Dr Daniella  Munene is CEO, Pharmaceutical Association of Kenya (PSK). She spoke to The Nairobian about the popularity of digital chemists and why the cost of the same drug differs.

Has the ministry of Health roped you into the distribution of Covid-19 vaccines?

 Yes, they have divulged the road map of Covid-19 vaccine distribution to us and other health sector stakeholders. We are well prepared to handle the task of distribution across the country.

The bulk of drugs in Kenya are from India which has a Covid-19 vaccine but we are sourcing from Europe. Any reasons?

Kenya is open to sourcing the vaccine from the WHO COVAX (Vaccine Global Access) facility, as well as from authorised manufacturers with approved vaccines. We are not limited to any geographical boundaries. The sourcing from Europe is because their manufacturers have been approved by the relevant global bodies, unlike India.

 How did the Corona pandemic affect pharmacies?

 The pandemic resulted in a drop in walk-in clients but an increase in demand for digital pharmacy services. Therefore, there has been a loss of customers for physical stores but a gain for online stores.

 Kenyans might find themselves buying fake Covid-19 vaccines…

I don’t think so. There is no vaccine that has been authorised in Kenya from unapproved sources, so it will be hard for fake vaccine to penetrate through.  

 Why is it hard to eradicate unscrupulous pharmaceutical dealers?
The government and our regulatory authorities have done a good job in ensuring rogue dealers are eliminated. As of now, approval of imports is done online on a portal with multiple government agencies taking responsibility. This eliminates  dealers using shortcuts to get through the approval process.

 How do you deal with pharmacists who are prone to selling prescription drugs?

 PSK has a mechanism for handling professional misconduct reported to us. Once such a dealer is caught, he or she has to face to disciplinary action, including the license being revoked.

 Why are drug prices not standardised?

 The regulations have not spelled price ceilings, therefore, it is still a free market.  However, there have been proposals to implement price controls and that is being considered. Sooner or later, prices of pharmaceutical products will be standardised.

 Drugs like Hydroxline, Aspirin and Paracetamol were in high demand during Covid lock downs. How did you educate the public on their efficacy? 

We have a robust public education process through various media. During this pandemic, we released numerous advisories to the public on rational use of medicines through mainstream media, social media and even public engagements.

 Like car washes, there are chemists everywhere. What makes it a lucrative business? 

I can’t say it is a lucrative business per se but everyone has a right to start a business of their choice, as long it is legal.

Some Kenyans treat chemists like medical clinics yet pharmacists are not doctors, but just play along… 

 I disagree. Pharmacists are doctors of pharmacy. Our expertise is one; to educate the health seeker on the best way to take their medicines to achieve intended outcomes, two; to participate in treatment plans, three; to monitor patients for medicine related effects and four; to ensure quality and compliance of the medicines supply chain. We are well trained to identify complaints and symptoms that need referral to a medical practitioner.

 Some chemist owners are merely former nurses who know a lot about drugs. How do you weed out quacks?

PSK is a self-regulating body that only recognises legally registered pharmacies. Members of the public are advised to use the Health Safety Code that is conspicuously displayed in legal pharmacies and use the SMS short code to check the authenticity of the outlet. They should not patronise any outlet without a Health Safety Code from the Pharmacy and Poisons Board.

 What are some of the greatest achievements of your organisation?

We have developed and published a code of ethics to which our members subscribe. This has helped in reducing pharmaceutical malpractices to a significant level.  We have an internationally recognised peer reviewed journal - the Pharmaceutical Journal of Kenya; besides, successfully holding scientific conferences each year.

 Some herbal medicines seem to work for certain ailments… 

You are right. Many herbs contain medicinal substances and are, therefore, approved to be taken as general body tonics. A pharmacist will advise you about herb-drug interactions and which herbs should not be taken with which drugs. All herbal products must be labelled with their ingredients, must be registered by the Pharmacy and Poisons Board and must not have claims of treating diseases. 

 Most families treat salt like medicine for stomachaches…is it mere belief or how does it work?

This is an unfounded claim. Stomachache has many causes, and specific treatment depends on the cause. Therefore, it is always a good idea for the patient to consult a professional.

 One drug brand for treating uric acid costs Sh5,000 and another Sh900…but chemists always dish out the most expensive first. Is greed good? 

Choice of drug dispensed depends on the brand specified on the prescription, the preference of the customer and its availability at the pharmacy. A pharmacist will discuss all the options to ensure the customer gets the correct product they can afford. This is called substitution, which when done by a qualified pharmacist ensures the patient gets a product that is exactly what is prescribed. 

 Drug distribution has gone online. What are the pros and cons?   

Online pharmacy is convenient to clients. On the other hand, it presents a challenge to the regulator as it is more difficult to inspect for compliance to standards. This can be overcome by developing stringent regulations for online pharmacies.

 What cultural barriers have you witnessed with different communities in relation to medicine?

Contraceptives, for instance, are more readily embraced by urban populations than by rural communities.

 Your organisation is over 56 years old but you don’t seem to be well known among many Kenyans, how come? 

We are a professional society that has a three-fold mandate - to advocate for better pharmaceutical policies in the health sector, to promote the ethical practice of pharmacy and to look after the welfare of our members. Our engagements are, therefore, predominantly to health sector stakeholders such as policy makers, regulators, pharmacies, academia and our members.

 You have the “Green Cross Charter”, which is a quality standard for all pharmacists. Aren’t you duplicating the role of the Pharmacy and Poisons Board in accrediting and certifying pharmacists?

 Ethics supersedes law. The law sets minimum standards of behaviour while ethics sets maximum attainable standards. Green Cross standards provide for best attainable pharmacy practice for safeguarding patient rights, patient safety and product quality. 

 Majority of staff at your secretariat are women, any specific reason?

This is merely a coincidence but they are doing a good job. We are an equal opportunity employer.