Saturday, April 30, 2011

The Proliferation of Fake Drugs in the Nigerian Market, Whose Faults?

By

Sani Garba, August 2004





The bitterness of low quality drugs remains long after the sweetness of low price is forgotten.

--Nigerian Association of General Pharmacist Practice [NAGPP]





The issue of fake drugs and others is assuming new dimension as to who is responsible or not in averting the situation. Is it NAFDAC, Federal ministry of Health, Pharmacist Council of Nigeria, or who? This article looks at those who in one way or the other have a hand in the control of drugs, foods etc, their power/functions by either law or circumstances, their achievements and failure, to see whether they are performing above board. In addition, we shall see what a fake drug[s] is [are], how they come into Nigeria and the way out.



NAFDAC



NAFDAC is established to do the following:



a] “regulate and control the importation, exportation, manufacture, advertisement, distribution, sale and sue food, drugs, cosmetics, medical devices, bottled water and chemicals;

b] “conduct appropriate tests and ensure compliance with standard specifications designated and approved by the council for the effective control of quality of food, drugs, cosmetics, medical devices, bottled water and chemicals and their raw material as well as their production processes in factories and other establishments;

c] “undertake appropriate investigation into the production premises and raw materials for food, drugs, cosmetics, medical devices, bottled water and chemicals and establish relevant quality assurance systems, including certification of the production sites and of the regulated products;

d] “undertake inspection of imported food, drugs, cosmetics, medical devices, bottled water and chemicals and establish relevant quality assurance systems and of the regulated products;

e] “compile standard specification and guidelines for the production, importation, exportation, sales and distribution of food, drugs, cosmetics, medical devices, bottle water and chemical;

f] “undertake the registration of foods, drugs, cosmetics, medical devices, bottled water chemical;

g] “control the exportation and issue quality certification of food, drugs, cosmetics, medical devices, bottled water and chemicals intended for export;

h] “establish and maintain relevant laboratories or other institutions in strategic areas of Nigeria a may be necessary for the performance of it functions under this decree;

i] “pronounce on the quality and safety of food, drugs, cosmetics, medical devices, bottled water and chemicals after appropriate analysis;

j] “undertake measures to ensure that the use of narcotic drugs and psychotropic substances are limited to medical and scientific purposes;

k] “grant authorization for the import and export of narcotic drugs and psychotropic substances as well as other controlled substances;

l] “collaborate with the National Law Enforcement Agency in measures to eradicate drug abuse in Nigeria ;

m] “advice federal, state and local government, the private sector and other interested bodies regarding the quality, safety and regulatory provisions on food, drugs, cosmetics, medical devices, bottled water and chemicals;

n] “undertake and co-ordinate research programmes on the storage, adulteration, distribution and rational use of food, drugs, cosmetics, medical devices, bottled water and chemicals;

o] “issue guidelines on, approve and monitor the advertisement of food, drugs, cosmetics, medical devices, bottles water and chemicals;

p] “compile and publish relevant data resulting from the performance of the functions of the agency under this decree or from other sources;

q] “sponsor such national and international conference as it may consider appropriate;

r] “liaise with relevant establishments within and outside Nigeria in pursuance of the functions of the agency; and

s] “carry out such activities as are necessary or expedient for the performance of its functions under this decree.



Achievements



Despite my criticism against some of the method NAFADC is adopting in dealing with drugs, it deserves some kudos in many areas.

NAFDAC created 6 zonal offices and 36 offices in the state of the federation, confiscated many questionable drugs and destroyed them. It also carry out some activities of enlightment to small and medium enterprises, for instance, it teach them how to do the right thing, show them how to how to register their businesses, products and make them operate legally, let all stakeholders know the law governing their businesses and make them understand the penalties that await those who go against the law; and assist producers regularizes their operations.



Such activities make many drugs dealers surrendered many of the fake and substandard drugs they posses which was very commendable so other people in other businesses.

NAFDAC also held a summit with Indian authorities, which sensitize and convince them to help Nigeria by stopping exportation of substandard drugs to the country. It held another one in conjunction with House committee on Health with ambassadors of the countries identified as the root of the influx of fake drugs to the country like India , Indonesia , China , Pakistan , and Egypt , which a position was reached that they will help Nigeria n addressing the issue.



