Nigeria – We Are Committed to Making Treatment for Hypertension Affordable, Says Ekunno

July 27, 2014 6:10 pm0 commentsViews: 25
Source : Google

The healthcare needs of the 170 million citizen are huge

Emmanuel Ekunno is the Managing Director/Chief Executive Officer (CEO) of Neimeth International Pharmaceutical Plc. 53 years old Ekunno hails from Abagana in Njikoka Local Council of Anambra State.

He graduated from University of Ife, Ile-Ife, Osun State, now Obafemi Awolowo University (OAU), in 1979, where he read and obtained a Degree in Pharmacy. Ekunno has an advanced Certificate in Management. He started his working carrier with Pfizer Product Limited in 1981and has occupied senior management positions in different departments in the company. In 1997 when Pfizer Products metamorphose into Neimeth International Pharmaceutical, Ekunno became the Senior Vice President (Sales, Marketing and Business Development) and thereafter became the Executive Vice President (Sales, Marketing and Business Development) a position he held until his appointment as Acting Managing Director/CEO of the company in September 2011. Ekunno in this interview decried the high prevalence of hypertension in the country and the deadly implications such as rising cases of kidney failure, heart attacks, and strokes. The pharmacists said the situation is worsening daily because most people do not know they are hypertensive until they are down with stroke and most that are aware cannot afford to sustain the drug treatment due to the high cost. Ekunno said to address the situation in the country and as a form of Corporate Social Responsibility, Neimeth International Pharmaceuticals Plc has decided to organize and institute a Programme known as Fight The Good Fight Against Hypertension (FITGAH) which involves a four pronged approach of: Action; Availability; Affordability; and Awareness. He said the company has slashed the price of hypertensive drugs by 50 per cent to make them more affordable and plan to make the drugs free for patients 65 years and above. Ekunno also said that the company’s novel herbal product for sickle cell, Ciklavit, endorsed by the World Health Organisation (WHO), has made progress in yet-to-be published clinical trials conducted in five Nigerian University Teaching Hospitals and Korle Bu Teaching Hospital in Ghana. He said patients reported clearance of crisis, pain and reversed stunted growth. CHUKWUMA MUANYA writes. Excerpts:

SIR, after going through most of your works, I realized that, basically, you have special interest in hypertension. Why the concern?

Yes, it’s because, when we… in my career, I think, early in the 1990′s, I was opportune to be the programme manager that launched Novasc- an anti-hypertension drug, a channel blocker, and to launch that product (we were at Pfizer then). To launch that product I had to read about hypertension, and one of the things that struck me about hypertension was that we knew little about hypertension, we knew little about the consequences. First of all, we didn’t know that many Nigerians were hypertensive; then, it was one in 10 of adults- 10 per cent.

We also did not know that hypertension is an insidious disease and a silent killer.


You see people die; someone may just, be eating and slumps and dies- he has, either, heart attack, kidney failure and stroke. All these, we didn’t know were the consequences of hypertension. So, that is what triggered my interest in that very area. We launched the product successfully, and since we left Pfizer, we have launched about five, or thereabout, products. I keep seeing these consequences growing.

The second reason was that, recently- about three years ago, I was in a chemist, and a woman came in, and the woman said she had a prescription; the doctor wrote “Anti-hypertensive”, the doctor wrote “B-Complex”, the doctor wrote “Tranquilizer” and wrote “Painkiller”. The chemist person calculated the sum said it was about N3,000. The woman shouted, she spoke in Yoruba language, “My child, give that one that is N200. That is B-Complex.

How will “B-Co” take care of, or moderate hypertension?

So, this is what has driven my interest and our corporate interest. Our goal was to interrupt, confront and silent this silent killer. That is the answer to your question.

Sir, there is a new concept which you are driving; how did you come about it?

Yes, it came about because of the four as, which we talk about. We call the programme, “Fight The Good Fight Against Hypertension”, and it is called FITGAH. It came about because of this reason I told you; why was that?

The first thing is Awareness- how many people are aware that they are hypertensive?

Number two is that if you read the book, Professor Akinkugbe wrote on non-communicable diseases, many years ago, in 1992, which he edited. He said that one-in-10 adult Nigerians are hypertensive. Only 33 per cent of this one-in-10 percent know it (that is the awareness). Of this 33 per cent of 10 per cent, only one-third of people are being treated, and only another one-third cases are controlled adequately. So, if you look at one-third of 10 per cent, … you now see that only three per cent of people who are hypertensive are usually well controlled.

