ACPN raises the alarm over quackery in family planning services

The Association of Community Pharmacists of Nigeria (ACPN) has warned the Federal Ministry of Health (FMOH) not to worsen the effect of quackery already in Nigeria’s health system.
The National Chairman of ACPN, Dr. Samuel Adekola, in a statement recently said the ACPN has learnt that the FMOH with some international non-government organisations has concluded plans to allow Patent and Proprietary Medicine Vendors Licence holders to handle fresh dimensions of Family Planning services including sales and dispensing of both oral and injectable contraceptives in Nigeria.
Adekola described the move as an absurdity grounded on the erroneous belief that these PPMVL holders have enough numbers to service the rural communities in Nigeria with a presumed competence coefficient that would drive success stories in our decaying and collapsing Health System.
He said that feeble attempts at enlisting Community Pharmacists and their practices to be involved in Family Planning Services even when the reward system for such has always been based on a loosely structured, weirdly and clearly undefined terms, will only make them more vulnerable to morbidity and mortality which of course aggravates our well-known negative health indices.
He said, “Today as it stands, any plot or scheme to involve untrained hands in the sale and dispensing of high grade medicines like steroidal preparations under the hypocrisy of accessibility to health or some other availability expediencies to provide unprofessionally inclined services to consumers of health will only make them more vulnerable to morbidity and mortality which of course aggravates our well-known negative health indices.
 “A Government that seeks to redress the damage inflicted on the image of our currently rated 187 out of 191 Health Systems globally should know this cannot be a route to ameliorating the permanent disorders and chaos in our Healthcare Sector.”
After a painstaking and critical appraisal, the ACPN posits as follows:
First, the FMOH and the international NGOs need to engage the Pharmacists Council of Nigeria (PCN) which registers PPMVL holders in Nigeria since it is a parastatal under the ministry. Such rules of engagement will confirm that the number of registered PPMVL holders in Nigeria will be lesser than 50,000 which confirms even the pool of available registered PPMVL will NOT provide the huge network the FMOH and the NGOs anticipate in the execution of this unholy implementation plan. To amplify this position is that the typical unresponsiveness of government is what allows the existence of about two million unregistered PPMVLs which are common-place all over Nigeria. Except if government decides to legitimise the illegitimacies of the unregistered itinerant medicine sellers, there can be no impact by PPMVL holders in this concept of opening up Family Planning Services in Nigeria.
 Second, the Federal Government set up the popular NAFDAC by virtue of an Act of Parliament to safeguard the health of the nation. In furtherance of that mandate, NAFDAC has classified drugs into: (a) Over the counter (OTC) (b) Prescription Only Medicines (POM) and (c) Controlled Drugs. There are current efforts to institutionalise a Pharmacist Initiated Medicine (PIMs) list as it is done in other climes.
Based on this classification, the PCN has structured an Approved Medicine List consisting of ONLY OTC drugs which have been tested over time as drugs and which have a wide safety margin and narrow toxicity levels in pharmaceutical practice. The corticosteroids are potent drugs which require professional handling because of the great potentials to manifest ADRs, side-effects and drug-drug interaction profiles.
In a very strict sense, it will amount to a monumental breach of both the PCN and NAFDAC Act for the supervisory FMOH to contemplate handing over the use of specialised care-products to persons who are not designated to do same under the laws earlier referred to.
 In addition, the condition precedent to earn a PPMVL in Nigeria today is to be above 18 years old as well as an ability to read and write. How reasonable will it then be to allow such persons to inject consumers of health with any drug at all in view of the attendant risks?
Currently, there are debates on the eligibility criterion for well-trained health professionals to inject patients in the care-process in its totality not to talk of untrained personnel. Any attempt to legislate that PPMVL holders should inject patients for any reason in poorly regulated climes like Nigeria will glorify and take quackery to the next level.
 It will become an incentive for PPMVL holders to freely inject patients with drugs outside their Approved List in the event of the type of restructuring the FMOH is contemplating




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