By Kemi Olatunde

“Concoction works better than drugs. Before the advent of Western medicine, and even now,  it had been used to take care of many influential people, including medical practitioners and it is still effective.

“These days, we record more sales than before as more people patronize us to get remedy for their ailments.

“Even though there is inflation in prices of goods and services, the prices of our herbs are minimal because we want to assist people to remain healthy.

“Everyone knows that the cost of drugs is high now and this alone is enough to bring people here, especially those who never believed in herbs before now. I will not agree that it is poverty that is bringing people to us anyway. To be candid, a lot of diseases are being cured with our products. Some diseases cannot be cured medically, even health professionals do refer some of their patients to us. Health professionals too patronise us.”

The above were the words of a middle aged herb seller while speaking with The Hope at her herbal shop  located within the popular Oja – Oba in Akure, Ondo State.

In many parts of the world, access to quality healthcare has become increasingly expensive, often putting essential medical services out of the reach of low-income populations. This growing divide between the wealthy and the poor has led to increased poverty, with families and individuals facing devastating consequences when they can’t afford the medical treatment they need.

However, an emerging trend in addressing these barriers is the use of self-medication—a practice that reduces reliance on costly medical treatments, although risky, and mitigates some of the psychological and physical stress associated with poverty.

In recent times, healthcare costs have risen sharply due to several factors, including inflation, and the rising cost of prescription drugs, among others. For the poorest communities, these rising costs can create a vicious cycle. People may forgo necessary treatments or go without preventative care, which can lead to worsened health conditions, requiring even more expensive interventions later. This perpetuates a cycle of health-related poverty, where individuals cannot escape their financial struggles because they are constantly faced with health crises that drain their limited resources.

Families face huge health risk through self medication- experts

For example, a person living with  chronic illness might be forced to choose between paying for medical care and buying food. In many cases, healthcare expenses make it impossible for families to save, invest in education, or secure better living conditions. This not only impacts physical health but also mental health, creating a sense of hopelessness and exacerbating social and economic inequality.

In response to these challenges, self-medication has gained popularity as a tool for managing both mental and physical health.

The escalating cost of healthcare is a major driver of poverty in many parts of the world. Self-medication helps individuals to manage the psychological and emotional toll of poor health and financial insecurity.

It is no longer news that the harsh economy is affecting homes, healthy living.

It is disheartening to see people especially the aged struggle to access health care, especially when they have no health insurance coverage. Most of them, especially the ones that lack children who can take good care of them, cannot afford to purchase their medications, due to the arduous state of things.

 To lessen the effects of the economy, most homes have resorted to self-medication of any sort to treat their ailments.

Self-medication is defined as the selection and use of medicines by individuals (or a member of the individuals’ family) to treat self-recognised or self-diagnosed conditions or symptoms.

Basically, when one uses one or more drugs that are not prescribed by a physician or controlled by medical health organization, it is called self medication. This includes herbal or chemical medications, previously prescribed medicine for similar cases, extra medicines at home, or not using medicine completely.

The prevalence of self-medication from several Nigerian studies ranges between 60 and 90 percent. For example, among undergraduate students of a Nigerian university, the prevalence of self- medication was 67 percent  and in Lagos, south-west Nigeria, self-medication was reported in 67.7 percent of infants being treated for colic.

Also, according to sage journals, in Nigeria, while  41 percent of the population was reported to be involved in self-medication during the COVID-19 pandemic, the commonest reason for self-medication was fear of stigmatization and discrimination. This has been attributed to increased uncontrolled availability of drugs usage without prescription in the country. Other factors that have been reported as reasons for self-medication include convenience, lack of time and cost saving.

Most times, these self-medicated drugs are obtained  over the counter  from drug shop owners, who administer pharmaceutical products from chemists and pharmaceutical  outlets within the community, otherwise known as community pharmacies. In Nigeria, these vendors are known as Patent and Proprietary Medicine Vendors (PPMVs). Although they lack formal pharmaceutical  training,  in order to achieve Universal Health Coverage in Nigeria, the PPMVs are registered and regulated by the Pharmaceutical  Council of Nigeria to sell orthodox pharmaceutical products for common illnesses on retail basis to Nigerian populace.

Patients’ patronage drops in Hospitals

Speaking with The Hope, A nurse who craved anonymity, explained that there has been a drastic drop in patients’ patronage in hospitals, noting that people are ensuring proper management of their health.

According to her, people are conscious of more fruit intake and  maintaining proper hygiene, among others,  to ensure that they stay healthy.

“Fruits are vital for our overall well-being. I observed that more people eat fruit unlike before when we forced them to. In my house yesterday , we ate a heavy portion of pawpaw fruit before we  retired to bed. My baby too now eats  fruit as food because I have told her that if she doesn’t, she takes injection which she detests.”

A staff of one of the government health facilities in Akure, Mrs Bimbo Badejo, explained that the inability of some parents to make proteinous food available to their children has made them pay the hard way even though  the economy is responsible for it.

“Some few days ago, as early as 7:30 am, a woman rushed her child  of about  seven years to the hospital. The doctors on duty made efforts to save the child but the child was long gone. Everyone who witnessed the scenario had pity on her as she took the dead child back with her. It was possible that the child died due to the unavailability of balanced diet coupled with other factors,” she said.

Herb sellers smiling to banks as patronage increases

A concoction hawker, who simply gave her name as mummy Basirat, said that the economy has in a way boomed her business, noting that everyone within her vicinity buys her products to cure their family members of common ailments like malaria and body pains,  among others.

