Professor (Mrs) Chinedum Babalola made history when she became the first woman to be appointed dean of the faculty of pharmacy at the University of Ibadan. But beyond being a history maker, Prof Babalola is passionate about the fight against fake and counterfeit drugs. In this interview with Michael Oche, she talks about the consequences of Nigeria’s overdependence on imported pharmaceutical products and her dream of a Made in Nigeria drug from the University of Ibadan.
As the first female dean of the faculty of pharmacy at the University of Ibadan, how do you feel?
It just makes me appreciate God who has been the leader of my life. To me, it humbles me and makes me know that God is the author of my life. It also means a lot of responsibilities. It has been a world of men, so if a woman now comes there, you must be good enough to make a difference so people can say, what a man can do, a woman can do better. So, it’s more responsibility.
What was the situation you met on ground when you took over and how you have improved on it?
There had been six deans before me and the six were men. They are the founding fathers of the faculty at UI. They were very committed. By the time I took over, I will say they had tried to improve on the facilities but we haven’t gotten to that place where we will say we have a purpose-built faculty of pharmacy in UI. So when I took over, I had my vision. My vision was three pronged, to improve the physical structures; to have a new curriculum – a new mode of teaching and learning; and to improve research so that we can have drug manufactured here in UI. I head a Centre for Drugs Research and Manufacture being funded by a grant. So, we are working hard on that, doing a lot of research and training so that one day, we can say we have a Made in Ibadan drug.
Many Nigerians have a misconception about the role of pharmacists. Some believe pharmacists only dispense drugs. Can you enlighten better on this?
We know and it’s a challenge. Pharmacy in Nigeria has an image problem and every opportunity I have, I make the students realise that they are very important in the healthcare chain; that without medicine, there is no healthcare. There is no way you go to a hospital and if they don’t give you medicine that you will be happy. Now, the pharmacy profession is very wide. However, in the healthcare sector like the hospitals in Nigeria, pharmacy has not been given room to expand. In developed countries and even in other countries, pharmacy has gone beyond giving out drugs. There is what we call drug information, counselling and medication therapy. The pharmacist goes together with the other healthcare teams to see patients and then give advice to the doctors, nurses and patients. It’s a whole lot of work, so that we can reduce a lot of medication errors. A lot of research has shown that there are a lot of medication errors when pharmacists are missing in the chain. And in this country, they are missing in the team. And also, there is the problem of non-skilled or non-pharmacy professionals practicing pharmacy outside. So they compete seriously with real pharmacists. If you have one pharmacy, you are likely to have 10 medicine stores and people will go there and they don’t know the difference. But when you have people that are not trained, I mean primary and secondary school leavers handling drugs, you can imagine the dangers.
So how can this be remedied?
You know initially because there were very few pharmacists, the government in its wisdom allowed more licenses to be released so that there would be more coverage with respect to provision of medicines because if you leave it to the pharmacists alone, they cannot cover a population of over 150 million. But now, we have since graduated from having one school of pharmacy to having so many. But right now, because there is no satisfaction with the practice, a lot of our professionals don’t even want to practice. A lot of our pharmacists are out of the country. When they graduate, they take professional exams and leave the country because it’s a better environment and some of them go into other things. Many of them don’t even want to go into the industries and manufacture because it is too slow for them. Many of our young people want the quick syndrome. So, the government should review the laws. They cannot be using the laws established in 1920 in 2016. We are appealing to them to review the laws. Since they are increasing, allow more room for the pharmacists to express. Make it mandatory for non-skilled pharmacists to practice where there are pharmacists.
You said one of your dreams is to see a Made in Nigeria drug at the University of Ibadan, why hasn’t this been possible?
We have done a lot of research. Drug development takes time and a lot of money. In developed countries, all these pharmaceutical companies may take 15 years to develop one of these medicines you see in the market and it might take billions of dollars. So first and foremost, it is either our nation doesn’t have that kind of money or such money haven’t really been devoted for such purpose but there has been a lot of research from the academia, not only in my university, on drug research and drug design. People have found things but most of the times, our researches end up with publications and promotions. And this perhaps is because we don’t have indigenous companies that have such money to put into such projects. So what we are left with is to depend on the drugs that are already developed. But I believe that with our natural medicine and bio diversity, we can do something.
How can the funding gap for research in Nigeria be closed?
I think they have actually tried by setting up TETFUND but I don’t know whether such fund can do what we are talking about. We also have NIPRID for drug research but I think there needs to be concerted efforts and plan. When NIPRD developed the drug for treating sickle cell, I think it wasn’t really handled well and it’s like we have lost that drug. So we need to study how it is done elsewhere and it should also involve the private sector, a kind of private-public partnership. There is a limit the researcher can go; the researcher can only say this is what is on the table, but is anybody ready to take it up for commercialisation? So many times, you might even develop something and no company is ready to invest in it. For some of those companies, it is a risk because after 15 years of investing in the project, the drug might never be registered. Then we need a good regulatory system. In the United States, we have the FDA. They regulate from start to finish – from new molecules till you have the drug. Is our system, our NAFDAC strengthened for that? I don’t think so for now. But I think they can get there with proper funding. So it involves regulation, money, the private sector, government and encouragement. The only way we can encourage the researchers is to come in and see what they have done. Despite the efforts of agencies like NAFDAC and SON, we still have the problem of fake and counterfeit drugs finding their way into the country, how can this be checked?
