Devex Newswire reports that the country received 1.7 million doses of the Oxford-AstraZeneca COVID-19 vaccine from the global distribution facility in early March. The government paused its vaccine rollout after several European countries suspended their use of the vaccine due to concerns about blood clots. The country has only distributed 1,000 doses since launching the vaccination campaign on April 19.

Studies by the Africa Centres for Disease Control and Prevention found that Vaccine hesitancy is a big obstacle. In study only 59% of respondents in DRC were willing to be vaccinated against COVID-19. Overall, respondents were wary of the safety of COVID-19 vaccines. The exception is Ethiopia, where 94% of respondents were willing to be vaccinated.

Dr. John Nkengasong, Africa Centre For Disease Control (CDC) director is urging African countries to accept the vaccine that is available to them. “We do not have choices,” he said at a briefing on Thursday. WHO’s Africa director, Dr. Matshidiso Moeti, applauded DRC’s “extremely wise” and “very generous” decision to return the vaccines for use elsewhere.

The World Bank previously found that out of 128 countries it surveyed, only 30% had plans for scaling up the necessary workforce to deliver vaccines.

The post DR CONGO RETURNS ITS COVID VACCINES first appeared on CPAN WORLD.

In Liverpool England, people danced together at a warehouse party as part of a Clinical trial to establish if and how social distancing can be brought to an end and people can get back to normal lifestyle. About 3,000 clubbers were rammed up against each other inside a Liverpool warehouse on Friday night, ”…waving (their) hands in they air, waving them like the just don’t care…” to pounding Techno music.

To get into the club, local clubbers had to take a lateral flow test for Covid-19 at one of four official testing centers in Liverpool, then upload the result to a website so it linked to their ticket. When they arrived at the warehouse, their results were checked, but once they passed security, the partyers were free to act as if the pandemic had never happened. There were no requirements to wear a mask, socially distance or even use hand sanitizer.

Some young women in bikini tops were dancing together, passing around half-full bottles of Rosé cocktail, while next to them a middle-aged man was dancing so hard a huge sweat patch had formed across his back. They were all beaming with clearly visible smiles, since no one was wearing a face mask, let alone social distancing. “This is the first dance,” Nick Evans, a 28-year-old legal adviser, shouted above the music. “And it could be the last dance, so I’m going to enjoy it,” he added before sashaying back into the crowd. Alice Mitchell, 20, said the only thing she’d been surprised by was a ban on bringing in hand sanitizer. A security guard had made her throw a bottle away, she said, in case she had been trying to sneak in alcohol. “Other than that, I’m having an amazing time,” she said, adding she was sticking to the edge of the dance floor to keep as safe as possible.

According to the researcher lain Buchan “This is down and dirty public health research,”. When arranging the trial, his team had quickly decided there was little point asking people to wear masks or stay in bubbles.

The New York Times reports that Since the corona virus pandemic hit Britain last March, nightclubs have remained closed. Whereas theatres and museums have been allowed to reopen (with caveats) when infection levels were low, the idea of people dancing up close to each other in a sweaty club has been seen as too much of a risk. If you wanted to go dancing in Liverpool, you had to go to illegal raves. (Last summer, thousands of people did just that, causing a headache for the police and lawmakers in Britain.) But that situation may soon change. In February, British Prime Minister Boris Johnson announced that because of the country’s vaccine rollout, he hoped to remove all restrictions on social life in England on June 21. That would include allowing clubs to reopen, based on recent trials of events in Liverpool.

The Liverpool club night, a second event was held in the same venue on Saturday and was the first of those trials, and an attempt to see how reopening might work in practice. Other trial events in the city have included a pop concert for 5,000 fans in a circus tent and a business conference.

Some academics had criticized the nights as “human guinea pig trials,” but Iain Buchan of the University of Liverpool, the scientist leading the trials, insisted Covid-19 rates in Britain were so low that the chances of an outbreak were slim. There were 69 cases reported in Liverpool in the week running up to the event, according to official figures. “The risk of encountering someone positive in there might be 1 in 5,000,” Buchan said.

 The trial was more about working out what measures could be used to allow clubs to reopen. That included seeing if people were happy to be tested before hand and link that with tickets, monitoring people’s movements inside and using sensors to check carbon dioxide levels and ventilation. In March, Dutch researchers ran a similar trial involving 1,300 party goers in the Netherlands. They found the masks lasted five minutes, People just threw them off.

Britain has over 1,400 nightclubs, according to the Nighttime Industries Association, which represents venues, many of which had been forced to lay off staff during the pandemic. Some of those have already leapt at the chance to reopen. Fabric, a famed club in London that can hold 1,500 people, has sold out a 42-hour-long reopening weekend party that begins June 25. The Cause, another London club, is close to selling out a similar event that same weekend.

The owners of four British clubs said they welcomed the Liverpool trials, but felt more were needed to reflect different types of spaces. “We’re not a warehouse,” said the owner of Dalston Superstore, a popular club for L.G.B.T.Q. party goers in London, said in a telephone interview. Many D.J.s said they wanted clubs to reopen soon as possible, and not just for the sake of their work.  

