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Why Nigeria and other African countries must get serious about their drug delivery industry Featured

By Magazine / Friday, 08 December 2017 03:01

As of my last visit to my home country of Nigeria, a friend who is a pharmacist shared that Nigeria was facing an epidemic of codeine abuse in the country. I was aware of high profile codeine abuse of various music celebrities and other high profile individuals who had overdosed on control substances. Now, my greatest fear was being confirmed by a trusted Nigerian pharmacist.

Having practiced the profession of pharmacy myself in the United States for 3 decades, I was immediately alarmed because of what the American populace was dealing with currently; the national opioid abuse epidemic that at its height was seeing the death of  7 to 9 people a day. This happening in a country that supposedly has the most sophisticated health care delivery system in the world was reason to take pause and ask what was going on. Based on my observation, this epidemic that President Donald J. Trump himself  had declared a national emergency in recent weeks did not occur by accident but, I digress. We will revisit this situation at a later time.  Back to Nigeria and how we can get a handle on the situation of the rise in codeine (and other controlled substances) abuse before it gets out of control.

Based on last reports, the Nigerian pharmaceutical industry is plagued by a high incidence of misbranded and adulterated drugs.  Misbranded drugs are those whose labeling do not correspond to what is purported to be inside them while adulterated drugs are those that may not even contain the active ingredient to cure what its being used for. These drugs are dangerous to the user for obvious reasons. Imagine spending your hard earned money for medication to treat an infection and the active ingredient is not contained in the medication. This means that the infection itself is not being addressed and may take over the individual’s body and systems, enter into the blood and result in death. I have heard of many of such tragic tales that had resulted in the demise of men, women and children in Nigeria and other African countries. Recent reports have placed the incidence of such drugs in the drug delivery system of Nigeria at 1 in 10 medications on the market. I personally would venture to say it’s higher than what is reported.  NAFDAC was put in place to address this scourge in the Nigerian Pharmaceutical marketplace and credit is due to them for drastically reducing the prevalence of these fake drugs on the market. I would be remiss if I did not give recognition to the late  great, Mrs. Dora Akunyili for her brave and selfless service as head of NAFDAC at the height of this epidemic. As she fought this scourge with the resources and authority bestowed upon her by the Federal Republic of Nigeria, those who profited from this illegal drug trade fought back with threats, armed aggression and even a failed attempt at kidnapping her son in school. As any Nigerian is aware, it was an aggressive fight where adulterated and misbranded drugs were quarantined and destroyed on site causing losses to these criminals engaged in such trade millions if not billions of Naira.  There obviously needs to be a dogged fight to eradicate these fake drugs in the market and the use of technology to trace medications from the source; manufacturers to wholesalers/marketers to end users via pharmacies and hospitals/clinics is a must.

 

Having practiced in several American states and still practicing in Florida, I have come to understand that the problems seen in Nigeria and other African countries fall more in line with challenges seen in Florida, especially south Florida. Due to south Florida’s large population from South and Central American countries, it presents certain challenges due to drug trade that passes through this particular area. Some of the illicit drug trade  has spilled over into the pharmacy practice space. For example, misbranded cases of Epogen which would normally be stored under refrigeration was found in the trunk of a car in sunny hot Florida. Obviously a drug such as this which is to stimulate red blood cell production in patients with kidney failure that turned out to be vials of water presents a safety and health risk to the unsuspecting public.

As a result of such discoveries here in Florida, a system was put in place as mentioned previously in this article; to have a document tracking  system that follows the medication from manufacturer to end user. These records must be maintained fastidiously to avoid serious legal and professional consequences.

The same is also required of controlled substances to prevent diversion to illegal users. Obviously, tracking is a must to keep the pharmaceutical delivery value chain free of criminals whose goal is to profit even if it causes sickness and death to the unsuspecting public.

Another “must have” to prevent diversion in the Nigerian (African) pharmaceutical system is to connect all medical practitioners, clinics, pharmacies, and hospitals with a prescription monitoring system. This is a database where all prescriptions written for controlled substances and narcotics are reported on a weekly basis to a database used to monitor patients to prevent “doctor shopping” and “pharmacy shopping”.  Doctor shopping and pharmacy shopping was a process being used by drug dealers to procure narcotics in bulk amounts to sell to addicts. It really fueled the opioid crisis that America is currently grappling with. What was happening is that drug dealers would find homeless addicts and sponsor them to see a doctor with complaints of chronic pain so they could get prescriptions for narcotics. These dealers would sponsor many different “patients” then take them to various unsuspecting pharmacies to get the medication. They would then sell them on the street for astronomical amounts of money. There are cases where these sponsors were raking in over a million US dollars annually. Some of these sponsors were in their twenties. One can only imagine what will happen in Nigeria and other African countries if this is allowed to happen. WE don’t have the facilities and systems in place to deal with an “opioid epidemic” so I ask that we, the people, put the lives of our youth above profits of unscrupulous drug dealers and implement a strategy now before things get out of hand. I have always said, that Nigeria specifically and Africa in general has some of the brightest minds in the world. We must protect these minds of our future generations and their lives if Africa wants to be truly great.

 

By: Dele Obaitan, R.Ph., MBA, Cons. Ph.

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Dele Obaitan

Dele Obaitan

Media

Codeine abuse on the rise in Nigeria TV360NIGERIA Published on Oct 20, 2017
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