Irked by the plight of Nigerians living with HIV and dwindling donor funds, the Civil Society Legislative Advocacy Centre, CISLAC, and Transparency International, TI, Nigeria have raised the alarm over alleged irregularities in the procurement process of Anti-retroviral, ARV, drugs by the National Agency for the Control of AIDS, NACA.
They noted that fraudulent contractors inflate the prices of the ARV drugs by over 50 percent even as they expressed worry that the practice is currently sabotaging NACA's efforts to correct the anomalies by buying directly from the drug manufacturers.
Speaking in Lagos, the Executive Director, CISLAC, Auwal Ibrahim Musa, called on President Mohammadu Buhari to intervene so as to ensure total reform in the procurement process.
"CISLAC and TI Nigeria gathered that the contractors currently sell the anti-retroviral drugs at $13 per patient as against $7 given by the manufacturers.
"These exorbitant prices quoted by existing contractors renders government financially incapacitated to adequately provide for, and make ARV drugs accessible across health care facilities, which record resultant stockouts, health hazards, and relapse of illnesses."
Musa lamented what he described as unchecked attitudes of the fraudulent contractors, whose unlawful activities hitherto dominate the procurement process even as he commended the recent decision by NACA to purchase ARV drugs directly from the manufacturers at half the cost quoted by contractors and middlemen.
"While we acknowledge NACA's plan to establish HIV Trust Fund driven by the private sector to support existing efforts of the government, we observe that without current support by the US Government and the Global Fund, it would cost Nigeria N50 billion to treat one million people living with HIV annually.
"Giving the existing cost-efficient practice by the US Government and Global Fund involving the direct purchase of the drugs from the manufacturers, we are worried by the ill-informed, pocket-serving and discrediting petitions by some vested interests, who have endlessly benefited from inflated prices of the drugs in the last five years, to discourage the ongoing effort of NACA to directly source the drugs primarily for sustainability and wider coverage.
"We are also concerned that over-reliance on donor funds in the fight against HIV in the country constitutes a dangerous trend to sustainability, hence the need for the government to take full ownership in the prevention and treatment of HIV in the country.
"Corruption in the treatment of HIV/AIDS is no different from corruption in the health sector. In 2003, Nigeria's ARV programmes attracted much criticism when treatment centres were alleged to be handing out expired drugs and rejecting patients."
Citing a detailed investigative news report of December 28, 2018, the International Centre for Investigative Reporting, ICIR, that hundreds of millions of naira released for HIV campaigns, counselling and testing services ended in private pockets, CISLAC and TI Nigeria prayed that fraudulent contractors who undermine the Public Procurement Act must be thoroughly scrutinised and discouraged from defrauding the government through inflated ARV drugs supply services.
They called on the Director-General of NACA to engage stringent reforms in the Agency's procurement process for impactful, efficient and cost-effective wider, and sustainable service delivery in Nigeria.
They maintained that the D-G must devise an appropriate sustainability plan for the procurement of drugs and consumables through cost-effective and encouraged technically know-how for domestic production in the presence of dwindling donors' support, and avert recurring of challenges thrown at the country by the Covid-19 pandemic;.
They called on the DSS to investigate the activities of Politically Exposed Persons (PEPs) who constitute themselves as faceless contractors and their relationship with the leadership of the Network of People Living with HIV, who we learned are secretly used to obstruct and frustrate NACA's effort from directly purchasing from manufacturers.
"As part of the sustainability plan, CISLAC/TI Nigeria calls on regulatory authorities, like NAFDAC, to support and enhance local production of affordable antiretroviral drugs with serious consideration while issuing marketing authorisation to local manufacturers;
"Also, calls for review of the heavy tax burden on the pharmaceutical sector to avert multiple taxations by local, state and federal governments as well as high tariffs on raw materials, packaging materials and other ancillary materials used to manufacture medicines, primarily to encourage local production in the country"
They also stressed that the government should develop a pricing policy to reduce reported high prices and a wide disparity between prices of essential drugs in the country.
On his part, a Legal Practitioner and a Board member of CISLAC, Adeshina Oke, harped on the importance of good health to leadership, productive economy, and healthy citizens.
"A sick country cannot have good leadership, neither can it have a productive economy or citizen. Hence we must get read of anything capable of deteriorating our health as a nation.
"We cannot depend on donors forever as a country. In the long term, we must begin to look towards empowering our higher institutions for research purposes. These drugs could be a lot cheaper if they are manufactured here in Nigeria.
"Nigeria must empower her institutions so that they can be fit enough to uphold the country, should in case that day comes and funding stops coming in for the purchase of retroviral drugs. And the time to start preparing is now," Oke stated.