The post Groovy Clinical Trial In A Party first appeared on CPAN WORLD.

The use of the word “Prescription” is changing the world over and medicines or drugs are being reclassified from the simple ancient days ’classification of prescription only medicines and non-prescription medicines because of the ever-increasing needs for equitable access to medications and improved continuity of patient care.

Pharmacists play very important roles in the delivery of primary health care across the world.  In the wake of the dramatic devastation and unprecedented loss of human lives inflicted upon the world by the COVID-19 pandemic. During the lock-down period and the attendant restriction of access to public health centers orchestrated by the pandemic, community pharmacists courageously stepped in to meet the healthcare needs of Nigerians. Unfortunately during the pandemic Pharmacists faced a peculiar challenge of accessing certain prescription medicines indicated for some common conditions in primary care. This was at such a sensitive time the entire Nigerian population relied on the Community Pharmacists as the source of medicines for primary care. This underscores the need for speedy approval of the category of Pharmacist-Initiated-Medicines (PIMs) in medicines classification in Nigeria as obtainable in other climes. This is supported by the latest policy document of the International Pharmaceutical Federation/Community Pharmacists Sector FIP/CPS Vision 2020–2025. According to the NAFDAC DG at the last NAPHARM/NG virtual conference ”Pharmacists are the backbone of the Nigeria’s healthcare delivery system

Eight models for pharmacists’ prescribing have been implemented internationally varying in their dependency on protocols, formularies and collaborations with physicians, to be specific, the models include:

• NON-PROTOCOL: 1) Formulary Prescribing (2) Referral to Pharmacists (3) Independent Prescribing
• PROTOCOL: 1) Patient Group  Direction (2) Repeat Prescribing (3) Supplementary Prescribing (4) Protocol Prescribing (5) Collaborative Prescribing.

For instance, Dr. Samuel O. Adekola was certified to prescribe and administer Naxolone injectable for the management of Opioid over dosage since September2019 by the MARYLAND Department of Health USA. Indeed, practice of medicine in relation to health is changing across the globe and Nigeria needs to get ahead of it to the benefit of the ever growing population.

The National Agency for Food and Drug Administration and Control (NAFDAC) is the primary agency saddled with the responsibility of regulating the importation, exportation, manufacture, sales and utilization of medicines in Nigeria. One of such responsibilities is the classification of medicines used in the country.

The Association of Community Pharmacists of Nigeria (ACPN) has enjoyed unfettered access, collaboration and supports from NAFDAC under the current leadership, with improvements in Internally Generated Revenue base and gadgetry in NAFDAC laboratories which both combine to improve service rendition in the Agency. But a previous effort to introduce the Pharmacist-Initiated-Medicines(PIMs) in Nigeria was not achieved due to non approval. For Pharmacists to effectively carry out the primary responsibility of providing primary healthcare services there is need for PIMs to be approved. This will enable Pharmacists to ethically explore their clinical judgment in recommending medicines within the PIM category to patients who need them.

Furthermore, the Federal Ministry of Health had enacted the Task Shifting Task Sharing Policy which implies that some primary care tasks should be shifted to other health care providers such as Pharmacists. So far, services such as Family planning have been successfully implemented. However, for other primary care services such as Medication Therapy Monitoring amongst others to be effectively implemented, Pharmacists must be authorized to recommend certain class of medicines. That way, the health care needs of the Nigerian populace would not be in jeopardy should there be acute lack of access to clinicians as was experienced in the heat of the Covid-19 pandemic. Pharmacists need to be properly re-positioned as Primary Healthcare Providers in Nigeria. This is to guarantee the achievement of universal health coverage. In many other countries across Europe and Americas, the capacities of community pharmacies have been maximally harnessed in the combat against Covid-19 pandemic. Pharmacists were involved in patient education, counseling, point-of-care testing, supply chain management of vaccines as well as administration of vaccines. This strategy tremendously helped in better handling the ravaging pandemic in these countries. Conversely, in Nigeria, Pharmacist were not adequately engaged in the entire response to the pandemic. This sad situation encouraged a number of vices in our Country, prominent among which are drug abuse and misuse.

To change this unenviable narrative, the Association of Community Pharmacists of Nigeria birth a foundation known as the Transgenerational Pharmacies Development Foundation, TGPDF, having one of its strategic primary objectives of repositioning community pharmacists and working to integrate Pharmacists as primary health care providers as being promoted by World Health Organization, WHO in partnership with the International Pharmaceutical Federation FIP. The later was consummated in the ASTANA DECLARATION of 2018 that was equally conveyed in the ABUJA DECLARATION of  December 2020 signed by Community Pharmacists in Nigeria. Kindly referred to the 50-point communiqué endorsed during the 2020 ACPN National Scientific Conference. The vision of this noble initiative was contained in the 50-points communiqué endorse during the 2019 ACPN conference in Abuja. Given the need for Pharmacists to be highly clinically inclined in order to provide high quality primary healthcare services to the community they serve, the Transgenerational Pharmacies Development Foundation, deemed it necessary to build the capacities of both upcoming pharmacists as well as practicing pharmacists through the PharmD undergraduate and conversion programs respectively. The ACPN-Transgenerational Pharmacies Development Foundation under the leadership of Prof. Lere Baale are sedulously working on strategic project of achieving a primary healthcare driven community pharmacy practice in Nigeria.

