Health-Nigeria: Govt Struggling to Guarantee Safety of Medicines
by Toye Samuel (lagos)Monday, March 09, 2009
Inter Press Service

In 2008, as many as a thousand children were hospitalised with diarrhoea and vomiting after taking 'My Pikin' teething syrup. At least 84 children are known to have died.

Investigations by Nigeria’s Federal Ministry of Health and the World Health Organisation (WHO) found the syrup, whose name means 'my baby' in Nigerian pidgin English, contained diethylene glycol.

Kola Okunola, the chief executive officer of Barewa Pharmaceutical Limited, manufacturer of the syrup, was arraigned on a six-count charge relating to manufacturing adulterated drugs on Mar. 5. The three pleaded guilty and have been remanded at the Ikoyi prison in Lagos pending trial of the case.

Njoku Bright, whose 14-month old daughter died on Nov. 28, 2008 after taking the syrup, said that his daughter died due to the negligence of those responsible for preventing sales of fake and adulterated products.

According to him, the National Agency for Food and Drug Administration and Control (NAFDAC) failed to exercise due diligence to effectively regulate and monitor the pharmaceutical sector, the sale of chemicals as well as ensure drug safety and distribution.

'The children who died would not have died if the government effectively carried out its responsibilities,' he argued.

The My Pikin saga was a highly publicised example of unsafe medication, but many other cases of counterfeit or adulterated drugs and other products go mainly unreported. Cynthia Alaba, a petty trader and mother of four, almost lost her 15 year-old son to a fake drug in January through self-medication.

'My son had malaria but I did not have enough money to take him to hospital, so like before, I just bought anti-malaria drug for him. After three days there was no improvement, instead his case got worse,' she told IPS.

Most people in Nigeria opt for self-medication because of the high cost of obtaining hospital registration cards, laboratory tests and drugs. Patients pay between between 5 and 14 U.S dollars for cards to see a doctor, depending on the hospital.

It is cheaper to visit a chemist shop and ask for an anti-malaria drug - which most often cures the ailment, but without proper medical supervision, correct prescriptions and dosages are frequently flouted. And without proper controls on medication, there is the risk that the drugs themselves are adulterated.

Luckily for Alaba, a friend who was visiting her saw the drug she was using and informed her that the particular batch of malaria drug (fansidar) had been declared by NAFDAC as unfit for consumption as it was a fake.

'I bought another brand and my son soon became well. If not for my friend, we may be talking of another thing,' she said.

Many Nigerians, old and young, have been sent to early graves by fake and adulterated products that are daily pushed into the Nigerian market by unscrupulous and greedy charlatans.

Though Biodun Familusi, Chairman of the Lagos State Chapter of Pharmaceutical Society of Nigeria (PFN) argued that adulteration of products was not peculiar to Nigeria, he agreed that the problem had become worrisome.

'The situation became compounded following the liberalisation policy of government [20 years ago under former military ruler, Gen. Ibrahim Babangida] as the market was thrown open to every one. People who are not professionals were allowed to buy, import and distribute drugs,' Familusi told IPS in Lagos.

'Charlatans took over the trade and started importing. Unchecked distribution of drugs is the main cause of adulteration. Such drugs can be easily seen at Onitsha, Idumota and Kano markets and they are handled by non-professionals.'

Familusi exonerated NAFDAC of blame over My Pikin deaths saying when the agency visits a company and tests a particular batch of drug, it gives a clean bill of health to the company based on what is on ground.

'But it is not possible for NAFDAC to continue visiting that company to check the production of such a product all the time. It is during this period that any thing can happen,' he said.

NAFDAC Spokesperson, Christie Obiazikwor, corroborates the PFN chairman’s view on effective monitoring. 'We go on routine inspection and check in the companies but it is not possible for NAFDAC to be everywhere all the time.

'What actually happened in the My Pikin saga was that though there are internal quality control units in the companies which should test every batch, the company in question did not do this,' she told IPS.

She said, however, that the new Director General of NAFDAC, Dr. Paul Orhi, had assured that a new structure would be put in place to ensure stricter regulation and also to make sure that the internal quality control mechanisms are functional.

She said as part of the measures, NAFDAC was working on reviewing the law on adulterated and fake drugs to ensure harsher punishment for offenders. Currently, offenders face 15 years maximum jail term or a fine of about 3,500 dollars.

Jide Idris, Lagos State Commissioner for Health, believes the fight against fake, counterfeit and substandard drugs and unwholesome processed foods should not be left to the government alone but should also be the responsibility of manufacturers, pharmacists, sellers and consumers.

Idris said that the havoc caused by the teething product My Pikin brought to the fore questions about the effectiveness of drug regulations, especially in the area of manufacturing and importation of drugs and ingestible items.

He urged all pharmaceutical and medical associations and bodies to collaborate with governments in checking the adulteration, manufacturing and importation of fake, substandard drugs and unwholesome processed foods.

Familusi agreed that there was need for NAFDAC to take more punitive measures against unscrupulous importers and manufacturers of adulterated products.

'We need to sanitise drug distribution in the country but first the government must close down all drug markets so we can monitor the distribution and sales of drugs,' he said.

'If sanitised, we will know who the distributors are and who the retailers are if anything goes wrong with a particular drug. Government must allow only genuine professionals to produce, import and distribute drugs.

'Government has the wherewithal to check the distribution of adulterated or fake products but the political will is not there,' he said.

© Inter Press Service