BACKGROUND

The Pharmacy Division was created in December 2005. As part of IHVN's scale up effort in treatment activities, the division was created to take over the Good Pharmacy Practice (GPP) responsibility previously handled for the Institute of Human Virology, Nigeria (IHVN) by Howard University, U.S. The inspiring leadership of Drs. Habib Abdulrazaq, James Shepherd and Maria Eng strengthened the development of a vision and focus by the pioneers of the division – Avong Yohanna Kambai and Charity Omenka. With a dedicated and hard-working IHVN pharmacists and facility based pharmacists, the pharmacy division continues to provide services in pharmaceutical care, drug logistics and adherence to antiretroviral therapy.

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 provision of high quality
• 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 division's objectives, there are four key activities for the division:

Ensuring Good Pharmacy Practice (GPP) at ART Pharmacies
Good Pharmacy Practice (GPP) incorporates maintaining standard practices that provide optimum care to the patient. These include drug dispensing, monitoring of side effects, patient counseling on drug utilization and adherence to antiretroviral therapy.

PHOTO: Pharmacists dispensing drugs to patients through the "Indoor Dispensing System

The Pharmacy division is especially proud of the efforts undertaken to stamp out the Window Dispensing System (where patient collect drugs through the window) for a more friendly and adherence-improving method – Indoor Dispensing System (IDS) in which drugs are dispensed in private and secured environment so as to facilitate confidentiality and improve adherence to antiretroviral therapy.

As at January 2011, pharmacists have dispensed antiretroviral medications to 111,986 HIV/AIDS patients scattered through out the 139 health facilities in Nigeria.

Capacity development of Hospital Pharmacists
The main focus of the capacity development is to support the local capacity of pharmacists for the HIV/AIDS treatment and care program of the Federal Government of Nigeria. The initiative has generated 500 Nigerian pharmacists who are providing care and inventory management at the various health facilities where HIV/AIDS patients are treated.

FOTO: Pharmacists receive training on providing pharmaceutical care

An official training manual consistent with the Nigerian National Treatment Guidelines for the training of pharmacists have been developed. Multiple tools, standard operating procedures (SOPs) and guidelines have also been developed to assist the pharmacists and to entrench the basic principles of GPP.

Drug logistics

Drug logistics activities include facility renovation, drug quantification, procurement, distribution, and storage and data management. Using procurement's standard operating procedures and guide lines, drugs are procured through reputable international and local vendors. To maintain the quality of drugs, drugs are stored in warehouses at manufacturers' recommended temperatures.

PHOTO: Drugs are warehoused at manufacturers' recommended temperature

Drug distribution employs the use of soft wares that allow the monitoring of stock level and therefore, minimize drug stock-outs or over stocking 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 antiretroviral regimens and medication errors are the key activities under the quality assurance initiative.

Adverse drug reactions constitute a great challenge to adherence to antiretroviral drugs. Under the pharmacovigilance initiative, these reactions are reported and documented using the standard tools.

PHOTO: Health Staff undergoing practical training on monitoring side effects of drugs (Pharmacovigilance)

STAFFING
The pharmacy division is staffed with eight registered pharmacists (R.Ph) – three at the central/head office and five at the regions including, Kano, Jos, Benin, Lagos and the Federal Capital Territory (FCT). There are three major departments: pharmaceutical supply chain, Training and Good Pharmacy Practice (GPP).