NAFDAC also held consultation with national and International stakeholders, which lead them to receiving assistant and collaboration in the sectors of training, equipment procurement and information sharing. Organization consulted among others includes South African Medicines and Medical devices Regulatory Agency [SAMMDRA], United State Food and Drugs Agency, Economic and Occupational Health Services Institute [ECHSI] etc.



NAFDAC succeed in making most drugs registered with it which to some extent confer such drugs immune from being faked, more so many also are in the process of registering, this only make people now conscious of whatever [food, drinks etc] they bought that they have to see NAFDAC's number.

Recently also, official signing of NAFDAC green page was done to ensure only registered and reliable drugs were allowed to be used in our hospitals, pharmacies and others. The director general of the agency Dr Akunyili was quoted saying “….NAFDAC recent raids and subsequent closure of the drugs section of the market in Sabon Gari, Kano, may not have arise if a publication such as the NAFDAC green page was available, it will be practically impossible for any marketer to claim ignorance of the authenticity of the products they sell as they can easily check and double-check all products and their sources”.

Mr. Ojo Sani, the director projects NAFDAC also added “with NAFDAC green pages all stakeholders in the industry would have a legitimate common grounds, where their products and services would be show-cased to Nigerian and the world, through three media; the book form which will be in volumes and yearly, compact disks and via internet”.



The most outstanding achievement it achieved which is unprecedented and is being sabotaged by some segment of the Pharmacists is drug market distribution model. The proposal was to establish Model Drug Mart in the six geo-political zones of Nigeria, and the whole objectives is to create an ordered network for the sale and distribution of wholesome pharmaceutical products instead of the now chaotic markets we are using. According to Abubakar Jimoh, the PRO of NAFCDAC “The concept is to farm out an area that is exclusively provided for the wholesome distribution of pharmaceuticals. This area will be securely delineated with buildings that are customized for the wholesale of drugs. The buildings or shops will be rented to accredited pharmaceutical manufactures, importers and wholesalers. Entry into the area will be restricted to duly licensed retailers and other health care practitioners. These people will share common services and create the ambience and convenience for one-stop shopping which is the major attractive of the current unregulated open drugs markets”. In addition, Jimoh added, “these building will have the relevant infrastructural facilities to ensure adequate temperature storage control which would safeguard the stability and shelf-life of the products”.



Jimoh also in continuation of explanation of the Drug Mart which I will continue quoting for more understanding of NAFDAC effort in this context which as I said before, some segment of Pharmacist are objecting it, is, “the new system being proposed will ensure that only registered and authorized companies manufacture or import drugs, market drugs and that drugs are stored under the best conditions which guarantee their acclaimed shelf-lives”. “The system” he also added “will ensure thorough inspection and enforcement, such that only registered efficacious and safe drugs are manufactured or imported into the country, and that such dugs reach the retailers and consumers only through registered and regulated distributors who operate under the purview of NAFDAC. The individual stall must also by law be registered by Pharmacists Council of Nigeria [PCN] and supervised by registered Pharmacist”.



“That is our DRUG MART concept” continued by Jimoh “and we believe that it is an appropriately simple but fundamental way to deal with this intractable problem. When these drug marts are in place, which will be patronized by professional, managed by duly authorized people, and located in the six geo-political zones of the country in the first instance, we can then proceed to demobilize the existing unregulated open markets through the following actions:

a] “Denial of pharmaceutical supplies as NAFDAC will ensure that all manufacturers and importers supply only the official and regulated drug marts or other approved variant.

b] “Denial of patronage by professionals and other authorized agents, since there is now a proper alternative. When supply and demand are denied such markets, they will automatically die natural deaths.

c] “[a] and [b] above will diminish the size and importance of the existing illegal markets and will make it easier for NAFDAC and law enforcement agencies to close down such markets. In such circumstances, the social impact of the state and local government involved in the exercise will be enhanced.

d] “Finally, NAFDAC has given the drug marts the name “Zonal Drug Distribution Centre to avoid any misconception about a similarity between the drug mart and the current chaotic drug market”.



This is drug mart concept which still remain mirage, to me is the most

outstanding achievements of NAFDAC so far though still remain a mirage.



