 Welcome to the second hot topic on the breakfast this morning. Federal government is set to reduce importation of drugs from 60 percent to 40 percent. This was revealed recently by the special advisor to President Tanubu on Health talking about Salma Anas Ibrahim. She disclosed this at a workshop in Abuja. The workshop was organized to strengthen the WHO Nigeria's cooperation strategy. We have been joined by Basil Abia, Research Advocate, Associate Co-Core Research Abuja, and Professor Cyril Osifo, President of Pharmaceutical Society of Nigeria. Good morning, gentlemen, to the breakfast. Good morning, Maureen. Pleasure to be here. Good morning. Thanks for having me. Okay, Prof. Let me start with you because this concerns you directly. How are you taking this, how are you responding to this development in your community of pharmaceuticals? We read just like any other person and I think it's good news for us, but at the same time there are some things that we need to raise and discuss on the matter. One, it improved local production and that's one of the things I campaigned with one that became president, that we need to improve local production, we need to make our own pharmaceuticals and medicines here. Indeed, we talked about medicine security. We all knew what happened during the COVID era. If we don't produce our medicines, we are likely to run into difficulties as time goes on. However, government as usual has come up with policies, do work on what? I am in doubt if stakeholders were properly consulted before such pronouncements were made. The reason is that if you reduce importation from 60 to 40, we really don't have many industries producing what we need for medicines. I'm talking about the APIs, active pharmaceutical ingredients. We need to get the infrastructure and basic things necessary so as to enable us to produce medicines and so that the pharmaceutical industries, not just with flourish, will be able to meet the needs of medicines for the average Nigeria. Maybe I will stop there and later I would throw in one or two more words. So meaning this may be something that has been done without due consultations? Yes, stakeholders should have been consulted so they were advised government appropriately. The second is to make pronouncements, which is a welcome idea, like I said, the industrial pharmacies who have it, but the enabling environment are not necessarily there. Because one, if a pharmaceutical company will have difficulties with energy, power, supply, then they may not be able to meet the needs. If pharmaceutical companies like some in Agbara, the roads are so bad, even when they produce medicines, they are not able to evacuate them appropriately. If they have difficulties assessing funds, credit facilities to enable them to invest in their business, because when you reduce importation, you are actually making them to be more productive. Then if they don't have access to credit facilities, that would be a problem. What I'm saying is that we need to engage the key players in the pharma industry so that they can tell government what exactly their credit companies are and together because a welcome idea, they can improve the situation. In addition, we have this JAPA syndrome, the pharmacies during my press statement earlier this year, many pharmacies are up to, right now I think I can count up to 7,000 pharmacies have left the shores of the country for greener pastures and employing pharmacies is becoming a problem because you don't have them to actually serve in pharmaceutical industry. Yesterday, a captain of industry talked to me that they are looking aggressively for pharmacies to man some of their standpoints in the industry. So manpower need is a big problem which we need to address adequately as this opportunity is right here in our dust step. But I trust that government would make the necessary arrangements and discussions with stakeholders so that we can partner with government for the better. Because for us, if we do more look at production, then we can not only supply Nigeria, we supply the West African subregion and that would be more foreign exchange for the country. And I hope the petrochemicals that will help us to produce the APIs will vigorously pursued. So also create employment for these pharmacies who are living in the shores for greener pastures. Hopefully, better remuneration, better health, a healthy nation, when people are healthy, the workforce is healthy. Then of course you'll be able to do better things and productivity, greater productivity in the country. Basil, let's have your research and macroeconomic perspective to what he has said and this new move by the federal government. Yeah, thank you. So this looks like the policy announcement for the federal government very much looks like there will be some forms of economic protectionism or protectionist policies to be able to protect the local industry and in their own words incentivize more productivity. I do not think that is the right policy direction to follow. Instead rather try and sort out some of the challenges that Prof has already highlighted. One of the things that we walked on two years ago was an economic master plan for all the 36 states and including the federal capital territory. And for Lagos, we highlighted that Lagos could be the hub for pharmaceutical manufacturing in West Africa. If certain things were fixed, first and foremost, the inadequate infrastructure which he highlighted with Agbara, I'm very much a massive manufacturing zone around that Lagos-Urban state gateway zone. There's skilled workforce issues and it's really, really scary to hear from the President Prof Cyril here that we have lost the word 7000 pharmacists in the last three years. That's really scary because we're hemorrhaging with skilled workforce that is necessary to feed that particular manufacturing industry. It's very important when you're in that very skill sensitive industry to have the necessary skilled workforce. And it's better if you have localized skilled workforce, obviously because it's cheaper, secondly, of course, for medicine security which Prof also highlighted. And then you have issues with financing structures for these