In the cause of the 89th Annual Conference of the Pharmaceutical Society of Nigeria, the debate raged on. In the light of the issues on ground it seems the agenda has been set for a new awakening in the practice of pharmacy in the country. Especially with the formal approval of the much touted PharmD programme, we may be looking forward to a completely new era.
Another important issue or question that is raging has to do with tackling preventable communicable diseases. Are the pharmacists well equipped to take this challenge head on, or what are they doing about it? Surely the pharmacists and body of pharmacists can do more than just distributing and dispensing drugs to end users. But how is the curriculum in terms of the training of pharmacy professionals? Also, every stakeholder wants to know what new energy the newly approved PharmD will bring to the scheme of things. Is there a difference between PharmD and a PhD degree in pharmacy?
Handling preventable communicable diseases
Reports say that Communicable diseases along with maternal, perinatal and nutritional conditions in Nigeria were responsible for about 67 per cent of all mortality in 2008. In 2012 the prevalence of HIV in Nigeria, as a percentage of population aged 15-49 years, was 3.1 per cent! Gladly the rates of infection and deaths have been reduced since then by about 15 – 20 percent, sources say. 551,187 cases of malaria were reported in the country in 2010; in 2009 there were 11,281 reported cases of pertussis (whooping cough) and 13,691 reported cases of cholera. And today, Nigeria is said to rank highest worldwide in cases of Vesico Vaginal Fistula (VVF)!
Meanwhile experts say the risk of (new) infections generally arising from preventable communicable diseases are still very high. These diseases are rolled into different categories like: food or waterborne diseases such as bacterial and protozoal diarrhoea, hepatitis A and E, and typhoid fever. Others are vector borne diseases like malaria, dengue fever, and yellow fever. We have also in the list water contact diseases which include leptospirosis and schistosomiasis.
Still posing serious health challenges for our various healthcare professionals are – respiratory disease such as meningococcal meningitis; aerosolised dust or soil contact disease like Lassa fever, and of course animal contact disease such as rabies. This has been the crux of the matter.
Training the healthcare provider
Experts argue that quality enhancement must be a conscious deed regarding product manufacture and service delivery on the part of healthcare providers. But the issue of research and development (R&D) has continued to be a thorny one in this whole matter. R&D is not encouraged for a number of reasons – paucity of funds, lack of proper vision and willingness by authorities concerned so to do, as well as the get-rich quick attitude of many a Nigerian investor, etc.
Experts also insist that specialisation cannot be discountenanced in the whole equation; pharmaceutical specialisation i.e. the development of specialised skills by practitioners can only be acquired in the clinical practice and not in the classroom. Therefore hospital pre-mentorship must be made available to the students for efficiency, while serious local pharmaceutical manufacturing is encouraged so as to further enhance the value chain in training and industry.
Our own people must made to align with the new priority to research, locally produce and begin to also export health and pharmaceutical products and services. There is need for a data base, and a call is out to revive the national drug policy to reflect today’s realities beyond just having a data base. Stressing these points Dr. Monica Eimunjeze, Director (R & D) NAFDAC, pointed out that the regulators have always had a rough time with operators. These operators tend to see the situation as that of “them versus us, but they ought to understand that we are all in this together” she said.
The sensitivity of the pharmacy profession is that, it is one that calls for continuous learning – with practitioners consistently updating themselves. It is this sensitivity perhaps that places somewhat stringent rules about them that some concerned stakeholders have even argued that the pharmacist seems to be over-regulated.
The pharmacists need the opportunity therefore to further their education so they can be specialised just like their medical doctor counterparts do – in oncology, gynaecology, obstetrics, etc. By this token, the pharmacist will be better prepared to pursue a practice to become a consultant such as the Federal Ministry of Health is preparing to make possible.
The pharmacist – specialist, and academic
Enter PharmD; in the cause of time and very soon too, many students who want to make a career in the pharmaceuticals industry will have to choose between a Ph.D. in pharmaceutical science and a specialised Pharm.D degree. Both may look alike but academics say there is a marked difference. In the industrialised clime like the US, choosing one over the other depends on factors like chosen career goals and expected salary. Usually a Pharm.D programme is a professional degree intended to train students for careers as pharmacists, either in retail or hospitals.
This implies that the PharmD curriculum is not very research intensive; instead, it focuses on gaining knowledge of the biological sciences and learning how to work with patients in applying that knowledge. But a Ph.D. in a pharmacy-related topic, however, is aimed at giving students the chance to produce original research. Unlike the Pharm.D the Ph.D. is an academic degree; it focuses on making new discoveries in pharmaceutical science, and not attending to patients with their care.
Somehow the two separate degrees are geared towards different career objectives: Students in the Pharm.D. programme are likely to work in pharmacy retail or in hospital pharmacies after their training. They will get the title of Pharmacist. Ph.D. recipients on the other hand, do not necessarily become pharmacists, but instead hold positions in academia or in pharmaceutical research.
The skills they acquire allow them to conduct research, while the Pharm.D prepares students to work directly with patients. By the same token, differentials will also be reflected on their salaries and remunerations. A Pharm.D Pharmacist averagely will likely be getting paid more than a Ph.D. pharmaceutical researcher.