Failures



Despite the achievement of NAFDAC, it failure seem to be more. Beside the

problems I cited in my earlier article as per registration of the drugs [which may not

necessarily guarantee it from it being faked by others] there are others too.

NAFDAC has no power to prosecute all offenders connected with faking or

manufacturing of substandard drugs, anybody arrested with such activities and taken to the court will not be prosecuted in shortest period. The case will be dragged to adjournment for many years which at last either the case to die natural death or something else. As at now, there are many pending court cases, but no end in sight as to when they will be disposed up.



For instance, “in the record of NAFDAC” according to Budah “they have cases over the years of people they have apprehended, of places and where fake drugs are displayed, the records are there, the information is available to them from different sources. What we are saying is that NAFDAC should act, but they have started saying that they will appeal to people’s conscience which is unfortunate” [emphasis mine].

NAFDAC has no all the necessary equipments, professionals, funds etc to carry out all its duties confer on it by law that established it. It is very unfortunate that the state food and drugs control agency has no enough equipments and work force to carry out every thing within it jurisdiction of law.



In addition, the way NAFDAC is paying attention to drugs only neglecting other foods, cosmetics, bottled/pure water [which recent studies by NAFDAC showed that 97% of pure water is contaminated with microbes], medical devices, the dangerous traditional herbal preparations and drugs hawkers is not in order. All of them are potential weapons that can dehumanize human lives, so paying attention to one direction will achieve nothing; rather it will set back all the achievements so far realized on drugs to zero level.



The insistence of NAFDAC to register all drugs at a time frame is improper, some drugs are new into the country as such they have to be given time before registering and that on its arrival they are good and quality, but upon started circulation in the Nigerian markets [especially if the drug[s] is profitable or less common] it will in the soonest be faked, therefore registration should be continuous but with strict observation not fixed to a particular time.



“To shorten registration as much as possible” according to Okpalafuaku, The president Anambra State Association of Pharmaceuticals importers “without compromising standard, NAFDAC has had to tax itself heavily. For example NAFDAC laboratory staff members work up to 11.00pm everyday only to resume at 8.00am the next day. Its pharmacist, laboratory scientists, chemists, microbiologist, etc are really stretched, yet it takes several months to complete the registration, which include documentation with Federal ministry of trade, public notarization, NAFDAC analysis, NAFDAC clinical trials and, finally NAFDAC grant of approval.

“Had NAFDAC gone ahead to implement the decision” of last December he added “there would have been two major related crises in the Nigeria pharmaceutical industry: acute scarcity of drugs in the country and very high prices of the few available ones. The resultant would have been chaotic and the casualties would have been Nigerians, the same people whose interest were meant to be protected by the policy”.



Pharmacists Council of Nigeria



Pharmacist Council of Nigeria [PCN] is an established body according to law that set it in charge of among others:

a] “determining the standard of knowledge and skill, to be attained by persons seeking to become registered member of the pharmacy profession and reviewing those standard from time to time as circumstances may require;

b] “securing, in accordance with the provisions of this decree, the establishment and maintenance of registers of person entitled to practice as members of the profession and the publication, from time to time, of list of those persons;

c] “reviewing and preparing from time to time, a statement as to the code of conduct which the council considers desirable for the practice of the pharmacy profession;

d] “regulating and controlling the practice of the profession in all its aspects and ramifications; and

e] “performing such other function as may be required of the council under this decree”.



Achievements



The Pharmacist Council of Nigeria as a body charged with determining the standard of knowledge and skill to be attained by person seeking to become registered member of pharmacy profession, has tried in making Pharmacy profession as distinct by making sure only registered member is duly deserved to practice. It ensures that quack members [to some extent] were given no room to practice as they are polluting the profession and render it unprofessional.



Failures



The council is not functioning as it is expected in determining who practice pharmacy in Nigeria that is why I said it ensures quack members not allowed to practice but to some extent.

Section 11 subsection A of PCN act stated who shall be entitled to be a pharmacist, it said “such a person should be Nigerian citizen; is of good character; and fit and proper; has attended a course of training approved by the council, or the course was conducted at an institute approve by the council; hold a qualification approved by the council; and has undergone the statutory continuous internship training for not less than one year under a registered pharmacist…..”