“May God help Nigeria. The economy has pushed a lot of people to me. Before now, I struggled to make good sales in a day, but these days what I have most time is always exhausted. Although I hawk more products now, the gain too has skyrocketed. Let me shock you.  Those we refer to as rich are also after us. We make  concoctions for them in bottles which they use especially for their children.”

A 38-year old woman, Mrs Bisola Ajayi who was seen patronizing a herbs trader explained that she resorted to it to keep her family members fit.

“I didn’t have trust in these things before but the economy has opened my eyes. Sincerely, there is nothing wrong with herbs. Since we can no longer buy drugs conveniently, I will always embrace this to ensure that all of us are alive. They have concoctions for all sorts of ailments. I have the one I give my children to prevent them from falling ill. My husband and I too have our own. We cannot afford to be sick at this time. May God continue to make it work for us.” She said.

Scarcity of active pharmaceutical ingredients made drugs expensive

According to Pharmacist Ayo Ayekun of a private pharmacy in Akure, the unavailability of active pharmaceutical ingredients in Nigeria has contributed in no small measure to the rising cost of healthcare, adding that few  pharmaceutical industries operate in the country.

He said; “One of the problems of the pharmaceutical industry is that active pharmaceutical ingredients are not sourced in Nigeria. The ability to bring them from abroad is a major problem, especially when the countries have not finished utilizing what they have.

“Secondly, the number of pharmaceutical industries manufacturing  drugs is few. For instance, in Ondo State, there is only one company that is manufacturing drugs. Most of the companies in Nigeria import, thus, the number of manufacturing companies for drugs has to be increased for the availability of more drugs.

“The importation of the API and the finished products, and the international trade are done in dollar. With the naira/dollar exchange rate, the price will be high.”

He stressed the need for government to make the pharmaceutical industry a priority, adding that it should encourage health insurance for Nigerians.

“There is a need for government to pay more attention to the sector like the petroleum sector. It should show interest and go to foreign countries to negotiate for the products in order to have the price of drugs reduced.

“Government should also work on improving the pharmaceutical  manufacturing sector. Soft loans should be provided to allow  more pharmaceutical companies to be established. There can be minimal discounts on health commodities from other countries,  to reduce prices.

“Also, middle men in the channel of drug distribution should be eliminated by government to prevent rising cost of drugs.”

Ondo state’s effort to mitigate effects of high cost of drugs, health care

In Ondo State, government has put in place measures to mitigate the effect by establishing the Ondo State Drug and Health Commodity Management Agency to cater for the drug needs  of residents of the state.

Recently, at a function, Executive Secretary, Ondo State Drug and Health Commodity Management Agency, Pharmacist   Amos  Aiyegbusi explained that the agency is mandated to provide quality drugs and health commodities in affordable price to health facilities.

According to him, the government is ensuring that qualitative care is accessible to all residents to ensure various health-related programmes, especially the health  insurance scheme.

 Nigerian Medical Association President, Dr. Uche Ojinmah, recently, said the rising costs of healthcare was pushing Nigerians deeper into poverty.

The association organized a seminar tagged, ‘Addressing escalating costs of medicines,’ which was a virtual event aimed at igniting a comprehensive dialogue on the alarming rise in the prices of essential medicines and medical consumables across Nigeria.

The webinar organized serves as a call to action, bringing together key stakeholders to identify practical solutions that can alleviate the dire situation and ensure equitable access to essential healthcare.

“Nigerians are going deeper into poverty as a result of purchasing healthcare. Nigeria should develop a health sector development bank to help the local pharmaceutical industry.

“If we cannot bridge the inequality in the health sector, the rich that can afford the drugs will stay healthy and stay rich while the poor would be on a downward spiral.  We will have a problem on our hands because there is a point it will get to and people will no longer sit in their houses and die but move into the streets and seek a solution.”

Acting Chief Medical Director, UNIMEDTH/Specialist Hospital, Akure, Dr. Adesina Akintan, described the harsh economy which he said has been putting a huge burden on Nigerians as major factor, stating that the inflation in Nigeria has affected all healthcare commodities.

According to him, cost of the running health facilities where health workers attend to patients has skyrocketed and the cost of medical tests is no longer as it used to be.

He explained that most health commodities are imported into the country, calling on government  to give priority to the sector.

“The cost of medical care is high as it has increased by 300 percent and it will continue to rise. In private health facilities,  the cost of accessing care for patients is high and that is why patients are trooping  to public facilities as the cost is lower when compared to that of private.

“Although there are challenges in the public facilities, patients are more attracted to  them  because, government facilities have more workers who enjoy prompt payment of salary. Hence, the cost is lower. The public facilities have become the preferred destination, not because of choice,  but what they are left with.

“There has to be urgent efforts to find a lasting solution to it. The government should declare a state of emergency in the health sector. The government  should consider local production of  drugs. In the short term, government should look at ways to bring down the cost of drugs. The government deliberately empowers companies that import the items to reduce costs. In the medium and long term, it should focus on local production of those items.

“Government must improve investment in the health sector. It should put money in the sector so that resources to do a good job will be available for managers.

“Also, health insurance in the country must receive attention. There should be a drive for  citizens to embrace health insurance. It is good that both the  Federal and Ondo State governments  are working in this direction but more has to be done in the area of advocacy and sensitization as a relief in times of medical emergency. Nevertheless, there should be capacity building for health workers in order not to give outdated care to patients,” he concluded.

Medical Director of a private hospital in Akure, Dr. Olumide Akadiri, while lamenting the high cost of health care stated that the purchasing power of citizens has reduced and been calling on the ENT to rescue the sector.