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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Aims Cutting Covid-19 Vaccine delivery time:

A handful of drone-delivery startups are currently discussing with governments around the world especially Africa on their ability to use unmanned aerial drones to transport Covid-19 vaccine doses from distribution facilities to health centers mainly in remote or hard-to-access region, flying along fixed routes to move doses in bulk. They are actively vying for a logistical role in the largest vaccination campaign in history. Several of these companies recently have entered into medical delivery partnerships with drug companies and retailers thereby positioning them to take part in the high-profile effort to distribute Covid-19 vaccines. The aim is to streamline operations and cut costs across distribution networks. The drones have temperature-control technology that is used to transport Covid-19 vaccines.

Tight security measures under consideration by governments such as Nigeria and companies meant to guard against theft and highly specific storage temperature requirements would have to be factored in.

Australian drone company, Swoop Aero, is currently discussing with the Democratic Republic of the Congo’s head of public health about delivering a Covid-19 vaccines via drone using a drone delivery network it has developed in the country.

Swoop Aero, which operates fleets of electric fixed-wing drones that take off and land vertically, has delivered vaccines, such as for Ebola, as well as other medical supplies, in Africa since 2018. Some of the company’s aircraft can fly up to 90 miles on a single charge and carry more than 500 doses of vaccines.

Venture-capital investors have poured $405 million into drone startups through the first nine months of this year.

Pharmaceutical giant Merck partnered with Volansi in September to fly medicines and vaccines using an electric Volansi drone capable of carrying roughly 5 pounds of medical cargo from a Merck manufacturing facility in North Carolina to a nearby health clinic in unmanned autonomous drones.

A Startup company, Germany based Wingcopter, which develops transport drones for Health and humanitarian operations, has succeeded in raising $22Million (approx N8.38 Billion) in its latest pitch to investors. This strengthens its position as as a leader in drone-based logistics in the Healthcare sector, with a special focus on healthcare-related applications, including the distribution of COVID-19 vaccines. The company is establishing more partnerships worldwide centering around othee fully automated delivery applications. Wingcopter The company develops, manufactures, and operates the unmanned eVTOL fixed-wing aircraft.

Silicon Valley-based Xplorer Capital and Futury Regio Growth Fund, a Germany-based fund are the core investors.
With new cash injection Wingcopter will now be able to finish building its its 7,200 square meter (77,500 square feet) partially automated serial production facility at the company's new headquarters in Weiterstadt, Germany. The facility is currently home to more than 100 employees. The company will carry out a swift ramp-up to mass production to meet a constantly growing global demand.

The Wingcopter 178 Heavy Lift, provides both one- and two-way delivery, covering distances of up to 120 kilometres. It can accurately lower a package through a winch mechanism, or land at the point of destination and return to its origin with a new payload.

The company says in an official press statement that its mass production strategy "combines the scaling methods of the automotive industry with an aviation-grade discipline for quality and safety,”

The company’s patented drone far exceeds the range and payload capabilities of commercial multicopter drones. Wingcopters can fly long distances as efficiently and quickly as fixed-wing aircraft, reaching ranges of up to 75 miles (120 kilometres) and a Guinness world record speed of 150 mph (240 km/h). Even in strong winds of up to 44 mph (70 km/h) or inclement weather.

Wingcopter is curently operting in Malawi, East Africa Providing COVID-19 support. It recently started a long-term COVID-19 response project named Drone + Data Aid to improve healthcare supply chains together with Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH on behalf of the German Federal Ministry for Economic Cooperation and Development (BMZ).

Wingcopter has also partnered with UNICEF’S African Drone and Data Academy to train local youth in drone operations, from mission planning to piloting beyond visual line of sight (BVLOS) delivery and surveying flights.

This is with the aim of improving public healthcare delivery and supporting healthcare infrastructure of African nations.

Don't be shy. Lets know your thoughts on this article in the comments section.

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Astra Zeneca owners of the worlds largest Corona Virus Vaccine production facility located in india have confirmed that 5 people have lost their lives in a fire which gutted the place late last week.

Indian government officials also confirmed the fire which started on thursday in the city of Pune in Maharashtra state. Large smoke clouds were seen erupting from a multi-storey building in India's Serum Institute Indranil's (SII) massive headquarters complex. Government officials were reported to have sent seven fire trucks from the local fire station the site.

