By Sola OGUNDIPE
THE menace of fake and counterfeit medicines in  African countries has been a worrisome point to governments across the region for several decades.

Last week, in the bid to implement and enforce relevant legislations and regulations that will prevent, control and reduce the incidence of counterfeit medicines,  30 national health professionals from 14 countries  met in Abuja to endorse the World Health Professions Association, WHPA, declaration tagged “Abuja Call to Action on Counterfeit Medical Products”.

Pharm Azubike Okwor

The event was  the first-ever African multi-professional workshop on counterfeit medical products in Africa.
President of the Pharmaceutical Society of Nigeria (PSN), Pharm Azubike Okwor, spoke on the importance of raising awareness about the risks of counterfeit medical products while encouraging governments of affected nations to take action to fight the problem. Excerpts:

How can the problem of drug faking in Nigeria be tackled?

The problem is in every country, but the way out of the quagmire is to ensure first of all political will from the highest level of governance. We need to show that we want to tackle this issue headlong.

Then we must strengthen the regulatory agencies and get the commitment of the operators of this scheme to ensure they are at least in tune with the law. And there should be a new national consciousness which aims to ensure that Nigerians are educated about the danger of ingesting fake drugs.

Government has a duty to protect the citizens. I tell you that the harm caused by counterfeits are incalculable.

You cannot calculate the harm to the economy, to the country, to the citizenry, to the health of the nation and to the healthcare system. The way out is that once we have the political will, it will increase the level of suspicion for every drug product coming into the country.

So why have we not achieved this?

We have talked about the routes through which drugs come in, which ports, the restriction of imports for medicines, to certain limited airports and seaports. We have said time and time again that the drug markets are repositories for the fake and counterfeit products. We have painted a scenario that if someone imports a trailer-load of fake or suspected fake items, and there is no central place where these can be off-loaded.

We have shown that the economic cost of distributing such products without a central distribution network would actually outweigh the profit from these products and would serve as a deterrent. However, what we have currently is that once these goods get to the ports, there is a central location where they can be dumped and offloaded. From there, these drugs filter into the distribution chain.

How about our drug distribution system?

Again one wants to ask what we are doing with our drug distribution system. As a nation, we should be concerned about how medicines are distributed. Medicines can be compared with guns. Medicines are weapons as dangerous as guns, and of course we do not allow guns to be sold on the streets. They are weapons of mass destruction.

They kill in numbers, so government at all levels must be concerned.

What is the real burden of fake drugs in Nigeria?

International bodies have said the burden of fake and substandard drugs in African countries is to the tune of 20-50 percent. Let us not delude ourselves by listening to an agency talking about five percent. It is a lot more than that.

We are not reporting properly, we have not even gone to the villages and there are areas where the rate is as high as 50 percent. We are worried as stakeholders in drugs and pharmaceuticals. Government should get worried like we are.

How do we tackle this?

The situation in Nigeria is probably better off than most other African countries in that at least some good work has been done by the regulatory agencies for some time. What we are saying is that this good work can continue.

All the countries in Africa need to come together and begin to sing this song about safety of medicines. Medicines are supposed to be safe.

We must  come home to manufacture our drugs. India and China have shown that this is possible to earn income from making drugs. Nigeria should become a hub for manufacturing drugs. The pharmaceutical sector can earn income for every nation, especially big nations like Nigeria.

We can manufacture excipients, we should develop the petrochemical sector and  begin to form the basis for making drugs. We can earn income, employ our people and ensure safety for those ingesting fake drugs.

And the fakers…?

As for those who are caught faking, what have we done to them? Until we begin to show examples with those who are caught, the problem will continue. But it can be done. Oshodi is a good example. Nobody thought it was possible but it has been done.  We must also do something to bring down the high cost of medication in this country. Poverty level is so high that people are always tempted to buy cheap alternatives.

What is the significance of the Abuja Declaration?

The Abuja Declaration is historic in that it is going to be an international call to action for all stakeholders, including government, healthcare personnel, the community, NGOs and patient organisations. We are going to go public with the Declaration.

We are trying to generate a mass movement. There are 14 countries represented by pharmacists, physicians, nurses, patients orgs, physiotherapists, dentists, and several others. We will be talking to the African Union, ECOWAS, each of the presidents of the  countries involved, civil society, etc.,  to begin a national consciousness which would generate the movement that would emphasise we are tired of fake and counterfeit medicines.

We are tired because it is destroying our people. We will go to the human rights commission and say we cannot afford to take fake drugs from any country making fakes and counterfeits anymore. If our government is not ready  through diplomacy to challenge this system that gives us fake and counterfeit medication, we are going to take it up and begin to challenge it at the highest court in the system.

We are going to the Hague. We will take China and India and whoever is involved to court and ask them to stop these products from coming to our country.

Role of regulatory agencies

The impression regulatory agencies will give sometimes is that they have stopped the hawking of drug products but I can tell you that worse things are now happening. In Nigeria alone there are people who still carry drugs in baskets and roam the streets. Counterfeit and fake drugs now have pornographic content, posing danger for our children and wards. Through medication, people are now passing on pornography.  It is unacceptable.