If Nigeria must make meaningful headway in its healthcare system, it must deliberately chart a path of deep, structural reforms. No healthcare system anywhere in the world can function effectively while systematically sidelining pharmacists. Diagnosis alone does not save lives; medication use does. When medication counselling, interaction checks, and handling are wrong, the entire effort of diagnosis becomes meaningless—the work done is zero.
Nigeria today is suffering from an acute shortage of pharmacists, yet this reality is being dangerously ignored by the leadership of the health sector. The current Minister of Health appears unwilling to confront this crisis, likely constrained by professional bias and self-interest as a physician, rather than guided by evidence-based health systems thinking.
I recently encountered a prescription written by a cardiologist in which clopidogrel was co-prescribed with omeprazole. Both drugs are metabolized via the CYP2C19 enzyme pathway. Omeprazole inhibits this enzyme, thereby significantly reducing the activation and effectiveness of clopidogrel. This interaction is well-documented and clinically significant. Had this prescription gone unchecked, the patient—who already had a history of myocardial infarction—would have been exposed to a high risk of another heart attack or sudden death. The clopidogrel would have failed, not because it was unnecessary, but because it was pharmacologically neutralized.
This fatal outcome was prevented only because a pharmacist intervened.
In another troubling incident, an insulin-dependent diabetic patient was handed insulin by an endocrinologist without any meaningful counselling. The patient, acting in good faith, repeatedly refrigerated—and at times even froze—the insulin after opening it. This completely denatured the protein structure of the insulin, rendering it ineffective. The patient’s blood glucose remained uncontrolled, and no one initially understood why.
What was missing? Pharmaceutical care.
Insulin, once opened, must be stored at room temperature, not frozen. This is basic drug-handling knowledge that falls squarely within the expertise of pharmacists, who are trained not only in pharmacology but also in drug storage, stability, distribution, and patient education.
These are not isolated incidents. They are symptoms of a broken system—a system that wrongly assumes that prescribing alone equals care. Pharmacists are the only professionals trained across the entire lifecycle of medicines, from manufacturing to monitoring outcomes in patients. Excluding them from clinical decision-making and policy leadership is a recipe for continued failure.
If Nigeria is serious about fixing its healthcare system, then President Bola Ahmed Tinubu must act decisively. The current Minister of Health should be relieved of office, and the nation should appoint a competent, neutral health systems expert—preferably a health economist—without professional bias, someone capable of designing a truly multidisciplinary, patient-centred healthcare framework.
Until pharmacists are fully integrated into clinical care, policy formulation, and health leadership, Nigeria will remain trapped in this avoidable quagmire—where preventable medication errors continue to cost innocent lives.
Pharmacist Adebola Lawal
08038453406