The government beleives the fire could have been caused by an electrical fault during construction work. Fire official Prashant Ranpise said what caused the fire was not immediately clear, but it was contained within a facility under construction to boost production capacity of the AstraZeneca coronavirus vaccine.

Serum Institute Indranil's Chief Executive Adar Poonawalla confirming the incident on Twitter wrote, "We have learnt that there has unfortunately been some loss of life at the incident, We are deeply saddened and offer our deepest condolences to the family members of the departed." Pune Mayor confirmed 4 people had been evacuated from the inferno while 5 had lost their lives.

The Indian regulatory Authority had approved two vaccines in January this year-- COVISHIELD produced by the Serum Institute Indranil (on behalf of Astra Zeneca) and COVAXIN produced by local firm Bharat Biotech.

Astra Zeneca is the world largest vaccine maker but the company has said the fire will not affect production of the Corona virus vaccine brand known as COVISHIELD. The company has developed a Corona Virus Vaccine in colaboration with Oxford university and Novavax Inc and licensed production to the Serum Institute Indranil (SII). SII had been contracted to produce a billion does of the vaccine developed by AstraZeneca and Oxford University. The company hopes to increase production capacity from 1.5 billion doses to 2.5 billion doses annually by the end of this year. The new facility gutted by fire is a big part of the exoansion plan.

The company was in the process of producing and stockpiling 50 Million doses a month as from April 2021 to meet growing demand in the world oopulation as the pandemic rages on. They also have plans to increase production to 100Million doses. The AstraZeneca vaccine is already in use in India, Bangladesh, Nepal, the Maldives and Bhutan.

Astra Zeneca officials said production of COVISHIELD will not be interupted because the company had multiple production work centers in different buildings as a production strategy and contingency plan. Though the SII company is estimating delays in launching new products and revenue losses of about $137 Million Dollars. Serum Institute is the world's biggest vaccine manufacturer by volume and has been contracted by the World Health Organization to supply and distribute 200 million doses to COVAX a consortium comprising GAVI, CEPI and WHO for distribution and inoculations to poor countries. Some Wealthy countries have already bought up 75% of the 12 billion coronavirus vaccine doses expected to be produced by companies globally this year. Consequently, Astra Zenenca's SII contract is likely to produce most of the vaccines that will be needed by developing countries.

WHAT DOES THIS MEAN FOR NIGERIA?

Many low- and middle-income countries like Nigeria, Bangladesh, Brazil, are depending on SII delivering the AstraZeneca vaccine. India itself had already began one of the world's biggest vaccine rollouts this in January, aiming to vaccinate 300 million people by July with both COVISHILED and COVAXIN.

With production interuption expected doses in these countries could be delayed. Also since two doses of the vaccine within a space of 3 months are required an interruption of vaccine supply could truncate complete vaccination plans in countries where individuals have already received their first shots.

Lets know what you think. Don't forget to drop a comment

The post FIRE CONSUMES WORLDS LARGEST CORONA VIRUS VACCINE PRODUCTION PLANT: first appeared on CPAN WORLD.

The Minister of State for health Dr. Olorunimbe Mamora and the Chairman Presidential Task Force on Covid 19 Mr Boss Mustapha have both advised that Nigerians do not become complacent once they receive their first dose of the Covid-19 vaccine. They have insisted that safety protocols involving frequent handwashing, use of sanitizers and face masks in public remain in force and will be enforced to the letter.

The government officials have made this assertions in the light of ongoing efforts by the Federal government to acquire the Covid-19 vaccines and initiate distribution nationwide based on a planned strategy. Public health experts have also advised that Vaccines will only facilitate 95% immunity against the prevailing strain of Corona virus and there is still a very small window of opportunity or risk of infection. The government officials have also advised that even though individuals may have been vaccinated and acquired immunity, they could still be carriers and transmit the virus to individuals who are at risk of contracting the disease. Consequently individuals are strongly advised to sustain all safety protocols.

While briefing the Presidential Task Force on Covid-19 earlier this month the Minister for Health Dr Osagie Ehanire reported that there was a reduction in case fatalities. He warned Nigerians not to let down their guard even as case fatality rates were reducing.

The current Corona virus pandemic has claimed millions of lives worldwide in the past 2 years and has necessitated what could eventually become the costliest vaccine development effort and biggest vaccination campaign on history.

Many Clinical trials are ongoing world wide both for drug treatment regimens and Vaccines. Drugs are meant for  treatment of already infected individuals exhibiting symptoms of illness while vaccines are meant to prevent the disease by stimulating immunity in individuals whom have been administered the vaccines.

