/ 27 November 2003

Fake medicines pose risk to Nigerians

For an insight into how fake drugs affect the lives of ordinary Nigerians, look no further than the Ajibade household.

Alice Ajibade, a retired nurse in the Lagos State Ministry of Health, recently sent her servant to buy medicine for her week-old grandchild. After taking a close look at the label on the syrup, Ajibade concluded that the medicine was fake.

”I personally took the drug back to the chemist, who told me that he does not have the original,” she said.

”After going round the whole area, I finally got the original from a chemist I did not even expect — it being a smaller and almost abandoned shop.”

Ajibade knows that she was one of the lucky ones. ”The medicine would have been administered to the poor girl, and only God knows what would have happened … Innocent people (can be) killed by the … fake and adulterated drugs being sold all over the place.”

Even under the watchful eyes of doctors, Nigerians have died or had their illnesses worsened by taking fake products. Towards the middle of this year, two children died when they were given such medicines after undergoing heart surgery at the University Teaching Hospital in Enugu, eastern Nigeria.

To date, 17 drug outlets in the city have been sealed by the National Agency for Food and Drug Administration Control (Nafdac) after its investigations showed that most pharmacies in Enugu State were buying drugs from unregistered sources.

However, drugs store owners believe importers should take the blame. ”If the importer does not bring them in, those selling them will not put them on their shelves,” said David Gabriel, managing director of Dogab Pharmacy in Lagos, Nigeria’s commercial capital.

”But because of the economic situation of Nigeria, everybody likes looking for cheap items whether they are genuine or fake, harmful or not,” he said. Dogab Pharmacy was closed three times by the Ministry of Health before Gabriel decided to employ two people whose job it is to supervise the purchase of drugs.

In a bid to end the import of fake products to Nigeria, Nafdac has given importers of pharmaceuticals 10 years to begin local production of these medicines. Failure to do so will result in the importers being deregistered.

The only products exempted from this ruling are the so-called ”orphan drugs”, medicines that are needed in small quantities to treat illnesses like cancer.

Dora Akunyili, director general of Nafdac, said importers must also insist that the firms they import from place Nafdac registration numbers on the packaging of their products.

”From January next year, any product that is imported without … [a] registration number on the packaging will be destroyed,” notes Akunyili, adding that the agency will not bother with testing the drugs to see whether they are genuine.

Nafdac has set the end of 2004 as a deadline for eradicating fake drugs in Nigeria. Counterfeit medicines were first noticed in the West African country in 1968, but the problem reached alarming proportions when government started issuing licenses to virtually all people who claimed an interest in importing drugs.

The trend has priced some legitimate products out of the market, prompting several local and international manufacturers of these drugs to shut their doors.

”Most of our local pharmaceutical industries that are producing genuine drugs, employing labour and boosting our economy, could not break even,” said Akunyili.

This was because of ”unfair competition with drug fakers who are only paying for packaging and probably freighting … [not] active ingredients, which are the most expensive components of a drug,” she added.

Akunyili says fake products have eroded public confidence in the health care delivery system. As part of efforts to check the import of fake and adulterated drugs into Nigeria, Nafdac officials have been stationed at ports, airports and border posts. This surveillance paid off recently, when the agency intercepted fake drugs worth about $70 000 at the Murtala Muhammed International Airport in Lagos.

Between April 2001 and October this year, the agency has carried out 70 exercises to destroy counterfeit products, valued at about $43-million.

Nafdac’s reforms appear to have boosted confidence in the legitimate drugs that continue to be produced in Nigeria.

”Ghana and Sierra Leone, which banned made-in-Nigeria drugs in their countries have lifted (this) ban,” said Dioka Ejionueme, director of enforcement at the agency.

”Some of the big international drugs firms which closed shop due to unfavourable competition by fake drugs are now coming back,” he said.

The World Health Organisation says the manufacture of fake drugs is on the increase, and that these account for up to 25% of medicines consumed in developing nations. The products are often used to treat life-threatening conditions such as malaria, tuberculosis and Aids.

In addition, the United States Food and Drug Administration estimates that fake drugs comprise more than 10% of the global medicines market, generating annual sales of about $32-billion. – Sapa