The silent crisis in public health: When medicines are available but ineffective

Nigeria’s health system focuses heavily on ensuring medicines are available in facilities, but a deeper crisis exists: many stocked drugs fail to deliver intended results for patients. Toyin Opeyemi Abobade, Deputy Director of Pharmaceutical Services at the Lagos State Health Service Commission, has spent 15 years addressing this gap, overseeing pharmacovigilance, drug interactions, and patient adherence across public health facilities. The issue spans multiple stages of pharmaceutical care. Prescriptions without proper counseling reduce correct medication use, undetected drug interactions can worsen conditions, and poor storage conditions degrade potency before drugs reach patients. These problems persist due to underfunded systems and overwhelmed healthcare infrastructure, despite efforts to stock essential medicines. Abobade’s career progression—from staff pharmacist to Deputy Director—reflects a focus on solving practical challenges in pharmaceutical care, not just policy. Her work emphasizes the need for pharmacists to intervene at every stage, from prescription to adherence, rather than treating pharmaceutical care as a mere logistics function. The conversation in Nigeria’s health sector must shift from stock availability to effectiveness: how many medicines work as intended, for which patients, and why. Closing this gap requires institutional expertise like Abobade’s and a health system willing to prioritize pharmaceutical care as a discipline. Current efforts often stop at ensuring shelves are stocked, but the real crisis lies in the discrepancy between availability and outcomes. Addressing this demands systemic reforms, stronger pharmacovigilance, and empowering healthcare professionals to bridge the gap between policy and patient recovery.