After Awareness, number two is Availability- that is the drugs available to manage hypertension.

The third one is Affordability. If people are hypertensive can they afford it (medications)? By the time you see the number you will see some of the hypertensive’s daily course of therapy is about upmost of N200 depending on type and that comes at N6,000 a month and N72,000 a year. Now, having said all that; we are talking about affordability, can people afford it? So this is why we say lets take the action, lets take the initiative of reducing the cost. Charity begins at home. We have about four or five anti-hypertensive drugs.

We reduced the cost by 50 per cent and that means our profit line have statistically decreased by 50 per cent. If anybody is hypertensive he can have access to our drugs at a lower cost of 50 per cent. It is a fight and fight starts from one point to the other. We are inviting other pharmaceutical companies to join this fight, well meaning Nigerians. How? They can take the other 50 per cent. Corporate organization or individuals can say you reduced your cost by 50 per cent, lets take the other half or 25 per cent and together we can fight.

We call it fight the good fight because it is a fight of faith. A good fight, which is faith-based or whatever will always win eventually if you don’t give up. So this is the reason why we did this. We believe it is a movement and as we do this other people will join us and since we have done it many other companies are trying to moderate their cost on hypertensive drugs.

You recently launched a new drug to tackle hypertension. Why?

To help fight against the scourge of hypertension in Nigeria, Neimeth International Pharmaceuticals Plc, introduced Norduet, a new antihypertensive into the Nigerian market.

The product was unveiled at a colourful ceremony recently at our head office in Ikeja, Lagos, and graced by top health professionals.

Norduet is a novel product specially formulated and produced through years of dedicated research and development in Neimeth’s continued effort in the fight against hypertension. Norduet combines the vasodilator action of Amlodipine with the diuretic actions of Hydrochlorothiazide and is indicated for mild to moderate hypertension.

How far have you gone in terms of getting the government and may be non-governmental organisations (NGOs) or other people involved in this concept?

In this concept we have gotten the Nigerian Heart Foundation (NHF), they are partners. When we launched the scheme you saw Dr. Kingsley Akinroye was there, Prof Olujimi Oladapo Akinkugbe who was the founder of NHF came; he was the chairman of that event.

50 per cent of the members attended the flag off and the current Minister, Prof. Onyebuchi Chukwu, sent a delegate and that was the first phase. Like I said it is a journey. We have tried to tell Nigerians we have this scheme. We believe the next step is advocacy; we start building partnership with other people so that we can get to where we are going.

A lot of companies are doing a kind of corporate social responsibility in the area of health like going for free medical tests especially checking blood sugar and pressure. So that means that naturally they will also be in the business of offering drugs.

Have thought about buying into what they are doing in terms of getting Nigerians to have these drugs?

Yes we have. Right now we are working with one or two companies and we give them these drugs are lower value. But we are also writing. We are engaging companies and individuals, politicians. Again we are doing screenings by ourselves. When we screen properly and the doctor is there we put them on our drugs.

The third phase of FITGAH is if you are over 65 years old and you cannot afford the anti-hypertensive drugs, Neimeth can give it to you free, Neimeth can help. That is where we are going. That will be the third phase of this very programme. So we are trying to work, how do we do this? How do we scheme it so that people who cannot afford will benefit and not allow people to abuse it? So we are working with Lagos State Government and they have even given us two centres and that is the second phase of this programme.

The first phase was to let Nigerians know that Neimeth has this scheme. The second phase is advocacy to government, companies and individuals. The third phase is where we intervene directly when anybody who is above 65 years and cannot afford the drugs, we give them free. We are also working with Nigerian Hypertension Society and Nigerian Cardiology Society. We are working with them in different fora.

Why are more Nigerians going down with hypertension?

There are so many factors that predispose people to hypertension. If you noticed that figure I gave you 10 per cent in 1992. We have studies from that paper where in some areas it is about 40 per cent and in some 30 per cent and some 50 per cent. Nigerians have done a lot of work.

One of the factors is genetics. The other one is lifestyle like smoking, heavy drinking and obesity, inactivity, lack of exercise. By the way, exercise it, if one losses weight by 10 per cent there is a compensatory gain in the reduction of Blood Pressure (BP). It is proven; it is scientific. That means if you BP were 150/90 and then you lose weight by 10 per cent, it will come down by 10 per cent compensatory that is proven. Another thing is our diet. Nigerians eat a lot of fried foods, fatty foods, and inactivity. Another big issue is stress that is promoting the high prevalence of hypertension in Nigerians.

