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Abuse of Ethical Drugs: Strict Prescription Policies Must Be Followed With Good Documentation –Dr. Albert Alkali

Abuse of Ethical Drugs: Strict Prescription Policies Must Be Followed With Good Documentation –Dr. Albert AlkaliDr. Albert Kelong Alkali, FPCPharm is the national chairman Association of Community Pharmacists of Nigeria (ACPN); in this interview with PharmaTimes WAIRE EMONEFE, he talks about his tenure so far and the problems in the health sector.

As the National Chairman of the Association of Community Pharmacists of Nigeria for over 2 years now, how would you assess your tenure so far?
My tenure has been very eventful and we have raised ACPN to another level. For the records, these are some of the things we have done: We have for long been in a rented two bed room flat in Fadeyi, along Ikorodu road, a place formerly used by PSN National. I am very happy to tell you that today we have a brand new National Secretariat in Ladipo Kuku street, off Allen in Ikeja, Lagos state. This will help the effective coordination of the affairs of ACPN and effective engagement with different organisations to the benefit of our members and the public. ACPN has also been repositioned for productive engagement with all relevant agencies like PCN, NAFDAC, and NDLEA, etc. through constructive dialogue. We have raised the standard of our national conferences to world class conferences with very rich content and very good attendance from members and government officials.
We also have our drug information centre. This centre has been pharmaceutically re-engineered with a full time Drug information Pharmacist who is in charge of the day to day running of the centre. Before now, we had no full time Pharmacist in the centre. The Centre, for the first time carried out a research and published it, and is currently carrying out another research on drug abuse which will be concluded before our national conference in Benin. The centre has been designing and publishing WHO important days for public campaigns by our members all over the country.
In this tenure we also inaugurated a community pharmacists practice and business committee to handle all practice issues and also effectively engage stakeholders and colleagues to ensure that Community Pharmacists are equipped with tools and skills to deliver great services thereby creating a healthy practice. This committee recommended the registration of CPNNEXUS, a non-profit company to engage our colleagues, business interest and donor agents. This company will facilitate the implementation of collaborative practice, remodelling of community Pharmacies with time following the expert advice of Advantage Health, our project manager. This is unprecedented in the history of ACPN.
This tenure has also provided access to finance for its members. We have engaged more banks than ever to provide finance to members for inventory purchase.
We have also been working with Howard University Global Initiative (HUGIN). We were able to bring HIV/AIDS medications close to members of our communities living with HIV/AIDS by mobilising members to participate in the Sustainable Finance Initiative (SFI) of HUGIN implementing partners of the pharmacy components of Fhi360 SIDHAS project. With this scheme, community pharmacists are being remunerated for delivering Pharmaceutical Care.

A lot of times people wonder who they should see first when they are ill; should they see the pharmacist first or the doctor? What’s your opinion on this debate?
The easiest person to see in the Community is the Community Pharmacist. He is very accessible, works long hours and can handle a lot of health challenges and make referrals where necessary. Just recently in the UK, the Community Pharmacist position as the first point of call in the community has been re-echoed, with advice for mothers to see the pharmacist first. The Community Pharmacist carries out a lot of health promotion, education, B.P and blood sugar checks, weight management, health outreach etc.

In many places in the country, it is very common to see quite a number of pharmacies, who do not have qualified pharmacists heading them. How can Nigerians differentiate between those that are not qualified community pharmacists and those that are?
The best way to identify a registered Pharmacy is to look out for the emblem that carries the green cross with the Rx sign. The emblem carries a unique number which is specific to a Pharmacy and can be used to track practitioners. Again, when in a Pharmacy, look out for the annual licence and the premises licence which should be displayed in the premises for the general public. The public must as a matter of urgency always seek counsel from the Pharmacist on drug matters.

The Annual National Conference of the Association of Community Pharmacists is coming up soon in Edo State with the theme “Medicine Abuse in Nigeria – A Call to Action for Community Pharmacists”. Why is the association running with that theme this year?
The conference in Edo is a unique one as it is an election year and I will be handing over to a new National Chairman. We chose the theme because of the increasing cases of Drug Abuse in the country and the increasing number of youths/ house wives abusing drugs in the country. We are absolutely worried about this and we are using the conference to create awareness of this menace and equip members with tools and strategies to handle this problem at the community level.
There will also be a panel discussion involving the regulatory agencies led by their Chief Executives, the PSN President and my humble self. This panel will look at drug distribution in Nigeria and its relationship to drug abuse. It would also look at other contemporary issues.

In line with this theme, how do we address substances like Marijuana and Morphine which have medical uses yet could be harmful to the body?
For prescription drugs like Morphine that can be abused, strict prescription policies must be followed with good documentation, the effective implementation of the National Drug Distribution Guidelines will go a long way in solving the menace of drug abuse. Again, effective regulation and public awareness can go the mile in curbing this problem.

With so many unpleasant things going on in the health sector right now, from the NHIS protest to the ultimatum given by health sector unions and AHPA, what steps should the government be taking right now to stabilise the health sector?
We should go back to the basics, where did this problem emanate from? Why are there so many acrimonies among healthcare Practitioners? Why are best practices being side-lined on the altar of professional aggrandisement? Why are our health Ministers sectional? Why are problems in the health sector not addressed holistically? Unless these issues are addressed holistically with all relevant stakeholders involved, solving the health sector problems will be a mirage. Why will you have a NHIS that does not appreciate the contributions of the Professional that handle the molecule that will treat patients? We have been shouting about the fraudulent Global Capitation model in the NHIS which negates the initial plan to no avail. No wonder the coverage is poor and the service is still decimal.

What legacy do you hope to leave as the ACPN National Chairman?
My legacies are numerous as you can see from our achievements. I want to be known by the grace of God as the chairman that acquired a new secretariat building for the ACPN, raised the DIC to an enviable level. I want to be known as the chairman under whom community pharmacists were paid for Pharmaceutical Care and grading of Pharmaceutical services in community pharmacies under the COPA initiative and for engaging regulatory agencies constructively. I want to be remembered as chairman that raised our conferences to international standard making it more informative and more productive; a Chairman that raised and made effective the board of Trustees of the Association. Finally, a media friendly Chairman.


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