Expired drugs and implications to public health

The moving story of an ailing old man who recently visited Egypt on a medical trip strikes me as most revealing. Disturbed by a certain medical condition, the elderly retiree went first, to a Nigerian hospital. He faithfully took all his prescribed medicines for a long time. But his condition didn’t improve. It worsened instead. Again and again, he complained at the hospital, until he eventually lost all confidence in his doctor.

So he rushed to Egypt. Before leaving, he went back to his confused doctor, told him of his intention, and took away all his records.

In the famous Egyptian hospital however, the doctors were soon startled. They found that the earlier Nigerian prescriptions were the most suitable for the treatment. For that reason, they only administered Egyptian medicines according to the Nigerian prescriptions. The man got cured within a few weeks and returned home. And before leaving, the hospital management gave him a letter to his Nigerian doctors and hospital, commending both for their professional efficiency.

We cannot but infer that in the previous Nigerian treatment, the man took substandard medicines; fake or expired drugs that lack any curative efficacy. But since the two evidently originate from different sources, they are, on that account, also sold by different categories of people.

In particular, the sale of expired drugs is committed by some dubious managers of credible firms who have direct and probably, exclusive access to them. Instead of discarding their unsold stocks properly, they sell them secretly in the markets.

I discovered this in my home state, Kano, some twenty five years ago, when I worked as a sales representative for pharmaceutical companies. A manager I knew then even offered to engage me on the line. At our scheduled meeting with three other strangers, he told us bluntly that we would be selling expired drugs. Then he took us to a warehouse where he showed us some samples. Indeed, they were both so elegantly relabeled that nobody would suspect any foul play, and in large quantities. Unfortunately, I’m just not cut out for that manner of making money. Anyone who yields to that tempting proposal would be exploiting the distressing plight of many ailing persons to his material advantage.

Every long day, countless innocent patients fall victims in various ways, to this cruel fraud. For instance, if this aged patient weren’t wealthy enough to undertake the trip and treatment abroad, his case might never have been treated. Second, if it were a fatal case, he would have died. Needless to say, before him, many a poor patient, incapable of undertaking a foreign medical trip must have either suffered pointlessly prolonged pains, or even lost his life. Third, because the trip is not even necessary in the first place, the efforts and money spent on it, like the entire Nigerian treatment, amounts to waste. Forth, doctors also become upset when, despite putting in their best, their patients still remain ill, or even die.

Be that as it may, the old man’s narrative has revealed that, one, expired drugs could be much as prevalent nowadays as they were two and a half decades ago. This shouldn’t shock us, as the health sector is not exempt from the decay that characterize our institutions in recent years. At any rate, the revelation, if linked with the criminal tendencies of that hiring manager, suggests, somewhat strongly, that more focused legal controls are needed in addressing the menace.

And two, that the supply of the offensive products undermines not only the professional competence of our medical personnel, but by extension, also the quality of our health care system. Therefore, they should be eliminated from our markets.

They are as bad as an epidemic, I believe; since in effect, they also cause indirect deaths, and unnoticeably prolong unnecessary suffering.

Also in my opinion, they pose a worse threat to public health than even psychoactive, habit-forming drugs, whose health-damaging effects are limited to their unfortunate addicts. In contrast, the effects of expired drugs affect every one of us equally, in as much as anyone of us may fall ill any time, and subsequently be exposed to their unhindered abundance.

So, the relevant government agencies, NAFDAC, NDLEA, SON and CPC, should be legally empowered to take full responsibility of the proper and timely disposal of all unsold, expired drugs, a disposal so important to our health and lives that it should not be absolutely trusted to the moral discretion of private companies and their managers. Importers, manufacturers and marketers of pharmaceutical products should be compelled by law, to declare them as at when due, and turn them in.

This measure will mark a step further in protecting the good health and precious lives of Nigerians. What’s more, it will not only enhance public confidence in our health care system but as a result, also conserve our needed foreign exchange earnings, wastefully being lost to avoidable medical tourism.