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Underperformance in the Nation’s Healthcare System Is Policy Driven – Pharm. (Mazi) Sam Ohuabunwa

Underperformance in the Nation’s Healthcare System Is Policy Driven  – Pharm. (Mazi) Sam OhuabunwaIn recent years the pharmaceutical healthcare landscape of the nation has continued to assume a turn for the better. As industry practitioners continue to emphasise, the practice is now more of patient-centred. Meanwhile as the apex body of pharmacists in the land, PSN gears up to elect a new executive team come November, a number of top-notchers are getting ready for the presidential ticket. In this media chat, PharmaTimes Editor, MORGAN NWANGUMA, and Correspondent, ‘WAIRE EMONEFE accost one of the aspirants, Mazi Sam Ohuabunwa on his perspectives on these and other sundry matters. Excerpts:

As a senior member of the Pharmaceutical Society of Nigeria (PSN), the apex body of practising pharmacists in the country, considering your vast experiences in the industry, how would you assess the contributions of PSN to the health service delivery in the country so far?
I think Nigeria’s healthcare system is underperforming, and it’s a true reflection of our country; Nigeria is an underperforming nation. It is for this kind of reason that Nigeria has continued to be referred to as either a third world country or a developing nation. Some of our peers in the 60s and 70s have left us and become developed nations. We have been lagging and it has affected every facet of the country and one area that has been affected is our healthcare.
It is sad to say, but Nigeria today has one of the lowest human development indices: we have one of the highest maternal mortality, one of the highest infant mortality; and life expectancy is one of the lowest – sometimes around 48yrs. Our healthcare has been terribly depressing. And so Nigerians including our leaders seek healthcare abroad, even for the most minor ailments because of lack of faith or confidence in the health system. Considering the contributions in the pharmaceuticals for instance, the problem is not necessarily with the professionals. Firstly, the pharmacist has had to fight battles, to establish its relevance, get its acceptability, and to be allowed a proper space to function within the healthcare system.
But this is due to historical facts: medicine came before pharmacy, and so the resistance is natural. But pharmacy has moved ahead from the days when they were called dispensing clinics; but now they are clinical pharmacies, and there is the PharmD degree. That is a lot of progress from where it began, to where we are today. In terms of number, they have grown. Today we have almost thirty thousand (30,000) pharmacists in the country compared to when they were less than one thousand. We also have growth in the number of outlets that can offer services to Nigeria medicine consuming public. We’ve had a large growth in the different sectors – from the hospitals, to clinics, communities to industrial, etc. There is growth in numbers, quality of education as well as in the quality of service. Pharmacy in Nigeria has equally moved from product to patient care, from pharmaceutical care to clinical care. But the underperformance in the nation’s healthcare is a policy driven thing.

You were known to have headed the management team of Neimeth Pharmaceuticals and you took it to great heights. How would you assess your tenure there, and how did you manage to take it to that enviable success?
You know, I joined Pfizer in 1978 as a Pharmaceutical Sales Rep, and within 15 years I became Chairman and CEO/Regional Managing Director for West Africa. I moved Pfizer business from when it was a few hundreds of millions to exceed one billion to two billion sales. In 1993 when I became CEO, there were political crisis in the country. And Pfizer at that time was acquiring companies – trying to expand, and they began to think of how to divest from finished markets i.e. markets that did not contribute enough to their global business. And Nigeria had such problems, when many essential drugs were declared fake during the tenure of Prof. Olikoye Ransome Kuti, the then Health Minister. But something held them down for four years because the kind of result we were producing was superior to the market expectations. In addition, we had the support of Mr. Neimeth (then President, Pfizer Int’l), who started his career in the country in the early 1960s.
And in 1997 Pfizer decided they couldn’t stay anymore due to their global policy, and they asked me to give management to buy out the company. And Pfizer sold their shares and left. When they left we had to change the name of the company from Pfizer products Plc to Neimeth International Plc. The name came by divine inspiration as well as the need to honour Mr. Bob Neimeth. And having started Neimeth we faced a lot of storms such as: when Pfizer wrote a memo that we were now a third party; they didn’t have shares in our company, … and most of the banks began to withdraw their funds because they gave money to the company based on Pfizer support, but they did not know these new guys on the block. And it took the grace of God to prevent a major run on the company. Also, we had to buy their brands and then pay royalty to Pfizer! To wriggle out of these difficulties I decided that we were going to create our own brands. And so I began to invest in research and development to create our own brands.
Research costs a lot of money. I then decided to use short term loan to do long term investment to create our brands. I also attracted some new investors; I did some financial engineering such as – debentures, equity infusions and we were able to transform from being a company dependent solely on Pfizer to an independent company. This is my greatest legacy. Pension liabilities of many years were in the books, and there was no money anywhere. But it took grace of God, dexterity, ethical management, deferment of gratification. I was virtually not taking salary, but stipends. And it was after I had completed this transformation that I decided to retire in 2011. I thought it was better for a younger person who has a marketing skill to take over and put the brands into the market. As Pfizer we did extraordinarily well; as Neimeth we haven’t done as well as we would have hoped to do because of certain unforeseen circumstances such as inheriting all the debts of Pfizer.

