Cancer patients lament proliferation, effects of counterfeit medicines

Cancer patients in the country have lamented the proliferation of counterfeit medicines nationwide.

They said the counterfeit medicines that some of them have unknowingly taken have left them with physical, emotional and financial pains as they worsened their health conditions and also affected their families.

They called on the relevant agencies and stakeholders to strengthen efforts towards tackling the menace.

Narrating her experience Gloria Orji, a breast cancer survivor, said she was placed on a drug for five years but discovered that she bought a fake one along the line.

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She said, “After taking it for four days, I woke up one morning and I couldn’t get out of bed, meanwhile this is the drug that I was supposed to take for five years.

“I couldn’t get up from the bed because the whole room was spinning. It was eventually confirmed to be fake. I had to report the drug to the pharmacists, who immediately took it off the shelf.”

Orji, who is also the president, Network of People Impacted by Cancer in Nigeria (NEPICIN), said many patients said they have come across drugs that subjected them to risks and death.

Another cancer patient, Dozie Akwarandu, said he had an ugly experience with a counterfeit pain relief medicine.

“During the treatment stage, I was using a branded drug and after about 10 days of using it, I lost consciousness. After recovery, I discovered that the pain relief drug prescribed to me, which I bought and used was fake,” Akwarandu, who is00 the president and founder of Nest of Hope Advocacy and Support Community, said.

Over the years counterfeit and substandard medicines have continued to pose a threat to the lives and health of Nigerians despite efforts to curb them.

Counterfeit medicines are of two categories, substandard and falsified. Substandard pharmaceuticals are products that fail to meet stipulated quality standards or specifications, while falsified drugs are deliberately or fraudulently produced to misrepresent their identity, source or composition.

A 2023 report by the United Nations Office on Drugs and Crime (UNODC) said substandard drugs kill 500,000 people in sub-Saharan Africa each year.

Surveys by the National Agency for Food and Drug Administration and Control (NAFDAC) estimate that the amount of counterfeit medicines and pharmaceutical products in circulation in Nigeria is about 16.7%.

The director general, Prof. Moji Adeyeye, said globally, the prevalence is about 10% and that “The last data we have on the prevalence of substandard and falsified medicines in Nigeria is 16.7%”

She added that the data was collected in 2005 and thus, “it is high time we did another survey on the prevalence.”

She said, “One of our strategic plans is to reduce substandard and falsified medicines to not more than 5% prevalence in Nigeria by year 2025.

“NAFDAC has been highly proactive and vigilant towards curbing substandard and falsified medicines in the country in all efforts to safeguard the health of the Nigerian populace.”

She said some health implications of counterfeit medicines include, increased hospital admissions, prolonged stay in hospital, development of drug resistance and treatment failures and death.

She said all these lead to: increased cost of controlling disease; increased out-of-pocket expenses; increased human suffering; loss of confidence in the healthcare system; and increased burden on the healthcare system.

Also, researchers like Chambliss WG, Carroll WA, and Kennedy D, have highlighted the negative impact of counterfeit medicines on cancer treatment.

“Imagine a patient taking medication without realising that the tablets did not contain an active ingredient. In this scenario, not only is the patient not receiving the prescribed medication but the physician and pharmacist are evaluating treatment outcomes based on the patient’s response to a placebo,” they said.

Way out

Some of the drivers of counterfeit medicines in the country identified by patients and experts include high importation rate including from unscrupulous sources, open drug markets where medicines are hawked and sold freely on street corners, bus stops, kiosks and stalls, and patients going to wrong sources in other to get drugs at cheaper rate.

They said there are gaps in current regulations and policies in place to combat counterfeit medications, adding that there is need for a review and improvement in regulatory frameworks.

For instance, the current law stipulates weak penalties, added to poor enforcement and regulations by some agencies.

Gloria, and Dozie the cancer survivors, called on NAFDAC and the Federal Competition and Consumer Protection Commission (FCCPC), to strengthen efforts against counterfeit medicines.

Gloria said the NHIA should also ensure that the medications are sourced directly from the approved manufacturers.

She said,” When we go to the hospital, all medications are expected to be sourced within the hospital as patients are not allowed to source for the drug themselves.

“You need to be aware that non-pharmacists are beginning to act as agents to sell these drugs and this is because hospitals allow the drugs to come in from wherever.

“The government should be decisive on this. Most cancer cases result in death but if we do proper research, we will discover that the cause of the death in some cases is not the cancer itself.”

The immediate-past national publicity secretary of the Association of Community Pharmacists of Nigeria (ACPN), Pharmacist Kenneth Edeh Ujah, said the economy has also made patients to seek cheaper drugs thereby increasing their risk of buying counterfeit medicines.

“When the cost of medication goes so high, usually they begin to look for alternatives. It is alternatives that encourage illegal or fraudulent or scrupulous importers to begin to look for shortcuts or bring in fake, substandard and maybe unwholesome drugs to sell at a price far cheaper or far lower than what the current market price of those drugs is.

“So importers have their own share of the blame, the client also do have their share of the blame,” he stated.

Findings reveal that NAFDAC has conducted raids, seized and destroyed counterfeit medicines running to billions of naira across each zone of the country every few months and also prosecuted offenders.

However, to further check the menace, the agency’s director general had in the last few years been calling for stricter penalties for offenders.

Prof. Adeyeye speaking at different fora in the last two years said the law for drug offenders in the country prescribed weak penalties underscoring the need for a review.

She said, “Fake and illicit drugs kill people and the judgment the offenders usually get is so insignificant when compared to the level of the offence committed. Getting judgment of a few months or two or three-years imprisonment is not enough. We must do everything possible to get a law in place that will recommend stiffer penalty for drug counterfeiters. “In 2022,  following the prosecution of an offender in Kano, Prof. Adeyeye lamented that perpetrators of the illicit trade more often capitalized on the weak law in the land to wreak havoc on the nation’s health system.

The suspect was charged to court for labelling paracetamol as Quinine Sulphate & Nivaquine (Chloroquine) tablets at Sabon Gari Market Kano.

She appealed to the judiciary to take sterner view of counterfeiting and apply the maximum penalty of the weak laws to deter counterfeiters and fraudsters, adding that the dangerous business would be made unattractive if it carries a maximum penalty for the offenders.

The immediate past  Chairman, House of Representatives Committee on Health, Dr Tanko Sununu, who is now the minister of State for Education had sponsored a bill at the National Assembly demanding for more punitive punishments for those involved in illicit and falsified drugs dealings.

The Bill was however not passed by the  9th National Assembly.

NAFDAC enjoined members of the public to assist it in ridding the nation of fake drugs and other unwholesome food products by providing useful information that would lead to the arrest of those who perpetrate the business of falsifying medicines.

It also advises members of the public against patronising unlabelled products.