Mazi Sam Ohuabunwa is President of Pharmaceutical Society of Nigeria and a corporate titan. As a leader in corporate Nigeria, his voice is well respected in government and the Organised private sector. A former chairman of the NESG, Ohuabunwa in this interview with UCHE CHRIS, reviews the state of the economy, insisting that something needs to change and points to the way forward.
The position of PSN on the Madagascar Covid 19 syrup is generating quite a controversy among the people; why?
It is normal and understandable. When you say anything that government does not understand or is contrary to official position or policy, most people are likely to see it as opposition against government. Our position is principled and patriotic; and is not really against what government has been doing or has done by accepting the foreign remedy for the virus. We believe that any help from anywhere in e world for the treatment of the virus is good and welcomed. It is even better that it is coming from an African country.
But we can’t be always looking outside for help or depending on others anytime there is a problem or issue to solve, especially for things we have local capacity and capability. Since the virus broke out, some Nigerians have been making claims that they have the formulations to deal with it and nobody has paid them any attention or done anything about them. All we hear is that nobody has come forward with such claims. I know that one of them has made a presentation to the ministry of health; so what has come out of it; have they started the laboratory procedure to validate it?
When NAFDAC says that people should come forward with their products for laboratory test, you know it is only half the truth – for the agency it is mainly a financial transaction. To submit your product for testing you have to pay a heavy fee, which some of these researchers and scientists may not have. Research and Development, R/D, is a very expensive venture and only government and large companies can afford it; so government has to come in to encourage them by assuming the risk and burden for it. Our position then is how to rally government support for these people to produce something we can use here not only for the covid 19, but many other things.
We have the human and material resources to achieve whatever we may set our mind to do – we are blessed with a rich variety of herbs and trees. It will be cheaper to produce here, and makes us self reliant in such critical area of national development; and saves us a lot of foreign exchange in the importation of products. Can you see how much it reported Madagascar is demanding from us for the syrup – $170,000? We are only trying to make government focus more on R/D in solving our problems because that is the core of the issue; everything begins there. This is not the time for individual effort; government should invite these people, and others and get a team of scientists and fund them to investigate this case and provide us a remedy.
Individual efforts like what is happening in some universities may not produce any tangible result because of the urgency and funding constraint. So government has to intervene strongly to drive the process. We should not always be waiting for other countries to provide the drug for us; who says we can’t do it? If a small country like Madagascar can offer the world something even at crude level, then we have no excuse not to try.
People believe that this pandemic has provided the country an opportunity to redefine and upgrade our healthcare sector, particularly the pharmaceutical sector, where you play; what do you think should be done?
That is a good question, but the answer is simple based on what we have been saying. The pandemic has seriously exposed the inadequacies in our healthcare sector in terms of service delivery and manpower development. Few people understand the level of decay in the sector over the years as a result of perennial neglect, underfunding and mismanagement. All we have been doing since Covid 19 outbreak is trying to set up a response mechanism, which should have been the basic infrastructure and manpower. Even now, almost two months after, we are hardly ready to fully respond to it. We are still not testing enough because of inadequate resources, such as materials and isolation spaces.
The first thing to do is to recognize the urgent and important demand of the sector, because it deals with human lives and determines the wellness of the nation. We are fortunate so far that the death toll has not been overwhelming as we have seen in some countries across the world with far more better healthcare system. But imagine if the rate of infections were to escalate beyond the present rate, we will be in big trouble. Going forward, we have to change our orientation of depending on others for our healthcare needs; and begin to make the necessary investment to develop the sector against future pandemics. Yes, there will be other pandemics after Covid 19; when we had Ebola in 2014, did we envisage that there will be Coronavirus soon after.