You are highly versed in the pharmaceutical industry and indeed the business world, and so we see you as a doyen in this area. And of recent we heard from the grapevine that your are rearing to run for the presidential position of the PSN, and some of us were taken aback. Don’t you think you should remain on the side line as the doyen you are – dishing out advice and observing things?
From the past I have been getting this invitation to be PSN president; the last was in 2008. Some friends and senior colleagues who saw our potentials then have been inviting us to come and be president; this is the second time. I accepted at first, but after a while I said I couldn’t. And this was at the time we were busy converting our brands to Neimeth. But ten years down the line I have the same invitations again – in 2018; when this idea came I rejected it. How leadership in any organisation happens is that people will see you as having the capacity. I actually felt that I have passed this stage. I have been Chairman of the Manufacturers Association of Nigeria, Ikeja branch; I have been President of Nigeria Employers Consultative Association (NECA); I have been Chairman of Nigeria Economic Summit Group. I have served on so many boards at different levels. But I was told that the experiences I had gotten from these places is what they want me to bring to pharmacy. I had to pray about it, and I had a rebuke in my spirit, and the question that arose was, “Can anybody overgrow his profession?” The revelation was that – no matter what I had become I will always remain a Pharmacist, even if one was once the head of state. And so, I had the leading that there is something for me to do (here). The profession is at the crossroads. Since the creation of the profession in Nigeria, Pharmacists had never gone on strike, but something happened recently; they went on strike this year under JOHESU!
In Lagos State the government had to cancel the Consultant Pharmacy cadre as a reprisal for pharmacists going on strike. God opened my eyes and He told me, “This is why I want you.” You have to bring the breath of your experience, the breath of your network, the breath of your contacts, to try and establish pharmacy at a level to overcome this issue of inability to recognise the correct impact, or get the proper place in the scheme of things within the health sector. Luckily we have a current president (of PSN) who is doing great things. My coming is to build on that. When Olumide Akintayo was there, he did a lot of litigation in the interest of the profession; Pharmacist Ahmed Yakasai is doing a lot of advocacy. And now, I’m being called to implement. I want to implement all those things to get results; to get to a position where pharmacists will be a little bit more comfortable in service. What is required now is to bring out the best face of the profession. You know, a people are recognised by who represents them; you get a kind of recognition by who is speaking for you. For instance, (in addition) I have three national honours, and have served on one presidential board or the other. I want to raise the status of my profession, and I have a service-oriented spirit.