Like I said before, many people who are hypertensive don’t know and by the time they know it is the consequences, something would have started failing either the eyesight, or the kidney or the heart would have increased. They call it hypertrophy and by the time you know it, it is swollen. That is why we say it is an insidious disease and a silent killer. So this is the reason. People are not aware that they are hypertensive. They don’t go for regular check up, even when they are aware they don’t participate in therapy. These are the reasons.

There is an unholy relationship between hypertension and diabetes and according to the World Health Organisation (WHO), they account for most of the burden of non-communicable diseases. So if you tackle only hypertension it means you is not doing enough.

Are you doing anything about diabetes and other non-communicable diseases?

Yes we are in a way. You know when you do intervention, for example when we say wash our hands after going to the toilet. By the time you wash your hands you not only reduce the transmission of communicable diseases like typhoid, dysentery, diarrhoea, you have also reduced cough and other diseases. So one intervention also reduces another because it is known that most people who are hypertensive are likely to develop diabetes and vice versa.

So we have free diagnosis scheme for individuals and it combines both diabetes and hypertension. Again we also bring in the slant of education, educating people. People need to be aware that these are the consequences and that diabetes and hypertension are not life sentences, they are not. You are not sentenced to die; you can fight it. It is actually a triangle-diabetes, hypertension and stress. It is a three-way thing. Sustained stress can provoke hypertension and diabetes. So if you interrupt one it will be beneficial on the other. If you control your diet and weight, you are controlling diabetes.

Are ruling out side effects? What other advantages do your drugs have over others?

Our drugs are tailored to the black hypertensive. There is a difference in clinical course between the black hypertensive and the white hypertensive. In the black hypertensive you have sodium dependent volume implications because salt is foreign to us. Genetically the black man cannot handle salt like the Whiteman who eats much salt. This is the work done by the former Minister of Health, Prof. Babatunde Osotimehin.

So our drugs are tailored to the black hypertensive. How? The black hypertensive must have a diuretic component. Without diuretic component being incorporate into the pill it may not be as effective as you want it. So this is the advantage that most of our drugs have, they provide reduction in BP in addition they provide reduction in volume in water and thereby satisfy that condition in black hypertensive. So this is one advantage our drug has.

Besides hypertension, Neimeth has been celebrated in other areas especially in the area of sickle cell. I remember several years ago that the former Minister of Health, Prof. Eyitayo Lambo, launched your drug, Ciklavit, which was even endorsed by the WHO. How far with the development of the drug?

Ciklavit made from the extracts of the plant Cajanus cajan (Fio Fio in Ibo) is an herbal formulation used for the management of sickle cell anaemia. This is one drug that was started by Mazi Sam Ohuabunwa, the Founder of Neimeth and President/Chief Executive Officer. I will sustain that effort. One of the things he said and I will sustain is that we want to go into natural products. Neimeth has to be known for natural products and he wanted a situation where we carve out the niche, where we encourage Nigerian scientists who have developed some products and it is rusting on the shelves in their laboratory.

So what we did was just to bridge that gap. Take the product from the lab and bring it to the market. The journey so far has been so encouraging and we want to thank all the doctors, pharmacists, governments and Nigerians as a whole for encouraging us. One Ciklavit has received fast track approval all over Economic Community of West African States (ECOWAS) in terms of regulatory. Where ever we went they said, ‘whao this is from natural product, this is from food, it is food, this is unbelievable.’

We have been very much encourages and we have received regulatory approval not only in ECOWAS but also all over the world. Remember sickle cell condition is a black man condition so wherever you have black man they ask for this product and they are having it. Three is that we have also reduced the cost. We have improved our processes, reduced the cost and making it more available. When we look around we thank God because there is no product like Ciklavit right now all over the world that can do the same thing and is a natural product. There are lots of advantages for natural products in terms of side effects.

Fourthly is that we said this thing you have test it. We have tested it. The clinical trials have been done in five Nigerian universities and one in Ghana, Korle Bu Teaching Hospital. So the results are being compiled right now and I believe in the next few months we will be able to publish these results. We are also looking at product improvement, how can we make this product in a better way to make it more transportable, to make it more applicable because some adults may not like to take liquids while so do and apart from that what else can the product be used for. So this is a journey and we have spent a lot of money in the Research and Development (R & D) and we keep working at it. Neimeth is determined to keep working at R & D. The company of the future in pharmaceuticals is those who will choose to go through this long expensive route on local products, on R & D. This is what we are known for and we thank every Nigerian for this.

