From Fred Ezeh, Abuja
The desire of Nigeria to achieve the global Universal Health Coverage (UHC) target seems threatened. This is due to the fact that the cost of health care services is becoming increasingly unaffordable, due to rising costs of pharmaceutical products and other consumables.
The experience, which began post-COVID worsened after President Ahmed Bola Tinubu, in his early days in office, announced the removal of fuel subsidies and floating of the currency. As a result, the cost of food items, transportation, and general cost of living went up sharply.
It, however, became difficult for low and middle class Nigerians to afford basic drugs for the treatment of ailments like malaria, typhoid and several other “common ailments.” This has resulted in an increase in avoidable deaths or vital human organ damages.
Alternatively, more Nigerians have embraced the option of self-medication, or consumption of some unhealthy herbal mixtures that might have long-term dangerous effects on their health, particularly the kidney, lungs and other vital organs of the body.
Some Nigerians, ignorantly, consume the herbal mixtures added with faith, as alternative to laboratory diagnosis and treatment, as might have been recommended by the outcome of the laboratory test.
What some people said
Mrs. Ekanem Bassey told Daily Sun, at a pharmacy in Karu, Abuja that she’s been a victim of fake drugs and the impact was devastating to her health.
She said: “There are lots of fake drugs in the market these days particularly the ones for the treatment of common ailments such as malaria, typhoid and several other ailments. These fake drugs are not restricted to pharmaceutical products. Herbal mixtures are also fake, and people consume them without questions. Unfortunately, these drugs are sold at high cost despite being substandard.
“Surprisingly, pharmaceutical drugs are no longer effective in response to these common ailments unlike they used to be in the past. For instance, my husband treated malaria virtually every month last year, with the nationally recommended A.C.T combinations, except for November and December, when he decided to change tactics/approach after several persuasions.
“My husband doesn’t take drugs without a laboratory test first. And he always completes the doses as prescribed. But despite the committed steps, he comes down every month with malaria, sometimes with typhoid. And each laboratory result shows significant presence of malaria and typhoid in his body system. It’s tiring with the huge cost of treatment.
“In November, I convinced him to change approach to the treatment. He hesitated at the first try, but with more push, he bought into the idea. It was a difficult decision for him but I encouraged him to try new thing. We decided to try alternative means of getting medication for the malaria and typhoid. As if I knew that it will get to that point, I started early to grow some trees and herbs that have medicinal values.
“In my house, I have lemon grass, saint leaf, guava, pawpaw and other leaves that have medicinal values. Lately, I decided to listen to the suggestions of my parents who asked that we try the herbal mixtures. I visited the National Stadium, Abuja, got some ‘dogon yaro’ leaf, returned home and washed them well with salt and clean water, boiled them together with other herbs, and served him. It helped in the treatment of malaria.
“These are things he has been taking for some time at a proportional dose in some intervals. All he did was frequent urination, and that was the way the stuff was getting out of his body. He has stayed for two months now without coming down with malaria or typhoid. Scientifically, this might not provide an urgent response to malaria or typhoid, but I can assure you that it chases the ailments far.
“We watched our parents prepare these herbs periodically for us to take against these ailments and other challenges, and they were highly effective.”
Impact of inflation
Inflation, at over 28 per cent and rising, has significantly weakened the purchasing powers of many Nigerians; hence they resorted to alternatives as regards food, drugs, transportation, and other means of livelihood.
Some food and drug dealers said that high inflation rate, high cost of energy, and other unfriendly operating conditions are some of the major factors responsible for the rising cost of pharmaceutical products in Nigeria. This is in addition to the high cost of transportation, which was worsened by the fuel subsidy removal early in 2023.
They maintained that the pharmaceutical sector is not different from other sectors of the Nigerian economy; neither are they operating under a different condition, nor enjoying any special financial or logistical interventions from the government.
Jeffery Mufu, an Abuja based pharmacist and a member of Pharmaceutical Society of Nigeria (PSN), said the pharmaceutical industry is also faced with ‘harsh’ business operating conditions in Nigeria just as other sectors of the economy.
“Besides, most of the ingredients, over 70 per cent, used in the production of these drugs are imported using foreign exchange which is unstable in price. Currently the exchange rate is over 1,200 to a dollar,” he said.
Recent investigation by Daily Sun revealed that, many indigenous drug-manufacturing companies have begun to compromise in quality and standards in order to keep the business afloat.
