In January 2017, I wrote in an article titled ‘That 20% Tax on Imported Medicines’ that the purchasing power of the average Nigerian cannot sustain the 20 percent tax imposed by the federal government on imported drugs. My argument then, stemmed from the understanding that drugs for proper healthcare are as essential as food. Many journals list drugs as the second most essential need of man after food. Rightly so! The majority of the population lives on drugs, especially, auto-immune drugs. These are described as drugs that last the lifetime of the patient and must be religiously consumed.
As of January 2017 when I authored the article, the US Dollar exchanged at N500 to USD 1. As a consequence, and with the 20 percent tax, the street price of drugs shot up astronomically. In fact, it went beyond the reach of many patients. As of the date Nigeria boasted of 300 pharmaceutical companies with just about five certified by the World Health Organisation (WHO). This means that the majority of the pharmaceutical companies in Nigeria lacked the capacity and requisite certification to produce essential drugs. The consequence is that Nigeria lacked the capacity to satisfy the drug needs of its population especially, as far as auto-immune drugs were concerned. The meaning also is that most of the pharmaceutical companies in Nigeria busied themselves with the production of OTC (over-the-counter) drugs, basically, analgesics and basic multivitamins. Further implication of this is that the Nigerian pharmaceutical market is saturated by pharmaceuticals from Asia, specifically, India, China, Pakistan, and quite a percentage from Europe and America.
With the US Dollar hitting the rooftop, it is only imaginable how much Nigerians will forcefully cough out to buy needed essential drugs. A cursory check at the nearby pharmacy will reveal that many of the pharmaceutical companies in Nigeria are majorly involved in the drug trade as marketing agents of Asian, European, and American pharmaceutical companies. This leaves Nigeria in a very precarious situation. The consequences are huge.
However, the issue to me is not about the consequences of this stark reality on Nigeria’s health index, which is obvious and disturbing, but about the progression in failure of the Nigerian governmental system in developing, and enforcing, a deliberate policy that would have turned the table around. The question is to go back to ask: how did India, Pakistan, and China achieve such superior places on the pharmaceutical giants’ index?
India, Pakistan, and China are faced with similar population issues like Nigeria. They also faced the prospects of devastation of their population and workforce by diseases, especially those that have the capacity for mass fatality – epidemics, and pandemics. My studies tell me that the realisation that their economies cannot grow on the strength of imported drugs, which means outsourcing a critical segment of their national healthcare protocols, forced the leaders of those countries to put on their thinking caps which were made of steel, to ward off foreign influence. Looking inwards, these countries realised the need to develop, design, and implement policies that were geared towards encouraging the creation and growth of pharmaceutical companies that have the capacity and requisite certification to produce not only OTC drugs but also, life-essential drugs for local consumption and export. These policies included tax holidays for investors in the pharmaceutical sector, deliberate access to funding for pharmaceutical companies’ development, and even loans at reasonable interest rates that would encourage borrowing and investment in the sector. There are also indications of executive support for indigenous pharmaceutical companies in the areas of sourcing machinery, raw materials, and equipment.
The fact, for me, is that whatever the governments of India, Pakistan, and China did to encourage the development and growth of the pharmaceutical sector of those countries, were effectively designed and implemented and the countries are today major pharmaceutical exporters to countries, like ours, that never learn. Except for Paracetamol and Vitamin C, the chance is that almost every drug pack you pick from your regular pharmacy, including basic anti-malaria drugs, bears the imprimatur of India, China, or Pakistan. The question then is: how does a country guarantee effective health delivery for its population in a situation where almost all essential drugs are imported and under a very frustrating forex regime? As it is, auto-immune drugs that sold for N500 in 2017 are selling at N5000, or more, today. Now, compare that to the purchasing power of the average Nigerian in 2017 as against today. What you get is a gradual asphyxiation of the Nigerian who is faced with a life-threatening health challenge. His story may be different if he/she lives off the government where he/she could be flown to London or Paris to treat common ear infection and common cold.
Who saves the hapless Nigerian who must cough out whatever the pharmacist charges for auto-immune drugs? His salvation comes from God. Isn’t it? I guess this is the reason many are looking towards herbal remedies and faith healing through holy water and cooking oil, christened anointing oil. Of course, herbs are cheap and God gave them to man freely. They cost almost nothing compared to essential drugs. They grow everywhere and are readily available. But, who regulates the dosage? Who monitors the toxicity and their effect on internal organs like the kidney and liver?
I think the Nigerian government must make a deliberate effort to go beyond building primary health centers and their supposed global standard hospitals. It really makes no sense to build that world-class hospital where patients get recommendations for drugs that are beyond their purchasing power. We may be able to get ourselves to begin to address this gap if we make deliberate policies to encourage the development of pharmaceutical companies that have the required certification and capacity to produce most of the essential drugs we spend scarce forex to import. This may be a positive way of announcing our seriousness in adequately addressing healthcare delivery in Nigeria. Don’t tell me about the dimensions of international pharmaceutical politics. We can also play it and win. It is about making a decision to challenge the status quo and force a shift. Nigeria can grow to become a pharmaceutical complex exporting essential drugs, not just OTC, and not just marketing Indian, Pakistani, and Chinese pharmaceutical products, if Nigeria desires to become. It is about the right policy and the will to administer it.