Does such person depicted above are the one in charge of the drugs section of our market and other medical stores, no, they are not. Majority [with few rare] of them are ignoramus of what drugs are in all ramifications but only to sell and get profit. These people has taken Pharmacy profession for granted as if it does not require any skills and training before a person become a pharmacist, and the PCN is paying lip service to the situation. For instance if you went to market and tell these drugs sellers [most of them] that you are a pharmacist, they will not even look at you or care about you, for they know they are dong what you claim to be [even though untrained], so the respect they ought to show to you is no where to be found. These people see themselves as authorities because even the pharmacist it seems wittingly or unwittingly surrendered their professional competency to them just to make profit to their various companies.



To show how decadence pharmacy profession is in term of regulation, now people prefer to go to the market[s] directly than pharmacies, so that they can get affordable prices and others which in turn the drugs they bought is either fake, expired or something bad or costlier than the outside market. Recently a patient comes to me with a prescription of Norfen tablet [a brand of Norfloxacin] and we do not have, he decided to reach market to buy it, so, upon reaching the market and enquire about it and he was instead given a Nurofen tablet [an analgesic] which incidentally he returned back and showed it to me. I then told him that the tablet he bought is entirely parallel with the one he was prescribed, while the former was antibiotics the later was analgesic [pain reliever], these kind of episodes do occur daily and the patient do not know because they are after cheaper drugs [though it the socio economic conditions of the country that forces them], nevertheless they are being cheated in most cases with either expired or fake drugs.



Another example is somebody took his prescription to the market and met an Igbo boy in a shop, he handover the prescription sheet to him, when the guy read and re-read the paper and could not understand what was written, he said “hey this doctor na yeye man, he no notin, shabi say he no go school, which drug na this, bobbo make I change this for you this na the correct one, this doctor no no drug”, and the person accepted the Proposal of the guy ignorantly. In reality the guy[the lgbo boy] does not know the drug in question talk less of understanding the prescription, dose, strength to be given, instead to cover his inadequacies and say he do not know he resort to useless attack on the innocent doctor. So these kinds of episodes do occur daily which leaves much to be desired but still PCN is dong nothing to see that the image of the profession is regained, respected and regarded. If you reach market, you will see the most unprofessional dealing of drugs by these so-called market pharmacists who are claiming they know drugs more than the pharmacist courtesy of their interaction with drugs.



If these must continue their business, when will PCN see it necessary to ensure they are train for not less than a year to know the basic information pertaining drugs? Unless this is done, the abracadabra and the contaminated desire of these people to get money in drugs business are downgrading the image of pharmacy, for it seem it now all comer affairs, hence the failure in curtailing the menace of fake drugs.



Pharmaceutical Companies



Pharmaceutical companies manufactured drugs and give it to distributors or move round the pharmacies, various hospitals and other relevant institutions for onward use.



Achievements



The pharmaceutical companies that have representatives in different locations are making their products accessible and reliable. In most cases their product are not being faked always due to their vigilante and surveillance in distributing their products.



Failures



The problem or failure of pharmaceutical companies is that, instead for them to patronized pharmacies, they will prefer to reach the open unregulated market purposely to get money. The pharmacist [both of the companies and the representatives] had compromise qualitative services to money and profit making, while they know these people are not professional [though that is how drugs is distributed in Nigeria ]. The pharmaceutical companies also preferred money than every thing, for instance they can produce a drugs and sold it to only one business man [drugs dealer] alone, which he will only be the one to determine who get it when, how and at what prices, he become the alpha and omega of the drugs sold to him. Infact, sometime even the pharmaceutical companies are onlookers in their products for in most cases if you are looking for some drugs from them you cannot get it, but if you dig your searching machine deeper, you will find out that one or some drugs dealers hoard the whole of the drugs produced by the companies so that they can determine every thing [the price, quality etc] of the drugs. This gives room for them to engage in faking it and producing in substandard manner to the unsuspecting people.



In contrast, Mr. Wole Olanus, the chairman of Pharmaceutical Society of Nigeria [PSN] Ondo state blamed the action wholly on drugs manufacturers to flooding the markets with fake drugs. According to him, many of the drug manufacturers sell their products directly to the highest bidder irrespective of whom the buyer is and the premises through which the products are re-redistributed.