It was discovered that the quality of chemical ingredients in drugs and other food items have been reduced, while the prices have increased for increased profit. This has reduced the potency of the drugs to respond to ailments, thus exposing Nigerians to huge health risks.
A patient, Nkasi Ekeh, told Daily Sun that she has bought several fake drugs lately including paracetamol tablets and other antibiotics. “We are in dangerous times in Nigeria. It’s dangerous that drugs are increasingly being faked in Nigeria, and they are not easily detected. I have fallen victim to fake drugs, and I ended up spending more money to cleanse my body system of these fake drugs.
“Though, no place is safe, I have decided not to buy drugs randomly from any shop or pharmacy. I choose carefully where I buy drugs now and the kind of drugs I buy, because we have a huge population and weak monitoring system to detect and control the quality of food and drugs being sold to Nigerians.”
FG, pharmaceutical
companies
Minister of State for Health, Dr. Tunji Alausa, at a recent meeting with indigenous manufacturers of hypodermic syringes, confirmed that pharmaceutical companies are facing serious operational challenges, which is being felt by Nigerians through high cost of food, drugs and other consumables.
He decried the rising cost of pharmaceutical products in Nigeria, and its negative impact on the desire of the Federal Government to achieve the desired Universal Health Coverage (UHC)
However, he said the President has mandated that all machineries be activated to ensure the adequate changes are effected that would herald significant reduction in cost of pharmaceutical products, and expectedly, increased access to quality and affordable health care services.
Dr. Lanre Shittu, Chairman of Medical Device Manufacturers Association, admitted that there’s a huge challenge in the health care sector, particularly as it concerns the cost of pharmaceutical products. “The reason is what we all know. It has to do with forex and operating conditions in Nigeria.
“From all indications, the Federal Government is concerned with the development. Few days ago, five pharmaceutical companies that produce hypodermic syringes and other medical devices met with the federal government representatives led by the Ministers of Trade and Investment, and Health.
“These challenges were discussed extensively. We highlighted the bottlenecks that we face which are existential threats that need to be tackled speedily. The point is part of the discussion we had with the Minister recently. The point is that if we stimulate local production, there will be an increase in supply as well as competition.
The reason for the rising cost of pharmaceutical products is because of limited supply, and besides, virtually everything is imported which brings the issue of high cost of forex into play.
Similarly, Mofid Karameh, of the Mikano Group, said the meeting was a good opportunity for the government to salvage the manufacturing industry from imminent collapse, which could result in massive job losses.
NAFDAC alarm
Few months ago, the National Agency for Food and Drugs Administration and Control (NAFDAC) raised the alarm that Nigerians are increasingly embracing some unhealthy practices and herbal mixtures prepared by individuals who are totally ignorant of the potency of phytomedicine combinations.
The Agency, recently, swooped on some unregistered herbal drugs merchants, arresting and confiscating their products. The most recent case was the merchant of a widely circulated herbal mixture popularly known as “Baban Aisha” who has been reaching out to thousands of people across the country with herbal mixtures he claimed has the potency to cures several ailments ranging from waist pain, infertility, malaria, typhoid, diarrhea, hormonal imbalance, among several others.
NAFDAC said the content of the herbal mixtures are often extracted from herbs and roots that have limited or no solution to the ailments as claimed by the merchants.
“Besides, most of the herbal mixtures are sold by ‘illiterate and semi-literate’ individuals who rely on their native intelligence, and have no clear or deep knowledge of phytomedicine combinations and reactions, hence they are counterfeit, substandard with no dosage, and therefore do not meet the quality, safety and efficacy requirement of regulated medicines.”
NAFDAC’s weak post-marketing system
Investigation further revealed that weak or compromised post-marketing systems of NAFDAC often contribute to the continuous and significant drop in quality of drugs and other food items.
Director General, NAFDAC, Prof. Mojisola Adeyeye, said she has repeatedly encouraged Nigerians to report any case of compromise in quality food, drugs and other consumables for proper actions and sanctions where necessary.
She had disclosed that the lapses being faced in the post-marketing system was because of inadequate manpower and state-of-the-art logistics, stressing that NAFDAC enforcement officials won’t be found at every location across the country, hence it often relies on reliable information from the public to act.
She assured the public that the Agency is more determined than before to break the chain of poisonous food and drugs merchants in the country, thus safeguarding the health of the nation.