•Industry players blame govt inaction, demand urgent reforms
•Weak regulatory foundation fuels unwholesome development —NAFDAC DG Adeyeye
A few weeks ago, Nigeria witnessed the destruction of over one hundred billion naira worth of fake, banned, counterfeit drugs and unwholesome products following the enforcement activities of the National Agency for Food and Drug Administration and Control, NAFDAC, at the Idumota, Onitsha, Ariara, Ezeuku open drug markets.
In Awka, Anambra State, another trillion worth of such products, containing paediatric and maternal pharmaceuticals allegedly stored in prohibited places, including vaccines, were destroyed.
These mind-boggling discoveries and the “trillion” mentioned by NAFDAC weren’t just numbers; they represent lives at stake, families shattered, and a healthcare system teetering on the brink.
With Nigeria’s fake drugs traced to systemic failure and regulatory collapse, experts have warned that every fake tablet sold in the market or pharmacy is a potential death sentence.
Preventable death
This fake tablet aptly describes Janet’s fate, a young mother of two, who lost her life in a fight against an illness that should have been easily treatable.
Struck by malaria, her husband bought her a “trusted” anti-malarial drug from a community pharmacy. But the medicine, though branded and well-packaged, was fake.
Within 48 hours, Janet’s condition deteriorated.
By the time she reached hospital, it was too late.
An autopsy confirmed the medication she took contained no active ingredients but only a poisonous cocktail masquerading as medicine.
Janet’s story is not unique.
She is one of the many Nigerians who fall victim each year to the country’s unrelenting epidemic of counterfeit and substandard drugs, a menace that experts say is not just a public health crisis, but a national security threat.
Unlike Janet, Amos was lucky to have survived consistent bouts, most of which shot up his blood pressure. Month after month, he was on malaria medication.
For over a year, Amos could not live freely without anti-malarial drugs until he decided to change the pharmacy where he got his drugs. Then, it dawned on him that he had been using fake drugs.
“I almost killed myself with ‘chalk’. I kept pumping my body with paracetamol tablets and fake malaria drugs”, he told Sunday Vanguard.
“I kept changing from one brand to another, and none worked until a colleague advised me to change the pharmacy.
“I did, and things changed. For six months now, I have not suffered malaria.”
Problem
In 2009, 84 Nigerian children died after consuming contaminated teething syrup.
In 2014, a child nearly died from a fake antibiotic. The stories pile up.
Today, fake anti-malarial, antibiotics, drugs for hypertension, diabetes, and maternal medicines like oxytocin remain widespread.
Also, banned products such as Analgin, controlled substances such as Tramadol 225mg, amongst others, still litter Nigeria’s open drug markets, where findings by NAFDAC showed prevalence may be as high as 80 per cent.
Trillion-naira
criminal enterprise
According to the World Health Organisation (WHO), 20–30 per cent of medicines in Nigeria may be fake. With a pharmaceutical market estimated at over ¦ 3.35 trillion, this suggests trillions of naira worth of fake drugs is in circulation, putting millions of lives at risk.
Statistics from NAFDAC revealed that during the last enforcement activities, over one hundred 40-foot truckloads were evacuated, with 27 truckloads from Idumota already destroyed, while in Aba and Onitsha markets, about eighty 40-foot truckloads of unregistered, banned medicines and narcotics were seized and evacuated.
For Aba and environs, it was discovered that 14 truckloads of violative medicines were evacuated from the Osisioma warehouse alone, four truckloads from the Ariara Road warehouse and 10 truckloads of the medicines were seized from the markets.
NAFDAC disclosed that in Onitsha, there are 110 lines where they sell drugs, aside from the plumbing market and the wood plank markets.
According to the agency, despite the sensitive nature of drugs, in Onitsha, drugs were stored in warehouses with plumbing materials.
These warehouses were filled to the brim, without windows, with temperatures more than 40 degrees Celsius, subjecting the medicines to degradation before the user starts to use them.
In that plumbing section, NAFDAC claimed that they knew through intelligence, three or four years ago, that something was going on there; they were there with policemen, and a team of staff and police narrowly escaped death.
NAFDAC alleged that the “merchants of death”, masquerading as medicine dealers among the shop owners, mobbed the police and NAFDAC staff to protect their illicit trade.
