Predatory Capitalism And The Fate Of Pharmacy Practise in Nigeria

It always starts like this: "A Reputable Pharmacy needs the service of a pharmacist..." The pharmacies are always "Reputable," which almost means the pharmacist must be ready to work for the money.  Or what better way will that 150k (Some 200k) be justified? Heard employers now even deduct randomly from the salaries paid to pharmacists. Let's call them deductions for pharmacy oversight. You know, in the case of the drugs on the shelf, not being "Pushed" and all of that. My colleagues should be fully aware of what I am speaking about by now. But before we get into the main gist, first of all, introduction...

The Current Landscape of Pharmacy Practice in Nigeria.

First, I do not like writing about seemingly tough topics, but they are drawn to me in a way. I see these anomalies and just want to get on my laptop and start typing. It is always like this; when you graduate as a pharmacist in this country, and after the compulsory internship year and possibly service year, you are thrown out there to find your feet. Don't blame us for that yet; we still need to find a solid structure for continuing education. 

Many of your pharmacists would opt to join the hordes of 'Civil Servants' in different secondary or tertiary healthcare facilities in the country to find that foot. Pardon my omission of the 'Primary'; they are still severely underrated in our strata of healthcare, and in 2024, we still need to find a way to utilize them, and pharmacists are rarely found there (I wrote about that issue here). Some others would opt for drug manufacturing companies, some medical sales representatives, and many of them find themselves in community pharmacy practice. 

After that brief overview, the target of my writing is the community pharmacy. Nearly every pharmacist in Nigeria belongs to one young pharmacist group, particularly in the state where they are currently domiciled. In one of the many conversations among the young professionals in this group, someone mentioned the term 'Predatory Capitalism,' and it stuck. The word was such a perfect description that I knew I had to spin something around it. 

What do we know about Community Pharmacy practice in Nigeria? 

I do not want to get into all that theory. Still, the main thing to note is that as the roles of the early practising pharmacists expanded, there was a need to improve their capacity and subsequently broaden the horizons of the practice to solidly contribute to the public healthcare landscape in Nigeria. Although this move also came with challenges and a subsequent loss of authority and advocacy within the Nigerian hospital space, I will leave that for another day. 

From Richard Zaccheus Bailey opening the very first pharmacy in the present Balogun Street, community pharmacy practice and its roles have expanded to contributing to public healthcare and helping to reduce the existing pressures on secondary and tertiary healthcare facilities in the country. However, with just over 3700 community pharmacies in the country and over 1000 of these pharmacies domiciled in Lagos state, the role of community pharmacies in the country's healthcare cannot be understated. 

Pharmacists who are registered and certified professionals responsible for manning and ensuring that community pharmacies continue providing efficient pharmaceutical care have been getting the short hand of the stick for as long as I can remember in terms of remuneration and conditions of service. I could go on about my personal experience while serving as part of an interest group for young pharmacists. Still, young pharmacists' constant charges, requests, etc., for increased remuneration are more than enough. 

Suppose you are one of the over 21,000 pharmacists meant to serve a growing population of over 200 million people by the side. In that case, the chances are high that you belong to a chat group of like minds. There is no day your phone is not beeping with the myriad of advocacies by pharmacists just asking for better treatment from their employers in the community pharmacies. With the current state of the economy, these calls are becoming more than necessary, and something needs to be done now more than ever. 

The current salary for community pharmacists in Nigeria stands between 150,000 - 200,000 per month, which translates to the fact that pharmacists literally go to work and get paid roughly 5000 per day of work.  This is aside from the disrespect, the unprofessionalism, and the sharp practices that pharmacy owners have reported countless times. We can only hope things get better at this juncture, but what can we do? 

Predatory Capitalism or the Consequence of Doing Business in Nigeria? 

The term 'Predatory Capitalism' might be sounding too harsh because it would seem as if I am only advocating for pharmacists professionals without taking a note of the many consequences of doing business in Nigeria; but would you blame me? I am a pharmacist after all. With the current state of the economy, the cost of doing business is increasing now more than ever. 

The cost of sourcing for medications from wholesalers as a retail pharmacy would have increased, and this would have also put a strain on the business. Sourcing for loans to boost the business is also another hard option, with the current increase in interest rates for loans granted to small, medium and large scale enterprises in the country. There are just a whole lot of challenges, but I cannot shake off the feeling that we need to do better for ourselves and our colleagues as pharmacists. 

Many of these community pharmacies are also owned by pharmacists, and the complaints of poor remuneration have always been a recurrent theme from time immemorial. If community pharmacies are occupying such a sensitive spot in the country's healthcare sector, the pharmacists who 'Oil the wheel' and make it run need to be paid what they are worth. That should be the standard. 

I just cannot shake off that feeling that pharmacists deserve so much more. In my little years of practice, I have been able to meet with a lot of senior professionals who offer me their opinions on the subject matter, and asked me to hold out hope that the pharmacy practice in Nigeria will get better, but I am just tired of seeing hundreds of young pharmacists complaining about how hard the situation currently is. 

We know about the '7-Star' pharmacist tag, and of these is that the pharmacist can also be a business person. Irrespective of his roles of ensuring rational drug use, and achieving top-quality health outcomes for patients, he still needs to survive a dynamic country, and his monthly pay is a sure fire way of doing that. 

This would be a good time to note that out of the 21,000 licensed pharmacists earlier mentioned, only about 58.5% are currently practicing, with majority of this number, over 40% currently in community pharmacy practice. This shows us that since a lot of our professionals are opting for community pharmacy practice, and opting for the sure cash flow it offers, coupled with the opportunity it provides to contribute to community development, they need to handsomely paid for their work. 

I will be holding out hope, that things change in no distant time, and I will be looking forward to positive feedback from young pharmacist professionals. This article might be too little in the grand scheme of things to influence decisions, I hope it provides a good jumpstart, and convinces community pharmacy owners that these unique healthcare professionals, these unsung heroes in public healthcare needs to be properly rewarded for all their labor.