The healthcare system depends on medicines to function effectively, and the pharmaceutical sector is responsible for production and distribution of medicines necessary to achieve optimum results. From Fig. 1 below it can be seen that 93.5% of the study participants indicated that access to medicines should be the key goal of pharmaceutical sector development.
The findings from this study are therefore in line with the paradigm shift that has now moved towards patient focused practice. Available evidence suggests that this approach is more efficient for improving access to healthcare for majority of the population.
The results from the study as indicated in Fig. 2 below revealed that almost all (96%) of the study participants agreed that the responsibility for initiating and driving development in the sector lays with the Government.
The role of Government in the development of the pharmaceutical sector can therefore be adjudged as critical, and the evidence emerging from this study can help provide policymakers with the necessary impetus for necessary reforms.
In Fig. 3 below, majority of the study participants indicated that increased investment in health research could stimulate the development of the pharmaceutical sector as 97.3% of the participants indicated “strongly agree” and “agree”.
The findings from the study in this thematic area is in tandem with the pressing need to build capacity in health research, particularly in Nigeria’s developing healthcare setting, where the gap is seemingly daunting.
3.3 Actualizing Potentials of Nigerian Pharmaceutical Sector
A favourable policy environment is an important factor for the growth of any sector. In this study, close to half (48%) of the study participants indicated that the current policy environment was not conducive for the growth of Nigerian pharmaceutical sector. Further details are presented in Fig. 4 below.
From the emergent findings from this study, the policy environment was perceived as hostile for the development of the sector. Without an in-depth understanding of the contributory factors, stimulating development in the sector will be difficult.
There are medicinal plants across different parts of Nigeria, and many herbal preparations are formulated from these abundant medicinal plants. Almost all (96%) the study participants however indicated that the potentials of phytomedicines and natural resources have not been fully explored. Details are presented in Fig. 5 below.
The fact that majority of the study participants indicated agreement with the stated item is a strong indication of a good understanding of the inherent potential of phytomedicines for both the pharmaceutical industry and the healthcare sector.
Currently, almost all the Active Pharmaceutical Ingredients (APIs) used in manufacturing medicines in Nigeria are imported and majority (92.1%) of the study participants indicated that there is need to partner with petrochemical industry to produce APIs. Further details are presented in Fig. 6 below.
Local production of APIs will significantly contribute to the assurance of Medicines’ Security and consequently improve access to healthcare in the country. Partnership between the petrochemical sector and pharmaceutical sector stakeholders will also improve efficiencies in the achievement of Government’s overarching objectives, especially with respect to diversification of revenue streams.
The production of raw materials for local production of medicines in Nigeria is an important factor with the capacity of boosting Nigerian economy and also create employment for its citizens. Almost all (96%) the study participants indicated that it is important to produce raw materials for the production of medicines in Nigeria. Further details are presented in Fig. 7 below.
Local production of various raw materials and manufacturing inputs will significantly contribute to the assurance of Medicines’ Security, as it will domesticate a significant proportion of the pharmaceutical manufacturing value chain. Job creation, knowledge transfer and capacity building are some additional socioeconomic benefits that this initiative can achieve.
There is currently no local Nigerian pharmaceutical company on WHO prequalification list and majority (89.5%) of the study participants indicated the need for Nigerian organization to attain WHO prequalification as this can boost the development of Nigerian pharmaceutical sector. A breakdown of the participants’ views is indicated in Fig. 8 below.
WHO prequalification enables Nigerian pharmaceutical companies participate in international procurement activities, particularly those funded by development partners. Attaining this status therefore increases market access for stakeholders in the sector.
Figure 9 shows responses of the study participants towards collaborating with research institutes. Almost all (97.3%) the participants indicated that pharmaceutical manufacturing firms should collaborate with research institutes so as to enhance their productivity.
The findings of the study in this area is in line with international practices, particularly in developed countries. Globally, there is an increasing emphasis on translation research, as a means of ensuring that resources committed to the knowledge industry actually ends up impacting on lives. In the case of the pharmaceutical sector, either as processes or as products.
3.4 Interests, Perceptions and Insights
From the findings, majority of the study participants were more interested in research and academics, compared to other aspects of the sector. On the contrary, the practice area which emerged as the least interesting to the study cohort was importation. It is however noteworthy that non-traditional areas such as policymaking, public health as well as supply chain and logistics emerged as areas of significant interest for the study cohort. Further details are presented in Table 2 below.
