BACKGROUND

The Pharmacy Division as it is today became a unit of the Institute of Human Virology Nigeria (IHVN)’s Medical/Clinical department in December 2005. As part of IHVN’s scale up effort in treatment activities, the newly formed Pharmacy unit took over the Good Pharmacy Practice (GPP) responsibility previously handled for IHVN by Howard University. The pioneering and inspiring leadership of Drs. Habib Abdulrazaq, James Shepherd and Maria Eng contributed immensely to the direction and provision of a clear focus to the Pharmacy unit. With dedicated and hard-working IHVN and site pharmacy staff members, the pharmacy unit continues to be a successful source of pride for IHVN.

VISION

The vision of the pharmacy division involves the attainment of two major objectives:

• Ensuring the uninterrupted drug supply to the patients at all ACTION sites

• Ensuring the rational use of antiretroviral drugs and other medicaments; determined by appropriate prescription, appropriate dispensing and adherence to prescribed regimen.

ACTIVITIES

In order to achieve the pharmacy division’s objectives, the activities are divided into four main areas:

Good Pharmacy Practice (GPP)

Good Pharmacy Practice (GPP) essentially incorporates all the standard practices that provide optimum care to the patient. These include drug dispensing, the monitoring of side effects, patient counseling and encouragement of proper adherence to antiretroviral therapy.  Hospital pharmacists are trained by the pharmacy division on all aspects of pharmaceutical care and are mentored in order to provide the optimal care, even in the face of limited resources. Multiple tools, standard operating procedures (SOPs) and guidelines have been developed by the unit to best assist the Pharmacists and to entrench the basic principles of GPP. The pharmacy division is especially proud of the efforts undertaken to ensure effective patient counseling, monitoring of side effects and the encouragement of pharmacist-patient relationships – vital in the management of chronic conditions.

Capacity development

The main focus of the capacity development activity is training of pharmacists and pharmacy technicians on patient care and inventory management. Over 300 Nigerian pharmacists have received training on different aspects of pharmaceutical care under this initiative.  An official training manual consistent with the Nigerian National Treatment Guidelines for the training of pharmacists have been developed by IHVN personnel. This manual is one of the greatest achievements of the pharmacy division.

Drug logistics

Drug logistics activities include facility renovation, quantification, procurement, distribution, and storage and data management.

The IHVN PEPFAR initiative collaborates with the Government of Nigeria (GON) and the Nigerian drug regulatory body – the national agency for food and drug administration control (NAFDAC), to ensure that high quality drugs are  procured through Supply Chain Management System (SCMS), International Dispensary Association (IDA) and representatives of trusted local manufacturers  all maintaining current good manufacturing practice (cGMP). The pharmacy division, on a continuous basis, verifies the procurement documents and certificates of quality assurance.

Consistent drug availability is critical to quality care as drug therapy depend on the availability of drugs. The acquisition and informed use of relevant computer software for effective drug quantification has been a focus of the pharmacy division.  Drug distribution also employs the use of different templates that allow the monitoring of stock level and therefore, minimize drug stock-outs or over stocking and drug wasting situations. In order to ensure optimal quality of the drugs at each site, pharmacists monitor the temperature of the storage facility daily. Managing waste is a very important component of drug logistics; therefore, in collaboration with NAFDAC, expired drugs are destroyed and disposed according to international guidelines.

IHVN has also been committed to ensuring that all facility infrastructures meet the highest standards. Poor infrastructures at health facilities minimize the delivery of pharmaceutical services and as such, site assessment and renovation remain the initial activities we perform before any site activation. The pharmacy division has developed a tool for site assessment with which infrastructural defects can be evaluated and necessary renovation effected in a timely manner.

Quality assurance

Pharmacovigilance and monitoring of regimens are the key activities under the quality assurance initiative. Adverse drug reactions constitute a great challenge to patients on antiretroviral drugs. Under the pharmacovigilance initiative, these reactions are reported and documented using the existing tools.  Patient management by the physicians utilizes such information to ensure the best possible patient’s care.

The monitoring of regimens to ensure quality of care and compliance as stipulated in the Nigerian National Treatment Guidelines has been an important activity for the pharmacy division. The information generated from the monitoring of regimen enables early intervention and ensures that patients are placed on the right regimen.

STAFFING

The pharmacy division is staffed with three registered pharmacists (R.Ph). The head of the division conducts managerial responsibilities and directly handles the drug logistics component while capacity development and quality assurance is handled by the other two.