Dr. Teresa Pounds is the Clinical Pharmacy Manager and Pharmacy Residency Programme Director, Wellstar Atlanta Medical Centre, in Atlanta, Georgia – USA. In this interview with PharmaTimes’ Gabriel Ifinnwa, she speaks about the pharmaceutical practice in Nigeria, and how to curb the high cost of drugs in the country. Excerpts:
Tell us about yourself?
My name is Teresa Pounds. I am a native of Asaba, Delta State; I went to pharmacy school in the US. I obtained my bachelor of science, Doctor of Pharmacy, and then I did my post graduate residency where I specialised in Parental nutrition support and critical care. I have been practising in the US for more than 20 years. I am currently the Clinical Pharmacy manager and Director at Wellstar, Atlanta Medical Centre in Atlanta, Georgia, US. I direct the residency programme there too. I am a preceptor. I do a lot with different pharmacy schools. For the past six years I have been doing a lot with Nigeria by doing preceptor development workshops. I am also currently a staff at Clinical Pharmacy Department at UNIBEN. What I enjoy doing now is given back to my country, especially helping pharmacists to get comfortable – providing patient centred pharmaceutical care.
Why did you decide to study pharmacy?
Originally, I decided to study pharmacy because I knew I would come back to Nigeria. And at that time pharmacy profession was striving. Am I glad that I studied pharmacy? I will say yes. I am blessed and very passionate about clinical pharmacy. And what I am most passionate about is the collaborations between pharmacists and physicians, especially the multi-disciplinary team approach to providing patient centred care to our patients. I think that will provide the best care to our patients and at the most cost effective rates.
Sale of narcotics is arguably striving in Nigeria. What ways do you think the regulatory agencies can put a stop to this?
In the US we have a lot of issues with opioid abuse. There are opportunities with opioid use. But I am of the opinion that it is abused quite a lot in the US. But I think that from what I have seen here in Nigeria that we are doing better in terms of using opioid. Though I do not live in Nigeria, so I do not know what is going on with the narcotics situation, but from observation, I think here we are doing better in terms of using opioid for pain control in Nigeria.
How can pharmacists outside the shores of Nigeria contribute to the pharmacy sector/profession in Nigeria?
I think we all need to start giving back to the country. Be it as resource persons or in whatever capacity. We can collaborate with stakeholders in Nigeria. We can hold workshops and give back to different pharmacy schools, or through medical missions. We also can give back through advocacy, identifying key organisations in Nigeria that we can talk to like the Ministry of Health, NAFDAC, Pharmacy schools among others. It is important to identify key areas and people. However, I must mention that Nigeria is not doing badly in terms of pharmacy department and the knowledge of the pharmacist themselves. A lot of good things are happening in Nigeria. So, when resource persons come from outside Nigeria in whatever capacity, they are here to share and gain knowledge and information as well. It is a give and take situation.
I belong to three key pharmacy associations like the ASHP (American Society of Health Systems Pharmacy), American Society of Parental and Nutrition (ASPEN), American Society of the Clinical Pharmacy (ASCP), Nigeria Association of Hospital Pharmacy (NAPPSA). I am also the Chairperson, Education committee of NAPSA.
Do you think mentoring and volunteerism can help deepen the pharmaceutical practice in Nigeria?
I think this will help our pharmacists. Then they would have learnt how we mentor our pharmacists in the US. And this will give them confidence that what they are doing is good and hopefully they will also benefit from the good things that we are doing in the US. Also, they can add to what they have. It is going to be mutually beneficial to both parties and help us move in the right direction.
How do you think that the high cost of drugs can be solved in Nigeria?
I think pharmaceutical companies manufacturing drugs in Nigeria need to be supported. Likewise, the insurance situation in Nigeria needs to be looked into as well; there is a huge opportunity. If you look at the incidences of malnutrition in hospitals, it is very high. If you identify these patients and you prescribe the nutrition that they need, they cannot afford it. These drugs also need to be made easily accessible to Nigerians. The important element still remains for the government and agencies to identify key companies that manufacture these drugs and provide the necessary support they need rather than depend solely on imported pharmaceuticals. That is why at some of the conferences that we hold, stakeholders like Pharmaceutical Society of Nigeria (PSN), Pharmaceutical Council of Nigeria (PCN), and others are invited to be part of it so that we can all be able to proffer solutions.
Can you compare the pharmaceutical practice in Nigeria and that of the US, especially in terms of the cost of drugs and affordability?
I think it is happening in the US where the costs of drugs are high. But what Nigeria can learn from the US is on the part of insurance and affordability. I have to be honest with you, I have been coming to Nigeria for the past 6 years, but I still do not understand the National Health Insurance Scheme (NHIS); it is so confusing. There is need to have a clear cut policy. The health care systems must be made accessible and affordable for Nigerians to really benefit from it; that is the difference.
In Nigeria, there is the issue with drug recall mechanism. If a drug is fake or substandard they cannot be removed from the market. How can this be solved?
I think transparency is the key, especially in terms of sharing the information. We have similar situation in the US, where certain times drugs have been recalled too. There needs to be one gatekeeper in Nigeria; it could be NAFDAC or whatever agency so that every recall information comes from that agency. The agency in return disseminates that information to hospitals and other health institutions. These health institutions will be mandated to pull out all those drugs or fake drugs from the shelf, and ensure that everyone is educated on that.