In fact we even performed better because of the experience and infrastructure garnered during the Ebola crisis. Then minister of health, Prof. Oshetimehin made a lot intervention in the sector, especially in funding and equipping the NCDC, which provided the foundations for the present effort; otherwise it would have been worse. Take, for instance, the number of Nigerians going for medical tourism every year, and how much it costs the country, about $1.5 billion. This is a clear example that Nigerians don’t have much confidence in the healthcare system in the country.
To be able to meet the situation requires the capacity to hold reserves of medical equipment and supply. This is very important because one of the reasons for the exodus of healthcare professionals from Nigeria to others countries is the dearth of appropriate medical equipment in the system to tackle health care situations. Why is it so? We return to the same problem of funding. Equipment provision is capital intensive and it is extraneous to talk about equipment when funding is hardly sufficient for personnel costs. Look at even the simple equipment such as ventilators and PPE (personal protection equipment) for the Covid 19 management and how we struggling to provide it. No country can overcome its healthcare challenges without investing in equipment manufacturing and production; that is why we at PSN believe that government should seize this opportunity to intervene decisively in the system to reverse this unfortunate situation.
Then, we have to deal with the issue of training; this means producing the right number as well as quality. At present, the country has produced about 75,000 registered doctors, but almost 40,000 practice abroad while over 70 per cent in the country are thinking of picking jobs outside. The WHO recommends 600 patients per doctor, while we have about 50,000 patients per doctor, which creates a huge gap between need and provision. So we need to produce more doctors to cope with both present and future demands. We are not talking about other healthcare professionals such as laboratory technicians, nurses, Pharmacists.
Beside the issue of number, there is also the problem of quality of personnel. The Nigerian educational system has suffered neglect, which has also affected standards. It is very important that we pay attention to the quality of the products of medical and health education because they have direct impact on the practice and management of the system. There is also the support production capacity involving the manufacturing of medicines and other medical products. Former president Obasanjo invested quite substantially in this area – in the tertiary healthcare sector through the provision of infrastructure.
The policy entailed the designation of some of the health institutions as centres of excellence for specific health need and investments were directed at such accordingly. I was a member of one of the committees overseeing one of them and it was a major step toward developing the sector. But you know our country; once there was a change of government, the whole policy also changed. Abandoning the policy was a huge setback for the sector and the country.
So do you see the recent intervention by the CBN with N100 billion for research as timely and positive?
It is very timely and critically important. Do you know something? The CBN governor, Mr. Godwin Emefiele, has really surprised everybody and largely exceeded public expectations of him. His performance has brought home the fact again that it is in a period of crisis that the true quality of leaders are displayed. He has demonstrated beyond doubt his leadership capacity, and we, as the organized private sector, commend his policies and actions since the crisis began. If the economy is going to experience moderate shocks we have the CBN to thank. The proactive interventions have brought some stability and confidence to the economy, especially the SMEs sector. They are very critical to reducing the shocks and for the quick recovery of the economy.
He actually preempted our (PSN) position; he is being proactive and anticipatory of the future; that is leadership. Like I said before, this will not be the last pandemic, so the time to start preparing for the future is now. R/d is very expensive, as I have said, and government needs to provide grants and subventions, and soft loans to individuals and companies involved in research to access, because not even companies can comfortably fund it. Individuals need grants while companies should get cheap loans because they have more capacity to prepay. It would be suicidal for a researcher to take bank facility to finance research projects they are not sure of the outcome. So, the CBN intervention has really cut through the heart of the matter and we believe there will be positive result from this.
Again, let me tell you something. In the 1980s, there was this policy on essential drugs manufacturing, which required the local production of 70 percent of basic drugs. It required pharmaceutical firms to make huge investments in expansion of capacity, and backward integration. The idea was to increase local content and value addition, unfortunately, the level is about 30-40 percent as the policy was not sustained and imports continued to flood the market, completely defeating the purpose. Even at that level, basic raw materials, such as starch, sugar – additives – are still imported; these are called API – additive pharmaceutical ingredients, which are mostly produced by petrochemical companies.
