The Future of Pharmacy in Nigeria

The future belongs to those who prepare for it today ~ Malcolm X

I chose to start this piece with the quote of a revolutionary intentionally even though I am aware of the likely makeup of my audience and how the word revolutionary sounds. But as you will realize in the next few paragraphs, if there’s anything the noble profession of pharmacy in Nigeria requires more than everything else, it’s revolution.

While waiting to address the community pharmacists in Lagos in the last bi-monthly meeting of the ACPN, I listened as pharmacists passionately discussed the issues and the challenges of the practice in Nigeria’s centre of excellence. For me, it was an episode of puzzles and problems back to back, from speaker to speaker. Even though the approaches to solve these problems changed and differed, the problems were the same.

Today, the community pharmacist is seen more as a business man/woman than as an healthcare provider. This, above all is where the problems converge. It explains for example why the Lagos State Government can decide to go ahead with an insurance scheme and not factor in community pharmacies.

The same attitude was experienced by Pharmacists with regards to NHIS. Even though ALL patients require the service of a pharmacist before getting healed, it doesn’t seem to make any difference in the attitude being accorded pharmacists in Nigeria.

As far as the business of dispensing is concerned, patent stores can (illegally) conveniently carry that out as well as open stores. When it comes to prescriptions, auxiliary nurses can now do as well as a pharmacist if the doctor chooses to pass the buck. When it comes to consultation, anyone can make the argument that even though illegal, anyone who’s been selling drugs for years can at least advice on most drugs being sold in stores.

“Everything” the community pharmacist does can be done by someone else who’s not a pharmacist.

Where does this leave the community pharmacist then? Should s/he just continue to pick the crumbs that fall off the primary health care centers and hospitals? Should s/he just stick to the business of buying and selling drugs and re-selling to whoever wants to buy? OR should s/he start to switch to other roles?

One could say there’s no way you can remove the pharmacist out of the healthcare equation. Without drugs, healthcare is not healthcare! This is true, but to a point.

As much as the pharmacist can’t be removed from the healthcare equation, s/he can be made so irrelevant from the healing equation that the only time a pharmacist is needed is when the drugs need to be manufactured. The patient therefore has no need for interactions with a pharmacist. This is grave for a couple of reasons, the consultations that the patient needs on drug interactions, compliance,drug therapy optimization for example are lost.

It will be easy to lay all of the blame for this on the government as regards regulation, registration, nepotism and all sorts. That however, will be like Daniel trying to beg the lions once he was thrown in the lions’ den.

For every challenge that pharmacists in Nigeria have, there is a technological solution. Shortage and distribution for example is a huge problem that is already being solved by a technological platform that helps pharmacies get orders from as many wholesale clients at once, track delivery and load inventory without as much as moving from point A to B.

Registration of pharmacies and the mapping of community pharmacies for example can be done using technology in such a way that every pharmacy premise that is registered can be accessed on one’s computer. Insurance cover for drugs for Nigerians anywhere they are in the country can be rolled out in an e-insurance scheme where every subscriber has access to drugs from any pharmacy in the country.

The unavailability of pharmacy premises to patients in rural areas is a challenge that has been solved by telepharmacy years ago in other climes and there already exists companies who can deliver drugs to patients in need with drones.

Just last year, Apprecia pharmaceuticals printed Spritam, an epilepsy drug from a 3D Machine. Atomwise discovered two drugs that will reduce Ebola infectivity using Artificial Intelligence and Machine Learning in less than 24 hours. These kinds of innovation might be a long shot for the Nigerian pharmaceutical space at the moment, I understand. However, if there must be a role for the pharmacist in the healing process, the adoption of technology in the practice is not an option, it’s a MUST.

It is obvious that there is a gap in the healthcare industry in Nigeria as things currently stand. There are not enough doctors to attend to the patients that continue to reach out to healthcare facilities and more doctors are leaving the country by the day. Until the pharmacy community can prove its critical role in this healthcare gap, I do not think there’s much to be said about a future of pharmacy in Nigeria, 2050 and beyond.

Jude ‘Feranmi consults for eMedrep … a startup focused on technology solutions for the pharmaceutical industry.