Adeyemi Adewole, Managing Director/CEO, Adcem Pharmaceuticals Limited, is a graduate of Ahmadu Bello University, Zaria, where he trained as a pharmacist. He has had an eventful career which began in Nigeria and later the Republic of Zimbabwe, where he worked as a Hospital Pharmacist, working closely with international development agencies, including Danish Development Agency, and as a clinical computer programmer in the United States of America. A life member of the Enterprise Development Centre at Pan African University, Lagos, a member of the governing board of General Hospital Lagos and a director of the TLP Centre for Autism and related disorders, Adewole speaks with Bukola Aroloye on the challenges of the healthcare hardware business and the need for more friendly policies towards the importation of medical equipment. Excerpts:
How did Adcem Pharmaceuticals Limited begin?
ADCEM Pharmaceuticals started in 1992 with the mission to dominate in a niche area where professionalism would make the difference. This was because the pharmaceutical industry was being represented by individuals and practices that were not very professional. I felt that to compete, I would have to find an area that was not saturated and that the barrier to entry would be a bit high. We commenced with parental nutrition and enteral nutrition – giving nutrition through the vessels and veins. It is a very specialised kind of pharmacy, not high volume, therefore not attractive, but also requires a lot of professional input.
Whilst researching on dialysis and kidney disease and discovering that services were inadequate, we partnered with Fresenius AG Germany (the company that we still work with today). They had both pharmaceutical and medical equipment divisions, mostly specialised in kidney diseases. As the company grew very rapidly in Germany, Fresenius bought another pharmaceutical company and became Fresenius Kabi. The medical equipment division then became Fresenius Medical Care. This is the company that manufactures dialysis machines.
For over 20 years, we have consolidated our mark in delivering quality services and providing sustainable solutions in the healthcare industry across the country to both public and private institutions. Our main area of operation, however, is in the provision and maintenance of state of the art renal care facilities; dialysis equipment, consumables, drugs and staff training, in a bid to consolidate our renal care service delivery. Other services we provide include blood expanders, cancer medication, vascular access implements and pneumatic tube systems. We are able to achieve these through our partnerships with Medcomp Inc, USA and Aerocom, Germany.
What are some of the major projects you’ve executed in Nigeria?
Through partnerships with corporate organisations, we have been able to execute a five-year turn-key and management service project with MTN Foundation, through which dialysis centres were established and managed in six geo-political zones in the country and the Heineken Africa Foundation HIV project, where a dedicated dialysis centre was established to cater for patients living with HIV and hepatitis infections. This centre is situated at the Lagos University Teaching Hospital.
What has been your personal experience operating in the Nigerian business environment?
It has its positives and negatives depending on where you are at a point in time. When you are a start-up, you find it very difficult to get the necessary support; but when you have developed a track record, things get easier. However, this is a very volatile business environment – you can imagine what we are going through right now, with the rapid decline in the value of the naira and foreign perception of risk in Nigeria.
As an entrepreneur, there must be some attributes a chief executive must have or lack which can determine the success or failure of a company in Nigeria. What are some of these qualities?
An entrepreneur in Nigeria has to be resilient and tenaciously strong in the face of multiple surprises and challenges. One needs to be strong as plans do not always go the way you envisage. You have to be a strong person. In Nigeria, you have to be extra-passionate and committed to your vision and goals, as a lot will happen to make you question your motives for going into the particular field you have chosen. I also believe one has to be forthright; do the right things and have integrity.
What are the major factors or challenges that militate against entrepreneurs in Nigeria?
Entrepreneurs in Nigeria have to deal with a host of problems. The first issue we have to contend with is lack of infrastructure (both physical and non-physical). We basically provide our businesses with the basic utilities needed to function. With non-physical infrastructure, I’m referring to access to financing or lines of credit; the human resources needed to get the job done efficiently and effectively.
What in your opinion is responsible for the spread of kidney diseases in Nigeria?
The major causes of kidney disease are hypertension and diabetes, which are described as silent killers because they typically do not warn you until they have progressed. Therefore, a lot of Nigerians suffer from these non-communicable diseases without being aware, especially because we do not have a regular check-up culture. These diseases have become more common due to lifestyle choices, whereby we eat less of fresh organic food and physical activity is on the decline. Other reasons could be abuse of pain killers and other non-conventional medication usually described as traditional medicine, which could be harmful to the kidney. The proliferation of skin bleaching/lightening cream use could also be responsible.
The theme of this year’s World Kidney Day is ‘Kidney Health for All’. How do we realise this?
