essay on the menace of fake drugs in nigeria

• DOI: 10.3923/RJMSCI.2011.257.261
• Corpus ID: 76420516

The Menace of Fake Drugs: Consequences, Causes and Possible Solutions

• A. Chika , S. Bello , +1 author M. Umar
• Published 1 May 2011
• Medicine, Psychology
• Research Journal of Medical Sciences

37 Citations

Factors associated with drug counterfeit in nigeria: a twelve year review.

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Nigeria’s marathon struggle against counterfeit medicines

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• Christine Ro , freelance journalists
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Counterfeit and substandard medicines are not unusual in Africa. A concerted enforcement effort and reworked regulation have lessened the problem in Nigeria—but the roots remain, report Oluwatosin Adeshokan and Christine Ro

In a large warehouse in the northern Nigerian city of Jos, people are repackaging medicines—including painkillers, antiretrovirals, and erectile dysfunction drugs—smuggled from South East Asia into the capital, Lagos, before being transported to Jos. The counterfeiters place the medicines in new packages labelled in English, with Nigerian registration numbers and false manufacturing dates. Often these convincingly mimic the logos of trusted brands.

Such counterfeits are on the more visible side of “fake medicine” in Nigeria. Cyril Usifoh, president of the Pharmaceutical Society of Nigeria, says that in some cases a batch of falsified drugs are mixed with a small quantity of the legitimate product. This can pass quality controls. “What we [really] struggle with is adulteration of products,” says Nelly Okpako, a pharmacist in Lagos. These are not deliberately falsified products but are substandard medicines with substantially different quantities of the active ingredients than advertised. 1

Overall, there’s a consensus that in Nigeria the fake medicine problem is far less severe than it was. Data are patchy, but one estimate is that in 2001 substandard and falsified medicines made up at least two thirds of medicines in Nigeria. 2 These were largely basic, quick selling medicines such as antibiotics and antimalarials. “There was a time in Nigeria when you just couldn’t buy a [real] drug,” reflects Bisi Bright, a pharmacist who leads the non-profit LiveWell Initiative.

Nigeria’s National Agency for Food and Drug Administration and Control (NAFDAC) claims that at least 85% of medicines sold today are legitimate, but others dispute this. 3 (NAFDAC did not respond to a list of questions from The BMJ .) The actual figure …

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Fake Drugs in Nigeria: A Double-Edged Menace in Need of a Double-Edged Panacea

Posted: 6 Aug 2013

Obiajulu Nnamuchi

Centre for Health, Bioethics & Human Rights

Date Written: August 6, 2013

There are dual dimensions to the challenges posed by fake drugs in Nigeria. First, there is the problem of lax regulation or oversight and overt corruption in the production and distribution of these drugs in countries where they are manufactured. And second, within Nigeria, there are local challenges that continue to stifle government efforts in getting a handle on the menace. Reversing the status quo, unarguably an indispensable component of revamping and revitalizing the nation’s ailing health system, must start with identifying these challenges and devising strategies for their effective and sustainable annihilation. That is the principal aim of this paper.

Suggested Citation: Suggested Citation

Obiajulu Nnamuchi (Contact Author)

Centre for health, bioethics & human rights ( email ).

Enugu Nigeria

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Fake medicine in Nigeria - When the drugs don’t work

The presence of counterfeit goods is acknowledged as one of the greatest global threats to creativity. Counterfeiting can be defined as an act of unlawfully imitating or reproducing items/works protected by the law of trademarks, patents, or copyright while portraying them as original. This is usually represented in goods illegally bearing registered/well-known trademarks.

The counterfeiting of many different products is on the rise globally, and in Nigeria today items counterfeited include documents, currency, software and electronics, among many others. However, no other product has as much capacity to kill consumers as illicit pharmaceuticals.

