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Why Pneumonia, Diarrhoea Persist In Nigeria



The prevalence of ailments such as pneumonia and diarrhoea in Nigeria has been linked to the inability of state governments to domesticate Amoxicillin dispersible tablet and Co-Pack Zinc tablet/Low Osmolality Oral Rehydration Solution for the treatment of the diseases.

This was one of the issues raised at the recently concluded Nigeria Essential Medicines List (NEML) workshop for South-West/North Central zones held in Lagos State.

Analyses and evaluations at the workshop revealed that mainstreaming the use of Amoxicillin dispersible tablet and Co-Pack Zinc/Low Osmolality Oral Rehydration Salt for pneumonia and diarrhea would save the lives of many innocent children from the killer diseases.

LEADERSHIP Weekend gathered that despite warnings from experts and concerted efforts by the federal government to reduce under-five deaths in Nigeria, some states of the federation are yet to domesticate such vital drugs in their domains.

According to reports by PACFAH@Scale, scarcity of these drugs, coupled with poor access to other life-saving drugs, are responsible for the record of about 854,000 of the 7,028,000 annual live births in Nigeria who die before their fifth birthday.

In addition, about 196,420 of the annual 854,000 under-five deaths in Nigeria are caused by pneumonia and diarrhea.

A medical expert, Dr Edwin Akpotor, said the dissemination of the EML would help to determine how diseases such as Malaria, typhoid, cancer, pneumonia, diarrhea and HIV could be treated.

Akpotor said these documents are revised every two years and during the revision, some drugs that are obsolete are removed while new drugs are included.

He noted that during the last review, chloroquine was removed and replaced with ACT for the treatment of malaria, just as other drugs were also removed and replaced with more efficient ones.

He stated: “This year, new drugs were included into the EML and part of the new drugs are Amoxicillin Dispersible Tablet and Co-Pack Zinc/Low Osmolarity Oral Rehydration Salt. For us at PACFAH @scale, we are passionate about these drugs for the treatment of pneumonia and diarrhea in Nigeria.

“These are the two new drugs recommended by the World Health Organization for the treatment of childhood pneumonia and diarrhea, the reason being that pneumonia and diarrhea contribute a lot to childhood mortality”.

On how to address the huge mortality rate in the country, Akpotor said, “We need to include theses drugs into the EML for the treatment of pneumonia and diarrhea and all the states in Nigeria should adopt it.

“We urge state governments to adopt the EML. If they have chloroquine in their shelf, it should be replaced with ACT, if you have something else for the treatment of pneumonia and diarrhea, please remove it and replaced with Amoxicillin Dispersible Tablet and Co-Pack Zinc/Low Osmolarity Oral Rehydration Salt.

“It will interest you to know that our country, represented by Goodluck Jonathan, was the head of the committee on United Nation Commission On Lifesaving commodities. It was that commission that listed 13 lifesaving drugs that all countries that have high maternal and child deaths should adopt.

“Nigeria signed that contract, that they are going to adopt it in 2010, but it took us six years later to adopt the policy. PACFAH@Scale wants to see these documents adopted by all state governments. We are assisting the Nigerian government in distribution of these documents and pleading with the state governments to adopt it.

“Over the years, we have found out that the compliance level is very low and the implication is that the deaths will continue. Some states in Nigeria still use drugs other than amoxicillin for pneumonia and chloroquine for malaria. This has led to increase in mortality. We want to support the government to use these documents and implement them even at the primary level.”

Speaking one low compliance to the use of EML by state governments in Nigeria, a Pharmacists at the Federal Ministry of Health, Bumi Arebiana, said the main objectives of the Nigeria Essential Medicines List workshop was to foster rational use of medicines at all levels of healthcare.

Arebiana said, “The workshop will help to provide adequate sensitization and awareness and to stimulate the states, plus Federal Capital Territory (FCT) to review their essential medicines list in line with national.

“It will also help in sensitising stakeholders on the Nigeria essential medicines list with addendum 6th edition 2018, which include a new entrance of six nutritional commodities for malnourished children.”

In his definition of essential medicines, Pharmacists Damian Agbo from the pharmaceutical services division, food and drug services department, Federal Ministry of Health, said essential medicines are those drugs that satisfy the priority health care needs of the majority of the population.

Agbo noted that these drugs should be available at all times in adequate amounts and in appropriate dosage forms at all levels of health care delivery system of the country.

He said the NEML comprises of two main components namely the core list, which is the minimum for a basic healthcare system, and the complementary list, which covers priority diseases that require special facilities, equipment and training.

  Agbo listed the 15 life-saving commodities to include female condoms; Contraceptive implants; emergency contraceptive; oral pills; intra-uterine device; oxytocin injection; misoprostol 200 tablet; magnesium sulphate injection 500mg/ml, 2ml and 10ml ampoule; sulfadoxime/pyrimethamine 500mg/25mg; four per cent chlorhexidine in 7.1 per cent chlorhexidine gluconate gel; neonatal injectable antibiotics; antenatal corticosteroids, neonatal resuscitation G devices; Amoxicillin Dispersible Tablet and Co-Pack Zinc/Low Osmolarity Oral Rehydration Salt.

He however urged state governments to domesticate these life saving commodities and prioritise the inclusion of the Amoxicillin Dispersible Tablet and Co-Pack Zinc/Low Osmolarity Oral Rehydration Salt recommended by the World Health Organization for the treatment of pneumonia and diarrhea respectively.