Why Nigeria attracts substandard, falsified drugs

Nigeria is attractive for the dumping of substandard and fake drugs because the country is unable to provide an enabling environment and incentives to get foreign manufacturers to set up facilities, and manufacture medicines, which can be effectively regulated for use by Nigerians.

Currently, the country is unable to capture up to 80 percent of potential revenue from the pharmaceutical industry due to importation of medicines, many of which are of questionable quality and standards.

With a pharmaceutical spend now in the USD$1 billion region, less than a quarter of this is currently retained in the country, despite the need to conserve foreign exchange, boost the economy, create more jobs and effectively monitor the quality of medicines that are produced for use in Nigeria.

In an exclusive interview with BusinessDay, Moji Adeyeye, director-general, National Agency for Food and Drug Administration and Control (NAFDAC), said “in Nigeria we import most of our raw materials; it is only water that we do not import.

“Right now, we import 70 to 80 percent of our medicines and what we need is the opposite. We need to start manufacturing up to 80 percent locally, because that is the way we can have easy access and that is how medicines can become (more) affordable,” said Adeyeye during an interview at the Medicine Quality and Public Health conference which was held in the University of Oxford recently.

Adeyeye also explained that a delegation from Nigeria, led by Isaac Adewole, the minister of health, was in China a few weeks ago, discussing partnership between the Chinese government and entrepreneurs in order for them to collaborate with Nigerians and set up pharmaceutical factories.

“We do not want people to just come and sell; we want companies to come, set up and partner with local manufacturers,” Adeyeye said.

As she explained, the medicines may not be as cheap as would be desired in the beginning but part of the discussions with the Chinese government is to attract manufacturers of the Active Pharmaceutical Ingredients (APIs) as well as manufacturers of non-actives to come and start manufacturing in Nigeria. That way, the products (that is, medicines) will become cheaper later. Apart from contributing towards Universal Health Coverage, this is expected to also strengthen the economy, as people will never be able to buy medicines, no matter the discounts offered if the economy isn’t strengthened enough to engage them.

At the MQPH conference, BusinessDay correspondent observed that input from a number of delegates from different organisations in the medicine and public health space suggested India and China are top on the list of countries where many substandard drugs emanate from and developing countries like Nigeria are the final destination.

Nigeria, with its over dependence on importation of medicines, has been exposed to an influx of substandard and falsified medicines which are shipped to the country and other developing nations at a discount, sometimes for as low as 15 percent of the original cost.

Jingying Xu, a doctoral candidate (and researcher) on Public Health Policy at the London School of Hygiene and Tropical Medicine, in an interview with BusinessDay, gave an instance of when a manufacturer of Active Pharmaceutical Ingredients (API) did not meet up to the standards set by a certain popular drug company (name withheld). The API manufacturer resorted to finding other companies that could sell the drugs to places in Africa and other developing countries. All the API manufacturer had to do was offer a 15 percent discount from the price it would have sold to the company that rejected the medicines on quality grounds.

Situations like this continue to expose Nigeria to Substandard and Falsified Medicines, particularly as the NAFDAC DG says many of those countries do not regulate what they label for export.

According to Adeyeye, “Tramadol, Codeine and others are being shipped from South-East Asia under ‘For Exports Only’ and their regulatory authorities don’t have control over what is labelled ‘For exports Only’. I have challenged them and asked; exports only to where? To Nigeria?”

While the NAFDAC boss explained that work is currently ongoing to ensure regulatory authorities have control of all drugs leaving their ports (not just what comes in), she charged the World Health Organisation (WHO) to strengthen its global monitoring system.

She said: “People know that most of our bad drugs come from South-East Asia; from India and China. If that has been narrowed down, then the light should be shone on those places so that they will know that the world is watching them and that will reduce influx.”

CALEB OJEWALE