The indiscriminate and illegal sale of drugs by artisans and traders in public places has continued to strive in most towns and villages in spite of the serious health risks it poses to the community. This is even as relevant regulatory agencies have made concerted efforts to address the situation. Osby Isibor writes.
The indiscriminate hawking of drugs in public places and the open markets, such as motor parks, buses and along the streets has become a common feature in most of our cities and rural areas. Efforts of regulatory agencies to curb this health menace over the years have not yielded remarkable results.
Again, the quality and efficacy of most of these drugs being sold by these unqualified professionals and itinerant hawkers cannot be guaranteed. More so as majority of the drugs are fake, expired or substandard.
The menace of fake and adulterated drugs in Nigeria has claimed many lives, across all the strata of the society. Of course, it is established that majority of them come more from the socially disadvantaged group, particularly those who live in the rural areas, with little or no privileges of having multiple sales outlets for over-the-counter drugs. In all these, the rural areas bear the brunt of the consequences of fake drugs because of absence of regulators.
A recent study of the activities of some drug hawkers within the Lagos Metropolis published in the Nigerian quarterly journal of hospital medicine (African Journal Online) showed a frightening dimension to the activities of these street vendors. The purpose of the study was to investigate the activities of selected medicine hawkers in Lagos in search of tools useful in controlling them and consequently improve the quality of service given to their clients.
Methods:
A prospective study was conducted on 290 medicine hawkers in 15 major areas of heavy human traffic within the metropolis using questionnaires filled by the interview technique.
The Results:
The drug hawkers had shifted their activities from the day to the night time to evade inspection by officials of the National Agency for Food, Drug Administration and Control (NAFDAC). Among the medicine hawkers, 109 (38%) and 116 (40%) completed primary and secondary school training respectively while 48 (17%) had no formal educational training.
Also 17 (5%) hawkers had prior training in the handling of pharmaceuticals. Their level of educational attainment appeared to influence the ability of these drug sellers to prescribe the appropriate drug regimen. The traders prescribe and sell both over-the-counter and prescription only drugs.
Conclusion:
NAFDAC regulatory activity, an improvement in the quality of service delivery in orthodox health facilities combined with a programme designed to recruit, train, and license these hawkers for the use of over-the-counter medicines only, may be key in controlling their activities.
A drug hawker in one of the commercial buses in Abuja, Mr Rauf? Abiodun told LEADERSHIP SUNDAY that his involvement in hawking drugs was to make a living since there was no job for him after graduation.
Abiodun who sells mostly multivitamin capsules, body gel, pain relief drugs and other assorted items said he had several encounters with officials of NAFDAC especially in Lagos before relocating to Abuja. He said he gets the products from importers and pays commissions based on the number of products sold. He vowed to continue in the business as, according to him, ‘‘I will always have my way. My bother, forget that thing, we know them, Na today”?
Recently, pharmacists under the aegis of Association of Community Pharmacists have condemned the involvement of unqualified professionals and artisans in drug business in the country. The ACPN Lagos State chairman, Mr. Yinka Aminu, at an Awareness Walk/ Enlightenment Campaign at Ojota Motor Park in Lagos, said the porous drug distribution network in the country had attracted more unqualified professionals and artisans to drug business in the country.
Aminu said over 50 per cent of drugs sold in the country were handled by unlicensed professionals and warned that lack of monitoring had increased self medication and drug resistance.
He said, “A drug is not an item that can be sold by anybody; it should be done by a licensed professional. More artisans and market women are peddling drugs and the government is yet to provide strict laws that can discourage this. We would be promoting quackery if we do not enforce and tighten drug distribution policies.”
He also called for a ban on advertisement of pharmaceutical products and other consumables in public places, adding that drug fakers had taken advantage of this avenue to exploit and also market substandard products.
According to him, “Nigeria is the only part of the world, where medicines are advertised in buses, markets and motor parks. It is another channel that counterfeiters use to distribute and sell fake drugs. It is an illegal act that should not be tolerated if we have effective drug control and laws.”
Other economic analysts say there is need for government to provide strict laws that can discourage hawking of drugs. They called on the Federal Government to implement drug distribution policies to save lives and reduce its indiscriminate use.
In a paper entitled “Fake drugs and the survival of the African child”, the Chief Medical Director, University College Hospital, Ibadan, Prof. Tope Alonge, said the death rate of African child is increasing at a faster rate compared to the rest of the world.