You have enumerated so many things, but is there one major point you want to bring to bear on the society (PSN) if you eventually become its President?
I believe the major problem the country has had is really about government policies. The inability for the pharmacists’ position to be properly understood and rewarded is because we have not got anybody at that policy level. Go back to 1994 or so when Pharm. Julius Adelusi-Adeluyi was the Health Minister for about six months; so much happened. For example, this EDL law or policy I told you about – introduced by Olikoye Ransom Kuti, which punished those of us who were multinationals, was reversed by Juli. And it has remained like that since then – because he understands the issues. One of my major objectives would be to use all the legislative powers that I can have to move the pharmacist to the top of the healthcare policy making level. Also, the problem of young pharmacists not having a place readily to do their internship is one situation I want to stop. As they’re graduating I want to ensure they have automatic posting for their internship programmes. And there are enough spaces, but it’s just that nobody is coordinating it.
And for community pharmacy, this issue of distribution can be sorted out once and for all. People can invest in pharmaceutical business, but distribution should be left in the hands of the pharmacist. Anybody can invest in businesses but the businesses should be run by the professionals; same for the pharmaceutical profession. Also, in the clinical sector, why can’t we have departments for pharmacy such as you have in medicine? All it requires is legislative work and lobbying. Pharmacy is a profession with specialty just like in the medical profession, and why can’t the consultant cadre be enshrined in a legislative work or policy of government? In the academic pharmacy, people are in the lab doing research and most of the results are not being applied or used. I intend doing something for them. If there are no mandated actions and incentives, then we’re going nowhere.
The community pharmacists on their own can do more than they’re doing now. They can participate in vaccination and primary healthcare services, wellness, etc.

Considering your many parts and vast experiences, you belong to so many professional bodies, you’re a fellow of PSN and more, yet you want to be PSN President. How will you be able to handle the affairs of PSN with all these ‘distractions’ as it were?
We manage our time; I’m not employed (by anybody). And secondly, there is so much that can be done even sitting in one place. I am a multitasked and multi-talented individual; I can do a hundred things in a day. I write three articles for publication in three newspapers each week; it is a matter of arranging time. And I write books too, you know I’m always busy. Certain things are regarded as urgent, and so I’m going to regard those three years as sabbatical. PSN presidency is supposed to be a part time job, and I want them to make maximum benefit of my time if they’re willing.

You have such a wealth of experience, but do you have any plans to transfer this to the younger/ upcoming pharmacists, and even those looking to starting their own business?
Today one of the things I do is that I have a foundation called the Sam Ohuabunwa Foundation for Economic Empowerment. What I do is mentoring young people – teaching them how to do business, business education and practical methods, from business conception to development of a business plan and even leading them to get funding. I am an angel investor in many young people’s businesses. This ‘job’ will be for me an opportunity to minister to pharmacists – helping the young, not so young and the older ones too, using my experiences to assist them. It is a part of my ‘7 points agenda’, and I am doing this kind of thing now – across board, not just for pharmacists only. But if I become PSN president, that will become my primary area of assignment. I will do this for the three years and then return to my normal life.

During the last ACPN conference in Benin, there were some allusions to people playing up the ethnic card as they approached the elections – leading to some crying foul at the end of the day. If you become President, what will you do to check this menace which has in fact become a national malaise even in our national politics?
I tell you one of the shocks I received in volunteering for this ‘job’ is that I didn’t know I was going to campaign. I was just going to create awareness to people that I have offered myself to serve. I’m told my competitors have gone to 36 states; I am ready to play by the rules of the game, but I am shocked that tribal sentiments can be brought into things like that. This should not be about whose turn it is or not, but yet I believe that at each point the more choice you have, the better you are able to decide on what is best – for any group, organisation or nation that wants to survive. But if it were just one person for example, you just live with him. Again, this is not a salaried job; it should be about honour of service that you give to society. And so it is expected that if anybody comes out to volunteer, they should be applauded because they’re coming to carry everybody’s problems. But if you do not have the motivation, don’t rush into it. We must therefore discourage anything that is mundane in our society. What is happening in our national politics is a disease and we must not bring it into the profession.
If we get a PSN President who gets to the top of policy making level in government, will he be making policies for one side of the country? People don’t have to follow you because you’re from their side, but it should be based on the fact that you are capable and competent. We must come against this kind of things; it’s not good for us.

 

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