Neil, thank you for your reaction to the comments by other members like Massimo, on the important challenge of irrational prescribing, especially of antibiotics.
I say especially antibiotics because irrational prescribing extends to other medicines such as opiates! We read of the situation with opiate addiction in the USA and wonder how big the hidden health and socioeconomic challenges of opiate abuse and misuse is in LMICs, in particular what role it plays in the terrorism, banditry, domestic violence, and other aspects of the prevalent terror and insecurity in those countries.
Sorry, I digressed, but back to irrational prescribing per se. I submit that ‘profit motive’ is only a symptom of a bigger problem with health governance. I think that the major cause of the symptom is the failure / lack of regulation/ of implementation of the existing laws, enacted to control access to prescription-only-drugs, including antibiotics. The uncontrolled availability and access and therefore use of antibiotics, is what has led to abuse of antibiotics for profit!
And the failure to implement laws that control access and use of medicines, includes the lack of availability of accurate information to prescribers, users and families, generally.
Where there is effective control of drugs, including antibiotics, both prescribers and users are encouraged (or forced) to engage in rational use If all drugs.
Some people may still abuse any drug, even with the best laws, but their numbers will be limited to a small minority. The knowledge of the consequences, if caught, serves as a great deterrent!
HIFA profile: Joseph Ana is the Lead Consultant and Trainer at the Africa Centre for Clinical Governance Research and Patient Safety in Calabar, Nigeria, established by HRI Global (former HRIWA). In 2015 he won the NMA Award of Excellence for establishing 12-Pillar Clinical Governance, Quality and Safety initiative in Nigeria. He has been the pioneer Chairman of the Nigerian Medical Association (NMA) National Committee on Clinical Governance and Research since 2012. He is also Chairman of the Quality & Performance subcommittee of the Technical Working Group for the implementation of the Nigeria Health Act. He is a pioneer Trustee-Director of the NMF (Nigerian Medical Forum) which took the BMJ to West Africa in 1995. He is particularly interested in strengthening health systems for quality and safety in LMICs. He has written Five books on the 12-Pillar Clinical Governance for LMICs, including a TOOLS for Implementation. He established the Department of Clinical Governance, Servicom & e-health in the Cross River State Ministry of Health, Nigeria in 2007. Website: www.hri-global.org. Joseph is a member of the HIFA Steering Group and the HIFA working group on Community Health Workers.
Website: www.hri-global.com Joseph is a member of the HIFA Steering Group and the HIFA working group on Community Health Workers.
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