It is hoped that these activities will set a momentum that will galvanize the overall interest of NAFDAC in expediting actions towards the actualization of a holistic primary care delivery in community pharmacies across Nigeria beginning with the approval/authorization of Pharmacist-Initiated-Medicines, PIM.

The post THE WORD “PRESCRIPTION” IS CHANGING THE WORLD OVER – Pharmacist Initiated Medicines (PIMs) first appeared on CPAN WORLD.

Guinea which is a west African country like Nigeria has been devastated in the past by the deadly Ebola virus. The Federal Ministry of Foreign Affairs in Nigeria issued a written advisory to the Ministry of Health alerting the Minister to the resurgence of the Ebola Virus in Guinea Conakry. The Liberian government has also requested that the Nigerian authorities take all necessary measure to avoid further spread of the deadly virus. The circular also stated that all relevant first responders and agencies were being prepared and instructed departmental and programme heads to initiate measure for an appropriate National response.

The circular is here reproduced.

FEDERAL MINISTRY OF HEALTH
DEPARTMENT OF PLANNING RESEARCH AND STATISTICS

To: All Heads of Departments and Programmes
Ref No: DHPRS 2/19/18/1

19th April 2021

SUBJECT : RE: RESURGENCE OF THE DEADLY EBOLA IN GUINEA

INTERNAL CIRCULAR
The Ministry is in receipt of a letter from the Minsitry of Foreign Affairs with Ref No. CWB/3/XXXII informing Nigeria of the recent outbreak and resurgence of the deadly virus of Ebola virus in Guinea Conakry which has devastated the country in the past.

2. In view of the above the Liberian government has requested the Nigerian authorities to take necessary measures to avoid the further spread of the deadly virus.
3. While the relevant technical departments/agencies are working on the national response and institution appropriate measure, you are to also be mindful of this outbreak and its implications to the West Africa (WA) sub region and be guided accordingly.
4. Please treat as important.

Dr Ngozi Azodoh
Director, Planning Research and Statistics For Honorable Minister.

The letter also contained a hand written directive to disseminate the information to relevant institutions under the Federal Ministry of Health.

The World Health Organization in Africa (WHO Africa) says has reported its first new case of Ebola in the West African nation of Guinea after 27 days with no new confirmed infections. The case was registered in Soulouta village of the southeastern N’Zerekore region after none had been reported since March 4, 2021. This brings the number of Ebola cases in Guinea to 19, including eight registered deaths, disrupting the countdown that began on March 24, 2021.

The WHO Regional Office for Africa has continued to support case management, surveillance and community engagement efforts, and remains on high alert supporting Guinean health authorities in surveillance efforts & preparedness in neighboring areas. The WHO had announced the recovery of the last Ebola patient in the West African country on March 24, thereby triggering the countdown to formalize the end of the epidemic after 42 days without a new case. A vaccination campaign was launched on Feb. 23 and more than 3,200 people, including 529 contacts, were vaccinated following the delivery of 11,000 doses of the Ebola Zebrov vaccine.

Ebola is a tropical fever transmitted to humans from wild animals. It was first discovered in Sudan and the Democratic Republic of Congo in 1976. It caused global alarm in 2014 – 2016 when it swept through Guinea, Liberia and Sierra Leone killing more than 11,300 people and infecting an estimated 28,600.

Reference: Ndiaye A, 2021, New Ebola Case Reported In Guinea, accessed at https://www.aa.com.tr/en/africa/new-ebola-case-reported-in-guinea/2196118

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PLUS TIPS FOR BETTER SLEEP

The results of a large recent study, tracking thousands of people from age 50 upwards, suggests those who sleep six hours or less a night are more likely to develop dementia in their late 70s. Thus it is advisable to sleep for more than six hours a night. Mental health disorders are known to be quite strongly linked with sleep disturbances.

The research which was published in the journal Nature Communications, studied nearly 8,000 people in Britain for about 25 years. All the subjects were 50 years old or older.

For many years, scientists have pondered whether getting too little sleep could affect physical and mental health and questions about how sleep relates to cognitive decline. Figuring this out had been difficult because it was hard to establish a relationship between insufficient sleep and the physiological changes that occur in the brain that underline the development of dementia.

The large new study highlights very persuasive new findings that clearly suggest that people who don’t get enough sleep in their 50s and 60s may be more likely to develop dementia when they are older.

