By Sade Adewale,Akinnodi Francis,Kayode Olabanji,Precious Owolabi &Adeboye Ado

50% of drugs in Nigeria is fake — Report

UNODC reveals 267,000 die yearly in sub-Saharan Africa

Nigeria’s healthcare system is on the brink of collapse as a combination of brain drain and the proliferation of fake drugs continue to endanger lives, stakeholders in the sector have warned.

Recently, the Minister of Health and Social Welfare, Dr. Muhammad Ali Pate, revealed that between 2018 and 2023, about 15,000 to 16,000 doctors left the country in search of better opportunities abroad.

He stated that between 2022 and 2023 alone, the number of Nigerian health workers under the UK’s Health and Care Skilled Work Visa rose from 8,491 to 26,715, representing a 215 per cent increase.

He attributed the worsening state of the nation’s health sector to poor funding, stressing that the government must increase its budgetary allocation to health from the current 4-5 per cent to the 15 per cent agreed upon by African heads of state in the Abuja Declaration.

According to the United Nations Office on Drugs and Crime (UNODC), fake and substandard drugs claim an estimated 267,000 lives annually in sub-Saharan Africa, highlighting the grave danger posed by counterfeit pharmaceuticals.

The brain drain in the health sector has also worsened, further crippling healthcare services across the country.

Experts, including the Director of Pharmaceutical Services at UNIMED Teaching Hospital, Akure, Pharm. Matthew Olusola Ogunmodede; Chairman of the Pharmaceutical Society of Nigeria (PSN), Ekiti State, Pharm. Martins Alutundu, and several other medical professionals, have raised the alarm over the worsening crisis.

Ogunmodede, in an interview with Weekend Hope, decried the mass exodus of doctors and pharmacists, lamenting that the country has also become a dumping ground for substandard medicines.

He cited a report from Bayero University, Kano’s Journal of Basic and Clinical Sciences, which suggested that about 41 to 50 per cent of drugs in Nigeria were either fake or substandard.

The National Agency for Food and Drug Administration and Control (NAFDAC), has equally raised concerns over the quality of essential medicines, including antibiotics, anti-malarials, anti-hypertensives, and anti-diabetics.

Ogunmodede painted a bleak picture of the situation, noting that the World Health Organisation (WHO) had already placed Nigeria on its red list of countries facing a severe shortage of medical professionals.

He stated that the country’s doctor-to-patient ratio currently stands at two doctors per 10,000 patients, far from the WHO-recommended one doctor per 600 patients.

The Chairman, Pharmaceutical Society of Nigeria (PSN) in Ekiti State, Pharm. Martins Alutundu, expressed concern over the mass departure of healthcare workers, including nurses, pharmacists, and physiotherapists, to countries such as the United Kingdom, Canada, and Australia.

He lamented that hospitals are losing staff at an unsustainable rate, making it difficult for institutions to retain professionals.

According to him, fake drugs lead to failed treatments, worsening disease burdens, and a rise in preventable deaths, especially among vulnerable populations.

A pharmacist at Dezubik Pharmacy in Akure, Pharm. (Dr) Samson Chukwudi Asokome, echoed concerns about the infiltration of fake medicines, stressing that they pose serious risks to public health.

He explained that the prevalence of counterfeit drugs is eroding public trust in the healthcare system, discouraging people from seeking medical help and worsening health outcomes.

He also pointed out that the financial burden of treating complications from fake drugs was straining both individuals and the country’s healthcare system.

Medical practitioners have called for urgent reforms to address the crisis.

A medical expert, Dr Adeyemi Adelakun, identified fake drugs as a major contributor to rising cases of hypertension, heart failure, stroke, and other life-threatening conditions in the country.

He warned that one of the greatest dangers of substandard drugs is the development of antibiotic resistance, which leads to treatment failure and the worsening of disease conditions.

 According to him, patients may unknowingly consume medications containing toxic substances or incorrect dosages, leading to poisoning, treatment failure, and disease exacerbation.

Another medical practitioner, Dr. Tobi Olawale, urged the government to intervene and curb the mass exodus of doctors, stating that the situation was deteriorating rapidly.

To salvage the sector, experts have recommended a series of urgent measures; including strengthening drug regulatory agencies such as NAFDAC, the Pharmacy Council of Nigeria (PCN), and the National Drug Law Enforcement Agency (NDLEA).

They also emphasised the need for mass recruitment of healthcare workers, particularly pharmacists, to improve drug distribution and monitoring.

Other recommendations include investing in pharmaceutical infrastructure to support local drug production and reduce dependency on imports, enhancing surveillance of drug supply chains through modern technology like blockchain, radio-frequency identification (RFID), and holograms, and improving working conditions and incentives for health workers, such as competitive salaries and better hospital infrastructure.

A medical expert, Dr. Adeyemi Oye, advised NAFDAC to the increase its oversight by conducting unscheduled inspections of pharmacies nationwide to weed out fake drug peddlers.

He said, ‘The issue of fake drugs in our country is becoming more serious, and something urgent needs to be done. Everywhere you go, you will find pharmacies selling fake or substandard drugs because they are cheaper than the original ones.

Similarly, Pharmacist Ayobamiji called on the government to invest in statewide pharmacovigilance programmes to monitor drug safety and adverse reactions.

‘The National Agency for Food and Drug Administration and Control (NAFDAC), should have offices in every local government area across Nigeria. This will help in the fight against fake drugs, especially those being sold in pharmacies.

‘Many Nigerians find it difficult to distinguish between fake and original drugs, which puts their health at great risk. By bringing NAFDAC closer to the people, it will be easier to monitor and regulate drug sales. Regular inspections will also help ensure that only genuine medications are available to the public.’