Posted on: Wed 25-02-2015

Alhaji Toyosi Raheem is the new National President, Association of Medical Laboratory Scientists of Nigeria, AMLSN. In this interview with Health Reporter, MARCUS FATUNMOLE, he speaks about his administration’s passion for free laboratory tests in Nigerian public hospitals, need to improve the capacity of his members to enable them contribute to health research in the country, among others. Excerpt:

What does your administration intend to achieve in the next three years?

What we intend to do in the next three years is to position our profession properly within the national and international community by making sure that all those activities that are expected of us in the health care system are effectively delivered. For instance, we want to ensure that all our capacity building activities are tailored towards meeting the needs of the people. What I mean by that is that in areas where we see there are gaps in the health care service delivery, especially when you talk of DNA, forensic analysis, where people travel abroad to get such services, we want to build the capacity of members locally, so that when you talk of DNA, forensic analysis, and others, people can afford such services locally.

We want to also encourage our colleagues in the area of developing their capacity towards transnational research. What I mean by transnational research is research that can impact positively on patients care. So, our colleagues are working in various university hospitals and research institutes to ensure that their capacity is developed and strengthened in a way that will enable them contribute their quota to research finding gaps, which would be useful to effective care of patients. That is what we mean by transnational research. Apart from that, we also want to collaborate with government and other stakeholders in such a way that the health system in Nigeria will be strengthened.

Globally, the laboratory services have been identified as the best physical component of the health system. As a result of this, over 70 to 75 percent of the information required to effectively care for the patient is generated in the laboratory. We want to ensure that the laboratory component of the health system is strengthened in such a way that we will be able to deliver effective lab services that meet global best practices, as contained in the ISO 15189 standards. That is our focus.

Apart from that, we also want to collaborate with other health professionals in such a way that the collaboration will be seen as an effective tool for health care delivery because health care delivery is a team work. And, all the component of the team should be strengthened in a way that none of the team member is weak. We want to ensure that we collaborate for national health care delivery.

Would you say the cost of laboratory tests in public hospitals today is affordable?

There are two approaches which we want to adopt. The first approach is to appeal to government to let the masses enjoy the dividends of having a government in place. What I mean by this is that the masses are looking up to government for effective health care delivery. The aspect we want to appeal to government on is the aspect whereby the government is trying to commercialize the health sector by the system they call private- public partnership, PPP. The way it is being done, it is making laboratory services not to be at the reach of the poor.

If you put a private investor in public health institution, the first thing that comes to the mind of the investor is to maximize profit. And, you discover that patients will benefit more if government makes provision for possibly free medical laboratory services in our government hospitals. The most costly aspect of health care services is the medical laboratory services where the cost of servicing the patients is highly expensive. When you want to do a test, the cost of procuring equipment, the cost of running the place and all that are too expensive. It is even better to fund laboratory services and allow the masses to enjoy it free of charge. To buy drugs is not too expensive. So, the masses can only benefit from this arrangement if government effectively funds the medical laboratory services and allow the masses to enjoy this by having accessible and affordable laboratory services through government-funded, well-staffed system; and not allowing investors to run the laboratory where cost of tests is so exorbitant.

I have a case of a patient that was referred to a Teaching Hospital here in Nigeria. The patient was referred to private laboratory within the Teaching Hospital. I wouldn’t want to mention the name of the laboratory, inside a government hospital. They referred a patient to a private investor which was under PPP. When the patient got there, the charge was so expensive that the patient couldn’t afford to pay for the test. Whereas, these services could be rendered (free) in that same Teaching Hospital if necessary equipment and facilities were provided by government.

This is the area we want to network with government in such a way that government will provided the necessary equipment and manpower that will be required to run our various laboratories in government hospitals, instead of relinquishing that function and giving it to the private investors.

How would you describe patient-medical lab scientists’ ratio in Nigeria?

The ratio is seriously low. If you put together all medical laboratory scientists in Nigeria, they are just around 20,000. Out of the number, you have a lot of them that have retired. We have a lot of them that are in the diaspora, working in various parts of the world. If you look at the ratio of those that are working in the country, the ratio is grossly below expectation. And, that is why we want to appeal to the federal, states and local governments to ensure that medical lab scientists are employed into the various health institutions.

Apart from that, we are also strengthening the capacity of various training institutions, especially the universities and all the relevant training institutions to ensure that there is adequate human resource in medical laboratory services.

Currently, the ratio of medical laboratory scientist to patient is grossly too low. And, for us to really perform effective lab services, the number of medical lab scientists has to be increased. The employment of graduates of medical lab scientists and those that have been trained will be of tremendous help if government makes consideration of employing more hands.

What has happened to the controversy over who manages the Invitro Diagnostic Equipment in the country?

The law setting up the Medical Laboratory Science Council of Nigeria which I call Act Cap F 25 LMN of 2004 empowers the Medical Laboratory Science Council of Nigeria to regulate the sale, marketing and distribution of Invitro Diagnostic Equipment in Nigeria. So, as it is today, the council is empowered by that law to do that. It is not contestable whether any other person than Medical Laboratory Council of Nigeria do it or not. No doubt about that, the Medical Lab Council of Nigeria is empowered to do that. That is why our association commends President Goodluck Jonathan for officially commissioned that Invitro Diagnostic reagent on the 6th of September, 2013.

It is one of those things that we so appreciate because it will effectively put to a stop the chaotic situation where fake reagent and substandard equipment and all those unregulated products that are used in medical laboratory services will find their ways into our various laboratory services. The council is effectively doing that. The Central Bank of Nigeria has also empowered Medical Lab Council of Nigeria by issuing a circular that will empower them to perform that function properly; and the council is effectively doing that.

We are happy that if truly allowed to do that function, there will be quality lab services in this country. No matter how highly trained the medical lab professionals are, if the reagents and all the materials used in generating tests are fake, substandard and bad, then, the outcome of that result will also be bad. And, then, the patients will not benefit from the services coming from the lab. That is why we are very worried. And, we want to do everything possible to support medical lab council in effectively controlling the Invitro Diagnostic Reagent and equipment in Nigeria.

What can you say about the National Health Act that was signed into law by the President?

The National Health Act, 2014, is a very commendable effort of the Federal Government of Nigeria. Initially, the reason we were not in support of the earlier version of the bill was that it was structured in a way that it would not serve the purpose it was meant to serve. But, with the input of all stakeholders, including our association, the National Assembly was able to come up with an acceptable version of the bill which became the harmonized version. It was the harmonized version which has taken care of the grey areas, which will even promote team work, promote cooperation among health care providers. It will also make funds available for various health institutions, primary, secondary and tertiary.

It will also provide for the people that cannot afford health care services. If you look at the various components of the National Health Act, for us as an association, we find it very good. It is an excellent document which will reposition and ensure quality health services in this country.

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