Pharmaceutical drug-sellers in the northern city of Kano are fighting moves by the National Agency for Food and Drug Administration and Control (NAFDAC) to close their businesses as it tries to clamp down on counterfeit drug sales in Nigeria.
Most of northern Nigeria’s counterfeit drugs are sold in Kano - the commercial hub of the north - and most of those in Sabon Gari market, where drug traders operate without regulation, according to NAFDAC. Kano’s population of 9.2 million also provides a huge market for pharmaceutical drugs.
“Anyone can go and buy any kind of drug without control or a prescription, with most of them fake drugs sold like vegetables,” said Ibrahim Musa, a doctor at Aminu Kano Teaching Hospital.
NAFDAC and Kano State health officials have long accused Sabon Gari traders of running a thriving counterfeit drug business, complete with fake drug warehouses. The most common counterfeit drugs are antibiotics and anti-malarials.
The World Health Organization (WHO) has rated the market Africa’s largest source of fake anti-malarial drugs, according to Ahmed Gana, head of the Pharmaceutical Society of Nigeria (PSN) in Kano, and a member of the Kano Taskforce on Fake and Sub-standard Drugs. A 2008 WHO study put the incidence of fake anti-malarials in sub-Saharan Africa at 64 percent.
On 31 December 2012, following months of eviction threats, NAFDAC raided the market to force out 650 drug traders they claimed were selling fake drugs, calling on them to register with a regulation agency and set up shop outside the market.
Traders fought back. On 10 December 2012 the National Association of Patent and Propriety Medicines (NAPPMED), which represents 5,000 traders, took out a one-week restraining order from the Federal High Court stopping the government from forcing them out. Though this expired on 18 December, NAPPMED claims the judge did not turn up to the hearing so the restraining order still stands.
On 8 January 2013 “we resolved to reopen our shops because of advice from our lawyers,” Hussein Labaran Zakari, Kano State chairman of NAPPMED, told IRIN.
“Although there are unscrupulous traders that engage in the sale of fake drugs… you cannot punish an entire group over the fault of a few bad apples,” Zakari said.
Nigerian law stipulates 5-15 years imprisonment and a fine of up to 500,000 naira (US$3,125) for selling counterfeit drugs.
But NAFDAC Director-General Paul Orhii said in June 2012 that the organization was sending a bill to the National Assembly prescribing life sentences for counterfeiters, saying the current penalties were not a strong enough deterrent.
In the last three years 52 counterfeiters have been convicted, and 108 cases are still in court, according to Abubakar Jimoh, spokesperson for NAFDAC. However, none of the 52 prisoners have served more than a five-year term.
The government is gradually making progress against the trade, says Jimoh. In 2001 in Nigeria, the proportion of drugs for sale that were fake was over 40 percent, shrinking to 16.7 percent in 2005 following a relentless push by NAFDAC. Since then, the proportion has incrementally declined, according to Jimoh.
The Kano task force was re-invigorated by the state government in January 2012 and since then has confiscated fake drugs worth $6.25 million.
In 2010 NAFDAC introduced TruScan technology at airports and border posts that can analyse the chemical composition of drugs through the interaction of light and molecular bonds, and conducts unscheduled inspections across markets such as Sabon Gari.
A “Mobile Authentication System” was also recently introduced, whereby consumers can authenticate drugs by sending a text message to NAFDAC, using the code on the packet.
Musa said a recent sharp rise in kidney and liver-related diseases could be linked to fake drug consumption, though there has been no study on the correlation. “Drugs are generally toxic and can do damage to vital body organs if misapplied or abused, even if they are genuine... Taking more of less than the recommended dose can have adverse effects. The situation is worse with fake drugs,” he added.
Resistance can also build up when fake or sub-standard drugs are administered. According to the taskforce chairman Ali Adamu, counterfeit drugs sold may contain one-tenth of the standard constituents “because the traders’ sole purpose is to maximize profits”.
“We recently raided a warehouse where we arrested people filling capsules with maize flour which they sell to the public as antibiotics. We also confiscated vials of chloroquine and analgin [the former used for the treatment of malaria, the latter a painkiller] which turned out to be ordinary water,” said Adamu.
Half of Nigeria’s drugs come from China and India.
Many drug traders travel to China to produce fake drugs, and smuggle them into Nigeria through Niger and Benin. Drug traders also repackage expired drugs sourced from neighbouring countries, to sell on, according to Gana.
The market remains large as fake drugs are comparatively cheap, said Ibrahim Bashir, who runs a pharmacy in Kano. Local drug companies find it hard to compete, with many closing each year, or relocating to the south.
The only sustainable way to stem the illegal trade from abroad is to boost local production, says NAFDAC, which proposed a US$1.25 billion Pharmaceutical Industry Bill to strengthen local drug companies. The move would provide 250,000 jobs, estimates Jimoh.