manufacturing industries. It's hard. The taxation problem, the multiple taxations that they experience, access to raw materials. Thank God for the refinery. We do not know when it will start production with regards to the key petrochemicals that serve the pharmaceutical industry in Lagos. But hopefully that happens in a year or two. So with all of these things, when you're able to sort out all of these structural imbalances, when you're able to sort out supply side constraints, then you now have production levels ramped up. I'm thinking that I'm hoping that the policy direction by the new federal government would be to incentivize local production first. That's also ensuring that energy scarcity issues, we no longer have it. As a matter of fact, last year when the price of diesel increased from 200 abruptly from around 190 naira per liter to around 860 liter, at some point in the middle of the year, we had a situation where the manufacturing association in Nigeria were reporting that 40% of their members were downsizing, reducing productive units. And that basically tells us that the macro story, the macro story is that production is shrinking and when production is shrinking, it's obviously affecting the entire asset. So from a macro economic perspective, it has to be incentivizing local production rather than going protectionist. Because if you're doing economic protectionism, a policy is what you're doing is that the price transmission is going to ensure that the prices of drugs actually increase. Because when you don't have local production meeting local demand and then you're making it harder to import, what you have is that the generic drugs for malarial treatment, for instance, for hypertensive treatments, they're definitely going to increase. And then you have the niche drugs, the very obscure drugs to get that will now be super sky high for people to be able to access. So first things first, solve the local challenges that we've highlighted. Infrastructure issues, skilled workforce issues. And you can do that by creating special economic zones. For instance, for our Lagos master plan, special economic zones where all of the regulations are streamlined, where their incentives with regards tax, taxation, their incentives with regards energy scarcity so that there's a supply stock of gas to supply the gas part plant that will be able to serve that particular special economic zone so that all of the manufacturing industries that are there, that are cited there, would have reliable energy to produce. Yeah, the key word there incentivize, that's the key word. They have said that the reason they're coming up with this policy is to promote local manufacturing of drugs. But here are the merits of challenges that the pharmacists, that the local manufacturers are facing. So incentivize is the key word. They have also said that other priority areas including cruising and improving access to equal healthcare services and national health insurance for at least 40% of the country's population. But here we have today on the front page of the Guardian newspaper, Professor Osifo, trouble in the health sector as drugs cost of care spike by 150%. Please talk to us about this. Well, that's not unexpected because if most of the drugs, like we know, especially the critical ones, the prescription drugs and what at times you call orphaned drugs, orphaned drugs may be drug needed by a few people, anti-cancer drug and the rest of them, if they are not produced here and you have to import them, then you'll need to go to the open market to source for your foreign exchange. And at the end of the day, you need to do the necessary markup and supply the drugs at such an expensive rate. However, I believe an additional thing I just quickly want to put, especially concerning the drugs, the medicine prices, is the fact that government has, in their own wisdom, decided to hands off the funding of regulatory agencies but for me, government should consider regulatory agencies, especially the Pharmacy Council of Nigeria. These ones regulate the policies, regulate pharmacies, even the pharmacy technicians and all the ramifications in the pharmacy space. If they are not funded by government, it means that we may be compromising the drugs or the medicines that the average Nigerian takes. They are very strict regulatory agency and they must be properly funded. So as to carry out the oversight function, they need to, if necessary, close down pharmacies or close down pharmaceutical manufacturing outlets if they don't meet the requirements. But if we say drugs are so expensive and people are not properly regulated, then the issue of taking an adulterated drug may be on the increase. And to avoid this, I would have the case as president of Pharmaceutical Society that the Pharmacy Council of Nigeria should be removed and funded by the federal government so that we can be sure of the quality, not of the quantity of the drugs or medicines that we take. All right, now that you've said this, you're reminding me of the issues of safe drugs that Nigeria had before and during the time of late Professor Dara Akonyali. She met such a horrible situation and she fought really hard for that. Has things, have things changed? Has the pharmaceutical industry been repositioned for greater efficiency and production of safe drugs for Nigeria? What has changed from that time to this time? Give us a scenario. Well, a lot has changed under the leadership of the new DJ of NAVDA. She has done extremely well and not just coming out with policies but has also been able to engage pharmacies and pharmaceutical industries on what to do. Most of the problems we have, concerning safe and adulterated drug, at times come from the open market and which I think started with the coordinator who selected a policy that the federal government enacted. I was there when it was opened. The minister of health, the minister of health was there and the governor and where we need to house everybody with PCN, the pharmacy council of Nigeria and NAVDA so that it can monitor the quality of drugs. That brings me to the issue of security. Our borders are the way police, anything come in. And even drugs that are