Towards the development of blue print for health security in Nigeria by 2050: A review of drug development, supply of quality medicines and treatment issues

Abstract

Background: Drug development, distribution and supplies require efficient supply chain systems and appropriate regulation to ensure that the medicines that reach the consumer are in their intended qualitative states thereby guarantee rational use and optimal outcome. This review was therefore designed to explore drug development, supply of quality medicines and treatment issues in Nigeria, with a view to develop a blue print for health security in Nigeria by 2050.

Method: A systematic search of relevant studies and documents on drug development, national drug distribution and treatment guidelines was done within a period of three-weeks.

Results: Fouty-six percent of the key medicines were available in public health facilities and 23% of the average weekly expenditure of people went into the treatment of an episode of illness in a member of their household. Medicine financing in Nigeria is generally out-of-pocket as the National Health Insurance Scheme is still facing challenges of sufficiently providing needed services to its subscribers. Approximately 70.2% of Nigerians live below the poverty line of less than 1 USD a day, while medicines are unaffordable to 90.2% of Nigerians. Generic medicines were generally more available in all outlets, but the availability of the basket of 34 priority medicines was low in all sectors, especially in the public and private health clinics. Issues surrounding access to medicine in Nigeria range from an uncoordinated medicines supply chain to lack of price regulation resulting in shortage of essential medicines in healthcare facilities across the country.

Conclusion: Concerted efforts should be made to review and implement national, regional and continental strategies towards availability and accessibility of medicines for use in Nigeria and in Africa as a whole. In general, a pragmatic approach focusing on the short, medium and long-term goals should be vigorously pursued.

Keywords: Drug development, Supply of medicines, Drug distribution, Treatment issues, Health security by year 2050

Résumé
Contexte : Le développement, la distribution et la fourniture de médicaments nécessitent des systèmes de chaîne d’approvisionnement efficaces et une réglementation appropriée pour garantir que les médicaments qui parviennent au consommateur sont dans leur état qualitatif prévu, garantissant ainsi une utilisation rationnelle et des résultats optimaux.Cette revue a donc été conçue pour explorer le développement de médicaments, l’approvisionnement en médicaments de qualité et les problèmes de traitement au Nigéria, en vue d’élaborer un plan directeur pour la sécurité sanitaire du Nigéria d’ici 2050.

Méthode : Une recherche systématique des études et documents pertinents sur le développement de médicaments, la distribution nationale de médicaments et les directives de traitement a été effectuée durant une période de trois semaines.

Résultats: Quarante-six pour cent des médicaments clés étaient disponibles dans les établissements de santé publics et 23% des dépenses hebdomadaires moyennes des personnes étaient consacrées au traitement d’un épisode de maladie chez un membre de leur ménage. Le financement des médicaments au Nigéria est généralement de leur poche car le Régime National d’Assurance de Santé est toujours confronté à des défis de fournir suffisamment de services nécessaires à ses abonnés. Environ 70,2% des Nigérians vivent en dessous du seuil de pauvreté de moins de 1 USD par jour, tandis que les médicaments sont inabordables pour 90,2% des Nigérians. Les médicaments génériques étaient généralement plus disponibles dans tous les points de vente, mais la disponibilité du panier de 34 médicaments prioritaires était faible dans tous les secteurs, en particulier dans les dispensaires publics et privés. Les problèmes liés à l’accès aux médicaments au Nigéria vont d’une chaîne d’approvisionnement de médicaments non coordonnée au manque de réglementation des prix, entraînant une pénurie de médicaments essentiels dans les établissements de santé à travers le pays.

Conclusion: Des efforts concertés devraient être faits pour examiner et mettre en œuvre des stratégies nationales, régionales et continentales en vue de la disponibilité et de l’accessibilité des médicaments à utiliser au Nigéria et en  Afrique dans son ensemble. D’une manière générale, une approche pragmatique axée sur les objectifs à court, moyen et long terme doit être vigoureusement poursuivie.

Mots-clés: Développement de médicaments, Fourniture de médicaments, Distribution de médicaments, Problèmes de traitement, Sécurité sanitaire d’ici 2050

Correspondence: Dr. R. Adisa, Department of Clinical Pharmacy and Pharmacy Administration, Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria. Email: adisaras73@yahoo.co.uk

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