Is Ciklavit a cure for sickle cell?

No. It is not a cure.

So what does it do? Give an insight into the clinical trials?

There are about seven clear benefits. One, the product is amazing just like many natural products, which are made by God. I remember when Mazi, my boss, gave me this assignment; I went to Obafemi Awolowo University Ife, I saw Prof. Sofowora, I saw it was the same thing with this Orin Ata chewing stick (Fagara zanthoxyloides). Ciklavit has the same chemical constituents with Fagara zanthoxyloides. I now asked them, ‘is there anything in the world like this?’ They said, ‘no.’ what happens when people take Ciklavit is one, crisis frequency is reduced, sometimes is gone even when patients stop taking this product for three months. The crisis removal or going even lasts from three to six months.

Secondly, growth sprouts. Remember that children with sickle cell are stunted, not only in physical growth, but also in secondary sexual characteristics, puberty is denied them. So we noticed that when children take this drug they experience immediate growth sprout, they just grow like they are being stretched. Two, all those sexual characteristics begin to come.

Fourthly, is that they miss school and attendance in school suffers but on taking Ciklavit attendance in school improved, they grow very well and the stigma is reduced. Five, we also noticed that clinically the drug somehow according to the insight we have from the clinical trials is that it improved what the scientists called deformability. You know the standard Red Blood Cell (RBC) is elastic, it can weave through the capillary beds and can do that and come out but sickle celled RBC are not. This is what happens because the sickle cell RBC is not deformable that is why when it wants to go through there is go slow and there is back log and you see these crisis of pain, hypoxia, is a condition in which the body or a region of the body is deprived of adequate oxygen supply. What Ciklavit does is to increase the deformability or the elasticity of these very sickled RBCs and they can go through, go out and thereby there is no go slow, there is no pain, appetite improves, these are part of the things coming out from the clinical trials. By the time we pull it together we are going to make a proper publication on this.

Besides Ciklavit and hypertensive drugs, which other area is Neimeth working on?

We are also working on natural products. We have partnership with Intercedd Health Products (IHP), a prominent Nigerian company that focuses on development, marketing, and sales of herbal and natural products and services. We are working with them and we are looking at diabetes. We are also looking at erectile dysfunction. We are also working with Intercedd in promoting the overall health of the individual with immuno-improving agents.

We are also working on natural anti-malarial with another corporate international body, which I am sorry I cannot name because of competition. We are working and we will probably be the first to come out with these elements and we are being encouraged by the very rich history of Ciklavit being pioneers in this area. So we are working on that and we are also working on natural stress modifying agents. So these are areas and also natural appetite modulating to improve overall well being.

Another issue working against most Nigerian pharmaceutical companies is getting endorsement from international organisations like the WHO so that their drugs can be procured for international use. What are you doing to bring up Neimeth to this position?

We will have this endorsement from the clinical trials. Once we completed it that will also through a positive attraction to international bodies. Secondly, our international affiliation; as I said we are affiliated to Intercedd and other people. That affiliation will also open the doors for us in that area so far we maintain our Good Manufacturing Practice (GMP) in that area also built on our own rich history. You see the Chinese are able export their own products, Indians have exported their own products, why cant we? In Neimeth we believe in reversed innovation.

We are very happy no matter the little we are exporting to the United States and United Kingdom and ECOWAS. People are buying and no other product opens the door to us like that. So these are the encouragement. We believe with time not only will Nigerians buy Nigerian products; we will continue to export them. The fourth thing is that we are the only company that did a research on our Artemisinin-based Combination Therapy (ACT), NimARTEM, we researched it locally we are no longer importing it.

We formulated it; it took us time. We call NimARTEM, Neimeth Malaria Terminator. Others import, we didn’t. So each time you buy NimARTEM or any of our products, do you know what you are doing? You are helping keep Nigerians at work; you know the high level of unemployment. So we should promote our own, we should buy our own.

Are you saying that NimARTEM is from local plants?

No not from local plant. You know to make drug you need the formulation, you need the process, and you need how to combine them. ACT is from artemisinin but other people import from India, from China. We took the long approach. It took us time to come out but it is our formula, we make it here. It is easier to import.


[Source : allafrica]

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