Specifically, the Director General, Prof Christianah Adeyeye, during a briefing, said the agency evacuated ten 40-foot truckloads of Tramadol from the plumbing, wood plank and the fashion lines of the market, noting with dismay that about four truckloads of syrup with Codeine that was banned almost seven years ago were also evacuated.
Despite these alarming figures, the government’s response has been inconsistent, underfunded, and undermined by policy failures.
The regulatory landscape, led by NAFDAC, remains overburdened and weakened by decades of neglect and poor political will.
Decades of crisis
Findings have shown that China and India remain the top sources of imported counterfeit drugs.
However, with 70 per cent of Nigeria’s pharmaceuticals imported, the country’s dependency has opened the floodgates to criminal networks and “merchants of death” operating with impunity.
Nigeria’s fight against counterfeit drugs goes back to the 1980s.
A WHO-backed study in 1988 found that a third of all drugs in circulation were fake, and seven per cent were fatal upon use.
These revelations led to Decree 21 of 1988.
However, enforcement has been ineffective.
Today, counterfeit drugs continue to flood open markets in Onitsha, Lagos, Aba, and beyond, while government policies meant to address the crisis, like the National Drug Distribution Guidelines (NDDG), remain largely unimplemented.
The Federal Government had, in February 2013, launched the NDDG designed to ensure better distribution of drugs, replace open drug markets, reduce the increasing incidence of fake, adulterated and substandard drugs, facilitate oversight functions of government agencies like NAFDAC and PCN, as well as ensure that all drugs in the system are safe, efficacious, affordable and of good quality.
Ten years after its launch, the NDDG remains a document gathering dust. Only Kano State has taken meaningful action by establishing a Coordinated Wholesale Centre.
Studies have shown that Nigeria is one of the world’s largest markets for fake and counterfeit medicines among developing nations of the world though progress is being made in the war against counterfeiting medicines, as NAFDAC claimed to have reported reduction in counterfeit medicines, from 40 per cent in 2001 to 16.7 per cent in 2005.
However, while it is difficult to put a definite figure on the actual prevalence of fake drugs in the country, in 2019, the NAFDAC Director-General, Prof. Christianah Adeyeye, claimed that 16 per cent of medicines in Nigeria were fake or substandard, with plans to reduce it below the global average of 10 per cent by 2025.
In Nigeria, drugs most faked include antibiotics, anti-malarial, and anti-hypertensive medicines.
However, the failure of government and its regulatory officials to find a permanent solution to the challenge not only puts citizens’ lives at risk but also highlights the systemic issues within the country’s drug regulation and distribution systems, experts revealed.
Porous borders
Despite periodic crackdowns by NAFDAC, such as the recent seizure of hundreds of truckloads of banned, falsified, and substandard drugs from major markets, fake drugs continue to enter Nigeria freely through porous borders, seaports, and airports. Nigeria has continued to struggle with substandard and counterfeit drugs.
A team of drug regulatory officials and policemen, recently, double-crossed a Lagos yellow bus carrying passengers coming from Idumota to Oshodi, Lagos.
Three fully loaded big sacs of Tramadol were discovered in the public bus.
Experts are worried that as long as Nigeria operates chaotic drug distribution channels with weak drug laws and delays in the implementation of the NDDG, Nigerians will continue to pay with their lives.
The Chairman of the Lagos State Medicines Association, Mr. Innocent Ezennaya, said: “The source of these drugs is known. Yet they keep entering because of weak border controls and compromised officials.”
While admitting the recent operations of NAFDAC were aimed at eliminating counterfeit drugs from their environment, Ezennaya said many counterfeit drugs enter the country through these channels despite efforts to control them.
“Some of these unregistered drugs come into the nation through our borders, airports, and seaports. This is where we need more control”, he said.
“Without blocking the source, our efforts will continue to be undermined, and we will keep fighting the way we have been fighting”.
Today, drug hawking under the scorching sun has continued unabated.
Even people who do not have any business selling drugs are into the trade.
According to pharmacists, drugs are poisons and should neither be consumed indiscriminately nor stored at an unfriendly temperature.
Weak Regulation
The current penalties for counterfeiters in Nigeria—a fine of N500, 000 and a five-year jail term—are grossly inadequate.
