The Association of Community Pharmacists of Nigeria (ACPN) has issued a pointed response to recent remarks by the National Association of Resident Doctors (NARD), reigniting the long-standing debate over healthcare leadership and professional autonomy in Nigeria.
In a detailed statement signed by its National Chairman, Pharm. Ambrose Ezeh, the ACPN addressed two major issues raised by NARD: the effectiveness of physician-led leadership in hospitals and the claim that doctors do not interfere with the roles of other health professionals.
While acknowledging the importance of professional dialogue, the ACPN stressed that healthcare administration should be a specialized and autonomous profession. It blamed the current challenges in the health sector on a 1985 policy shift—specifically the enactment of Decree 10—which mandated that only physicians can head Federal Health Institutions (FHIs). According to the association, this change marked the beginning of widespread inefficiency and corruption in hospital administration.
“Prior to 1985, hospital systems in Nigeria functioned with more efficiency and decorum under trained professional administrators,” the statement noted. “Since the takeover by physicians, the system has witnessed unprecedented levels of dysfunction and mismanagement.”
Citing various media and investigative reports, the ACPN alleged that the health sector, under physician-dominated leadership, has become the most corrupt segment of the national economy. It referenced multiple corruption scandals involving high-ranking physician administrators, including ministers and medical directors, some of whom have been implicated in the misappropriation of funds designated for essential health services.
The association further revealed that the sector is now indebted to pharmaceutical suppliers to the tune of over ₦30 billion, attributing this to poor financial oversight and a disregard for effective supply chain management.
Beyond allegations of corruption, the ACPN criticized what it described as a lack of administrative competence among physician leaders. It argued that most physicians appointed to managerial roles lack training in communication, strategic planning, and modern healthcare management—skills the association considers critical to running efficient health facilities.
“The absence of these skills continues to weaken public healthcare delivery, and this is reflected in Nigeria’s worsening health indicators—particularly high rates of maternal and infant mortality,” the statement read.
On the claim by NARD that physicians do not interfere in the affairs of other health professionals, the ACPN pushed back, citing opposition to the Consultant Pharmacist Cadre and other collaborative healthcare reforms as evidence of continued marginalization.
“Physicians have historically resisted the elevation of other professionals within the healthcare hierarchy. This culture of exclusion hampers progress and teamwork,” the association said.
The ACPN concluded its response with a call for sweeping reforms across the healthcare system. It advocated for a governance model that aligns with global best practices—one that values the expertise of all healthcare professionals and promotes inter-professional collaboration.
“To achieve a functional, equitable, and people-centered health system, Nigeria must end the era of physician-only leadership and embrace comprehensive reform,” the ACPN stated.
The debate highlights broader tensions in Nigeria’s multi-professional health system, where calls for inclusivity and reform continue to challenge entrenched administrative norms.