Precisely 8,000 individual subjects (people) were followed in Britain over a period of about 25 years, beginning when they were 50 years old. The findings from the study show that those who consistently reported sleeping six hours or less on an average weeknight were about 30 percent more likely than individuals who regularly got seven hours sleep (defined as “normal” sleep in the study) to be diagnosed with dementia nearly three decades later.

Dr. Kristine Yaffe, a professor of neurology and psychiatry at the University of California, San Francisco, Said “It would be really unlikely that almost three decades earlier, this sleep was a symptom of dementia, so it’s a great study in providing strong evidence that sleep is really a risk factor,”.

Accumulations of proteins associated with Alzheimer’s are known to begin about 15 to 20 years before people exhibit memory and thought coordination problems, these characterize the Pre-dementia changes in the brain. So sleep patterns within that time frame could be considered an emerging effect of the disease. According to Dr. Erik Musiek, a neurologist and co-director of the Center on Biological Rhythms and Sleep at Washington University in St. Louis, “that has posed a chicken or egg question of which comes first, the sleep problem or the pathology,”

“I don’t know that this study necessarily seals the deal, but it gets closer because it has a lot of people who were relatively young,” he said. “There’s a decent chance that they are capturing people in middle age before they have Alzheimer’s disease pathology or plaques and tangles in their brain.”

A review of data from a prominent study of British civil servants in the mid-1980s, called Whitehall II, researchers tracked how many hours 7,959 participants said they slept in reports filed six times between 1985 and 2016. By the end of the study, 521 people had been diagnosed with dementia at an average age of 77.

According to the New York Times several behaviors and characteristics that account influence individual sleep patterns were considered in the study. These include smoking, alcohol consumption, level of physical activity, body mass index, fruit and vegetable consumption, education level, marital status and conditions like hypertension, diabetes and cardiovascular disease, whether or not people were taking sleep medication and whether or not they had a mutation called ApoE4 that makes people more susceptible to develop Alzheimer’s disease. Depression is also considered a risk factor for dementia.

The researchers separated out people who had mental illnesses before age 65 and the study’s analysis of participants without mental illnesses found a similar association between short-sleepers and increased risk of dementia.

The researchers found no general difference between men and women.

Short sleep is very common among the elderly and because of that, even if it’s modestly associated with dementia risk, it can be important at a societal level. Short sleep is something that we have control over, something that you can change.

Experts say most of the data in the research is self reported and therefore subjective. Thereby challenging the data accuracy. This is one of the limitations of the study.

At one point, nearly 4,000 participants did have sleep duration measured by accelerometers and that data was consistent with their self-reported sleep times, the researchers said. Still, that quantitative measure came late in the study, when participants were about 69, making it less useful than if it had been obtained at younger ages.

In addition, most participants were white and better educated and healthier than the overall British population. And in relying on electronic medical records for dementia diagnoses, researchers might have missed some cases. They also could not identify exact types of dementia.

Robert Howard, a professor of old age psychiatry at University College London says “Insomniacs — who probably don’t need something else to ruminate about in bed,” he added, “shouldn’t worry that they are heading for dementia unless they get off to sleep immediately.”

Studies have found that cerebrospinal fluid levels of amyloid, a protein that clumps into plaques in Alzheimer’s increase in people deprived of sleep. Sleep is also thought to be important for clearing proteins from the brain or limiting the production. One theory is that the more people are awake, the longer their neurons are active and the more amyloid is produced. Another theory is that during sleep, fluid flowing in the brain helps clear out excess proteins, so inadequate sleep means more protein buildup, he said. Some scientists also think getting sufficient time in certain sleep phases may be important for clearing proteins.

Too little sleep might also function indirectly, fueling conditions that are known dementia risk factors. Someone who commonly stays up too late to have snacks or because they get very little sleep, they have low motivation for physical activity will likely be predisposed to obesity, diabetes and hypertension all of which have been pretty robustly linked to dementia risk.

Another theory is “a shared genetic link,” genetic pathways or profiles that go along with both shorter sleep and increased risk of Alzheimer’s. It is also postulated that the sleep-dementia relationship is “bidirectional,” with poor sleep fueling dementia, which further reduces sleep, which worsens dementia.

The new study also examined whether people’s sleep changed over time. There appeared to be slightly increased dementia risk in people who shifted from short to normal sleep, a pattern which may reflect that they slept too little at age 50 and needed more sleep later because of developing dementia.

How Can You Get More Sleep:
Four out of five people say that they suffer from sleep problems at least once a week and wake up feeling exhausted. What you need is deep sleep and sleeping pills and a lot of other sleep aids don’t really give you deep enough sleep.

1) Naps are okay to catch up on missed sleep, but getting a good night’s sleep should make naps unnecessary. Scientists recommend people with sleep disorders or apnea should consult sleep specialists,

2) Having a regular sleep schedule, avoiding caffeine and alcohol before bedtime and removing phones and computers from the bedroom are recommended.