He said “The distributor[s] who in most cases is [are] not pharmacist in turn sells any drug to just anybody who brings money in order to increase his sales volume, meet his banker’s obligation and impress his manufacturers who at the end of the year may give out various gift including car and others” [emphasis mine].



Drugs Dealers



Drugs dealers in the markets represent some manufacturers and other sole agents’ selling drugs, they are ether literate or illiterate, educated [but not in health related fields].



Achievements



They are serving as wholesalers between the pharmaceutical shops, chemist and other medical stores. They distribute also or sale various drugs of the companies they collected to others for sale.



Failure



They do join hand with medical representatives to either hoard drug[s or increase prices unnoticed.



Customs



Customs are the responsible agents for allowing what should be imported in to the country or will be exported outside the country. They are vigilante in all the various boarder of the country checking to ensure law of the land is maintain as per in and out of the country [drugs, food etc inclusive].



Achievements



They are helping NAFDAC in confiscating drugs that have questionable sources, or are either fake or those not allowed to be imported into the country without permission. They are also easing NAFDAC in other ways to ensure that everything goes accordingly so that the public health of the nation be safeguarded.



Failures



They are colliding with drugs dealers by allowing them to bring substandard products despite their security and check up. Is it they are corrupted or they too are part of the business is uncertain. However, whatever is the answer, they are a failure in that direction [though sometime they cannot go beyond certain limit, as they will be ordered ‘from the above’ to do what is against the law], which is unfortunate.



Environmental Health Officers



These are professional preventive health practitioners charge with the control of waste, food hygiene, housing and environmental planning, pollution control, diseases vectors control and others. The essence of including them is because they have the power to enter any premises to ascertain whether nuisances exist and their power to inspect food [drugs, drinks inclusive] exposed for sale. What I meant is that, in relation to power to enter into any premises, according to Northern Nigeria Public Health Edict CAP 109 section 11 subsection 1a “it shall be lawful for the health officer to enter any premises at any time between the hours of six in the morning and six in the evening for the purpose of examining as to the existence there on of any nuisance….”. This nuisance is “any act, omission, place or thing, which is, or may be dangerous to life, or injurious to health or property”, and it can be police/public/common law nuisances, statutory nuisances, summarily abatable nuisances, structural nuisances, health nuisances or sanitary nuisances.



Our main concern here is health nuisances, which fake drugs and other drinks if allowed to be consuming, will cause a devastating effect to the consumer’s health. So the EHO’s power is to ascertain in any premises [be it pharmaceutical premises or wherever nuisances exist] he deem fit necessary and take appropriate action.

Also, section 14 empowered that “the health officer may at all reasonable hours, inspect any carcass, meat, poultry, game, fish, vegetables, corn, breed, flour, or other provisions exposed for sale or deposited in any place for the purpose of sale or of preparation for sale and intended for the food of man…”. So in this context “other provisions exposed for sale or deposited in any place for the purpose of sale…” include drugs food, bottled water and all other items NAFDAC is charged to oversee, hence the role of EHO cannot be overemphasized, infact, they have to be integrated in its activities, for it will reduced the work load NAFDAC staff are undergoing.



Achievements



As at now we cannot say this is their contribution for two reasons, one, their activities is no longer appreciated and given high regard talk less of empowering them in all they needed coupled with the corrupt mind of some of them who collide with perpetrators of offence to cover them and in return they will be given bribe, two, NAFDAC seem to be one man show by not incorporating them into its activities which they have full professional competency in the area related to their profession.

Therefore, Environmental health practitioners ought to be reform in tune with the reality of Nigerian situation if the objectives of NAFDAC are to be achieved.



Failures



They are not doing as expected due to their inadequate number in the country, in addition to lack of equipment, motivation, retraining and other things that will encourage them to work efficiently, hence the failure of NAFDAC in helping it appropriately.



General comment



Having seen the roles of the above bodies on how they are playing roles in the control and distribution of drugs, I will now to talk on fake drugs. “When we talk on Fake drugs” according to Ahmed Ibrahim a former deputy president of the PSN “it is either there is no active ingredient at all or it has very little of it [in the drug]. Actually, fake drugs are the umbrella name for all the others. With substandard drugs, it is possible there is little active ingredient in them, while the cloned ones may have all the ingredients but they are not the original makers of the products of a reputable pharmaceutical company, take to India or the far east and make exactly the same kind of drugs and brings them back to sell as products of that reputable company. That is cloning. In adulterated, you have two litres of syrup but somebody will dilute it to ten litres of that syrup or use other things to contaminate it, or sometimes they buy cheaper chemicals to produce such drugs. All come under fake drugs”.