The World Health Organization (WHO) defines counterfeit drugs as those “that have been deliberately or fraudulently mislabelled with respect to identity and/or source”. The products can include incorrect ingredients, may mis-state the amount of active ingredients, or can be manufactured under circumstances that lack quality control. Counterfeit drugs in Nigeria include preparations without active ingredients, toxic preparations, expired drugs that are relabelled, drugs issued without complete manufacturing information and drugs that are not registered with the National Agency for Food and Drug Administration and Control (NAFDAC).

Nigeria’s struggle

Over the past two decades, Nigeria has struggled to reduce the production and trafficking of counterfeit drugs without an adequate infrastructure or the political will to properly enforce legislation and standards. Growing numbers of deaths prompted the public and the Pharmaceutical Society of Nigeria to pressure the government to take positive steps towards controlling the prevalence of counterfeit and substandard drugs in Nigeria. The government responded by enacting Decree No. 21 of 1998 on counterfeit and fake drugs, which prohibited the sale and distribution of counterfeit, adulterated, banned, and fake drugs or poisons in open markets and without a licence of registration.

NAFDAC was created in 1993 and given the responsibility to regulate and control the importation, exportation, manufacture, advertisement, distribution, sale and use of food, drugs, cosmetics, medical devises, bottled water and chemicals. In 2001 under the leadership of Dora Akunyili as the director general, the agency underwent intense restructuring and reforms with the aim of revitalising NAFDAC’s mandate to “safeguard the health of the nation”. As a result, drug failure rates fell to roughly 16% in 2006 from 2002 and the circulation of counterfeit drugs was reported to have been reduced by more than 80% of the level in 2001.

Before these reforms, counterfeit drugs had a prominent and destructive impact on those who used them unknowingly. In 1990, 109 children died after being administered fake paracetamol tablets. In 1995, the Nigerian supply of 88,000 Pasteur Merieux and SmithKline Beecham meningitis vaccines to Niger during an epidemic resulted in about 2,500 deaths after vaccination.

Despite NAFDAC’s reported successes, counterfeit pharmaceuticals remain prevalent. In 2004, three Nigerian hospitals reported cases of adverse reactions from the use of contaminated infusions produced by four Nigerian companies. It was established that the infusions were heavily contaminated with microorganisms and 147 of the 149 brands of screened water used for injection were found to be non-sterile.

In November 2008, 34 Nigerian children aged between four months and three years died and more than 50 were hospitalised with severe kidney damage after taking My Pikin, a teething mixture containing paracetamol. The injuries were due to the use of diethylene glycol (DEG) as a solvent for the paracetamol. DEG was present because of inadvertent or deliberate substitution of propylene glycol, a less toxic compound than DEG which is widely used in the pharmaceutical industry.

Loss of confidence

The prevalence of counterfeit drugs in the Nigerian market has long been a source of embarrassment to Nigerian healthcare providers and resulted in a loss in confidence among the public in the nation’s healthcare delivery system. Fake drug proliferation has led to treatment failures, organ dysfunction or damage, worsening of chronic disease conditions and the death of many Nigerians. In some cases, even when patients are treated with genuine drugs, no response is seen due to resistance caused by previous intake of fake drugs.

Counterfeit drugs pose great threats to the reduction in infant mortality, improved maternal health and the combating of HIV/AIDS, malaria and other diseases, all aims of the WHO. They deny the Nigerian people the right to safe, effective and quality medicines and rob the country of valued manpower resources and economic benefits.

The major factors facilitating the preponderance of fake drugs in Nigeria have been reported to include the ineffective enforcement of existing laws, unqualified vendors, loose control systems, high cost of genuine drugs, greed, ignorance, corruption, illegal drug importation, chaotic drug distribution network, and demand exceeding supply, among many others.

The loose control system in the Nigerian economy has contributed to the circulation of counterfeit drugs in the country. A major function of NAFDAC is the regulation and control of imported products. This is done by having inspectors at various airports and seaports. Registration of pharmaceuticals is a criterion that must be passed before any drug is released into the Nigerian market. A condition for registration is the analysis and testing of the drug to ensure quality and safety.