Table 2
Areas of interest by the participants
Item
|
N
|
Percent
|
Manufacturing
|
22
|
28.95
|
Supply Chain & Logistics
|
27
|
35.52
|
Investment
|
22
|
28.95
|
Hospital practice
|
27
|
35.52
|
Importation
|
10
|
13.16
|
Academics/Research
|
57
|
75.00
|
Public Health
|
31
|
40.79
|
Community Practice
|
17
|
22.37
|
Policy making
|
32
|
42.11
|
Traditional Medicine
|
18
|
23.68
|
NGO
|
18
|
23.68
|
Further to the descriptive statistical analysis undertaken on the data, more sophisticated statistical analyses such as cross tabulation were also undertaken. Findings shows that some of the responses of the study participants were influenced by their socio-demographic characteristics, as chi square test was significant for some of the items. A strong majority of public servants (95%) agreed that access to medicines should be the key goal of pharmaceutical sector development, compared to only half (50%) of policymakers that agreed with the same concept. This finding was statistically significant (p = 0.007) and for the first time in the extant literature, there is empirical evidence suggesting a possible dissonance between policy makers and policy implementers.
Another interesting finding that emerged at this level of analyses, was in relation to respondents’ perceptions on strategies for actualizing the potentials of the Nigerian pharmaceutical sector. The findings indicated that participants’ views differed significantly, based on their level of education. Whilst there was a strong agreement amongst degree holders and postgraduate respondents on the need for the pharmaceutical manufacturing firms to collaborate with research institute to enhance their productivity, only respondents who were not educated up to degree level disagreed with this strategy. This finding too was statistically significant (p = 0.0001) and provides desperate new insights into the role of educational qualification, as regards how government policies are formulated, implemented and understood.
Textual data provided by the study participants in relation to the development of the pharmaceutical sector were analysed thematically following the qualitative research paradigm. In relation to the development of the pharmaceutical sector, it emerged that the adoption of a collaborative approach involving all relevant stakeholders, was perceived as most appropriate for the Nigerian setting.
“...all stakeholders have to be involved to achieve a robust and comprehensive development” (Male Participant, Public Servant, above 51 Years).
“…continuous collaboration with other stakeholders would help improve the current situation” (Male Participant, Pharmacist, above 51 Years).
The study respondents further identified government as the key stakeholder responsible for articulating, driving and organizing the relevant reforms in the sector
“Government needs to demonstrate commitment to pharmaceutical sector as a national priority” (Male Participant, Public Servant, above 51 Years).
“…there must be a government structure to ensure policy implementation” (Male Participant, Development Sector Professional, 41–50 Years).
“Government should not take sole responsibility on investing but private companies, international organizations should partake and partner in drug production” (Female Participant, Public Servant, 18–30 Years).
In addition to outlining government’s role and responsibilities, the findings from the qualitative part of the study further corroborated findings from the quantitative aspect, particularly with respect to identifying the need for partnership with the private sector and with development partners.
From the study participants’ perspective, there was a need for the Nigerian Pharmaceutical sector to embrace emergent new technologies in various aspects of the sector as a catalyst for the overarching development of the sector.
“Adaptive technology should be put in place properly to improve the development of the Pharmaceutical Sector” (Female Participant, Public Servant, 18–30 Years).
“…many researches [sic] conducted are not transformed into products” (Male Participant, Public Servant, above 51 Years).
In addition to the need to integrate new technologies in the Nigerian setting, participants also identified a lack of a framework that supports translational research, resulting in a situation where most research output are left on the shelf.
Another important theme that emerged in the qualitative aspect of this study was the hitherto unexplored socioeconomic potential of the pharmaceutical sector
“Leveraging on local research outcomes should be considered by pharmaceutical industries to support local production” (Male Participant, Public Servant, 31–40 Years).
“The potential of Nigeria pharma sector is large and if tapped, it will increase the economic indices of Nigeria” (Female Participant, Public Servant, Above 51 Years).
The findings from the thematic analysis have identified associations between quality local manufacturing and national economic growth. These linkages between strengthening local manufacturing through contextual research, and achieving socioeconomic objectives such as revenue generation, job creation and capacity building, is at the very core of the Medicines’ Security concept.