The Association of Community Pharmacists of Nigeria (ACPN) has urged President Bola Tinubu to approve the immediate nationwide implementation of a ‘Pharmacy First’ protocol to enable community pharmacies to identify suspected Ebola cases early and strengthen Nigeria’s preparedness for infectious disease outbreaks.

The association warned that excluding community pharmacies from the country’s frontline disease surveillance system could expose healthcare workers, patients and the wider population to avoidable risks, particularly if suspected cases are first identified in crowded secondary and tertiary hospitals.

In a position statement issued after a press conference and signed by its National Chairman, Pharm. Ezeh Ambrose, the ACPN called on the Federal Government to issue an executive directive integrating community pharmacies into Nigeria’s epidemic preparedness and primary healthcare frameworks.

The association said the proposed protocol could leverage the widespread presence of community pharmacies across the country’s 774 local government areas to improve early symptom recognition, facilitate prompt referrals and strengthen grassroots disease surveillance.

It added that the initiative could bring essential healthcare services closer to communities, particularly in areas where access to conventional healthcare facilities remains limited.

“We consider it necessary to sensitise and mobilise the Federal Government to approve specific investment plans to leverage the Pharmacy First Initiative as a front-line Ebola detection protocol, which stands as one of the best mechanisms to catalyse Universal Health Coverage (UHC) in Nigeria,” the statement read.

According to the ACPN, the initiative would expand the role of community pharmacies beyond dispensing medicines to include early symptom recognition, health education, basic screening and prompt referral of individuals presenting with symptoms suggestive of Ebola and other infectious diseases.

It explained that properly structured community pharmacies could serve as accessible first-contact points, helping to identify suspected cases and direct individuals to designated health facilities for appropriate assessment and testing.

The association also said integrating pharmacies into the national surveillance system could strengthen referral pathways, support contact-tracing efforts and ensure that individuals suspected of having highly infectious diseases receive timely guidance on appropriate isolation and further medical evaluation. Such an arrangement, it argued, would help minimise unnecessary exposure in crowded hospital settings and reduce pressure on secondary and tertiary healthcare facilities.

At the centre of strategising for epidemic response and Universal Health Coverage, governments at all levels must structure community pharmacies to provide first-line Ebola screening and Primary Health Care services through better access to essential drugs and management of uncomplicated diseases, which ultimately reduces the burden of services on secondary and tertiary health facilities

— the association stated.

Calls for Immediate Implementation

Making a case for urgent government action, Pharm. Ezeh warned that delays in establishing an effective grassroots surveillance mechanism could undermine efforts to contain outbreaks before they spread.

He argued that community pharmacies, because of their accessibility and regular interaction with residents, could help bridge the gap between communities and the country’s formal healthcare system.

We cannot afford to repeat past missteps where delayed grassroots surveillance allowed outbreaks to spiral out of control. If the Federal Government fails to integrate community pharmacies into this primary protocol, our major hospitals will inevitably become ground zero for cross-infection, overwhelmed before an outbreak is even fully mapped. Leaving community pharmacies out of the first line of defence is not just a missed opportunity; it is an unacceptable hazard to national health security,

— he said.

The ACPN chairman urged President Tinubu to issue an executive directive to facilitate the immediate rollout of the protocol, maintaining that the existing community pharmacy network could provide a foundation for rapid implementation.

“Every day of delay places an unnecessary burden on our tertiary hospitals and leaves millions of Nigerians without accessible early detection. Community pharmacies are already fully staffed, equipped, and embedded across all 774 Local Government Areas. We require zero infrastructure expenditure from the government to deploy this immediately. We urge President Bola Tinubu to issue the enabling policy directive today, and our national network will activate the ‘Pharmacy First’ screening protocol within 48 hours,”

— Pharm. Ezeh

ACPN Identifies Gaps in Epidemic Preparedness

Beyond the proposed Ebola detection protocol, the association identified persistent gaps in policy leadership, digital integration, evidence generation, quality improvement and collaboration among healthcare professionals as major obstacles to Nigeria’s epidemic preparedness and response.

To address these challenges, it proposed a five-point reform framework focused on establishing a unified vision for epidemic preparedness, improving clinical quality and public trust, integrating digital technology and data-driven surveillance into routine pharmacy practice, strengthening collaboration with primary healthcare centres, and building effective partnerships with health insurance providers.

The ACPN also called for standardised reporting systems through which community pharmacies could transmit relevant surveillance data to national health databases.

It said timely access to such information would enable public health authorities to monitor disease patterns, identify potential outbreaks and respond more effectively to emerging health threats.

Citing international experiences, the association noted that community pharmacy networks had helped maintain access to essential healthcare services and support frontline clinical activities during public health emergencies.

It referenced the United Kingdom as an example of a health system where community pharmacies had played an important role in sustaining access to care during disruptions to conventional medical services.

The association maintained that deeper integration of community pharmacies into Nigeria’s primary healthcare system would improve access to essential services and strengthen the country’s capacity to respond to public health emergencies.

Pharmacists Urged to Upgrade Facilities

While calling for government support, the ACPN also urged community pharmacists nationwide to improve operational standards, embrace modern practice models and invest in facility upgrades to meet their expanding public health responsibilities.

“In view of changing times, Community Pharmacists must respond accordingly to explore investment opportunities with free funds to achieve the goals of Good Pharmacy Practice (GPP) in the realistic interest of patients,”

— the statement added.

The association stressed that successful implementation of the initiative would require clear clinical guidelines, standardised referral procedures, effective surveillance protocols and coordination mechanisms to guide pharmacists in identifying and reporting suspected cases.

It therefore called on the Tinubu administration and the Federal Ministry of Health to establish a joint task force to develop and formalise the framework, ensuring that community pharmacies operate within clearly defined professional and public health standards.

For the ACPN, the proposed ‘Pharmacy First’ protocol represents an opportunity to extend Nigeria’s frontline epidemic response beyond hospitals to neighbourhood pharmacies that millions of citizens already visit for healthcare advice and essential medicines.

The association argued that, with appropriate government backing, professional oversight and integration into the national disease surveillance system, community pharmacies could become a critical link between grassroots communities and the country’s wider epidemic response network.