3) Stretching and meditative movement like yoga before bed can improve the quality of your sleep and the amount you sleep. Try short and calming routines like 11 stretches and exercises.

Reference : Belluck Pam, 2021, Sleeping Too Little in Middle Age May Increase Dementia Risk, Study Finds, Health, New York Times, accessed at https://www.nytimes.com/2021/04/20/health/sleep-dementia-risk.html?campaign_id=51&emc=edit_mbe_20210421&instance_id=29489&nl=morning-briefing%3A-europe-edition&regi_id=158757475&segment_id=55992&te=1&user_id=ae364b2b5baf8ea0ff972231bd5e2a8f.

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The pharmacists alleged that wranglings amongst profesional groups, interprofessional rivalry and greed amongst amongst professionals has continued to encourage the inequitable spread of privileges and resources of players in the sector to the detriment of consumers of health.

Quoting from a statement issued by the ACPN National Chairman, Dr. Samuel Adekola, and the National Secretary, Pharm. Ambrose Ezehthe Association advised: “We Must Save the Health System in Our Country Now” and  noted that consumers of health had been short-changed by the Government and providers.

The ACPN expressed concern that despite the fact that the goals and objectives of both the National Health Policy and National Drug Policy which focuses on accessibility, affordability, safe and efficacious health care services, and credible drug supply system these objective may never be achieved.

They pointed out that there is Identifying a ’glaring ineptitude’ in the health system, which is against the international best practice that hinges on the philosophy of meritocracy which allows for selection based on merit and competencies. They sighted the repeated observation where appointments as Federal Minister for Health , State Commisioners for Health anf Permanent Secretaries in the Health Ministries were reserved for only Physicians. This ugly scenario is also extended to all appointments into the MDAs at Federal and State levels with deleterious consequences on Public Health output in Nigeria.
They stressed the need to have appointments in Nigeria’s health sector liberalised to give room for meritocracy.

“It should interest observers that all appointments into prime MDAs in Health sector for instance; NHIS, NPHCDA, NACA, NCDC, Essential Drug List Committee and all special Health intervention programmes including National Malaria Control, Tuberculosis Control, Leprosy Control, etc are dominated by physicians in Nigeria, including heads of all public hospitals at both State and Federal level. whereas, at the international fora and other saner climes, positions of leadership are based purely on merit, skill, and competencies.

They lamented that the Decree 10 of 1985  reversed the gains of the fruitful headship of Health Administrators in Federal Health Institutions and replaced same with the headship of Physicians as Chief Medical Directors, Medical Directors, Chairman, Medical Advisory Committee, Head of Clinical Services and they are numerous deputies in all Health Institutions across the board at State and Federal Levels.

“The domination is extended to even appointments into the Boards of Management of the various Federal Health Institutions where about 8 out of 13 slots are permanently reserved for physicians at the detriment of consumers of health. “Today as it stands when these serial violations failed with the implementation of the Yayale Ahmed Report, the MDCAN has rushed to the Federal High Court, Abuja, seeking reliefs to bar the National Assembly from enacting Acts of Parliament to regulate the plethora of health professions in Nigeria, while also praying that the Office of the Head of Civil service of the federation is stopped from drawing up the schemes of service for all cadres of health workers.

The ACPN further listed unethical conducts in task grabbing, alleging a recent attempt by Physicians to annex the statutory and professional responsibilities of pharmacists to dispense medicines legitimately in the Health System.
Consewuently the ACPN called on other professional bodies to join forces with JOHESU, Civil Rights Societies, and other patriots to form a workable coalition force to save the health system.

They called on all health workers and their leadership to convey a roundtable to strategise on how best to tackle the lingering Medical and Dental Council of Nigeria, MDCAN, suit at the Federal High Court, Abuja as well as come up with an agenda for a robust healthcare delivery system in Nigeria in the best interest of the people.

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In a joint World Press conference held earlier today in Abuja by the World Health Organisation (WHO) and the National Primary Healthcare Development Agency (NPHCDA) the WHO Country Representative in Nigeria, Dr Walter Kazadi Mulombo has confirmed that WHO has secured 16 million doses of the AstraZeneca COVID-19 vaccines for Nigeria through the COVAX Facility. This is the amount alocated to Nigeria out of the 88 million allocated to Africa.

The Executive Director of National Primary Health Care Development Agency (NPHCDA) explained that the press conference became “necessary in order to ensure that just a few of us do not bring our country to ridicule.”

COVAX received requests from 72 countries around the world, of which 51 countries were considered by the review committee as “ready” (Nigeria was among these countries) and 18 countries in total were finally chosen to receive initial Pfizer Vaccine doses. Demand for the initial allocation of 1.2 million Pfizer vaccine doses was exceptionally high.

Unfortunately, Pfizer has a limited capacity to handle so much demand from so many countries at once so it was not feasible to provide each of these 51 countries with Pfizer doses, amongst several reasons.