Unfortunately, the forensic laboratory, which is the major public laboratory for the purpose of quality control analysis, is not adequately equipped to cope with the volume of requests, particularly for analysis of imported drugs. These inadequate control systems are exploited by counterfeiters to manufacture, import and distribute fake and adulterated products.

There is therefore a need for government to provide funds for the agency to purchase equipment necessary for testing and analysis of all drugs, both imported and locally manufactured, in a bid to assure the quality and safety of drugs in the Nigerian market. Positive trends have been seen of late, such as the deployment of the handheld spectrometers, which allow the inspection and authentication of products at the point of sale.

Legislative review

Various laws regulate and control the manufacture, sale and distribution of drugs in Nigeria. Sadly, empirical data show that the situation is far from adequate. The weakest point in Nigeria’s drug regulation is in the area of implementation and enforcement. Some Nigerian drug laws are in conflict with each other, aiming more at deterrence and resulting in difficulty in bringing offenders to trial.

A review of the law is therefore essential to help ensure stability in the legislation and regulations governing drugs in Nigeria. An important short-term strategy for fighting counterfeit drugs is that pharmaceutical companies focus more on developing better technologies for protecting the identity of their genuine products. Pharmaceutical companies should develop complex labels and holograms which are difficult for counterfeiters to imitate.

Additionally, the penalties for drug offenders are not commensurate with the severity of the crime. Currently, the maximum punishment for contravening the decree on fake drugs in Nigeria is ₦500,000 ($2,500) or three months to five years in prison upon conviction. Stiffer penalties would help sharpen the attitudes of fake drug dealers. It would make the practice harder and less lucrative for drug counterfeiters.

Healthcare professionals are in a good position to assist the government in fighting the problem of counterfeit drugs. This is most useful in countries that lack the resources needed to combat this crime. The presence of non-professionals in the pharmaceutical business is a contributing factor to the availability of counterfeit drugs in Nigeria. These non-professionals are less capable of identifying fake drugs and have the aim only of making a profit, when it should be the general wellbeing of the community.

They can educate themselves and patients on ways of identifying fake drugs using visual security tools which may include the size and shape of tablets, the quality of the print and the examination of holograms. It is clear that good practices and initiatives are being implemented to combat this issue in Nigeria, but we have a long way to go.

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Drug regulation and control in Nigeria: The challenge of counterfeit drugs

2001, Journal of Health & …

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Various interventions, including innovative technologies, have been used to solve problems. Over the years, the Nigerian government has introduced a good healthcare delivery system, including providing quality, efficacious and affordable drugs. The study used a qualitative design method adopting a focus group discussion approach. The selected states for the study are Lagos, Kano, Anambra and FCT Abuja. The study population comprised NAFDAC stakeholders who are dealers in pharmaceutical products or Marketing Authorization Holders (MAHs) of medicines, Consumers and Policymakers. The focus group participants were selected based on convenience sampling. The interventions highlighted were Mobile Authentication Services (MAS), on-the-spot checks on drugs through a TruScan, Black-Eye and Radio Frequency Identification Devices (RFID). The respondents also highlighted using NAFDAC registration numbers and holograms as important ways of checking the features of medicine before using it. The participants also highlighted the lack of public awareness about these interventions and the need for proper regulation and enforcement of laws against the sale and distribution of fake drugs as challenges that hinder the successful development and implementation of interventions against fake and counterfeit drugs. The participants suggested KYC measures to address issues within the supply chain to evaluate the effectiveness of their current strategies. Regular meetings, advocacy efforts, and educational workshops are recommended to raise awareness and educate stakeholders about their roles and responsibilities in pursuit of addressing the challenges related to counterfeit drug interventions.