According to the World Health Organization (WHO) vaccines work by training the body's immune system (natural defense mechanism) to recognize and fight off antigens like Viruses and Bacteria. The vaccines themselves contain microbial part or whole viruses which have been inactivated. The body is able to keep records of these microbes when exposed to them via vaccines thereby developing a natural defense against them. If infected by the virus, the body would have enough antibodies to combat the Virus and prevent full blown disease. WHO currently recognizes more than 50 Covid-19 vaccine candidates undergoing clinical trials. COVAX is the consortium comprising WHO, GAVI and CEPI that is responsible for ensuring adequate vaccine distribution to nations and prioritizing at risk individuals. Currently the vaccines which have been released require administration of a first dose and then a booster dose 3 weeks later to activate the recipient’s immune system and minimize the risk of infection from the virus.

A vaccinated person may not fall sick if infected but can still transmit the virus to friends, family and close contacts.

Lets know what you think in the comments section

The post DO NOT LOWER YOUR GUARD : MINISTER FOR HEALTH first appeared on CPAN WORLD.

Last year before the lockdown during a brief visit to Benin I visited a close friend, colleague and former classmate at the University Of Benin Teaching Hospital. She is a Deputy Director at the hospital and unit head at the Paediatrics Pharmacy Unit. One of the many things we talked about was the evolution of Clinical Pharmacy practice and inpatient Pharmaceutical care management. She spoke so passionately about her pediatrics unit and displayed a vast knowledge of drug therapy management in various pediatric conditions and then she expressed a need. She wished there is a specialty course in Pediatric Pharmaceutical care she could attend. I was so proud of her passion for Pediatric Pharmaceutical care. I recomended she check with one of the special centers between College of Medicine and Faculty of Pharmacy UNIBEN maybe they might point her in the right direction. Though I had never heard of any in Nigeria she may eventually need to do the certification online or abroad.

Pediatric Pharmaceutical care is a Clinical Pharmacy specialty that basicaly narrows down medication therapy management to specific age range of 0 to 12 years. Opara 2020 et al'., describes it as Pharmaceutical care in a heterogenous group with infants ageing from birth to 1 year and Children 1 to 12 years, and also includes neonates ageing from birth to 4 weeks and preterm babies. It is the provision of drug therapy (Pharmacotherapy) management to this specific age group based on their anatomical and physiologic peculiarities (age, body mass, organs at various stages of development and maturity, disease condition, genetic predisposition, pharmacodynamics and intersubject variability) with the ultimate purpose of achieving definite outcomes that improve quality of life. In plain English "you dont manage drug therapy for children the same way you manage for adults"

It explores dosage administrations and routes of administration based or peculiarities and disease conditions in children at various developmental stages.

Pediatric Pharmaceutical care is necessary because though studies show that Nigeria has ample supply of medications for primary care use, there is a deficiency of pediatric dosage forms for prescription only medications used for secondary and tetiary care. Consequently extemporanous reconstitution of prescribed medicines in the Pharmacy becomes necessary. Recostitution of pediatric medications is a highly sensitive but commonly overlooked area. Hospitals which take it seriously have had to locate a Pediatric Pharmaceutical Care unit within the Special Care Baby Unit (SCBU) and/or the Paediatrics Unit.

The American Society of Health-System
Pharmacists and the Pediatric Pharmacy Advocacy Group in 2018 published a gudeline titled "ASHP–PPAG Guidelines for Providing Pediatric Pharmacy Services in Hospitals and Health Systems" to guide Clinical Pharmacists in meeting the special needs of the pediatric population. This underscores the importance of Pediatric Pharmaceutical Care as a specialty in Hospital Pharmacy practice. This is because studies show the pediatric population is a more vulnerable group to Adverse Drug Reactions (ADRs) than the adult population, exhibit higher variability in Pharmacokinetic and pharmacodynamic profiles of drugs and have pharmacogenetic variations such as Glucose-6-phosphate dehydrogenase(G6PD) deficiency, short gut syndrome and lactose intolerance. There is also a lesser tendency for recipients to report ADRs either because they are too young to recognise the injury(children), are too young to communicate (Babies) or are not being monitored by a vigilant caregiver. Pediatric Pharmaceutical care specialty is important because many drugs that are safe for adults are not safe for children.

