Odimegwu Onwumere writes that before Nigeria can realise its goal of making cheap drugs, factors such as the international politics on drug transactions, failed health policies by successive governments, and industrialisation, amongst others, must be resolved
Before now, there have been suggestions that local industries should be supported in order to produce guaranteed pharmaceutical products for local utilisation, because no nation progresses by importing everything it uses without the local content. This has made the opinion expressed by Prof. Temitope Alonge, recently signifying that expensive drugs can be a thing of the past if only Nigeria can talk to the World Health Organisation (WHO) for authorisation to churn out vaccines and tablets that are cheap and relevant to healthcare.
Alonge, who is the Chief Medical Officer of the University College Hospital (UCH), Ibadan, believed that successive governments have not done much through their policies to alleviate the pains that Nigerians go through in getting medical attention, but especially drugs. Nigeria has over the years been implementing policies in the health sector without much execution in the area that they will positively affect the people, therefore making Alonge’s clarion calls essential for Nigeria and her citizens to recognise and take pharmaceutical products as susceptible items.
There have been different bans placed on some pharmaceutical products by successive Nigerian governments to enhance the health sector, especially the ban in 2005, of which Paracetamol was the only drug among the banned regarded as being locally produced to be self-contained. That was a feint to Nigeria considering the fact that India had 16, 000 companies where drugs were manufactured with over 1, 000 of them certified by the WHO.
An eye-opener, when Nigeria was gasping in speculation to produce cheap drugs, is the revelation made by a lecturer at the University of California, Irvine, Kristin Peterson, the author of the book, ‘Speculative Markets: Drug Circuits and Derivative Life in Nigeria’, in an interview with a Nigerian newspaper published in August this year said “There are over 80,000 chemical and drug companies in China (some of which are foreign owned) and national regulatory agencies might inspect 20 or 30 of them per year.”
The irony was that Nigeria had not taken some decisions in the health sector and considering such decisions with paramount watchfulness. While at any blink, the government would ban some pharmaceutical products, Nigeria by 2010 hadn’t factories that produced Ibuprofen, Tetracycline, and among others. In the same year, the lives of 140 million Nigerians were virtually and harmfully impinged on, by the policy assessment.
Some health organisations in the country hence proposed for the launching of a scientific foundation for decision-making. They were of regret that when foreign donors made donations to Nigeria in the area of drug purchasing, the country turned around to expend the money in foreign market. A case-of-study was in 2009 when N4b was made available by the Global Fund for the purchase of drugs and no pharmaceutical company in Nigeria was of standard to purchase drugs from. However, analysts have said that independent drug importers in the country are patriotic, but in the international periscope, standard is top priority than patriotism.
The sad aspect was that there was no pharmaceutical industry in Nigeria that was of the WHO standard, making the Nigerian pharmaceutical sector incapable to apply for loan from Global Fund, therefore giving the Europe, China, India and America the edge to continue to see Nigeria as a great purchaser of their drugs. This was revealed by Peterson, saying: “In the 1970s, prior to the implementation of the structural adjustment programme, American and European brand name pharmaceutical companies saw the Nigerian population as buoyant purchasers. And, of course, at that time, the naira was at par with the dollar and the pound. There was a fairly robust middle class and people were able to afford many of the products produced by those corporations.
“But the moment the economy started to take a downturn after Babangida’s 1986 implementation of structural adjustment, many things changed. On the one hand, the private sector could no longer cope because the value of the naira was crashing. It also became risky for drug companies to do business because the population could no longer afford their drug products.
“Because of that risk, the brand name multinational drug companies abandoned the Nigerian market that they themselves created. On the other hand, the population was expecting social welfare entitlements like pensions and free education, both of which they were receiving. But dictatorship and austerity led to mass protests as Nigerians’ sense of security was slipping fast out of sight.”
In 2005, some of the banned pharmaceutical items went up above 500 per cent, with Lavampisol, a worm expellant, as an archetypal example. The relevance of the position by the Professor Alonge will help douse the stereotype among many Nigerians who misconstrue cheap drugs for counterfeit drugs, even when Nigeria has not won the battle against fake drugs. Peterson further highlighted, “The global brand name drug industry at one time did exceptionally well in Nigeria. Companies such as Pfizer, Roche, Upjohn, Ciba, among many others came to Nigeria as early as the 1940s and 50s. By the 1970s, Nigeria’s oil boom attracted the major drug companies around the world and they distributed and manufactured products within Nigeria. In some cases, they made a lot of money – in fact, some products that sold in Nigeria were the highest selling products in the world.”
The battle against fake drugs has been in vogue, especially with the National Agency for Food and Drug Administration and Control (NAFDAC) subjecting to superfluous inspection of every drug imported into the country. The NAFDAC has been in this battle against fake drugs since it was established by Decree 15 of 1993 as amended by Decree 19 of 1999 and now, the National Agency for Food and Drug Administration and Control Act Cap N1 Laws of the Federation of Nigeria, 2004.
The Association of Pharmaceutical Importers of Nigeria (APIN) in 2010, fought a battle against fake drugs, by helping the government owned health organisations perform their official roles in checking the drugs imported into the country and making sure that drugs from India and China that came into the country were not fake and substandard. Nigerians have however, always shown concern over alleged fake drugs imported into Nigeria from India and China.
Nevertheless, what Alonge invariably meant was that Nigeria has to tow the line of the APIN which gave China and India a condition that their drugs, before they are imported into the country, must be certified by the WHO. If there were incidences of fake drugs from India and China imported into Nigeria, the WHO ought to be asked questions. While the authorities may buy the idea raised by Alonge, there are factors that may hinder the proposal except they are put in place.
It is saddening that Nigeria has grown thick skin not to accept industrialisation with electricity being the arch-hitch to investors in the country. Banks hardly give loans without increased interest and other financial institutions hardly fund projects in the country making entrepreneurs the melon that proverbially sourced for its cooking water.
The hardship in the country has spurred bad eggs in the medical profession and the government has been tapping their back with the kid’s glove when a country like China once put-to-death the head of China’s Food and Drugs Authority. The victim’s ordeal was his involvement in illegal trades in drugs, using his office. Nigeria has to put in place every mercenary for zero tolerance in the peddling of fake drugs and to their producers. By 2010, the world stood still when Chinese government also killed five persons involved in the creation and selling of contaminated baby milk with melamine.