What role should alternative medical practice play in all this?
This is the thrust of our (PSN) position on the Madagascar Covid 10 drug. We believe there is a gap in the healthcare system and the alternative medicine could be useful and also contribute to national development; after all the Madagascar concoction is a herbal remedy. This country is blessed with a rich variety of herbal trees and we seem to have developed quite a significant competence and capacity in the area over the years, which we can now harness in this challenging period. They should not function exclusively but integrated into a national healthcare policy and practice to reduce the problems existing in the sector. The most important thing to us is finding solution to our health needs.
The economy is facing double attacks – the oil price slump and Covid 19 lock downs. What do we expect post Covid 19, given the devastations in other economies such as U.S?
Our problem is not just the present situation; you know, the economy just exited recession in 2017, but the recovery was fragile and sluggish, before the present crises. So, we should expect the economy to be pretty bad in the immediate and short term; but the extent of the damage is what we cannot determine now. The oil price affected adversely government revenue while the Covid 19 lockdown crippled productive activities; government depends oil to about 80 percent of revenue and 93 percent of foreign exchange, and the economy was grounded for over a month. It will take a miracle for the economy not to go into recession again.
Although government is planning some stimulus response to fight it, and the CBN has been very pro-active and supportive; the challenge is that government is borrowing to finance its package, which does not give any comfort and consolation, because every debt must have to be repaid. Even at the concessionary rate of five percent of the loans, we should all be worried, because there is a revenue challenge and the lack of capacity to repay.
You mentioned our dependence on oil, which has become perennial; what is responsible for this?
It is sad; very sad! As a country we are not prepared to change the way we do things especially old habits. How could we be still talking about oil dependence after many years of suffering from its debilitating effects? There is something wrong with us. The Covid 19 lockdown would not have been as severe as it is but for our dependence on oil and the price crash. It is simply a problem of leadership and it will take a strong leader who is ready to make sacrifices to reverse the trend. To diversify our income or revenue base, we need a leader who is ready to change things. Countries like Norway, Sweden, and Denmark etc don’t even spend their oil revenue; they spend only the profits from their investment of oil proceeds and save the rest.
Former president Jonathan tried to change the situation by setting up the Sovereign Wealth Authority, as well as boost the ECA, but the governors fought him and wanted the money shared. Now it is the same NSWA, which they kicked against its establishment that is funding part of the stimulus package. We should make a law that fixes the oil price benchmark for the budget at not more than $25 per barrel notwithstanding the actual price so that we can begin to save enough for oil price uncertainties. It seems to me that all the talk about diversification has become just political slogan to look good in public perception; it only takes another oil windfall to burst the pretense.
Do you think government is handling the situation effectively?
Well; I am not sure what they are doing because we have not seen any policy on the table from them to evaluate, apart from the discordant tunes by officials. There is no coherent policy strategy yet. There are committees here and there working on one thing or the other, but we are waiting for proper coordination, which is not there yet. Even the budget is a serious issue but government approach is casually. How could the budget be reduced by just N70 billion given the revenue short fall being experienced, while we are borrowing heavily to fund recurrent expenditure? It doesn’t make sense. There is an urgent need for a change of orientation and philosophy of how government is run; policies should be based on timeliness in implementation with measureable targets. Things have gone the wrong way for too long.
Finally, the border closure in August 2019 seems to have had mixed results; what is your assessment?
It was a desperate action that is not well articulated and should not be for the long term. There are usually many different ways to address a problem but what is important is sustainability. A policy cannot be viable unless it is sustainable. Border closure can only be a short term measure for short term gains. Beyond that it becomes a problem in itself. It is better to reform the Customs and get the right people to man the borders than to close the borders. Smuggling is done in broad day light with open connivance of the officials. In parts of the north, like Katsina and Jigawa it is uncontrolled and those involved are well known. We need to change the psyche of people to believe in the country. The root of all this is our inability to enforce bans.