As at the 18th of January deadline COVAX received 13 submissions from Africa alone and a multi-agency committee evaluated the proposals of which 9 were recommended as ready to deploy the Pfizer vaccine including Nigeria.

The WHO also emphasised that it had not disqualified any country in Africa from accessing COVID-19 vaccines through the COVAX facility and reiterated its aim to support all countries to access Covid-19 vaccines as quickly as possible.

Dr Mulombo was reacting to the rumours of disqualification of Nigeria from access to COVID 19 vaccines. He said “Currently, all countries on the continent are expected to start accessing the AstraZeneca/Oxford vaccines by the end of February.” adding that “WHO has not disqualified any country in Africa from accessing COVID-19 vaccines through the COVAX facility, but rather is supporting all countries to access vaccines as quickly as possible.”

Epidemiological data was taken into consideration, the decision was taken to proportionally balance the number of self-financing and AMC Participants, as well as Participants across all 6 WHO regions. Other factors taken into consideration were the mortality rates from COVID-19, the number of new cases, the trend in the number of cases, the population of countries and the availability of the appropriate Cold Chain equipment.

Countries like South Africa received more of the Pfizer allocation because they have the new strain of the COVID-19 virus, has the highest mortality rates and is struggling to contain transmission.

Nigeria has received over 18% of the total doses of the AstraZeneca Vaccine allocated to Africa making the country the largest recipient of the Vaccine.

The WHO representative states that the AstraZeneca Vaccine is under review by WHO for emergency use listing. In Addition there is also an inittial limited volume of Pfizer Vaccines available through the COVAX facility.

The NPHCDA has demonstrated capacity for storage and distrubution of the Covid-19 Vaccines on a National scale. This is as demonstrated in their new National Strategic Cold Store (NSCS) which has an Ultra Cold Chain Equipment (UCCE). These were comissioned under the oversight of the Presidential Task Force on COVID-19 (PTF) and Federal Ministry of Health (FMOH). The Ultra Cold Chain equipment can store over 400,000 doses of the Pfizer vaccine at recomended temperatures.

The NPHCDA has categoricaly stated that it has the capacity to store any type of vaccine that is allocated to Nigeria.

The post NIGERIA SECURES 16 MILLION DOSES OF COVID-19 VACCINES first appeared on CPAN WORLD.

Nigerians woke up to sad Breaking news this morning that the world health organisation had disqualified Nigeria from accessing Covid-19 vaccines due to its inability to meet vaccine storage requirements. While some schools of thought beleived that it due to Nigerias epileptic power supply others claimed the Nigerian government had contacted and applied to WHO without taking into consideration the countries overall vaccine storage capacity. The rumours also claimed that the Nigerian government failed to consult with the necessary Supply Chain professionals and Healtgcare experts to collate to WHO.

But the WHO office in Abuja Nigeria quickly issued a short statement on twitter through its representative Dr W. Kazadi Mulombo to dispel the rumour flaging it as FAKE NEWS. In a brief statement Dr Mulombo said “WHO is part of the COVAX facility, and can never disqualify a member state from accessing an approved vaccine forbtheir population. I call upon members of the press in Nigeria and globally to contribute to fighting missinformation”

Dr Mulombo who is a Medical Doctor and Public Health Expert emphasized that WHO is committed to equitable distribution of COVID-19 Vaccines to Nigeria.

About COVAX : COVAX is consortium comprising the WHO (World Health Organisation) , CEPI (Coalition For Epidemic Preparedness Innovations) and GAVI (Global Vaccines Alliance) formed with a committment to ensuring vaccines supply to all countries. Its a Special Purpose Vehicle (SPV) with the objective of guaranteeing manufacturing of affordable Covid-19 vaccines and equitable distribution of at least 2 Billion doses globally by end of 2021. This is without prejudice to location, race, tribe, affordability and capacity for storage and distribution.

It hopes to achieve this by collaborating with world governments and the private sector of which the Bill and Melinda Gates Foundation (BMGF) is a key player. COVAX is continuously acquiring a large pool of funding to support this drive. It projects it will need $27.2 Billion. So far it has secured $6 Billion.

President Muhammadu Buhari at the last African Union virtual summit admonished Heads of member states to support indigenous local Covid-29 vaccine manufacture. The COVAX facility is set to support this drive.

We encourage all to follow the WHO representative for factual news about WHO’s collaboration for COVID-19 Vaccine distribution in Nigeria.

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During a lecture on Sexually Transmitted Diseases (STDs) at the West Africa Post Graduate College of Pharmacists (WAPCP) some years ago my lecturer described symptoms an adult married male patient was experiencing involving painful urination, whitish milky discharge from the urethra and fever. He wanted the class to deliberate on the possible diagnosis and recommend drugs to cure the infection and alleviate the symptoms. After being satisfied with the various spectra of antibiotics recommended by the class depending on results of culture and sensitivity tests he decided to move onto another topic. But suddenly he froze as if reflecting on something. Then he wondered for a bit and asked as if pondering the previous question all over again  “but why would a married man have an STD?”. The class was silent for quite a while. Nobody really wanted to respond the obvious and say “because the married man went to play away match.” Probably because the lecturer didn’t seem to have much of a sense of humor. After all why would he ask such a question with an obvious answer. This man is just looking for trouble for nothing.

