By Kingsley Obom-Egbulem
If you’ve ever threatened to sue your doctor for negligence, please think again. He or she may just be one of the many victims of the activities of fake drug merchants. “That is just the truth and I am not holding brief for any incompetent or negligent doctor”.
Those were the candid submission of Dr. Ifeanyi Azuibuike. Azubuike, currently works at the Military Hospital Ikoyi, Lagos and have been at the receiving end of fake drugs at different times in his over ten years career. He certainly knows exactly where and how the shoe pinches.In 1995, he almost lost his dad due to complications resulting from an attack of asthma. His dad had been placed on a popular brand of Aminophylline widely recommended in the treatment of asthma because of its effects in widening the bronchial tubes.
“I had an emergency call that my dad was dying so I had to rush home and seeing him I requested for his medicines and was told he’s been on Franol. We took him to the hospital immediately and the doctor on duty gave him Franol again and in less than four (4) hours he was responding well to treatment and by the following day he was discharged.”
From Azuibuike’s submission, the Franol his dad was given before being taken to the hospital was fake and according to him “that drug was prescribed by me and if my dad had died while taking it, they would have said I killed him”, he added.
Azubuike may have been lucky with his dad but not so for Dr. Jide Adesanya(real name and name of hospital withheld).Adesanya continues to live with the scar left on his practice by fake drugs.
In 2008 a hypertensive patient was admitted into his hospital. “We had her medical history, so it was not difficult for us to know exactly what was wrong with her”, said Adesanya.
The woman was placed on Nifedipine and Propranalol. Both drugs were bought from the hospital pharmacy.
While Propanolol slows heart rate and heart output and used in the treatment of angina pectoris, irregular heart rhythms, migraine and high blood pressure Nifedipine specifically helps to stop the heart muscles from taking up calcium and is also used in the treatment of high blood pressure and angina pectoris.
She kept taking these drugs but wasn’t responding well. Her blood pressure kept rising with every dosage.
“We invited a consultant and as part of his prescription requested for Hiaza-a brand of Nifedipine sold only in the US. Somehow, we got the drug here and by afternoon of that same day her blood pressure came down. We were happy”, Adesanya added.
But it was not yet celebration time. Before she was given Hiaza-which helped to bring down her BP (blood pressure), the high BP had caused her a brain damage. “We found out that the temporal lobe of the brain had been affected badly. She eventually died at 56 of brain damage six months after.”
“So many doctors have earned a vote of no confidence for medical accidents which after careful examinations have been traced to poor quality drugs and doctors are also prone to being sold fake drugs as only those who manufacture these drugs can confidently identify the fake one by merely looking at the external features”, said Azubuike whose antidote to the menace of fake drugs has been to personally buy the drugs especially when it involves critical cases.
“I personally buy the drugs I use especially when I have an operation to perform or when handling complicated labour; I don’t want to be embarrassed or get myself into avoidable trouble.There have been cases where doctors tried to give drugs for induction of labour to women and nothing happens”.
In a bid to assist a woman undergoing prolonged labour, certain drugs, when administered are meant to dilate the cervix and cause uterine contraction and expulsion of the baby and save the woman the agony of delayed and complicated labour. But the presence of fake drugs is making this normal practice dangerous.
These experiences place even more responsibilities on the shoulders of the Dr. Paul Orhi led National Agency for Drug Administration and Control(NAFDAC).
Professor Dora Akunyili-former Director General of NAFDAC popularized the war against counterfeit drugs and gave life to a dying and irrelevant NAFDAC that in less than four years of being in the saddle, most Nigerians became conscious of ‘expiration dates’ and checking out for ‘NAFDAC approval numbers’ especially on imported products.
By the time Akunyilli left NAFDAC in 2008 following her appointment as Minister of Information by the Late President Umaru Musa Yar’Adua, the agency was close to becoming a nemesis for drug counterfeiters in Nigeria. Or so it seems.
But the fight had only just begun since the agency could only carry out raids, seize fake products, carry out public bonfires, close down and reopen markets believed to be hubs for fake drugs.
These, many analysts say are not sustainable models for dealing with the problems of fake drugs. The right legislation and policies for instance are not in place. And even Akunyili did acknowledge this anomaly in several public gatherings.
“The war against counterfeit drugs, beverages and other food products in Nigeria is not backed by effective legislation that can ensure sustainable results and impact; as grievous as this crime is, which is even worse than armed robbery, the penalty is like a slap on the palm, the most ridiculous of which is a fine of 50,000 naira. Any offender would gladly pay this fine and return to business the next day”, she told a town hall meeting in Kano.
Akunyili contested for the Nnewi South Senatorial seat on the platform of the All Progressive Grand Alliance (APGA), arguably the most popular party in her State-Anambra in South Eastern Nigeria.It was not an easy contest for the Professor of Pharmacology and rookie politician who was running against a more experienced politician and former governor of Anambra State Dr. Chris Ngige.
After the votes were counted, Akunyili lost to Ngige by hairsbreadth. Some analysts have satirically likened Akunyili’s contest against and loss to Ngige to the war against fake drugs. Counterfeiters have been formidable foes and it doesn’t seem that the war is being won given our unsustainable strategy.
Despite investments in modern laboratory equipments, products scanners, recruitment and training of personnel, Nigeria still has not demonstrated enough seriousness in terms of addressing legal impediments affecting smooth prosecution of the war against fake drugs merchants. This remains a huge impediment on the path of NAFDAC and the fight against fake drugs.
The sms technology being piloted in the country and some parts of West Africa may take more grounds from drug counterfeiters. But not a few people like Azubuike believe that the country is losing patients daily to fake drugs and this loss continues to erode the integrity of the Nigerian health system and weakens the confidence of the average Nigerian in the capacity of Nigrian doctors.
For now, it appears that the problem of fake drugs is still like an elephant; so huge and the part you see and the impact its leaves on you depends on where you stand. “But one thing is certain; we can all see and feel its negative impact”, Azubuike added.
(c)NIGERIAN HEALTH JOURNAL