Ex­pired drugs and im­pli­ca­tions to pub­lic health

Sunday Trust - - VIEWPOINT - By Mustapha Aminu Yusuf Yusuf is the for­mer Sec­re­tary Gen­eral, Al­liance for Democ­racy

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.

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