By Chioma Obinna

Drug is one of the major aspects of medical treatment irrespective of the patient’s condition. When this is mishandled, it becomes a  source of treatment failures and, in some cases, leads to death.

This explains why drug experts  describe the current drug distribution in Nigeria as an embarrassment.

According to Dr. Adesoji Adegbite, a senior pharmacist, the chaotic drug distribution in Nigeria has continued to fuel treatment failures, drug resistance, mortality and morbidity.

To him, chaotic drug distribution is  a monster.

“Drug is not sweet. It is a poison. You cannot play with it. It has to be regulated. A tiny drug can kill or maim if not used properly,” he said.

Speaking at a summit organised by the Association of Community Pharmacists of Nigeria, Lagos State Branch, in collaboration with Philips Pharmaceuticals, Nigeria Limited, he maintained that the system has made every player in the chain including the patient a loser whereas   they all supposed to gain.

“In every layer of distribution in Nigeria, the rules have not been followed. A manufacturer is ready to under play other players within the channel and, at the end of the day, everybody becomes a loser. There is  the need for all hands to be on deck to save the country from the embarrassment. There is need for us to have a change of mindset and play according to the rule,”Adegbite, the chief executive officer of Hesstee Pharmacy, said..

Encouraging pharmacists to embrace the National Drug Distribution Guidelines, NDDG, he said: “A new concept has come up in which manufacturers are to sell to wholesalers and not to retailers. When professionals play by the rule, the country will have reduced treatment failures and fake drugs will be eradicated.

“Chaotic distribution system has allowed fake drugs. It is because we do not have good records in Nigeria and no good medical system. Many people that are dying now may have died of fake drugs.”

The Chairman, ACPN, Lagos, Pharm. Biola Paul – Ozieh, echoed the same sentiment when she  said the drug distribution system is a great embarrassment not only to Nigeria but to individuals, consumers and patients.

“Treatment failure rates are so high. Drug abuse and misuse in the society has led to resistance. Everything is traceable to the distribution and un-coordinated system.”

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.

The loose control system and chaotic drug distribution system have  also contributed to the circulation of counterfeit drugs in the country.  According to the World Health Organisation, WHO, counterfeit drugs are 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.

In 2008, 34 Nigerian children aged between four months and three years died and more than 50 were hospitalised with severe kidney damage after taking  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.

Paul – Ozieh explained that the summit was to create awareness on the NDDG among  wholesalers as well as update them on the impending changes in the system.

She recalled that the implementation of the guidelines was planned to take effect  from the day of launching but was shifted following an outcry by a section of the supply chain.

The summit is an attempt to align with the vision of the proponents of the NDDG that government would have overcome a major challenge of uncoordinated drug distribution in Nigeria if the NDGG is systematically implemented.

Dr. Lolu Ojo explained that the NDDG was not part not a perfect document but if implemented could take Nigeria far.

Ojo, who was among stakeholders who worked on the guidelines, maintained that the 2012 edition of the NDDG as gazetted is good enough for operations because it has accommodated every player.

On his part, Senior Business Development Manager, Philips Pharmaceuticals, Kaushik Banerjee, advocated a proper channel of drug distribution, adding that the company was collaborating with ACPN because its their members are important in the sector.

“We want  to ensure that as professionals they are updated with the latest evidence-based medicine. We want to ensure that they are continuously updated on what is happening in the global forum,” he added.