By Temitope Ben-Ajepe
A few weeks ago, I participated in a global health certificate course organized by the AB Global Health Initiative in conjunction with the Global Health Focus and The Pharmaceutical Association of Nigeria Students (PANS) amongst other partners at the Obafemi Awolowo University, Ile-Ife. This was the final point of the triangle that started at Ahmadu Bello University, Zaria before proceeding to the University of Port-Harcourt and then completing its orbit at the western cohort. The main focus of the course centered on the place of Pharmacy in Global Health. Global Health — an emerging science, is the area of study, research and practice that places a priority on improving health and achieving equity in health for all people worldwide. It’s not surprising then, that the Pharmacy profession aligns favorably with this given its contribution to the availability of medicines.
Throughout the course of two days, (a week in total without breaks for the entire country) there were intensive sessions on health economics/ Pharmacoeconomics, Pharmacovigilance/Counterfeit Drugs, Global Health Logistics, Vaccine Development, Medicines in Health Systems, Neglected Tropical Diseases, Orphan Drugs, and Health Advocacy & Policy taken by Professor Don Eliseo Lucero Prisno III, a global health thought leader, Professor Adesegun Fatusi, a pro and other distinguished speakers. I learned so much in such seemingly little time. And while all sessions hit the nail right on the head, some shone brighter than others. For me, it was the topic(s) of Antimicrobial Resistance and Health technologies.
A few weeks ago, the World Health Organization released its list of Antibiotic Resistant priority pathogens drawn up to guide and promote research and development of new antibiotics. The bacteria of interests are classified into “Critical”, “High” and “Medium” priorities. And in every category, sub-Saharan Africa sits snugly; a big part of the problem also at the mercy of big pharma corporations and G20 health experts. Antimicrobial Resistance is becoming a worldwide emergency because our antibiotics are on the last line of defense. This means that if new antibiotics aren’t discovered in time, we’ll be forced to resort to the old ones put away for their toxicity. In the same week, G20 health experts met in Berlin in a bid to discuss AMR; developing new antibiotics using the list as a resource tool for research and development because like Mr. Hermann Gröhe, Federal Minister of Health, Germany stated, “We need effective antibiotics for our health systems. We have to take joint action today for a healthier tomorrow.”
But in thinking globally as Global Health requires, the second phase of acting locally here in Nigeria meets a brick wall. In the absence of the development of new antibiotics in this neck of the woods, especially as a result of the dearth of research and development owing largely to the fact that there is little to no collaboration between indigenous pharmaceutical companies and pharmacy schools, what then can be done to slow down the fast rate of the superbug mutants? Every day, antibiotics continue to fly off the shelves, counters and even trays of unqualified persons merely out to do brisk business completely unaware of its dire consequences. In turn, superbugs (resistant gram –ve bacteria) are evolving and posing a serious threat to the population as a whole.
Referring back to the course, plausible solutions to this included the very obvious imploring of pharmaceutical companies to invest financially into Pharmacy schools to encourage research and development in drug innovation (like it is practiced in saner climes) and a call for student pharmacists to team up in a bid to churn out research papers. Even mention was made of building our traditional medicines to the level of the Chinese and the Indians. The most pressing and urgent problem of continued, unrestricted access to antibiotics remained the white elephant in the room. Sensitization of the general public, we seemed to anonymously agree, was the most feasible way in alerting the public of its dire consequences. And as a result, more campaigns will be aggressively carried out. And the message? Do not buy antibiotics when they have not been prescribed by a qualified healthcare personnel. Ensure to completely finish the dosage for your prescribed antibiotic and if there are any left overs, dispose them off properly!
It’s quite obvious at this point that while more research and development is vital, alone, it cannot solve the problem. To address resistance, there must also be better prevention of infections and appropriate use of existing antibiotics in humans and animals, as well as rational use of any new antibiotics that are developed in future.