Therefore, how does fake drugs come to the country despite the availability if customs and others? According to Prof Okhamafe Augustine of University of Benin, the reasons for the helplessness of fake drugs are organic due to the porous nature of our national boarders, ineffective monitoring at the port and the element of corruption. He also added, “most of the drugs imported in to this country are imported by non pharmacist or people who are not trained. They are simply interested in importing drugs just because of the gains in them”.

In another perspectives, Prof Okhamafe said also our “our businessmen go there and say we want a particular drug, but we do not want it to contain what it should contain or where it should contain 100mg, just put 20mg. In appearance, the packaging, the leaflets look the same, but they are substandard”. It also seems that the effect of these fake drugs is being underestimated by both health authorities and at individuals’ levels. According to Lere Baale, “the implication” of fake drugs is “enormous. I always tell people that fake drugs are synonymous with silent killers, because the people are taking these drugs to cure a disease which ultimately will not be cured but will instead worsen it…..imagine a patient given antibiotic, and when analysis is done on the drug, it is discovered that it does not contain any active ingredient. I therefore strongly suggest that those who deal in these fake drugs should be treated as killers and punished accordingly”.



After importation of drugs [both good and the fake], by far the greatest to the replication of fake drugs is the explosion of unregistered outlet for their sales. It has been observed that in Lagos within the period PCN is without board, over 45,000 unregistered outlets emerged which is common scenario nowadays even-though PCN is now under full control.

To show how this issue of fake drugs becomes confusing is the statement of Yaro Budah that “even the professional pharmacist or doctor, even the original manufacturer cannot tell these drugs apart. We have demonstrated this over and over. I remember as far back as November 2000, we went to see president Olusegun Obasanjo and we actually demonstrated this problem at the Aso rock Villa, where we took genuine products with their fake counterparts and he could not tell them apart. We dramatized it for him to see and he said to quote him, that people who bought fake drugs were foolish, which meant that indeed he too could be foolish”.



Therefore, the case of fake drugs is beyond imagination as the situation is becoming intractable daily and the responsible authorities are either handcuffed because according to Okhamafe “it is very difficult to enforce laws regulating drugs circulation in Nigeria because there are a lot of powerful people. Most of them depend solely on the importation of these drugs for their business” and/or, “FG is not serious about the fake drugs war” according to Kikelomo Sunmomu, the director of pharmaceutical services, Lagos Ministry of health Lagos.

Though the PSN has advised NAFDAC to shut down unregistered premises through enforcement of federal task force under decree 25 of 1999, which is on counterfeit, fake drugs and unwholesome processed food and stipulates penalties for those found guilty of faking or counterfeit drugs, still nothing was achieved since.



The way out



Government/NAFDAC



Government must allow NAFDAC [without interference] to carry out its activities with neither fear nor favour on whoever was caught in the business of manufacturing or importing fake drugs.



The open unregulated market must be closed down throughout the federation [a change from my earlier stand] so that the people affected can be incorporated in to the proposed drugs mart model instead of allowing then to be out of business

. Hence, “the issue of wiping out the drugs markets as we have” according to Rosemary Nikoro “in Idumota, Ariaria, market in Aba etc is a question of policy, it is a question of will of the government. If the same government can put a ban on the importation of second hand air conditioners or compressors, and the list of other things, and that same government can’t look into what the society is asking in the area of wiping out illegal drugs markets, it is a quite a pathetic situation because the whole of the environment can be wiped out through a fake and dangerous product that is brought into the country, so it is not for any professional gains per say that the society has been advocating the closure of the market, it is just for the environment.





There is the need according to Okpalafuluaku “to institute regular policy dialogue between government agencies and other key stakeholders included, apart from NAFDAC, indigenous manufacturers and drugs importers. It will therefore be appropriate for NAFDAC to hold meeting, say every quarter with all stakeholder on government policies before they are adopted”.



