A lot of fake products abound in the Nigerian markets. Fake cosmetics, fake electrical appliances, fake canned food, fake spare parts, fake drugs, fake designer shoes and clothing- the list is literally endless. It is just about a fake of everything you can think of. However, with fake drugs, the effect can be so far-reaching because it is a matter of life and death.
The simplest scenario depicting this was a sad event which occurred in 1995. An asthmatic purchased a fake inhaler and when she had an attack, she simply reached for the inhaler she carried everywhere with her. It was no use. She boarded a bike to the nearest hospital for medical assistance. She passed out on the steps of the hospital and never regained consciousness. A fake drug and not the asthma was her Waterloo. Like her, many have died from the scourge of fake drugs in this country.
Enter Dora Akunyili who is best remembered for her work in the National Agency For Food, Drug Administration and Control, NAFDAC. The agency came into the consciousness of Nigerians when she took over the helm of affairs. With some cooperation, the quantity of fake drugs in the Nigerian market was reduced drastically. Her efforts led to increased public awareness about counterfeit drugs and tougher surveillance by the Nigerian Customs. At the height of her battle, fake drugs worth about N2 billion (US $16 million) were voluntarily handed over by counterfeiters or seized after tip-offs from the public.
What is happening now? The truth is that there is a resurgence of fake drugs. Why? Is it that the importers and manufacturers of counterfeit drugs have found new ways of beating the mechanisms put in place to crack down on the illegal trade? Or has the corruption, which Akunyili said had been the bane of NAFDAC, returned? Has the surveillance at the sea and airports been relaxed? Do the inspections which led to surrender of fake drugs, arrest of counterfeiters and shopkeepers still take place? What about the legislation that should support efforts which are already in place?
Or is it a combination of all these factors? Nothing can be quite as disheartening to agents as risking their lives to gather information, arresting culprits and in no distant time, see them walk free and in some cases, have enough information to threaten their lives. No worse morale killer. The penalty for fake drug producer or importer ranges from paltry fines to between three months to five years imprisonment. That is preposterous for the billions they make, the hardships suffered and the lives lost. It was good news to read in the papers recently that an importer of fake drugs was apprehended. A big fish going by the worth of seized goods worth about a billion naira or more.
However, how will the story end? What of his collaborators within and outside the country? The fake drug business is worth billions of US dollars and is a powerful international cartel. Unfortunately, Nigeria – in fact many African countries – are where they are able to do their dirty business (in collusion with people of that country) and get away with it. It is clear that counterfeit drugs are more of our problem than it can ever be for any Western nation. This is a battle we must fight ourselves. Appropriate legislation should be put in place. Our lives are at stake. No one is immune.
NAFDAC and other agencies cannot do it alone without the necessary backing and political will. Enabling environment and active wooing of multi-national drug companies to encourage them to establish their factories within the shores of our country should be made a priority.
The sheer volume of drugs we import from them is the bait. These companies establishing in Nigeria will serve more than one purpose: the monitoring agencies will be able to monitor their production processes and ensure that adequate standards are maintained. This is currently an uphill task where what is produced in far-away Asian countries can hardly be monitored by our regulatory agencies. In addition, badly needed jobs for our teeming unemployed youths will be provided. Also, they will bring in their resources to fight counterfeiting of their products so they can make profit. Our local manufacturers should be greatly encouraged.
More quality drugs can be produced by them with government support. Even when we eventually succeed in getting these foreign pharmaceutical giants to come to establish, protecting their interests jealously is very important.
Funding research in the use of our rich diverse local flora as raw materials to make our own drugs ought to be highly encouraged and promoted. This is a goldmine yet to be tapped. We should begin to look inwards so that over time, the tide will change in our favour.
In addition to these relatively long term plans, it is critical that something should be done now. Relatively mild ailments are no longer easy to treat. The experiences of physicians around me tell a whole lot. My experiences and those of friends where relatively mild ailments need trial of drugs from different drug outlets before one gets ‘lucky’ and gets an original product is disheartening.
In the past few months, for a relatively healthy individual, I have had quite a few experiences with counterfeit drugs that I am left pondering: If I have had as much exposure, how about those who are sick and literally depend on drugs to survive? Antibiotics don’t work; a cocktail of antibiotics is used to treat patients thereby encouraging antibiotic resistance; wounds and ulcers remain unhealed, compounding the misery of sick, suffering Nigerians while draining their pockets of scarce resources. Efforts of health care providers are frustrated, making a mockery of diagnostic efforts. How and when will this end? Who will deliver us?
Dr. Chukwuanukwu is a lecturer at Nnamdi Azikiwe University, Awka.
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