Nigeria: High Costs of Drugs: Declaring a State of Emergency Before Many Die

The situation is more terrifying with major drug manufacturing companies folding up their operations in Nigeria as the environment for business becomes more difficult.

Nigerians with health challenges are in grave danger as the prices of medicines are now beyond the reach of most people. Steadily, the depreciation of the naira against the US dollar and other major global currencies, since President Bola Tinubu assumed office, and the deregulation of the foreign exchange market, sparked a chain of economic crises, in which healthcare delivery has become one of the major casualties. The concern does not demand the usual government’s tokenism, but an effective emergency response.

The situation is more terrifying with major drug manufacturing companies folding up their operations in Nigeria as the environment for business becomes more difficult. There is also the underlying problem of the mass exodus of medical doctors, nurses and other paramedics to Europe, the United States, Canada and Saudi Arabia for better pay and working environment. This period is really a difficult one to fall sick in Nigeria. The prices of antibiotics, analgesics, hypertensive and anti-diabetic drugs, among others, have soared to between 400 and 500 per cent. Augumentin, a popular antibiotic that used to cost N3,500, now goes for over N30,000. This means that for the poor – minimum wage earners and the over 133 million Nigerians who have been identified as multi-dimensionally poor – falling ill becomes the end time.

Most pharmaceutical products used in Nigeria are imported either from China, India or Europe. The non-availability of drugs is on the trajectory to worsen with the exit of GlaxoSmithKline (GSK) from Nigeria in October, after 51 years. The British firm has expressed its desire to transition to a product distribution model in the Nigerian market. We seriously doubt the plausibility of this business model since the easy repatriation of income from sales in foreign exchange to the home countries of multinationals is not currently feasible due to Nigeria’s fiscal conundrum.

The economy, according to Reuters, “has about $7 billion in forex forwards that have matured, a major concern for investors as foreign currency shortages continue to weigh down the naira currency.” The Central Bank of Nigeria, (CBN) says it has cleared a backlog of about $2 billion of these forwards across the aviation, oil and manufacturing sectors. Foreign airlines are owed $792 million, out of which $65 million was paid. Some of them have abruptly stopped their operations here.

In addressing Nigeria’s drug crisis, part of the focus should be on why most local pharmaceutical companies thrive on marketing and distributing products manufactured abroad, instead of being manufacturers themselves. Some pharmaceutical products made under their corporate brands are actually manufactured by Indian and Chinese firms. This untoward situation is exemplified in the 70 per cent of drugs used in Nigeria being imported, as the Pharmaceutical Society of Nigeria affirms. This is why fake and substandard products easily get into the market, aided by weak regulation, porous borders and corrupt customs personnel.

Data from the International Trade Centre put Nigeria’s drug import in 2020 at $2.4 billion, which has been declining since then due to forex pressures. In 2021, it was $1.37 billion and $1.05 billion in 2022. The downward trend continues as forex scarcity intensifies. Citizens buffeted daily by hunger, with food inflation at 33.93 per cent as of December, cannot defray healthcare costs, so they avoid treatment with quality drugs. This is a most dreadful double whammy!

Though it has dawned on the government that major drugs are no longer affordable to most Nigerians, the Coordinating Minister of Health and Social Welfare, Ali Pate, has said an Executive Order from the President is in the offing to improve the situation. A Federal Executive Council meeting on the issue, penultimate week, reportedly sealed packages that will make drug manufacturing thrive, regulate the prices of drugs, release funds to the Medical and Dental Council of Nigeria (MDCN), and cancel waivers in the recruitment of health workers, to be carried out by the Ministry of Health, unencumbered by the bureaucratic bottle-necks of the Civil Service.

There is no time to waste on whatever needs to be done. The lamentations of the Chief Medical Director of Lagos State Teaching Hospital (LASUTH), Professor Adetokumbo Fabamwo on this crisis are instructive: “Nigerian citizens are already impoverished and cannot even afford to buy food to eat; if they are sick and need to buy drugs… we will have increased morbidity and mortality.”

When the cost of healthcare is out of the reach of the poor, they avoid going to the hospital for a doctor’s attention and resort to self-help through self-medication, patronage of quacks and indulgence in the use of herbs and other local concoctions without proven scientific bases, all of which could kill, or cause life-threatening damages to organs of the body. Others rely on prayers and spiritual interventions only.

Evidently, the solution is not in the impracticable idea of regulating the prices of medicines, which are imported, amid the worsening forex situation. Last Thursday, the naira depreciated to N1,405 to a US dollar in the parallel market, while it went for N900.96 in the official window. This picture still shows a wide gulf between the two markets, thus making nonsense of the government’s policy drive for their parity. We dare say this is causing more harm to the economy and danger to the existence of Nigerians, than whatever it has achieved.

It is for this reason that we applaud the recent observation of the CBN governor, Olayemi Cardoso, that the naira is “undervalued” and he has made a promise to expedite action in discovering its genuine value in the near term. Nigeria’s economy must be made to work for all; and this invariably means, grafting the anti-corruption crusade into Tinubu’s governance template. It must go beyond rhetoric. The forex pressure on the naira must be eased for the economy to find its groove and to rescue the pharmaceutical sector from its downward spiral.

For the sick to breathe and dream of survival, the more than $100 billion value of stolen crude by some oil majors, identified by the immediate past government, NIETI, and indicated in the JVC profit-sharing revenue, and which the Supreme Court judgement said should be recovered, must be. Otherwise, the hit that the naira gets against the dollar, and the operations of economic rogues, which the MT Kali vessel arrested by Tantita Security Services Nigeria Ltd, two weeks ago, typifies, and whose captain, David Adeboye, said he did not know how the crude oil he was carrying was loaded, will continue to ruin the economy and imperil the lives of Nigerians.

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