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OPEN DRUG MARKET: A historical perspective of an undying monster

OPEN DRUG MARKET: A historical perspective of an undying monster

Holly Martins looked directly at Harry Lime and asked, “Have you ever visited the children’s hospital? Have you ever seen any of your victims?”
“Victims?” replied Harry, pointing to the small children moving below them, appearing as small dots in the far distance. “Would you really feel any pity if one of those dots stopped moving forever? If I said you can have £20,000 for every dot that stops, would you really, old man, tell me to keep my money? Without hesitation?” in the classic British f lm noir The Third Man, which portrayed an underground trade in adulterated penicillin after World War II,

The Nigerian civil war otherwise known as the Biafran war occurred between 1967-1970. During that war, there was acute shortage of health personnel on the war-torn Biafran territory, in what was then known as the old eastern region, but known as south-east and south-southern parts in present day Nigeria. This shortage of health personnel compelled international humanitarian organization like red cross to give basic medical training to ‘’Biafrans’’ to enable them treat injured soldiers, and those affected by the war. When the war ended in 1970, those trained, began to use their knowledge to sustain themselves and their families, the rented small shops and began selling minor drugs, treat minor injuries, formed little cooperative society and associations among themselves and in turn trained others. As time went on, they metamorphosed into what we know today as ‘’chemist’’
Open drug market is as old as Nigeria itself, and its connections with fake and adulterated drugs are inseparable. In the early 60s, fake drugs arrived in small amounts, fake drugs began entering Nigeria as early as 1968, when Crown Agents, the main British company charged with national drug distribution since the colonial era, divested.
Taking over distribution was the Pharmacists Board of Nigeria, a government agency. Because it was saddled with other tasks, including regulation, it could not meet all the country’s distribution needs. It turned distribution over to state governments, which issued patent medicine vendor licenses that were increasingly held by traders (those trained during the war, who were already in the drug business). There had been an extreme shortage of pharmacists since independence and so these licenses were meant to fill this gap. From this period till late 80s and early 90s, multinationals of European and North American origin held sway, thus minimizing the onslaught of fakery on Nigeria.
In 1986, the then Nigeria head of state, Ibrahim Babngida had implemented a structural adjustment program (sap) that included a significant state and market austerity policy. Following the 1970s recession in the West and the collapse of commodity markets in Africa, implementation of sap was insisted on by the International Monetary Fund and overseen by the World Bank in exchange for new loans to Nigeria, whose national economy became troubled after the collapse of an oil boom. Economic and state adjustments had profound negative consequences on African economies, including massive job loss, high inflation, and widespread poverty. After structural adjustment was implemented in 1986, the citizenry and markets got remade into newly discernible risks via military governance. The newly rendered widespread poverty generated by structural adjustment also meant that the vast majority of Nigerians could no longer afford brand- name drug products. As a result, the brand- name companies abandoned the Nigerian pharmaceutical market. After the market for brand-name drugs crashed, a new market was built. This new market made it possible for the control over national drug distribution to switch from Nigerian pharmacists and North American and Europe an multinational drug companies to traders (mostly from the eastern part of Nigeria, the reason is not farfetched) and generic drug manufacturers located mostly in China and India. In Idumota market, traders hold patent medicine vendor licenses and import directly from pharmaceutical manufacturers. Thus increasing diffusion of wholesaling from a centralized body to multitudes of private trading companies was a result of both holdovers from the colonial infrastructure and state reforms in the 1980s. As a result, multiple paths to importation opened up new avenues to smuggle fake drugs into the country.
Today,the federal government, through ministry of health and its agencies have decided to end the open drug market by the end of 2018, to cater for those already in drug business, the federal government came up with the coordinated wholesale centres, In a statement made available by the Pharmacists Council of Nigeria (PCN), the registrar said one of the major challenges in the use of medicines in the country was the unsatisfactory drug distribution system which has led to poor product handling, difficulty in product tracking for statistical purpose and for recall, circulation of substandard products , difficulty in audit trail and destruction of professional practice. Recall that the Federal Ministry of Health had in 2013 issued the National Drug Distribution Guidelines (NDDG), in its effort to reverse the ugly trend. The Registrar, Pharmacists Council of Nigeria (PCN) , Pharm, Nae Mohammed, said the CWC was a concept within the National Drug Distribution Guidelines (NDDG), to cater for those who are in the open drug market , adding that it would help sanitize drug distribution in the Nigeria because open drug markets were the hub of major drug supply and drug problems in the Nigeria and by extension west Africa. According to him, the CWC would provide effective regulatory activities and ensure good and regulated pharmaceutical service delivery in the country, adding “This will ensure control over the efficacy of the drugs that are coming into country, and that are being made available for consumption for Nigerians.” He said: “It is a purpose built infrastructure that will cater for a lot of things, like professional practice environment, good storage condition security and also adequate regulatory activities. There are some drugs that need to be stored within a specified temperature, and the CWCs has such warehouses constructed for them, unlike what is obtainable now in the open drug market where everything is lumped under the sun and in stores that have no windows for adequate ventilation. Definitely, the quality and efficacy of those drugs will be maintained, that is the main purpose.” The registrar said the four major open drug markets in the country that were of concern to the federal government were Onitsha overhead Bridge, Anambra State south-east Nigeria, the Idumota Drug market, Lagos, south-west Nigeria Ariaria market Aba, Abia State and Sabon Gari market, Kano state, in the North. He said the minister of health has inspected the CWCs in the first three states (Lagos, Abia and Anambra states) and would soon inspect that of Sabon Gari in Kano stat.
1. It is hub for unwholesome practices, anybody can walk into the open drug market and buy anything they want without question
2. It is a very difficult terrain to regulate, the only regulation possessed by drugs sold in those places is NAFDAC number whose authenticity is sometimes questionable, because, most times unknown brands purchased there are not effective, but have NAFDAC nos.
3. From fakery, to altered label, to parallel importation and so on, the open drug market has, for so many years acted as a safe haven for those who have little or no regard for human life. The detrimental effect of chaotic drug distribution, “headquartered” in open markets are so far reaching that it requires not just an urgent attention, but a total state of emergency.
4. The chain reaction brought upon us by their continual existence are numerous. For instance, a wrong diagnosis which will ultimately lead to treatment failure is blamed on drugs, irrespective of its effectiveness, because the source is not trustworthy, and is most likely open drug market.
5. Wrong storage by community pharmacist which leads to drug deterioration is blamed on open drug market, and rightly so.
6. Many pharmacists and doctors has lost patient confidence because ineffectiveness of drug bought from those markets.
Conclusively, take time and take a trip to Idumota in Lagos, head bridge in Onitsha or Sabon Gari in Kano and experience these things first hand and I am quite certain you will be a vanguard for its closure.


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