•Can lead to patient’s death, experts warn
By Doris Obinna
Medical device providers under the Hospital Equipment and Medical Device Providers Association of Nigeria (HEMDPAN) have expressed worry over high cost of medical devices in the country with regards to patients safety in the health industry.
• Nwankwo (4th left) Falaki (6th left); Omotseye (5th right) and others.
These worries were the highlights at the recent association’s Annual General Meeting (AGM) at the Sickle Cell Centre, Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos.
The theme of this year’s AGM; “Patient Safety: The role of healthcare equipment providers.” The aim according to the National President, Dr. Ifeanyi Nwankwo, highlights the critical role and the position of the providers of healthcare equipment in the healthcare value chain.
“Some of us do not appreciate the core value of our services to the care of patients. The safety of the patient in a hospital is dependent on some critical factors including; quality of the environment, training of the clinical staff, and quality of the equipment and government regulatory policies.”
According to him, quality of healthcare equipment as it affects safety of the patient is very important such that every provider of medical equipment must understand the value of services to the safety of the patient and not place money or profit over and above human life.
Potential risk
Nwankwo stated that fake or substandard medical devices could mislead the doctor, which can worsen the patient’s condition or even kill the patient. “We owe it as a duty and responsibility to our conscience not to expose the patient directly or indirectly to a greater risk by providing inferior products to the caregivers.
“And so, our pledge to the nation should be our watchword at all times irrespective of whatever any other person is doing. Don’t forget that everyone is a potential patient.”
Nwankwo added that some of federal government regulatory policies fail to focus on patients’ safety. “Some of these policies lay much emphasis on revenue generation, as against affordability and patient’s safety.”
Sighting high cost of good manufacturing practice (GMP) by National Agency for Food and Drug Administration and Control (NAFDAC), Nwankwo disclosed, has consequently encouraged sharp practices in the industry which ultimately compromises the safety of the patient as well as so much increased the landing cost of these medical devices making it quite exorbitant and unaffordable for patients and healthcare institutions.
“Most hospital cannot afford basic diagnostic devices including government health institutions, hence, the issue of medical tourism and the emigration of our trained medical personnel. Government should make the process of product registration easy, simple and affordable to encourage due diligence and discourage sharp practices and importation of inferior products.
“Also, policy on syringes is meant to encourage local manufacturing but the 60 per cent rate is too high. The capacity of local production is still far less than 50 per cent of the national demand. Syringes are n essential commodity in the primary healthcare, some hospitals, especially in the rural areas are now reusing syringes due to the high cost and patients’ inability to pay high bills.
“This practice is very dangerous to the safety of the patient and the society because it encourages spread of infectious disease. What government should do is to start with the rates of 20 to 25 per cent levy on imported syringes and increase gradually as the local capacity increases to ensure availability, affordability and safety of patients.
Role of HEMDPAN/Challenges
Highlighting some of the challenges faced by HEMDPAN, Prof. Auwal Abubakar, from the division of Paediatric Surgery, Modibbo Adama University Teaching Hospital, Yola, Adamawa State, revealed and alarming statistics.
According to him, one in 10 patients presenting to a health facility is harmed, with more than 50 per cent of these cases being preventable. He said approximately 43 million patient safety incidents are reported every year, leading to three million deaths annually. “In low-to-middle-income countries, as many as four in 100 people die from unsafe care.
“One in 20 patients are harmed due to preventable causes with about 43 million patient safety incidents are reported every year. Three million deaths occur yearly due to unsafe care. Patients’ harm potentially reduces economic growth by 0.7 per cent per year.
“Investments in reducing patient harm will lead to significant financial savings and economic growth. World Health Organisation (WHO) recognises patient safety as a global health Priority. Patient safety is recognised as an essential component of strengthening health systems.”
Vice Chairman of the Board of Trustees (BoT), Clare Omotseye, discussing the ‘Strategic role of healthcare equipment providers in the healthcare industry and its challenges in Nigeria,’ reiterated the need for better access to quality healthcare for Nigerian patients
Omotseye, who is also a pharmacist, identified the barriers to entry, including the high cost of medical equipment, tools, and consumables. She urged for streamlined regulations to reduce the burden of multiple taxes and tariffs imposed on medical equipment importation.
She highlighted the challenges faced by the association, which include; high government fees Nigerian Nuclear Regulatory Authority (NNRA), supply chain disruptions, regulatory hurdles, legislative gaps, funding and forex issues.
“Others are; equipment standards, ISO certification bottlenecks, Original Equipment Manufacturer (OEM) challenges, technology and innovation barriers, contractual complexities, importation complexities and timelines, duties and tariffs, training gaps, and technology adoption barriers. The NNRA is the government entity responsible for nuclear safety and radiological protection regulation in Nigeria.”
Barriers to patients’ safety
Omotseye said: “What we want to be able to do is to have better access to quality healthcare for Nigerian patients and one of the barriers to entry to access is the cost of medical equipment tools consumables, we are looking for ways to lower the barrier to entry and reduce some of the multiple taxation that are on medical equipment. We see that there are a lot of tariffs for importation, from NNRA, NAFDAC and Standards Organisation of Nigeria (SON).
“By the time you add all these together, it adds to the cost of very important life-saving equipment, so we are looking for one way in which we can one single corridor like a desk within either the ministry of finance or ministry of health that would be able to do all various regulation that concerns the importation and maintenance of medical equipment in Nigeria.”
The BoT Chairman, Mustapha Falaki, added that, the challenges faced by the industry are mainly due to the heavy reliance on the dollar, as almost 100 per cent of all medical devices are imported.
He urged the government to take measures to mitigate the impact of the rising dollar on service delivery and emphasised the importance of prioritising quality over price when it comes to medical devices.
He stated, “I solicit the public to understand that when it comes to medical devices it is not an issue of price, it is an issue of quality, people have to stop thinking of the cheapest medical devices, people should start thinking of the most qualitative devices”. He therefore urged the government to take steps to cushion the effect of the rising dollar on service delivery.