The government must do everything to see that NAFDAC get rid of all questionable drugs, food, bottled water, chemicals, medical devices etc if the objectives of fighting drugs is to be achieved.





The element of Bias should be stop, for I know a person who is a Hausa man but spent over two years looking for his drugs to be registered but did not get it, while many Ibos and Yoruba’s that comes after him got their own with out much hitch.



The Pharmacist



The pharmacist according to Prof Okhamafe are of the view that the first step to be taken by government to ensure only genuine, reliable and dependable drugs are imported is to designate only two ports of entry for drugs importation.



The PCN must checkmate the proliferation of patent medicine stores without fulfilling the provision of law. Some stores are full provisions but you will see drugs inserted in the shops, so there is need to regulate such. It should also make sure that all those who are selling, dispensing and prescribing drugs in either chemists, pharmacies and others to at least [if they are neither pharmacist nor health professionals] to have knowledge no matter how small on drugs before they will be allowed to continue business.





Journalists



The journalist have a bigger roles in sensitizing the public and others in the dangers of fake drugs to our health, and informing the government whether or not its policies have loopholes so that appropriate action be taken.



Journalist should know that they are the shapers of the society to whichever side [government inclusive], so they have a great role in this crusade against fake drugs, foods etc.



The drugs importers



Drugs importers should stick to importing only the drugs that registered with NAFDAC that will be published in the new green pages. If any drugs that did not register with NAFDAC must be imported [especially those that have no representatives in the country], the importers [they know themselves] should join hand and register those particular drugs, so that whoever want import them ,it if he is not part of them [that took the responsibility of registering it], he must register with them. This mean they will be like the owners of the drugs courtesy of the register, since many important drugs are not yet registered and they have no registered alternatives and yet they do not have representatives in the country, and also they are equally very important..



Others



Everybody has role to play irrespective of his status in joining hands with appropriate authorities to end the circulation of fake drugs, food etc in the Nigerian market. Wherever you see something questionable, you can report it the appropriate authorities for appropriate action.

Therefore, this fight against fake drugs is not the action of NAFDAC alone, it need multisectoral approach [both formal and informal] for holistic and comprehensive achievements of the objectives of making Nigeria a better environment for all aspect of drugs dealing so you are expected to do something.



Last word



I am neither a pharmacist nor a medical doctor, but an interested health practitioner [a public health technologist who want see the Nigerian drugs situation is safeguarded with reliable, dependable, qualitative and tested drugs, and also as a stakeholder in public health] who found himself in pharmacy as a pharmacy assistant, and my comment may not be necessarily reflect the view of pharmacists and others, therefore, it my own opinion based on how I see them.

In addition, whatever is my fault it is limited to my knowledge on whatever I discussed.





Corrigendum

In my article posted on this website titled “ Environmental Health in Nigeria, ………”, I inadvertently said “The position of Environmental Health Officers in Primary Health Care [PHC] has been hijacked by medical health practitioners [Most especially medical doctors], whom their professional orientation centred wholly on curative health, thus they are not giving any attention to the preventive aspect of health due to their poor knowledge on environmental health. They now dictate where the pendulum of the PHC will swing by hijacking every thing whether or not it is within the profession, for they do not separate their duty with those of other profession”.

The statement could have included others like community health officers, nurses and others in the bracket who hijacked the roles of EHO’s. I was accused by being selfish to cite only a medical doctor. I am also very sorry to those who feel bad over using the word ‘poor’ in relation to limited knowledge of doctors in environmental health. My point is just to show the disparity between them [doctors] who study environmental health as subject and those who studied it as a course of study. Therefore, to those who were not happy over what I said should forgive me, but they should know I only raised a fact.





References



1 Weekly Trust February 22-28, 2002

2 Weekly Trust March 14-21, 2002

3 Pharmacy and Drugs law in Nigeria , a compilation of Pharmacist Council of Nigeria

4 The Nigerian Journal of Pharmacy, Vol 34, April-June 2003

5 The Daily Sun July 21, 2004

6 The Punch July 21, 2004

7 Daily Trust July 23, 2004

8 Northern Nigeria Public Health Edict, CAP 109

9 Everyday Newspaper July 26- August 1, 2004

10 Daily Trust July 27, 2004

11 New Age July 26, 2004