Delay in releasing the National Essential Medicines List is holding states back from going ahead to procure amoxicillin dispersible tablets (AMX DT) to treat pneumonia, a disease which kills nearly 146,000 children aged under five years annually.
The antibiotic amoxicillin dispersible tablet has been recommended in guidelines by the World Health Organisation, United Nations Children’s Fund, Paediatric Association of Nigeria as first-line treatment for childhood pneumonia.
It is also on the federal health ministry’s Essential Medicines List (EML), but the launch of the document earlier expected this November has stalled since last year, Daily Trust learnt.
Officials in the federal health ministry suggest funding is a crucial drawback, and are looking to civil society groups to help fund the document’s launch.
Without the launch and dissemination to states, state governments cannot procure AMX DT for use in any health facility, and are forbidden for procuring medicines outside the national EML or an individual EML based on the federal version.
Rolling out
The Pharmaceutical Society of Nigeria, which leads efforts in pneumonia and diarrhoea treatment under the aegis of the Partnership for Advocacy in Child and Family Health (PACFaH), called on the federal health ministry to implement the roll-out of AMX DX in full to enable use of the tablets, especially at community level where burden of pneumonia.
“Implementation of this recommendation is a vital step towards total eradication of childhood pneumonia death in Nigeria,” said Remi Adeseun, programme director for strategy at PSN-PACFaH.
PACFaH’s call to give childhood pneumonia more priority comes amidst events to mark the World Pneumonia Day on November 12, calling for a stop to the disease by mainstreaming it in national health planning.
“More attention or focus should now be extended to pneumonia and diarrhoea eradication interventions in Nigeria,” said Adeseun.
“Pneumonia mortality rate is increasing by the day. The figures are alarming. It is time to mainstream Pneumonia in our National Health Planning.”
14 in 100 deaths
It is estimated pneumonia alone kills more children yearly than HIV/AIDS, malaria and measles combined, and accounts for up to 14 out of every 100 deaths among children aged less than five, according to the National Demographic Health Survey.
A pilot study by the project Expanded Social Marketing Project in Nigeria used patent medicine vendors in two local governments in Ebonyi to treat more than 2,500 children for pneumonia and over 8,000 for diarrhoea between November 2015 and June this year, according to Boladale Akin-Kolapo, deputy chief of party for the project run by the Society for Family Health.
Patent medicine vendors are in line to be trained by their regulator Pharmacists Council of Nigeria, but the council cannot add AMX DT to its list until it is approved by its board, which has been dissolved along with governing boards of other health regulating agencies.
Without a national EML that includes AMX DT, states cannot adopt the antibiotic. Treatment of pneumonia currently is by use of amoxicillin in regular tablets or suspension, said Dr Eno Ekop, of the Paediatric Association of Nigeria.
Suspensions can only stand for a number of days before becoming unusable, and tablets have to be broken, crushed and watered before it is given to children, leading to wastage and increasing expense.
But dispersible tablets are formulated to dissolve in water or breast milk and fed directly to even babies, Ekop noted.
Credit: dailytrust