Acho Orabuchi
27 September 2007
Lagos — "The problem of counterfeit drugs and other regulated products is rapidly rearing its ugly head in developed countries and this is fueled by purchase of drugs via the internet. The negative impact of counterfeit drugs and other regulated products knows no boundaries. Resistant strains of micro-organisms do not need visa to travel from country to country." -Prof. Dora Akunyili
Sadly, the above quote captures the dilemma the world is facing in the hands of fake drugs manufacturers and distributors. Indeed, the problem of counterfeit drugs is now a global phenomenon with its effects felt adversely in the developing countries.
Unfortunately, many countries are increasingly facing hydra-headed problems of counterfeit drugs in various ways, but the problem continues to get worse largely due to the lucrative nature of the business with minimal overhead and easily accessible distribution channel facilitated by the internet. For instance, America's Food and Drug Administration (FDA) has recently revealed publicly the presence of "counterfeit versions of the cholesterol drugs Lipitor and Crestor, as well as the painkiller Celebrex, blood-pressure medication Diovan, baldness treatment Propecia and five other prescription drugs" in the drug market.
In his recent study of fake pharmaceuticals, Dr. Paul Newton of Oxford University found a disturbing amount of fake malaria drugs sold in Myanmar, Laos , Cambodia , and Vietnam . He disappointedly concluded, " about half of the artesunate contained no active ingredient. So, logically, if malaria is a public health problem in Southeast Asia and is potentially fatal, if people are taking these drugs that contain starch and chalk, they're very unlikely to survive their malaria infection." He continued, "In one shop, a hundred thousand fake artesunate were offered for sale. So they're not being produced in somebody's kitchen. They're produced on an industrial scale. And if organized crime is involved, which seems very likely, then that makes it much harder to do anything about."
In the face of the daunting task of safeguarding the public health through the assurance that only genuine drugs make it through the distribution channel, various countries are working assiduously to combat fake drugs in their respective markets by averting the introduction of counterfeit drugs. They are also working to facilitate the identification of counterfeit drugs and educate the public of the presence of such drugs through various means. Some countries have found success in their campaign, especially in creating public awareness, while others have employed high technology to help them with the identification process. However, the fight is a daunting one due to greed and corpulent profit for the perpetrators of the ills.
In America and in most other countries with high levels of pharmaceutical manufacturing firms and complex distribution channels, once drugs are manufactured, they go through a multifarious maze of primary and secondary wholesalers before reaching the pharmacy and subsequently the final consumers-the patients. As a result, fake drugs could easily get into the system through unscrupulous wholesalers and in some cases due to innocuous errors. FDA has come up with a means of tracking the drugs in the supply chain through the use of RFID. RFID is Radio-frequency identification. Wikipedia encyclopedia defines it as "an automatic identification method, relying on storing and remotely retrieving data using devices called RFID tags or transponders. An RFID tag is an object that can be applied to or incorporated into a product, animal, or person for the purpose of identification using radiowaves. Some tags can be read from several meters away and beyond the line of sight of the reader." This technology could help other countries in their fight against counterfeit drugs.
Though drug counterfeiting is a global problem, Nigeria is the most lucrative dumping ground for counterfeit drugs and other regulated products with catastrophic public health consequences. Counterfeit drugs are widespread in Nigeria . Prof Dora Akunyili lamented the enormous problems of fake drugs and the steps NAFDAC has taken to tackle the ugly problem in her recent speech at the inaugural convention of the Nigerian Association of Pharmacists and Pharmaceutical Scientists in the Americas, Inc. (NAPPSA) in Houston , Texas . The progress NAFDAC has made under the leadership of Akunyili has been widely commended. However, Akunyili reminded the audience that, "The fight against drug and other regulated product counterfeiting requires collaboration among all nations. International co-operation is important if trans-national criminal networks are to be dismantled."
Dora Akunyili, therefore, pleaded with members of NAPPSA and other Nigerian professionals in America to come home and assist in eradicating fake drugs that have infested the drug supply chain in Nigeria . She pleaded, "I encourage you as pharmacists and pharmaceutical scientists to come home and establish drug manufacturing factories and wholesale outlets in Nigeria . You can pool your resources as cooperatives and you will be surprised that the return on your investment will be better than what you can get anywhere in the world."
"Some of us complain about poor infrastructural facilities like inadequate power supply, water, etc, but Indians, Chinese and other nationals are all over Nigeria making it big, despite these challenges. If foreigners can make it despite the prevailing challenges, you too can," she concluded.
Most Nigerians in the audience responded positively to her call. Dr. Funmi Ajayi, Senior Director, Department of Experimental Medicine and Drug Safety, New Technology Development, P&G Pharmaceuticals, Cincinnati , Ohio , USA agreed with Dr. Akunyili. She concurred, "As a firm believer in "to whom much is given, much is required", I see my involvement with NAPPSA as a great opportunity to give back to my country. I obtained all my education in Nigeria and fully appreciate our God-given potential as a nation. I see NAPPSA as an avenue to leverage tremendous expertise and career experiences that reside in the organization to (i) support various on-going government efforts geared towards building a formidable state-of-the-art infrastructure that promotes robust and internationally attractive research & development opportunities, (ii) foster improved networking potential among its members, and (iii) build strong, straight-forward paths for future generations thereby solidify Nigeria's position in global pharmaceutical research & development."
Also, Jonathan Obiagwu, Chairman and Managing Director of J-Pharma in Aba , had already answered the call to invest at home. He, however, opined, "It's really overdue to have an association of this magnitude in the Diaspora to bring pharmacists and pharmaceutical scientists in the Americas under one roof to discuss how to help Nigeria's ailing healthcare sector. From a personal standpoint, meeting fellow professionals and networking was very gratifying. The NAFDAC director-general's call for Diaspora professionals in the pharmaceutical industry to look towards home (Nigeria) fits well with what I am currently doing in Nigeria. Nigeria is the place to be; however, it presents its challenges notably the lack of power, bad roads, non- existence of municipal water supply. We are hopeful that President Umaru Yar'Adua will address these problems which may result in some visible improvement in the next 12 months. The other area that presents challenges is human resources. Most of the graduates coming out of the universities are ill-prepared for the corporate world. Retraining becomes crucial in order to have a work force that is suited for the challenges especially in the pharmaceutical industry."
It is apparent that fake drugs and counterfeit regulated products have for a long time jeopardized the public health in Nigeria . It is true that there is no mechanism to account for the number of deaths resulting from the consumption of fake and contaminated drugs and other products in Nigeria ; one does not have to go a rocket scientist to realize the phenomenal cost-both in human life and economic realm-of the presence of these dangerous products in the market. Despite the challenges, it is therefore imperative for everyone to join hands to stamp out fake products in the country. The government should work diligently to strengthen and enforce laws that discourage counterfeiting of drugs and regulated products in Nigeria.
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