Texila International Journal , Olakunle Olaniran

The threat of counterfeiting medicines is probably growing, particularly in poorer countries with weak regulatory mechanisms and poorly monitored distribution networks. Various interventions, including innovative technologies, have been used to solve problems. The study used a quantitative design method adopting a hybrid quantitative method such as desk, online and physical interviews approach. The selected states for the study are Lagos, Kano, Anambra and FCT Abuja. Data were obtained using structured questionnaires with mainly closed-ended questions and analysed using SPSS (IBM-SPSS version 21). The findings show that the highest proportion of consumers who have heard about counterfeit or fake drugs before was from Lagos (97.1%). The study also found that stakeholders know highly about fake/counterfeit drugs (94.3%). The results show that 62.0% of consumers knew about drug anti-counterfeiting technology, and most stakeholders (79.0) knew about NAFDAC Anti-Counterfeiting Interventions. However, respondents from Lagos had the highest level of awareness (77.3%) of the Anti-Counterfeiting Interventions. The results also revealed that stakeholders exhibited a positive perception of NAFDAC's innovative techs., (TruScan, RFID, GPHF MINILABS, Black Eye, Others) to curb fake drugs. The findings emphasise raising awareness, implementing effective anticounterfeiting strategies, and addressing financial limitations to protect public health and combat Nigeria's growing threat of fake drugs.

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Background: The proliferation of counterfeit drugs is of public health concern and worthy of discourse. Aim: The aim of the study is to assess the perceived factors affecting the distribution of counterfeit drugs in community pharmacies in Calabar municipality. Methodology: This study is a cross sectional descriptive study that employed the use of closed ended pretested questionnaire for the collection of data. Data was analyzed using the SPSS 20.0. Results: Findings show that 23(74.2%) of the respondents were males while 8(25.8%) were females. Majority of the respondents 28(90.8%) were community pharmacist, 2(6.5%) nurses and 1(3.2%) pharmacy technician. Findings show that about 58% of purchase of drugs is been determined by the medical/pharmacist representative while 42% of drugs purchased is been determine by the distributor. Majority of the respondents 19(61.3%) buy their drugs from medical /pharmacist representative. Respondents were able to detect counterfeit drugs through: customers report (19%), close scrutiny (32%), regulatory officials (13%) and news/company alerts (36%). Poverty 10(32%), greed 6(19%), heavy taxes/VAT on drugs 5(16%), government policies towards health care delivery 5(16%), and poor implementation of relevant laws by government agencies 5(16%) were factors identified as responsible for proliferation of counterfeit drugs. Conclusion: Poverty is a significant factor responsible for the proliferation of counterfeit drugs. The most common means used by community pharmacists to identify counterfeit drugs are scrutiny and news/alerts. There is need to create more awareness, and seek collaboration with community stakeholders in the fight against counterfeit drugs.

Texila International Journal of Academic Research

Counterfeiting medicines is a global phenomenon affecting developed and less developed countries. The World Health Organization, in its report, describes counterfeit medicines as becoming "a global public health crisis. This study examines consumers, stakeholders, and policymakers' perceptions of NAFDAC anti-counterfeit technologies and interventions regarding counterfeit drugs in Nigeria. This study uses a qualitative research method to examine consumers, stakeholders, and policymakers' perceptions of NAFDAC anti-counterfeit technologies and interventions regarding counterfeit drugs in Nigeria. Participants were selected using convenience sampling, and data was collected through an online interview. Data were analysed using thematic analysis. Stakeholders emphasised the importance of NAFDAC having a comprehensive anti-counterfeiting strategy and implementing measures such as checking for NAFDAC registration numbers, inspecting packaging, and requesting seller receipts to identify genuine medicines. Policymakers at NAFDAC acknowledge the seriousness of the problem and recognise the roles of stakeholders in implementing anti-counterfeiting interventions. They emphasise the need for effective communication, engagement, and collaboration with healthcare professionals. Consumers express concerns about the accessibility to good quality medicines and the prevalence of substandard and counterfeit drugs. However, consumers also demonstrate a willingness to support NAFDAC's efforts and show a preference for quality medicines, which is a positive indicator for the Nigerian pharmaceutical industry. The findings underscore the importance of continuous efforts to raise awareness and implement effective anti-counterfeiting strategies to safeguard public health and combat the growing threat of fake drugs.