Quoting the definition by WHO, he said, “Fake drugs/medicine is one which is deliberately and fraudulently mislabelled with respect to identity and/or source. Fake products may include products with the correct ingredients or with wrong ingredients, without active ingredients and with insufficient active ingredients or with fake packaging.”
He further said there are factors encouraging production of fake drugs which, over the years, had been endangering lives of innocent Africans. He gave the lack of political will and commitment; lack of appropriate drugs legislation and absence of or weak drug regulations as some of the factors.
Alonge also said non-governmental organizations or community-based organizations, such as consumers association, should be informed about the problems of counterfeiting and the possible presence of counterfeit drugs in the national distribution chain.
According to him, the associations needed to be provided with information and methods for detection, so that it would be able to report cases to the national drug regulatory agencies.
He, however, blamed the Nigerian government’s policy on the? rising increase of fake drugs in the country, emphasizing that the policy of government destroyed the basis upon which drugs are being procured through government’s change of policy.
The Chief Medical Director also said that enacting new laws or updating existing ones for prohibiting counterfeit medicines and making available necessary financial and other resources would help government to stop the flourishing of fake drugs in the country.
He, therefore, concluded that training of personnel, including enforcement officers for national drugs control, is another major means through which fake drugs could be eradicated in the country.
The Acting Director, Special Duties, National Agency for Food, Drug Administration and Control (NAFDAC), Mr Abubakar Jimoh attributed the hawking? of drugs in public places to attitude of Nigerians, saying virtually everything is been hawked in the country.
Jimoh said it also borders on the issues of literacy level and economic condition of the people.
‘‘Most of our people don’t scrutinize things; they are very careless. For instance, you see a man hawking drugs in a luxurious bus and people will just start rushing to buy due to cheap remedy. Buying drugs from hawkers is like using your money to buy poison and it can kill the person out rightly. You ensure that you are not only buying drugs, the quality of the drugs is also of upmost important. You also find out that the issue of drug hawking is predominant in the villages and remote areas where the people are vulnerable.
“Drug hawkers are death merchants; nobody should patronise them; nobody should have any dealing with them because the drugs they sell cannot be guaranteed; so, people should not patronise them; people should not buy drugs from them,” Mr Jimoh emphasized.
On the issue of enforcement, Mr Jimoh said NAFDAC is collaborating with NDLEA, Nigeria Security and Civil Defence Corps and other law enforcement agencies to strengthen the fight against fake drugs in Nigeria. ‘‘We have organised several raids; we carry out raids spontaneously. And recently under the leadership of Dr. Paul Orhii in 2011, we arrested 44 drug hawkers in Sokoto and most of them were from Niger Republic.
We are using diplomatic channels through the ambassadors to help us talk to their citizens. We also held consultative meetings with luxurious bus owners and told them that NAFDAC will not hesitate to ground their vehicles if they don’t stop hawkers using their vehicles’’, he stated.
To wipe out drug counterfeiting in its entirety, the NAFDAC Acting Director said the agency was collaborating with local government councils in the use of public address systems and town-criers in disseminating regulatory information in their various dialects, such as dangers of drug hawking and illegal advertisement of herbal drugs. He said NAFDAC had also embarked on several enlightenment campaigns through the media and the use of posters.
‘‘We organised grassroots sensitization campaigns in the villages, taking the campaigns to the doorsteps of the people who are vulnerable. Whenever we go for such grassroots sensitization campaigns, it is not just about hawking of drugs. We have a checklist of messages that we pass. We talk about Vitamin A fortification, salt iodization, the issue of correct application of herbicides and chemicals in the harvest of agricultural products and storage. We also have NAFDAC/NYSC sensitization campaigns. We are leveraging on the Corps members to carry out these campaigns across the country’’, he stated.
He also said the agency had established NAFDAC/Consumer Safety Clubs in various secondary schools and that the desk officers in the local government councils would help educate communities more on the agency’s activities. He further said that the measure was aimed at checking the circulation of fake and substandard drugs, medicines and other foods.
He advised Nigerians to get their drugs and medicaments from licensed pharmacies and be careful when buying medications online and always consult a professional. He further urged Nigerians not to buy drugs indiscriminately and avoid open markets that are open to anything.
‘’Never patronize roadside or mobile drug hawkers because you might be digging your grave with your carelessness.”