Healthy Skepticism Library item: 1729

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Publication type: news

The menace of fake drugs in Nigeria
2002 Mar 22

Full text:

When Lagos banker Banji Onimode was recently diagnosed with a bacterial infection, his doctor prescribed a course of antibiotics that Onimode bought from a local pharmacy. But after completing the course of medication without improvement in his condition, the doctor asked to see the drugs.

“After inspecting both the packet and the capsules, the doctor pronounced them fake,” Onimode told IRIN. “He now had to procure a new of the antibiotics himself and before I completed the prescribed course, the symptoms disappeared.”

In Nigeria, Onimode’s experience is common, sometimes with fatal consequences. Almost every efficacious patent or prescription drug sold in Africa’s most populous country – one of 120 million people – has either a fake or adulterated version. They range from common analgesics, through antibiotics to drugs for ailments such as diabetes and hypertension. Sources in Nigeria’s pharmaceutical industry estimate 40 percent of the drugs in circulation in the country are either fake or adulterated. At the forefront in the battle against the menace is the National Agency for Food and Drug Administration and Control (NAFDAC). In the past five months NAFDAC has on an almost weekly basis published lists of newly identified fake and adulterated drugs in circulation, giving the public advice on how to spot them.

A recent list published in national newspapers on 15 March included fake versions of Peflacine antibiotics originally manufactured by Rhone-Poulenc. It also identified counterfeit versions of Betnesol-N eye, ear and nose drops produced by Glaxo Wellcome, and the Diabinese drug for diabetics made by Pfizer. A majority of the fake items were identified as having been imported from India.

NAFDAC officials say some of the fake products either contain ordinary powder or starch, while others contain ingredients that may be poisonous. In other cases the drugs had expired and were still kept in circulation. Often, especially antibiotics, the active ingredients in fake drugs are well below the advertised doses printed on the packaging.

“For instance we frequently have cases of ciproflaxacin antibiotics advertised to be 500mg when in reality they are 250 mg,” one official told IRIN.

A pharmacist and an official of the Pharmaceutical Society of Nigeria, Tony Ude, blames the phenomenon of fake and adulterated drugs on the “chaotic” distribution system in the country. He traced the current situation to developments in the health sector and the pharmaceutical industry between the 1960s and the 1980s.

“The fact remains that drug distribution in pre-independent Nigeria was very orderly and lawful,” he said in a recent paper published on the subject. “Due to the paucity of registered pharmacists at independence, the few available pharmacists resorted to multiple registration of pharmaceutical premises,” he added.

Ude said pharmacists did this by simply presenting photocopies of their annual license to practice in as many shops as possible for fees agreed with the shop owners. Consequently, ordinary traders “with no knowledge of poisons or prescription drugs” engaged in the pharmaceuticals business without supervision, thereby defeating the purpose intended by the stipulations of the law. Even traders in the market now obtained licences to deal in patent and proprietary medicines, he said.

In the past two decades, huge markets dealing in patent and prescription drugs have mushroomed in the country’s major cities: They include the commercial capital Lagos, northern Nigeria’s biggest city, Kano and the main southeastern trading town of Onitsha. These have also become the nerve centres of the counterfeit drug trade.

“There are very rich businessmen in these centres who travel to Asian countries, especially India, and connive with manufacturers there to produce fake and substandard drugs,” Osita Okeke, a marketer for leading drug manufacturers in Nigeria told IRIN. “They now import these drugs into the country and sell at huge profits.”

He said the damage done by such dealers could not be quantified in health terms, but in monetary terms ran into billions of naira – the local currency. “Not only is the health of the entire nation endangered, a lot of money that could have been put to good use is being spent by Nigerians on drugs that have no value due to the activities of some unscrupulous people,” Okeke said.

With the dangers obviously in mind, NAFDAC has redoubled its efforts to interdict fake drug peddlers. During the past year, the agency seized and destroyed huge stocks of fakes in Lagos, Onitsha and Kano; and prosecuted their owners.

NAFDAC Director Dora Akunyili is now working to implement a novel idea to replace the current drug distribution system: drug distribution points or “drug marts” are to be established in Nigeria’s 774 local council areas.

“Right now, the drug distribution network is in total confusion and we cannot continue this way. We cannot regulate the market and professionals are not in charge of sales,” she told reporters recently.

But she said the current system could not be abolished until the alternative was put in place. Under the new system she envisages designated markets, properly regulated and with air conditioned storage – unlike the current market situation where even genuine drugs deteriorate quickly for lack of proper storage.

“With the agency’s commitment to fight and win the war against fake drugs, we need a channel for genuine drugs. The drug marts will (also) check the cost of imported drugs to make them more affordable,” she said.

[ENDS]

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