There is even the school of thought which intends to include unborn children in pediatric pharmaceutical care by trying to prevent genetic anomalies or irreversible damage to the unborn baby as a result of substances consumed by the mother during pregnancy. For example, an eight month pregnant mother taking Tetracycline capsules as antibiotic treatment for her infective cough will likely cause bone distortion in the child as a result of calcium/phosphorus chelation and Dental dysplasia (brownish/yellow coloring of teeth). There is neonatal death due to chloramohenicol induced "grey baby" syndrome and Kernicterus from taking Sulphonamides. So should this be included in paediatric pharmaceutical care or left to the OBGYN?

A recent study by Tareq 2017' et al'., insists that Pharmacists must have a baseline knowledge of Pharmaceutical care in pediatrics not only for the purpose of councelling care givers but also for dosage form reconstitution and inpatient interventions to correct medication errors that could result in ADRs (Adverse Drug Reactions) or suboptimal dosing.

For example, at the National Hospital Abuja in Nigerias Federal Capital Territory the Pediatric Pharmacy unit is tasked with the responsibility of carrying out interventions. The Clinical Pharmacists :

1. - recomend dose adjustments where necessary,
2. - proactively intercept medication errors during prescription review and revert back to prescriber, (dosage calculation errors are known to be the most common sources of medication error)
3. - Track patient adherence and persistence,
4. - identify drug therapy problems based on known classifications, and
5. - take appropriate action where necessary
6. - educate parents and children themselves.

In all these clinical pharmacokinetic parameters such as age, weight, Body Mass Index(BMI), Renal function, Cardiovascular impairments, Drug elimination rates, Bioavailability, Volume of Distribution etc are considered. The pharmacist actually takes a wholistic picture of the situation and arrives at a care plan which will also involve the patients parents or care givers upon discharge. This is all done in collaboration with the entire inpatient management team at the hospital. Nurses are very fond of crosschecking and reviewing medication administration plans with the pharmacist and it is not uncommon for them to frequently seek clarification for routes and modes of administration. Post discharge the parents or caregivers also maintain close collaboration with the pharmacists and report on progress and any unwanted effects observed. Communication is maintained effectively via phone and wattsap chats which also enable sending photos and screen shots as visual aids.

In Pediatric Pharmaceutical care one thing is most improtant, VIGILANCE. Its simple, the Pharmacist must remain vigilant in prescription review, extemporaneous preparation or precribed medication reconstitution, medication administration, patient/care giver counceling and ADR monitoring. Hence Pharmacovigilance within the pediatric inpatient unit takes a different dimension. The Pharmacist is aware of common drug related problems identified with specific medicines and takes measures to look out for them.

Pharmacists should realise that after discharge and the patient becomes an outpatient the larger burden subsequently lies on the pharmacist who will be frequently contacted by the childs caregivers for clarification on various drug related issues.

Picture this : For a drug like Digoxin the optimal dose for a Baby may instantly kill an adult. We all observe that children are prescribed lower doses than adults. But do you know that children actually require higher drug doses than adults? Doses are determined on a milligram per kilogram (mg/kg) body weight basis. Anyways, that is a story for another day.

Let me know your thoughts by droping your comments below. As men of honour………!

References :

American Society of Health-System
Pharmacists, Inc., and the Pediatric Pharmacy Advocacy Group, 2018, ASHP–PPAG guidelines for providing pediatric pharmacy services in hospitals and health psystems. Am J Health-Syst Pharm. 2018; 75:1151–65.

DIGOXIN Pediatric Monographs, 2021, Copyright 2021, Medical Security Card Company, LLC, dowloaded at https://www.wellrx.com/digoxin/pediactric-monographs/ on 16th January 2021.

Enato E, 2020, lecture notes, Sukthankar V, Individualization of dosage regimen, Clinical Pharmacokinetics, Mpharm 2020, Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, University of Benin.

Moles.R, Carter. S, 2028, Pharmaceutical Care in Pediatrics, Springer Link, downloaded at https://link.springer.com/chapter/10.1007/978-3-319-92576-9_31. on 16th January 2021.

Opara A, 2020, lecture notes in Pediatric Pharmaceutical care, Pharmaceutical care, Mpharm 2020, Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, University of Benin.

Tareq L. Mukattash, Anan S. Jarab, […], and James C. McElnay, Pharmaceutical Care in Children, Sultan Qaboos University Medical Journal, downloaded at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6443271/ on 16th January 2021.

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