The Association of Community Pharmacists of Nigeria, ACPN, has called on the federal government to urgently embrace holistic and inclusive reforms rooted in global best practices to rescue Nigeria’s ailing healthcare system.
The call came in response to recent comments made by the Nigerian Association of Resident Doctors, NARD, which claimed that hospital leadership by physicians delivers better patient outcomes and that doctors do not interfere in the affairs of other health professionals.
In a strongly worded press release signed by ACPN National Chairman, Ambrose Ezeh, the association challenged what it described as misleading claims by NARD and laid bare what it views as the catastrophic consequences of physician-dominated hospital administration in Nigeria.
It maintained that the health system began to deteriorate following the implementation of Decree 10 of 1985, which mandated physicians to lead Federal Health Institutions (FHIs), sidelining trained professional hospital administrators who had previously ensured efficiency and decorum.
“The hospital system in the 1970s and early 1980s flourished under the leadership of professional administrators. Hospitals like the University College Hospital (UCH), Ibadan, were globally acclaimed, attracting patients from across the Commonwealth. The imposition of physicians as hospital heads disrupted that order and opened the door to systemic decay,” the statement noted.
According to the ACPN, the consequences of this shift have been far-reaching. It alleged that civil service protocols were eroded, corruption became institutionalized, and critical leadership positions, such as Chief Medical Director (CMD), Chairman of the Medical Advisory Committee (CMAC), and even roles involving procurement and logistics became exclusive to physicians.
“This centralization of control has led to waste, inefficiency, and unethical practices.”
The association further referenced recent reports by the Independent Corrupt Practices and Other Related Offences Commission (ICPC), which ranked the health sector as the most corrupt in the Nigerian economy
It also noted the collapse of Drug Revolving Fund (DRF) schemes in over 90% of FHIs, blaming mismanagement under physician leadership.
“As of November 2023, the pharmaceutical industry was owed over ₦30 billion due to the diversion of DRF funds. Meanwhile, newly acquired hospital equipment becomes moribund due to poor planning and lack of technical foresight,” the ACPN stated.
The pharmacists’ group also criticized the poor performance of the National Health Insurance Authority (NHIA) under physician leadership. It said the agency achieved over 10% coverage when led by trained administrators, only to suffer a decline to 1.72% following the appointment of physician CEOs, some of whom were later dismissed over allegations of corruption.
Environmental Control
The ACPN further accused physician leaders of undermining preventive health services in favour of curative care for personal gain. “Physician CEOs have failed to prioritize environmental health interventions.”
“This is evident in how malaria, which accounts for 65% of clinical visits, is tackled almost exclusively through curative treatment instead of environmental control and preventive strategies,” it said.
On inter-professional relations, the ACPN dismissed NARD’s claim that physicians do not interfere in the affairs of other health professionals, calling it “a distortion of the truth.”
The association cited recent opposition by the Nigerian Medical Association (NMA) to the implementation of the Consultant Pharmacist Cadre and the long-standing refusal to support salary structure adjustments for non-physician health workers.
The statement also condemned the intimidation of non-physicians aspiring to become health ministers or commissioners, recalling how the NMA opposed the appointment of Pharm. Prince Julius Adelusi-Adeluyi as Health Minister in 1993.
“Only exceptionally bold presidents or governors have dared to break this monopoly,” the statement added.
Prioritizing Professionalism
In its concluding remarks, the ACPN urged the government to chart a new course by prioritizing competency, inclusiveness, and professionalism in the health sector.
“For Nigeria to move forward from years of challenges in the health sector, the government must adopt comprehensive reforms based on global best practices,” it added.