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Background: Pharmaceuticals are critical for the health and well-being of populations. However, they can be poisons, and drug disasters such as that of thalidomide and other less dramatic cases of drug injury, constantly remind us of the imperative of testing and control of medicines. Sadly, in Africa and Nigeria in particular, pharmaceutical regulation is severely constrained by limited national capacities to undertake core regulatory roles. Citizens have continued to be exposed to potentially harmful medicines, substandard and counterfeit products and irrational prescription of pharmaceuticals. This study seeks to deepen the understanding of how pharmaceuticals are regulated, what regulatory constraints there are, and proffer policy solutions to improve regulatory capacity and performance in Nigeria. Method: The study adopted a mixed method approach, using questionnaires and semi-structured interviews to collect data from key pharmaceutical actors in Nigeria. The questionnaires were analyzed using SPSS version 20.00, while interview data was transcribed, coded and content analysis undertaken. Key themes were identified and interpreted. Results: 80% of business premises were formally registered with the Pharmacy Council of Nigeria, while 83% of questionnaire respondents were satisfied with overall regulatory performance. 60% of retail pharmaceutical retail outlets surveyed had at least one regulatory inspection in the last one year preceding the study and 6.7% of the sample had not had an inspection visit. Qualitative interviews revealed a number of regulatory capacity challenges ranging from inadequate financing, infrastructural deficits, socioeconomic to official corruption. Conclusion: We conclude that improving services at pharmaceutical retail outlets to achieve health system objectives will require a modification of current rigid control approach by integrating market driven strategies that creatively engages all stakeholders, while recognizing appropriate relationships and balance between needs and standards.

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Influx of fake drugs to Nigeria worries health experts

Nigerian health experts are worried over the influx of fake and substandard drugs into the country, which they complain is endangering the public's health.

Dr Dora Akunyili, director general of the National Agency for Food and Drug Administration and Control, said that fake drugs are responsible for the growing number of cases of hypertension, heart failure, stroke, and other illnesses in Nigeria.

“When people are taking fake or substandard antihypertension drugs, their blood pressure will continue to rise—because what they are taking is rubbish—until they go down with stroke or even die,” she said. “Some of these fake drugs contain nothing. Some of them contain chalk, milk in capsules, and some of them contain little of the active ingredients.

“The fakers are very smart. They know for instance that a drug like chloroquine is bitter and that if they don't put a little chloroquine in their fake chloroquine, people will know that it is not chloroquine. So instead of the 200 mg chloroquine that should be in the tablet, they will put 41 mg. That is what we have been getting from our analysis.”

Dr Akunyili said there was an increase in reported cases of patients who no longer respond to genuine antibiotics as a result of resistance induced by previous intake of fake antibiotics. But not all fake drugs in Nigeria come from abroad. Unscrupulous local manufacturers are also involved in the racket.

Mohammed Yaro Budah, a pharmacist and the president of the Pharmaceutical Society of Nigeria, said that 70% of the drugs in Nigeria are fake. It is believed that imported fake and substandard drugs in Nigeria come mainly from India, China, Pakistan, Egypt, and Indonesia.

“During the Indo-African health summit last year, we sensitised and convinced the Indian health authorities to help us stop exportation of substandard drugs to Nigeria,” said Abubakar Jimoh, spokesman for the National Agency for Food and Drug Administration and Control.

“We are very pleased that we now have the full cooperation of the Indian government. They send to us on a regular basis the list of blacklisted Indian pharmaceutical manufacturers and those involved in fake products.

“We held meetings with ambassadors of countries identified as sources of fake drug exportation into Nigeria. These countries, which include China, Pakistan, Indonesia, Egypt and India, have already begun to take measures to discourage this racket.”

The national agency, which is charged with drug control in Nigeria, said that it also plans to visit and inspect pharmaceutical plants that export drugs to Nigeria to ensure that they are certified by the World Health Organization. It also plans to send approved analysts to exporting countries to carry out pre-shipment inspection of drugs meant for Nigeria. The exercise is scheduled to begin with India next June, with other countries following later.