The chaotic drug distribution system in the country has been largely blamed for promoting counterfeiting, drug abuse, among others. Implementing the New Drug Distribution Guideline will restore order. APPOLONI A ADEYEMI reports
I n 2011, Toluwani Cooker was in Austin, Texas as part of five American states’ visit under the International Visitor Programme (IVP), which was fully funded by the United States Educational and Scientific Programme. After leaving the Texas Government House on that fateful day, she and other members of the visiting team were taken to a local restaurant for lunch. As she sat down and placed order for the meal, she whispered to the guide that she had been under intense headache in the last two hours.
“I have a severe headache,” she also told a colleague that was siting near her. “I need any medication that can tackle the pain,” she added. The guide quickly informed the head of the restaurant who promised to get an analgesic for Toluwani.
More than 15 minutes afterwards, the sad news reached Toluwani: “Without a doctor’s prescription, the pharmacist nearby couldn’t be persuaded to dispense the needed drug.” This happened in faraway America. But in Nigeria, it is a different story.
Enter any patent-medicine store and even some pharmacies in this country and ask for non-prescription drugs, without a doctor’s prescription, a consumer of health seeking to purchase the drug will get the medication. The death of Cynthia Osokogu, the Nasarawa State University postgraduate student, who was killed by her facebook lover, was an example of how drugs getting into wrong hands could be deadly.
What is instructive in her death is that, Rohyphnol the medication used to drug Osokogu before killing her, was bought from a pharmacy in Festac, Lagos without a doctor’s prescription. Orji Osita, the pharmacist that sold the medication was prosecuted but finally discharged for want of evidence. Although, Rohypnol is not a prescription drug, yet it was sold without a doctor’s prescription. This is a common feature in Nigeria where drugs are merely handled as articles of trade, prompting all manner of people to be in the business of medicines. In Nigeria, people that are not supposed to be handling drugs are handling them and this is as a result of the existence of illegal drug premises popularly known as open drug markets.
Today, the four major open drug markets in the country that are of concern to stakeholders are the Idumota Drug market, Lagos, Onitsha Overhead Bridge , Anambra State, Ariaria Drug Market in Aba , Abia State and the Sabon Gari Drug Market in Kano State. One of the major challenges in the use of medicines in the country has been traced to the current chaotic open drug distribution system in the country.
The unsatisfactory drug distribution system has led to poor medicine handling, difficulty in product tracking for statistical purpose and for recall, circulation of substandard products, difficulty in audit trail and destruction of professional practice. C onsequently, the Minister of health, Prof. Isaac Adewole recently announced plans of the Federal Government to close these drug markets so as to pave way for a new order that would ensure sanity by January 2019.
This is not the first time the government would announce plan to close existing open drug markets. Under the administration of the former President, Goodluck Jonathan, June 2017 deadline was initially fixed to close down all such markets, but that date has passed without the Federal Government taking the necessary step to dislodge the operators of the markets.
Highlighting the dangers inherent in the current open drug markets, President of the Pharmaceutical Society of Nigeria (PSN), Dr. Ahmed Yakasai said in multiple drug premises like Aba, Onitsha, Kano and Lagos, drugs are kept in poorly ventilated structures housing between 10,000 to 20,000 smaller drug holdings and kept in extreme temperature, which often leads to accelerated degeneration of drugs.
“If you produce a medicine that is designed to expire after three years and you perpetually expose that medicine to a temperature of above 25 degrees centigrade, the expiry which is about three years will automatically drop to about six months within days,” he said. Yakasai lamented that in these illegal drug premises, operators dispense and sell all manner of drugs including narcotics and other controlled drugs and substances. He said, “This is possible because the practice is unregulated; hence anybody walks into those places including our west African neighbours, to buy huge chunks of drugs.
“These encourage extremes of drug misuse and drug abuse because drugs get into wrong hands. “That is where drug hawkers get their drugs; that is where unregistered drug premises scattered in the nook and cranny of Nigeria source their medicines as well.” President of the PSN said what these promote is unhindered access to medicines in Nigeria which comes with tragic consequences including high rate of morbidity and mortality.”
However, National Chairman of the Association of Community Pharmacists of Nigeria (ACPN), Dr. Albert Kelong Alkali said “We find ourselves in this situation because of the chaotic drug distribution system that we have in this country. I know that the National Drug Distribution Guideline was launched at one time, but the implementation date has been shifted severally and that is because of lack of political will by the Federal Government. “Government is not taking this matter seriously. I think that the key culprit in this situation is the Federal Government.”
Beyond the affirmation of the minister of health, the Registrar of the Pharmacy Council of Nigeria (PCN), Elijah Mohammed similarly asserted that the open drug markets will be relocated to the Coordinated Wholesale Centres (CWC) by January 1, 2019.
“The PCN has inspected and approved the various locations of the CWC for each of the open drug markets in Idumota (Lagos State), Onitsha (Anambra State), Ariara (Abia State) and Sabon-gari(Kano State). Explaining how the new order would emerge, Mohammed said the Manufacturers and importers of medicines will only supply their products to the Mega Wholesale Centres (MWCs) otherwise known as Mega Drug Distribution Centres, Public Wholesale Centres (PWCs) otherwise known as State
Drug Distribution Centres, Coordinated Wholesale Centers (CWCs) or Stand-alone Wholesale Centers, which are the conventional wholesalers. These middle level wholesalers will be responsible to supply the retailers which include community pharmacies, public and private health institutions and Patent and Proprietary Medicine Vendors (PPMVs) from which point the public access drugs. “The PPMVs have approved list of medicines which can be sold by them and these are the items they are allowed to stock,” added Mohammed.
According to him, the new system would bring sanity to drug distribution system in the country and promote product tracking and recall when the need arises. Consequently, he noted that the quality and efficacy of the drugs in the new distribution system can be guaranteed and better health assured for the citizenry.
“The operations of the current open drug markets are not under the regulation of any of the regulatory agencies. What this means is that neither officials of the PCN nor that of the National Agency for Food and Drug Administration and Control (NAFDAC) are present in these drug markets.”
However, the Registrar of the PCN said the CWCs will in the first instance be subjected to the rigours of inspection, recommendations and approval and each shall be registered and superintended by registered pharmacists.
He added, “This will instill high ethical accountability.” He stated that the facilities are purpose built. “There will also be distribution managers who shall be pharmacists to coordinate the operations of the subsidiary units. “There are already drawn out operational guidelines and Standard Operating Procedures (SOP). Each CWC will have offices for PCN, NAFDAC and Police Post.
“All CWCs will operate within the framework of the National Drug Distribution Guidelines approved by the Federal Ministry of Health.” Furthermore, Mohammed said the new system will improve international businesses whereby those individuals and companies from African countries who in time past patronised the Nigerian pharmaceutical markets in Kano, Onitsha and Lagos but left for some obvious reasons would come back.
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