“Dr. Jamie Aten, a cancer survivor who researches how people respond to trauma, intimated that when going through adversity, perspective is everything. After Superstorm Sandy ravaged Seaside Heights, New Jersey (USA), one of Aten’s colleagues was deployed to help with relief efforts. She met a man whose roof had been blown away by the strong winds. Instead of wallowing in pessimism, the man gave some surprisingly optimistic advice: “Sometimes, you have to lose the roof to see the stars.” This man chose to see joyful meaning even in a great hardship.”, Excerpt from Our Daily Journey 2nd March 2018
Our Honorable Fellows, Respected Seniors and Esteemed colleagues,
There is a great sense in the family of pharmacy that the profession of pharmacy has lost its roof during some the past tumultuous two decades.
We have seen a rise in isolation of the profession, invading of the practice space by quacks and purposeless investors out to get a quick double your money return at detriment of Best Practice, Public Interest & Professionalism. This has fueled the rise in mortality and morbidity from drug abuse, drug misuse and inappropriate drug use.
As we look up through this gaping hole in our roof, I cannot help but be joyful as I gaze at the starts we have been so blind to all along – the patient.
We commend the government of H.E. President Uhuru’s efforts in coming up with the “Big Four” Agenda to boost our efforts into taking Kenya into an industrialised nation by 2022.
As we welcome this move, I call on all professionals in Kenya (not just in Healthcare) to come together to get an understanding of their roles in this new agenda to get our beloved country industrialised by 2022.
This will prevent a repeat of the mess that befell us in the 1990’s when H.E. the 2nd President of Kenya Daniel T. Moi declared HIV a national disaster. Many unscrupulous individuals formed brief case companies and messed up the agenda making us loose valuable time and impact opportunity.
As professionals we need to be awake, with solutions and expertise to support the government and our fellow citizens to realising tangible and valuable outcomes and not fall prey to briefcase and wheeler dealer companies out to kill our destiny for short term gain.
HOW THE PHARMACEUTICAL SECTOR PLUGS INTO THE BIG 4 AGENDA.
Universal Health Coverage is about Kenyans accessing healthcare (in our case Pharmaceutical Care, Medicines & Technology) that they need, of the highest quality (as envisioned in Articles 43 (1) (a) and 46 of the Kenyan Constitution) and affordable.
As the Pharmaceutical Sector, we therefore come in to offer Pharmaceutical Care, Medicines & Technologies to Kenyans that they need, is of the highest quality and affordable (from our diverse fields & sectors: patient care to local manufacturing) so that we are productively pushing the country forward to industrialisation by 2030.
THE BIGGEST THREATH TO REALSING THE ABOVE VISION: THE CATASTROPHE AND DISASTER OF DRUG MISUSE, DRUG ABUSE & INAPPROPRIATE DRUG USE
I would like to bring to the attention of your readers that we are witnessing a catastrophe and disaster of drug abuse and misuse that is leading to loss of lives and livelihoods of Kenyans and indeed Africans in great proportions.
This catastrophe is inadvertently and actively perpetuated by:
1. Professionals who lease their licences to investors and donors without giving a care to the levels and practice standards of care being offered
2. Professionals societies in healthcare who have not taken up the role of benchmarking Best Practices Standards abroad, tropicalising and modelling them in the peculiar local set up
3. Governments and regulators allowing for aid/support in private & public health programs without ensuring that practice standards of highest level of care as promised by Article 43 1) a) are available. That structures or support needed to be given for upholding and promoting Best Practice, Public Interest and Professionalism in healthcare are enshrined in the donors & investors project design
4. Donors & Investors who in their quest to help are also conflicted at how to make their ‘forex’ count by making healthcare accessible but quickly get their return in a short time. They then are only left with the agenda of task sharing and shifting to reduce standards from Best Practice to accommodate ‘realities’ on ground.
5. Public and payers of healthcare who now are getting sub-par quality of care than their counterparts in industrialised and developed countries are now left seeking healthcare that is price sensitive and getting short changed. Forgetting that they are guaranteed healthcare of the highest quality by Article 43 (1) (a) of the Kenyan constitution.