It is something for which a lot of work is needed. I want to commend the government, both present and in the past for their interest with respect to that, but we have not reached there at all. When you think about our population of 170 million, I don’t know how many people work in NAFDAC. Do we even have the staff strength to cater for regulation? Regulation is serious. There is what you call strict regulatory guidelines that will ensure that the medicine everybody is taking is quality. There is a lot of importation and the fact that there is a lot of importation is enough to destroy us in the country. If there are policies that will encourage our pharmaceutical companies to manufacture here, then it will be easy for agencies like NAFDAC to go and see what they are doing. But as long as it is cheaper to import than to manufacture, companies will rather go to India and China to import. And in that China and India, you will have both good and bad just like any product because drugs are also treated like any article of trade. The forces against us having quality medicine are so many and strong. We need strong and strict regulatory guidelines that will be obeyed and we also need the backing of the law. So that when people are found guilty they are really punished. The legal system, the laws governing these things have to be reviewed. We need more training for the people, more awareness. Medicine can be poison. Yes, they can treat diseases but they can be poison. I know that many people have died due to fake medicine. And then you need laboratories to continue to test. One of the things we do in the Centre for Drug Discovery in UI is to test for quality medicines that are circulating in the country and of course we need appropriate statistics and data. We need to strengthen NAFDAC like I said and we need to strengthen the Pharmaceutical Council of Nigeria (PCN). They regulate our practice, sometimes they seal up bad places and those people go back and open it. So the government needs to support the agencies so that their work will not be tampered by charlatans. And it also goes hand in hand with the wrong people practicing the profession. As long as there are wrong people practicing the profession, they don’t care; they don’t know the effect of counterfeit medicine. If you can just wake up one day to go and import without being trained, you will import anything. I have so much passion for this issue of counterfeit drugs, only God knows the number of people who have lost their lives to this issue of fake drugs. There is what we call generic medicines, if you pick anyone, like the one called Coartem, only God knows how many brands of it there are. You can go to China now and say make a brand, call it my name. So many generics; there are different types of paracetamol, different types of anti-malaria and different types of antibiotics. And what of what we call prescription only drugs? Prescription only drugs should only be found in pharmacies – some of these drugs we call them ethical – but you find people that are not pharmacists handling them. So something must happen to the laws. It is either we make new ones or strengthen the existing ones or else we will be a dumping ground and we will be killing ourselves slowly. It will just be like a time bomb.
People probably have a vague idea of the effects of counterfeit drugs. How bad is the situation in Nigeria?
For example, everybody knows about ‘My Pikin,’ that it can kill and there are different ways you can have medicines that instead of having 100 per cent of the active forms, they have 50. We have seen and have analysed some of those things. During the time Halofantrine was being used, we were running some experiments in our labs, we bought one batch, there was Halofantrine, we bought another batch and tested it, there was no single Halofantrine, it was another chemical and that chemical can kill. And you will be taking and the malaria will not go. We have analysed Ampicillin that you will open the capsule and you will see a mixture of something that looks like garri. So if you have infections and you are taking the wrong antibiotics, the infections will continue to increase. Even today, bacterial resistance has become a global problem. And you know in Nigeria, everybody can buy antibiotics and they even use it wrongly. So you can imagine even using the one that is substandard. We have substandard, we have wrong labeling and we have seen cases where they labeled Flagyl, Chloroquine. What frightens me now is how people mix orthodox medicine and herbal medicine, they will tell you this can cure madness and they will go and put Fenigal inside it. Or people want aphrodisiac, they want to be able to sleep with their girlfriends and they take things. They say it’s energy drinks, they will mix some drugs in it and you hear a lot of cases now of people who go into hotels with their girlfriends and they die. Why? It is because that thing affects the heart. I was in Ghana recently talking to a quality assurance person and we were talking about the analysis that has been done so far and how much Viagra is in some of these things that people take. Some of them are put in energy drinks and energy concoctions. So, it’s a big thing and it could lead to death.
You have talked about UI carrying out several drug quality tests at the university laboratory, how come the government has not invested in such laboratories in other parts of the country, especially knowing how important it is in the fight against fake and counterfeit drugs?
It will be my joy. In fact, it is my desire that the university will not just be looked at like being there, but what we do there should also touch the public and vice-versa. Like I said, if we involve the academia, we can do more. They have the expertise and specialists, they can analyse, they can help agencies, universities can be empowered and laboratories can be set up there. Of course, such laboratories must be WHO certified. The academia can be invited to give advice to the government, agencies, and industries and once that is achieved, we can strengthen the structures that we have and NAFDAC can then go ahead to do more regulation and surveillance. So it will be my desire to see this come true.
By: Micheal Oche
Leadership News
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