Since no one was willing to ‘Bell the Cat’ I decided to give him a seemingly harmless answer. Worst case scenario, the class will laugh at me. I responded “Sir, maybe his wife used a public toilet in an office and has a toilet infection”. The look on his face was one of satisfaction as he responded “true, that’s quite probable”.

But another more likely probability is that the man chose to play an “away match” as stated earlier. The risk is that he will infect his wife. The cost to the family is that both husband and wife will have to be treated for sexually transmitted diseases. Also the psychological cost could be huge.

I have seen situations where a husband complains of symptoms of an STD and is suspecting that the wife played “away match” or wife complains of symptoms of an STD and suspects that the husband played “away match”. I have had to counsel someones husband or someones wife that their symptoms did not absolutely imply that they got the infection from their spouse and even if they did it in no way implies that the spouse is “playing for another club”. This is not football where players get temporarily transferred on loan for a short time. But in our world of today we have to be straight with ourselves, infidelity is rife and the implications of having unprotected sex go far beyond damaging the relationship.

Research gathered by the Nigeria Urban Reproductive Health Initiative (NURHI) says that 25% of Nigerian Teenagers are sexually active with age of sexual debut ranging from 10 to 25 years. Also statistics shows that this same group of teenagers between the ages of 10 and 25 years of age have testified to having unprotected sex. This practice also exposes them to Sexually Transmitted Infections and HIV with a prevalence of 17% among adolescents in the southeastern Nigeria and 14 % in Northern Nigeria. Further studies have shown that amongst these Teenagers unsafe sex is a common practice resulting in unwanted pregnancy and sexually transmitted diseases. Unsafe sex usual results from :

– Non use of a Condom
– Improper use of a Condom
– Damage to condom during use (tear)
– Use of substandard condoms subject to easy tear.

Also females are sometimes unable to access a contraceptive due to location, lack of affordability or they may purchase substandard contraceptives many of which are usually in circulation. The result is an unwanted pregnancy.

Now one of the major implications of these statistics is that the person you are attempting to have unprotected sex with has most likely been having unprotected sex with someone else who is in turn having sex with someone who is having sex with someone and so on and so forth. There is a one in four chance that your girlfriend or Boyfriend is having unprotected sex with someone else. Its a merry go round.

Additional implications of having unprotected sex are :

– recurrent and untreated STD s in men which can lead to infertility.
– recurrent and inadequately treated STD s in women which can lead to infertility

We all know that before you use a product you read the user manual or guide. So before you have sex without protection it is necessary you read this users guide.

So when next you want to have sex without protection read this manual and think again.

References

Aloysius O, Chiemezie S., Ijeoma I, Ngozi J.I, Nkechi G.O, 2020, Risky sexual behaviours among adolescent undergraduate students in Nigeria: does social context of early adolescence matter?, Pan African Medical Journal, Accessed at https://www.panafrican-med-journal.com/content/article/37/188/full/  on 6th February 2021.

Okonkwo A.D, 2013, Generational Perspectives of Unprotected Sex and Sustainable Behavior Change in Nigeria, Sage Journals, Accessed at https://journals.sagepub.com/doi/full/10.1177/2158244012472346 on 6th February 2021.

Vanguard New, 2017, 25% of Nigerian adolescents are sexually active — NURHI, News, Vanguard, Accessed at https://punchng.com/25-of-nigerian-adolescents-are-sexually-active-nurhi/?amp=1 on 5th February 2022

The post YOUR GUIDE TO SEX WITHOUT A CONDOM. first appeared on CPAN WORLD.

Many a time the challenge health care providers face all over the world in is the patients lack of compliance with medication therapy regimens as agreed with prescriber. Various research have been done on medication compliance which is a major topic within the pharmaceutical care space. Several reasons are documented for patients non compliance.

Compliance issues are commonly faced by patients who are on medications for short term treatment of curable diseases such as infectious diseases – hypercholesteremia, Malaria, Typhoid, or for life long illnesses that are managed such as Diabetes, Phaechromocytoma, Hypertension, Congestive heart Failure, etc. During the process of dispensing and counseling patients on their medication the Pharmacist usually requests for information on previous medication being taken and compliance to the medication especially if it is a refill prescription. When the Pharmacist identifies a lack of compliance an inquiry is made as to reasons for non compliance. Excuses normally given by patients for not being able to follow medication regimen include:

• 1) Cost -drug is not affordable or there was an upward market review of the price.
• 2) Side Effects – the drug causes more discomfort than the patient can tolerate.
• 3) Forgetfulness – normally the patient forgets to take or apply a particular dose resulting in some missed doses.
• 4) Communication – patient was inadequately counseled and so did not fully understand how to use medication as well as the importance of the medication.
• 5) Concerns about Privacy – HIV positive patients on ARVs usually make this complaint related ti stigma and so have to travel long distances avoiding their nearest pickup location for bimonthly refills of prescriptions. When transportation affordability becomes a problem compliance becomes an issue.