Experts say this leniency emboldens criminals while insulting victims.
Speaking to Sunday Vanguard, the Chairman of the Association of Community Pharmacists of Nigeria (ACPN), Pharm. Ezeh Ambrose, said: “We need to raise penalties to N50 million and up to 20 years imprisonment. These are not petty crimes; these are mass murders.”
He expressed worry that with porous borders, open drug markets and weak laws, the problem may remain for a long time.
Yet legal reforms remain stalled in the National Assembly.
NAFDAC DG reacts
NAFDAC Director-General, Adeyeye, acknowledged the scale of the challenge.
Adeyeye said she inherited a debilitated agency burdened with debt, outdated equipment, and insufficient manpower.
Adeyeye attributed the persistent fake drug problem in Nigeria to a foundational weakness in regulation. “If you do not have a foundation, it’s a matter of time. The house will collapse”, she said.
She noted inheriting an under-resourced NAFDAC, describing it as an agency with “only the roof on its head with debt, no computers and about 80 per cent of the laboratory equipment was not working. It shows no foundation.”
Highlighting the impact, the DG recalled a near-fatal incident: “That boy almost died because of bad medicine. I knew the regulatory system, there was no foundation.”
Adeyeye further pointed to a significant rise in ineffective essential drugs, with poor-quality oxytocin jumping to a staggering 18 per cent.
Regarding the scale, she stated, “It may be 80 per cent in Onitsha or Idumota.
“That’s a problem for us. My sister died 40-something years ago at Island Maternity, postpartum. Maybe she was given oxytocin that didn’t work.”
The DG, who also recounted her own traumatic childbirth experience involving the drug, said she had been in labour for 27 hours and had to be rushed to the operating theatre in an emergency.
“They were cutting my hospital gown with scissors as they wheeled me in because there was no time to change.
“My life or the child’s life would have been lost.
“That is why we are doing what we are doing—because it affects everybody.
“In this country, there is nobody who has not been affected directly or indirectly.”
Adeyeye stressed the need to build a strong regulatory system, saying, “That is what forms the foundation of a regulatory system. We started thinking of the customer. We are all customers. It’s a mindset change.
“We had no foundation. We’re now rebuilding from scratch.”
She said that despite these challenges, NAFDAC has continued its raids and is pushing for WHO accreditation to boost drug quality assurance.
How govt inaction
fuels fake drug crisis – Experts
Some pharmaceutical industry players, who spoke to Sunday Vanguard, unanimously insisted that the chaos in Nigeria’s drug supply chain is a direct result of the failed implementation of the NDDG and the National Drug Policy (NDP).
Stating that urgent reforms were needed to protect the health of Nigerians and eliminate the dangerous presence of fake medicines in the market, they say government inaction was fuelling the fake drug crisis in Nigeria
They confirmed that the failure to regulate the drug distribution system effectively has left Nigerians vulnerable to preventable health risks.
According to Pharm. Abiola Paul-Ozieh, Chairman of the Healthcare Providers Association of Nigeria (HCPAN), open drug markets must go, adding that the longer they remain the more lives Nigeria will lose.
Paul-Ozieh blamed the government’s failure to implement regulatory policies as the root cause.
“Medicines are not mere commodities. They must be stored, distributed, and dispensed professionally”, she said.
The HCPAN leader warned that Nigeria’s overreliance on imported drugs, coupled with weak local manufacturing and non-functional oversight, is a dangerous cocktail.
Paul- Ozieh maintained that the lack of political will from the government to fully implement existing drug policies has sustained fake drugs in Nigeria.
She warned that the haphazard implementation of the NDP and the non-functional NDDG are creating a fertile ground for illicit drug trade and endangering public health.
“The lack of political will on the part of the government to implement the various policies meant to strengthen the drug distribution value chain in Nigeria is a key element”, the HCPAN boss said.
“We have the National Drug Policy being implemented haphazardly.”
She stated that achieving self-sufficiency in drug production remains a distant dream, adding that Nigeria’s heavy reliance on imported finished drug products has inadvertently opened doors for unscrupulous actors.
“The inadequate level of drug production creates a vacuum for all kinds of players, both genuine and those with ulterior motives, to bring in imported finished drug products”, she said.
“In the process of doing this, a number found an opportunity to bring in fake, substandard, and falsified medicines”.