MANIFESTATION OF THE CATASTROPHE
This catastrophe and disaster of drugs misuse, drug abuse and inappropriate drug use is now manifesting itself through:
• High numbers of Kenyans living with drug related and induced mortalities and morbidities because their 4 drug related needs are not being met i.e. they are not accessing the qualified cadre of pharmaceutical professionals who can guarantee them pharmaceutical care, medication & technology that is:
ii. effective and
iii. safe and delivered in a manner that ensures
Other ways in which this catastrophe is manifesting is through:
• Proliferation of unregistered healthcare premises and professionals (Quacks),
• Proliferation of counterfeits products (between 10% to 40% in Africa),
• High cases of drug abuse
• High cases of drug misuse
• High cases of inappropriate drug use
• High cases of morbidity and mortality related from drug misuse, inappropriate use and abuse
• High Cases of Antibiotic resistance
• High and growing rate of unemployment of higher & mid level cadres of healthcare providers (right now we have over 1,500 medical officers, dental officers and pharmacists unemployed not to mention thousands of mid level care providers). The rate of unemployment within the high level of care cadres is at the rate of 1,000 per year
WHERE IS THE SOLUTION?
The medicine (drug) is the most widely used medical intervention
The pharmacy professional is the most trusted and first point of call for care (over 70% instance) at the community level. In Kenya we have over 75,000,000 patient visits annually in private community pharmacies.
Our members are practicing in diverse industries and field all under the pharmaceutical Sector. Namely:
Public | Academia | Trade, Commerce & Enterprise | Equipment | Hospital & Specialization | Policy & Legislation
Leadership & Admin | Manufacturing | Community | Clinical Research | Nutraceuticals | Herbal Medicine | Supply Chain
Medical Waste Management | Regulatory & Quality Assurance | Health & Wellness Coach | Systems & Processes
Statistics & Analytics | Pharmaco & Health Economics | Post Market Surveillance | e-Health | Drug Discovery | Sports Medicine
Green Cross Franchise | Epidemiology | Agrovet | Clinical Pharmacy | Human Resources for Pharmacy | Practice Standards
Image 1: A sample of services offered at the Community pharmacy level by responsible Community pharmacists in developed countries. These pharmaceutical care services guarantee the healthcare system the best bet at getting the intended Clinical, Economical & Quality of Life outcomes & highest quality level of care to its citizens. These services are as captured in page 12 of the Pharmacy At A Glance 2015 – 2017 report by the International Pharmaceutical Federation FiP.
Image 2: A sample of services offered at the Hospital pharmacy level by responsible hospital pharmacists in developed countries. These pharmaceutical care services guarantee the healthcare system the best bet getting the intended Clinical, Economical & Quality of Life outcomes & highest quality level of care to its citizens. These services are as captured in page 14 of the Pharmacy At A Glance 2015 – 2017 report by the International Pharmaceutical Federation FiP.
The solution has been there all along, uniting the pharmaceutical sector to offer its diversity a as solution to healthcare and governance problems in Kenya.
WHAT OUR SECTOR CAN OFFER THE BIG 4 AGENDA AT A LARGER SCALE?
Our Sector Plugs into The “Big Four” Agenda through the Ministry of Health under the able leadership of Mrs. Sicily Kariuki, EGH and her counterpart in Industry, Trade & Cooperatives the able Mr. Adan Mohammed, EGH and together works towards:
1. Saving thousands of lives lost & put an end to the catastrophe of the drug misuse, inappropriate drug use and drug abuse epidemic.
2. Implementing the MOHs Human Resources for Health (HRH) Norms & Standards towards quality UHC policy document.
3. Linking MOHs CHV within the Kenya Community Health Strategy to Community (Primary Care) Pharmacy to achieve desired Clinical, Economic & Quality of Life for all outcomes.
4. Having an Expanded & Reimbusable Primary Pharmacy Care & Drug List package to make NHIF avail affordable & quality healthcare for all.
5. Having our Community (Primary Care) Pharmacies to accelerate NHIF enrolment to realise healthcare for all by 2022.
6. Eliminating quacks, fraud and Counterfeits in pharmaceutical sector as threat to realising quality & economical healthcare for all by 2022.
7. Building and strengthening local pharmaceutical manufacturing sector to drive access to quality and affordable medicines (only less than 25% of what we consume is locally manufactured and out of the 300 essential list only 25% is locally manufactured).
8. Delivering on the Job creation target for Healthcare Sector (we have capacity offer you over 50,000 jobs annually).
9. Delivering support to GDP contribution getting Kenya to 15% by 2022.
10. Having an integrated HMIS and e Health framework to boost research, supply chain, accountability and quality assurance of the UHC for all by 2022.
11. Running our Community Pharmacy Best Practice Centres – Green Cross Franchise of Pharmacies & Health Centres as setting standards & models to make UHC affordable, accessible and affordable and achievable by 2022.