Interestingly while looking at the available literature from the United states and Europe the reason of “availability with the medicine” (i.e patient could not find the drug in a Pharmacy) is not indicated as one of the common reasons for poor medication compliance. Rather such reason seems to be more common in the African setting.

One of the commonest excuses given by patients for non compliance is that the medicine was not accessible. Further drill down into this excuse will break the lack of accessibility to :

• a) The medication is not affordable to the patient
• b) Patient could not find the medication in any Pharmacy outlet.
• c) Patient can not find the recommended brand or generic form.
• d) The patient doubted the genuineness/authenticity or the brand seen.

This is a Health supply chain challenge. Research shows that health supply chain interruptions have a direct Compliance, Pharmacoepidemiological and Pharmacoeconomic impact on the patience medication therapy and National treatment planning. The specifics are :

1)It affects the patients ability to afford the drug. Scarcity increases value (Basic economics).
3) It impacts health supply chain data negatively by causing inaccuracy in drug consumption patterns across populations.
4) It impacts health planning at the facility, state and national level by its effect on (3) above.
5) It affects patients trust and confidence in the health system.
6) It compels Physicians to prescribe less desirable alternatives
7) It exposes patients to less efficacious or more expensive alternatives.
8) It increases the overall cost of the patients access to treatment.
9) It increases the overall cost of healthcare to the system.

Health Supply Chain expertise is important to patient medication compliance because it operates on the principle of bridging the gap between the drug and the patient. It is the movement of the drug product from the point of origin to the last mile where it is consumed. It involves several robust components such as manufacturing, inventory Management, Information management, distribution (logistics transportation), warehousing and service points or point of care.

A Supply chain that is well planned and working optimally will bring the right drug at the right quality from the manufacturer to the patient at the right location, the right time, in the right condition, at the right price. This is the concept of the 6 rights that serves as the fulcrum of Health Logistics and Supply chain management. They must be guaranteed and are non negotiable just like the fundamental human rights of an individual.

An example is HIV treatment drugs known as ARVs (Anti retroVirals) which are used extensively and in different Fixed Dose Combinations (FDC) in HAART (Highly Active Anti Retroviral Treatment). A cardinal principle being that treatment with ARVs can not be interrupted as the consequences are huge and ranges from drug resistance and cross resistance, treatment failure to death. Same goes for Tuberculosis (TB). I personally experienced the impact of supply chain interruptions on HIV positive patients who were meant to refill bimonthly supplies of ARV FDCs at the Special Treatment Clinic. Patients on regimens that had Lopinavir as part of the combination had issues because the drug was out of stock for almost 3 months. This was because Lopinavir had been touted as one of the Antiviral drugs effective against the nCovid-19 Virus. Consequently this caused an instant shortage of the drug as the main source China stopped exporting it and National governments started redirecting remaining supplies in stock towards managing Covid-19 treatment in Isolation centers. There was a national shortage in Nigeria. We were helpless in the treatment clinic. One patient even told me she had gone without the drug for the second month running and it was part of a second line regimen recommended for her since the first line FDC had failed due to resistance. All I had to give at that point was empathy. It was almost a month later that I saw on a friends status who is a warehouse manager at GHSC-PSM that Chemonics had been able to secure fresh supplies of Lopinavir for the country.

The above are ample reasons public health experts and health policy makes in the executive arms of government and legislature should prioritize optimizing and integrating Pharmaceutical supply chains in both private and public sectors nationwide towards maximizing utilization of funds and reducing the overal cost of healthcare.

References

Cennimo D.J, 2020, What is the role of the antivirals lopinavir/ritonavir in the treatment of coronavirus disease 2019 (COVID-19)?, Medsacpe, accessed at url https://www.medscape.com/answers/2500114-197452/what-is-the-role-of-the-antivirals-lopinavirritonavir-in-the-treatment-of-coronavirus-disease-2019-covid-19 on 4th February 2021.

McGrail S, 2020, Fundamentals of Pharmaceutical Supply Chain, Supply Chain News, Pharmanews intelligence, Xtellingent Healthcare Media, accessed at https://pharmanewsintel.com/news/fundamentals-of-the-pharmaceutical-supply-chain on 4th February 2021.

Ross M, What is Medication Compliance: 5 Things Providers Should Know, Medication Compliance, Cureatr (Comprehensive Medication Management), Accessed at url https://blog.cureatr.com/what-is-medication-compliance-5-things-providers-should-know on 4th February 2021.

Resnick R, 2018, How Medication Compliance Affects Patient Outcomes, Cureatr (Comprehensive Medication Management), accessed at https://blog.cureatr.com/how-medication-compliance-affects-patient-outcomes on 4th February 2021

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