I believe, through a lot of sustainable collaborations, this can be possible. Firstly, through the sensitisation and education of individuals with apparently healthy kidneys, in order to place them on the right track and to avoid future illnesses. Secondly, there is a need to ensure continuous professional development for medical personnel specialising in Nephrology. Thirdly, supporting the provision and establishment of renal care centres, subsidised/ free dialysis sessions (through reimbursement programmes) to enable people afford them. Fourthly, by reaching out to rural areas where people will not have access to the established centres and subsidised sessions.
Installation of the MTNF Haemodialysis Centres at public hospital locations across the country are among the projects Adcem has executed. Considering the high quality of these installations, do you employ the services of expatriates for their implementation?
In the early days when we started the business, we needed the expertise of our foreign technical partners in the installation of equipment. However, over the years, our technical team has been instructed and trained, which enable us carry out installations on our own. Furthermore, we continuously expose our technical staff to annual foreign and local training and support to keep them abreast of modern technology and global best practices. We did not get any foreign help to implement MTNF Haemodialysis Centres. We have very well-trained engineers who execute to the highest standards established by the original equipment manufacturers.
How do you ensure that the standards are maintained after you have handed over?
We ensure that the bio-medical technicians in the institutions where these machines were installed are trained regularly on the basics of equipment maintenance and management. We also provide online and offline technical support in form of planned preventive maintenance and ad-hoc repairs.
How did your partnership with MTN Foundation come about and how would you describe the journey so far?
We were approached by MTNF when the foundation wanted to set up centres around the country. We started the conversation, sent proposals and quotations to them concerning the establishment of dialysis centres. We also assisted in short listing beneficiary hospitals for the commencement of the project. So far, it has been an interesting and impactful journey.
How has this partnership with MTNF affected your business?
The partnership with MTNF has enabled us fulfil our mission and vision as an organisation one step closer. It has also given us more visibility as a business providing sustainable solutions in a niche market. Furthermore, we have benefitted from the accountability practices and guidelines required of a business partner to MTN Foundation. These practices have been a source of education to our staff.
How would you describe the efforts of MTNF’s role in renal failure and would you say the haemodialysis centres have made a significant impact in the lives of the people?
MTNF’s role has been immensely helpful in ensuring that renal failure is tackled in a sustainable manner. Their involvement and continuous monitoring of the project has ensured that more individuals have access to treatment through the provision of equipment and consumables.
In terms of impact, I will say highly significant! Using Alimosho, which is the centre with the highest traffic as an example, the centre is being used to its full capacity as patients no longer need to travel so far for a service they are required to access three times a week. They are also used as screening points and providing awareness. In terms of the actual treatment and awareness creation, these centres have been of tremendous impact. From time to time, MTNF actually organises these outreach events where people are screened free of charge and so I would say the impact is very tremendous.
Access to haemodialysis centres is still a big challenge. How can we overcome the gaps?
We can overcome the gaps by having more centres being established through support from both the government and corporate organisations such as MTNF. Also establishing innovative practices such as mobile clinics which will carry out dialysis in remote locations will definitely solve the problem of access to centres and equipment.
What are the most memorable stories of survivors that you would like to share with us?
Patients at the centres mostly talk about the affordability of the sessions and how pleased they are on the accessibility of the centres. The improvements of their physical conditions after undergoing dialysis at the MTNF centres is also another source of joy to them.
How would you assess the contributions of the MTNF to the health sector in its 10 years of operation?
MTNF has contributed immensely to the health sector in Nigeria and it must be commended. Over the years, the foundation has positively affected various aspects of the health environment, through a lot of programmes: its medical intervention scheme, sickle cell project, medical support project (haemodialysis and mammography centres), Y’ello Doctor mobile medical intervention scheme, eyesight restoration and its work on AIDS and malaria. With this, one can see how the organisation, through partnerships, has succeeded in creating measurable impact in a sector that needs a lot of attention.
What is your advice for other organisations?
I will advise other organisations to look beyond the financial benefits of being in business and focus on the social benefits instead, because in the long run, the economic rewards will come. In addition, to be a successful organisation, you need a strong and dynamic team. Therefore, there is a need to get human resources right and invest in your staff. At ADCEM, we focus on continuous professional development.
Leadership is imperative; you need to be the embodiment of the ethics and values you wish to promote throughout the organisation. This is the only way you can get your staff to buy into the vision of the company. Finally, organisations need to communicate with each other, share ideas and collaborate to take on projects that will create impact. No one can do all things on their own; partnerships are very important for business success.