To unlock this value to the nation from the Pharmaceutical Sector, we will be intimating to the public and government on the role of walking with the professionals to getting healthcare & governance right the first time.
Particularly for government we will be calling for the formation of an Inter Ministerial Pharmaceutical Sector Delivery Unit (PSDU) to coordinate the unlocking of this value.
To focus our effort we have come up with the PSK Pharmaceutical Sector Stimulus Plan 2018 that looks at
i. Practice & Policy
ii. Human Resources for Pharmaceutical Sector (HRPS)
iii. Commercial Sustainability of the Pharmaceutical Sector
iv. Strengthening the Institutional Capacity of the Pharmaceutical Sector
OFFERING LEADERSHIP & SOLUTIONS THROUGH BEST PRACTICE CENTRES
AS we endear ourselves as a solutions giver and problem solvers to our fellow citizens and government. We will design and launch several efficient, effective and sustainable Best Practices Centres and the flagship of which will be “The Green Cross Franchise PLC – the Mc Donald of Health Centres and Pharmacies (setting Best Practice Standards in Sustainable Patient Care)”
Basically we want to write history as first company to give Kenyans and Pharmacists (plus other healthcare workers) a chance to own and invest in their healthcare.
We will be launching this at this years Annual Symposium which is themed around UHC.
Also to note that this years Pharmacy Awareness Month will be around Medication Check Up and will be spear headed by Hon. Fellow Prof. F. Ndemo, FPSK to address the growing catastrophe of drugs misuse, drug abuse and inappropriate drugs use.
The Green Cross Franchise Model brings in self regulation and modelling of over 50 years of expertise & experience to:
• Offer Professionalism & Best Practice Standards for both business and practice of pharmacy
• Change patient health seeking behaviour from price shopping to value deriving & rating (getting it right the first time)
• Offer patients price stabilisation and affordability of medicines
• Offer Kenyans Quality Assurance of products, service, technology and professionals.
• Offer Kenyans Patients systems that promote Patient Safety and Avenues for traceability and prevention of errors.
• Collect and keep information and avail it just in time for healthcare workers to make timely and effective decisions concerning their operations and most importantly for the care of their patients
• Standardisation of care and costing at different levels of practice
• Research to inform evidence based practice and business interventions
• Employment and impartation of business skills
• Post Graduate training and feedback to universities on training for the market needs
• Tracking and documenting each patients and or their families treatment, economic and quality of life outcomes for purposes of achieving & improving on them
• Positioning the Primary Care Pharmacists and the profession of pharmacy as a solutions giver and problem solver of matter of Best Practice, Public Health Interest and Professionalism in Healthcare and other local issues.
• Linking the Community Health Workers with Primary Care Pharmacists through the Community (Primary Care) Pharmacy Referral & Standards System
Image 3: The Community (Primary Care) Pharmacy Referral & Standards System as envisioned by the Pharmaceutical Sector Stimulus Plan 2018 – 2020
The Best Practice Centres in the Pharmaceutical Sector will require the participation of all sectors in the profession from public to pharmaceutical manufacturing through primary pharmacy patient care & practice.
We will deliver this united behind the Pharmaceutical Sector Stimulus Plan 2018 – 2020.
I have gaped through that massive hole in our roof and seen into the future.
The future has no space for anger without a plan & action; nor for forgiveness without a conscious plan for honest introspection and crafting plans to do it differently.
For me the things that made me angry, that we are in a country and region:
That is 5 to 10 times below the current median of healthcare workers to population ratio
That is seeing a growing and catastrophic levels of mortality and morbidity from Drug abuse, drug misuse and inappropriate drug use.
That the patient has no coach and advocate to ensure they achieve and surpass their treatment, economic and quality of life outcomes as well a safe and quality healthcare
Where the healthcare workers are unemployed and cannot afford the very healthcare they offer
I became angry, sat down, listened to you and together we crafted this plan since July 2017 when offered myself to run for this office I have just taken an oath of here today.
I commit myself over the next 3 years of my life to getting the professional and the patient back into focus.
It is therefore with great pleasure and pride that I present to you my plans and request for approvals and invite you to join hands as leaders and general membership. The time and chance has come for us to make strides at getting the patient and professionalism back into focus.
God bless the Pharmacy profession,
God Bless PSK
God Bless Us all.
Dr. Louis Somoni MACHOGU | MPSK 1940
mobile: +254 70 501 5 501 | twitter: @somoni | web: www.linkedin.com/in/louismachogu/