Sickle Cell Burden and the Pharmacist

The tragic death of twin sisters, Dr. Hadiyah Usman Abdullahi and Pharmacist Aidah Usman Abdullahi, within 48 hours from sickle cell complications in Nguru, Yobe State, has again brought to the fore the heavy burden of sickle cell disease in Nigeria. That the daughters of a Medical Director, one a medical doctor and the other a pharmacist, could succumb to the disease underscores the severity of the challenge facing millions of families across the country.

The incident coincided with the commemoration of World Pharmacists Day on September 25, with the theme “Empowering Pharmacists for a Healthier Future.” The International Pharmaceutical Federation notes that empowerment entails equipping pharmacists with the competencies, recognition and enabling environment to respond to evolving health needs. In the Nigerian context, sickle cell disease provides a clear case for such empowerment.

Nigeria bears the highest global burden of sickle cell disease. According to the Federal Ministry of Health, about 25 percent of Nigerian adults carry the sickle cell trait, with an estimated 100,000 infant deaths annually from complications. The World Health Organisation estimated that 7.74 million people lived with the disease globally in 2021, with nearly 80 percent in sub-Saharan Africa. Its prevalence in malaria-endemic regions is linked to the partial protection conferred on carriers against severe malaria.

It is important to note that sickle cell disease is not without available interventions. The WHO recommends Hydroxyurea for children aged 9 months to 19 years to reduce painful crises and complications. Other proven measures include vaccination, penicillin prophylaxis, newborn screening, stroke-risk assessment and timely blood transfusion. The challenge for Nigeria, therefore, is not the absence of knowledge, but the gap in delivery.

This is where the role of pharmacists becomes critical. The WHO health systems framework emphasizes that medicines achieve desired outcomes only when the right medicine is given to the right patient at the right dose and time, with appropriate monitoring and adherence. Pharmacists occupy a central position in this chain. Evidence indicates that their involvement reduces medication errors, improves adherence, curbs antimicrobial resistance and prevents avoidable hospitalisations. In many underserved communities, pharmacists are often the first point of contact with the health system.

However, pharmacists in Nigeria remain largely underutilised. Issues of inadequate legislative backing, limited funding, weak integration into primary healthcare, substandard and falsified medicines, and low local manufacturing capacity continue to constrain their full contribution. While the Pharmaceutical Society of Nigeria marked World Pharmacists Day with health outreaches and public sensitisation, such efforts need to be complemented by systemic reforms.

The observation by Professor Musa Yerima, Professor of Ethnopharmacology, on the need to harness indigenous knowledge for local drug and vaccine development is instructive. Nigeria must build self-reliance in the production of medicines tailored to its peculiar health challenges.

The case of Niprisan is relevant. Developed by the National Institute for Pharmaceutical Research and Development from indigenous knowledge, scientifically validated and patented, Niprisan demonstrated potential in sickle cell management. Licensed to XeChem of the United States in 2002 as Nicosan in 2006, the product could not be sustained due to financing and production constraints. The lesson is not about the loss of intellectual property, but about Nigeria’s weak ecosystem for translating research into industrial and commercial output.

If the gains of World Pharmacists Day are to be meaningful, empowerment must go beyond rhetoric. The Federal Government, through the Federal Ministry of Health and Social Welfare, NAFDAC, NIPRD and other relevant agencies, must take deliberate steps.

First, newborn screening for sickle cell should be made a national policy and integrated into primary healthcare. Second, Hydroxyurea and other essential sickle cell medicines must be made available and affordable at primary health centres. Third, pharmacists must be fully integrated into the health system, particularly at the community level. Fourth, adequate funding must be provided to NIPRD and related institutions to revive local research and drive the next Niprisan from laboratory to market. Fifth, regulatory enforcement against falsified and substandard medicines must be strengthened.

Sickle cell disease should no longer claim the lives of young Nigerians, including health professionals, when proven interventions exist. What is required is political will, institutional support and sustained investment in the health value chain.

For us in Peoples Daily, the deaths in Nguru should serve as a call to action for a more responsive and resilient health system.