adulterated, manufactured in other countries, when people know they can't pass through our ports and NAVDA could be there, then you have a problem if these drugs are brought in from elsewhere and they're used to populate the market. But there must be constant surveillance and the one of the things I'm trying to do to engage NAVDA, that NAVDA may have a vision about it may not be able to cover all the places. We may need to engage pharmacists who are domestic side in the university so that from time to time, they can conduct random analysis and make reports on to pharmacovigilance or what they found out because a drug that is adulterated, most of the time are drugs that are used by a greater percentage of the people. Fakers are everywhere, even in the United States, even in Britain, but the rate is not very high but we must attempt to reduce that in this country. And I must say, with all forms of sincerity, I must posit that the digital NAVDA can't do well but we need to assist them to do more. And that's why I'm struggling and believing that if also the NAVDA is properly empowered and not necessarily made a fundraising institute for the federal government, then we might have some of these things stemming down in a drastic way. Pharmacists- If NAVDA is properly empowered, if NAVDA is properly empowered, talk to us more about this because this is raising some alarms in my ears. Yeah, talk to us more about NAVDA being properly empowered. What are the constraints that NAVDA is having? Are you telling us that NAVDA is not living up to expectation? NAVDA is falling short of expectations because her hands or its hands are tight? No, not exactly. What I mean is that government is doing a proper oversight function, but I believe NAVDA, one, should be able to work hand in hand with the Pharmacy Council of Nigeria with also a regulatory body. Then two, federal government should be able to set up laboratories for them. If possibly in all the states of the federation, particularly where you have more jobs, and then NAVDA should be provided with the state of the art pieces of equipment so that they will be able to carry at short-term analysis when required to know the sort of jobs that the average Nigerian is consuming. And the most important thing, like I said, NAVDA carry out post-market surveillance, but they may not be able to go around. And I am suggesting very strongly that we could engage the services of pharmaceutical analysts, both in the companies and particularly in the academia to help carry out these post-market surveillance and report their findings appropriately to NAVDA. But again, that calls for equipping some of these facilities in the universities so that we can do that, because every drug is a poison. And if you take the drug at the wrong dose at the wrong time, not in the right place, even giving to the wrong person, that easily results. But so we must be able to assess drugs that are proper and in the right perspective and just give you a very good example and experience I had. Somebody was supplying some drugs to a particular essential drug outfit. I will mention the state. It's a foreigner and insisted that the person must buy the drugs in good quantity. It's a very simple drug, paracetamol. But by just carrying out, I directed a dissolution test to be carried out between that drug and what I would call a standard MZOP paracetamol product. At the end of the day, the MZOP paracetamol actually went into solution within seven minutes. But that particular one that was imported after 30 minutes was not, didn't go into solution. What does that mean? Simply, if you take the one that was imported that even after 30 minutes was seen in a solid state, you won't get any particular therapeutic outcome any pharmacological effect. So these are some of the things that I think empowering NAVDAC, so that NAVDAC can empower academia to assist them do what they should do for the safety of Nigerians. I wish we had more time. If this paracetamol, you can imagine if it were anti-cancer drugs or anti-appetensive drugs. Your guess is as right as my work will happen to the patients. Horrible description there. Yeah, horrible. And time will not allow me. I would have wanted Basil Abia to give us, his research analysis. What research have you done with regards to safety of drugs in Nigeria? And, but time will not allow us. Can you give us just one minute, one minute? Tell us your response to what he has just said. I think he answered it even properly. And what we were able to find out was the scarcity of post-market surveillance. Not using evidence. And that's what we researchers are here for. And we'll be analyzed here to be able to be empowered to go out there in the market and survey outcomes from some of these drugs. And we're equipped with the skill set. However, the problem is, is there an intentionality from the demand side? And in this context, the demand side is actually supposed to be NAVTAC and maybe a coalition of multi stakeholders in Nigeria's pharmaceutical industry. So the scarcity of post-market surveillance as Pofas earlier alluded is the number one issue with regards to safety of drugs in Nigeria. Well, the special advisor to the president on health, Selma Anas Ibrahim has her job covered for her, obviously. And I don't know if she's starting on the right footing, coming out policies without the stakeholders' involvement. Well, let's work and see how all of this is going to play out the president of the Pharmaceutical Society of Nigeria, Professor Cyril Osifo and Basil Abiyah, Research Associate, Kwakor Research, Abuja, have joined us to take a look at government's move to reduce importation of drugs from 60% to 40%. Thank you so much, gentlemen, for your time. Thank you, Maureen. You're welcome. That's the size of our package this morning on the breakfast, but I will not leave without giving you a quote of the day. If your actions inspire others to dream more, learn more, do more, and become more, you are a leader. And that's from John Quincy Adams. Thank you for being my guests today, watching from home. Join me tomorrow on the breakfast as we come with another package for you. I am Maureen Menonwes. You can do have a splendid day.