a negative effect on the economy, ultimately affecting the overall economic mood.

Paul noted, “For instance, if you take a loan for five years at the rate of N750 per dollar and the exchange rate goes up, you are not repaying the same amount because the dollar has gone up.

“As the dollar goes up, it will affect the amount you pay. So when you talk about the economy, you do so in relation to people and the resources around them.

“The health sector in Nigeria is a foreigner. Everything about medicine in Nigeria is imported, starting from machinery, to raw materials, finished goods and drugs.

“When you touch the dollar, you have touched the people, and consumers’ participation will drop. If the dollar is good, it will be an achievement for this regime but the exchange rate, electricity tariff and removal of fuel subsidy affected the larger number of consumers.

“The health sector is not performing as the manufacturing capital is dwindling. Tinubu can still do something to restore the naira to a certain level where it would enhance production.”

Paul encouraged the President to bring down fuel prices to at least N300 and see how the economy would pick up and poor masses would have access to essential drugs.

He pointed out, “Anything that affects the dollar and naira, affects the price of soap, clothes, food, and everything you can think of.

“So, let Tinubu do that magic he did when he was a governor. Let the Central Bank of Nigeria and Tinubu bring down the exchange rate and make naira at least N300 per dollar and see what the economy will become.

“Our leaders need to show some sense of self-denial to make the people happy and not spend on exotic cars at the expense of the poor masses. Come and do the same magic again; reduce the cost of diesel, fuel, and electricity among others and people will be happy with you.”