According to her, the problem is compounded by the stalled implementation of the NDDG.
“Nigeria instituted the National Drug Distribution Guidelines over ten years ago but the implementation is nothing to write home about,” the expert lamented.
“The menace of substandard and falsified medicines is strengthened by the preponderance of open drug markets places all over the nation. “The NDDG was to streamline the Nigeria Drug Distribution System such that all along the pharmaceutical value chain, adequate control and regulatory oversight can be deployed to assure drug safety, effectiveness, and accessibility.
“It is regrettable that some see medicines as articles of trade and merchandise drugs without being cautious that drugs can heal but can also harm if in the wrong hands, wrong places, wrong storage, and wrong use.
“The way out is for government and numerous agencies to go back to those policies, NDP and NDDG, and implement them to the letter.
“The chaotic drug distribution system must be replaced by the system spelt out in the NDDG, with various licensed operators handling whatever level of service delivery they are registered.”
She highlighted the development of Nigeria’s petrochemical industry as a vital step towards enabling local manufacturers to access essential ingredients and packaging materials.
The HCPAN Chairman stressed the importance of a well-regulated distribution system, saying, “If the government had implemented the National Drug Policy and NDDG fully, we wouldn’t have the chaos we face today.”
According to her, the lack of oversight in the open drug markets is especially concerning, as counterfeit and substandard drugs are not only harmful to individuals but also undermine the entire healthcare system.
For his part, the Chairman of the Association of Community Pharmacists of Nigeria, ACPN, in Lagos State, Ajayi Tolulope, said the country’s regulatory bodies are often underfunded, understaffed, and lack the political will to enforce the laws.
Tolulope pointed out that the failure to properly regulate open drug markets is one of the key reasons fake medicines continue to flood the country.
According to him, the markets where drugs are sold without the oversight of professionals are a breeding ground for counterfeit medications.
“Many Nigerians unknowingly buy medications that are ineffective or even harmful to their health”, he said. “This is because regulatory bodies like NAFDAC are not equipped to properly monitor and close these markets, leaving people exposed to the dangers of substandard drugs.”
Tolulope said the government’s failure to provide NAFDAC with adequate resources, staffing, and security has hindered its ability to effectively control the distribution of drugs, resulting in a continued presence of illegal drug markets.
The solution, he said, lies in establishing coordinated wholesale centres in every state.
“These centres would allow for better regulation, with bodies like NAFDAC, the Pharmacy Council of Nigeria (PCN), and law enforcement agencies ensuring that drugs meet the required safety and quality standards”, the ACPN Chairman said.
“Creating these centres would allow us to monitor drug distribution and ensure that only licensed professionals are involved in the process.
“We need a system where the quality of medications is guaranteed, not left to chance.”
Tolulope emphasized: “Everything rises and falls on leadership.
“If the government provides the necessary resources and political will, NAFDAC and other regulatory bodies could make a significant difference in the fight against counterfeit drugs.
“It is not just about closing these markets; it’s about creating viable alternatives that ensure Nigerians have access to safe, effective medications”.
The Lagos State Chairman of the Pharmaceutical Society of Nigeria, PSN, Babayemý Oyekunle, also speaking, said a reliable and good-quality medicine supply is essential for health, but it is often missing in countries with weak regulatory systems like Nigeria.
Oyekunle explained that counterfeit medications increase deaths from malaria, stroke, hypertension, asthma, cholera, and other illnesses.
Meanwhile, a study by the UN Office on Drugs and Crime shows that up to 500, 000 people die annually from counterfeit drugs in sub-Saharan Africa.
The study also shows as many as 267, 000 deaths each year from substandard malaria drugs and up to 169, 000 deaths from fake antibiotics used to treat pneumonia in children. It also shows that between $12 million and $44.7 million is spent each year treating people who have used counterfeit or substandard malaria drugs.
Every inaction from the government is an endorsement of this silent epidemic.
As counterfeiters flood the nation with fake drugs worth trillions, the regulators meant to protect lives are struggling against a tide of systemic failure.
Experts worry that without urgent, sweeping reforms, Nigeria may remain a global epicentre for counterfeit medicines, a graveyard for victims like Janet, whose only crime was trusting the system to heal her. (Vanguard)
