Nigerians turn to unregulated local herbs for treatment as essential drugs remain unaffordable

… Saw Palmetto cancer drug price surges from N65,000 to N200,000 in just one year.

Key points:

• Patients now result to use of unregulated drugs

• Essential medicine scarce, out of stock

• Major health crisis looms as prices of drugs prices soar

• How GSK’s exit complicates Nigeria’s drug problem

• Government need to promote localization of pharmaceutical companies in Nigeria

By Emmanuel Kwada

Bulus Bulama will never forget 14 November; a day tragedy greeted his household resulting in the death of his five year old son. Bulus who resides in Adamawa State fits into the category of the 133 million Nigerians classified as multidimentionally poor. His son bled to death after consuming some herbal concoctions supposedly meant to address fever.

Jummai Ishaku, Bulus relative narrated to The Insight how her brother, who was not financially buoyant to purchase orthodox drugs, resulted to patronizing local herbs from an itinerant vendor in Madagali, a community in the state.

“My brother’s son complained of stomach ache in the early hour of November 14, 2023. The boy had suddenly developed symptoms suspected to be malaria fever and considering the high cost of drugs and hospital treatment, my brother decided to visit an herbal store in the community. Upon consuming the drug, we noticed that the boy started bleeding and we eventually rushed him to the hospital. We were not so lucky as the hospital confirmed to us that his internal organs has started getting ruptured as a result of the herb we administered earlier,” Jummai said.

The death of Bulus son is coming at a time the Nigeria government is celebrating a decline in infant mortality rate in the country. The current infant mortality rate for Nigeria in 2023 is 54.740 deaths per 1000 live births, a 2.63% decline from 2022.

The death of Bulus son is coming at a time the Nigeria government is celebrating a decline in infant mortality rate

Mal Garba, a taxi driver, has recently expressed his frustration over the difficulty he faces in accessing essential drugs to cater to his waning health condition. He had been sick and was used to getting drugs like augmentin (625mg) to treat respiratory tract infections at N3,500. However, he now has to pay a whooping sum of N26,000  to buy the same drug, that is about 642 percent of the previous price. Garba lamented the sudden and outrageous increase in the price of the drugs, which has been attributed to the increase in exchange rate.

“I was not expecting the astronomical rise in the prices of drugs. The last time I bought this same augmentin three months ago was N3,500, so I went with an extra N1000 in case the price had changed, but I ended up buying it for N26,000. I was just confused. Seriously, we need help. If the problem is the dollar exchange rate, the Nigerian government should do something about it,” Garba said.

Garba’s case depicts the situation many Nigerians are going through in just about six months since the current administration took over power.

Many Nigerians facing life-threatening diseases are expressing common concerns about the difficulty of purchasing essential drugs. As a result, individuals lacking the financial means to afford their necessary treatments have resorted to unconventional medical practices, including the unregulated usage of local herbs.

An extensive survey conducted on the current drug prices in various pharmacies across Abia, Abuja, Nasarawa, Katsina, Kaduna, and Adamawa has revealed a staggering increase of 150% to 250% in the prices of essential drugs. Consequently, numerous patients who cannot afford these inflated prices are left feeling disappointed or forced to seek alternative solutions which include the usage of herbs, this is like in the case of Mr Rowland who tells The Insight that he has been using herbs instead.

“Since the prices of things gone up especially conventional medicines, I and my family have been using local herbs to treat ourselves from illnesses, I only buy the roots and mix it, and it has been helpful indeed,” he said.

Photocredit: Online

Investigation by The Insight revealed that a cancer drug, Saw Palmetto (900mg), which sold for N65, 000 just a year ago now goes for between N200,000 to N210,000. Also, 30ml of Hempwork, which can be used to manage pains in cancer patients was N35,000, but now sells for N90,000.

Nigeria inflation and exchange rate has gone all time high and the prices of essential commodities have become unaffordable to a vast majority of the citizens. As at November 19, 2023, $1 exchanged at the parallel market for N1,300, while the Central Bank of Nigeria rate stands at N840.54.

The National Bureau of Statistics (NBS), reports that Nigeria’s inflation rate as of October 2023 stood at 27.33%, the highest recorded since August 2005. This persistent upward trend in inflation has been a key driver in the rising costs of various goods and services, including pharmaceutical products.

Mostly affected by inflation are drugs for malaria, as well as prescription drugs for the treatment of hypertensive, arthritic pains and diabetic.

A Chief Nursing Officer in Federal University Teaching Hospital, Owerri, Imo State,  Onyemeh Helen, said there is no doubt that prices of medicines have skyrocketed in the last three months, and the trend is worse with imported products that are not manufactured in Nigeria.

Saw Palmetto (900mg), which sold for N65, 000 just a year ago now goes for between N200,000 to N210,000

“The recent inflation in the country due to subsidy removal, high import tariff and the exit of other pharmaceutical companies like GSK has impacted the Nigerian health care system negatively.

“This economic hardship is hitting hard, and it has far reaching implications on treatment outcomes, mortality and of course morbidity. Those patients suffering from life threatening diseases are extremely vulnerable, because failure to access their medications could result in death,” she said.

Onyemeh, further explained: “Of course, it is already affecting healthcare delivery. A good number of patients that manage to visit the hospital, after obtaining their prescriptions, they get to the Pharmacy and upon learning of the new cost of their prescribed medicines, some will tell you, ‘I am coming’ and disappear from the hospital and you will never see them again. Others may just barely afford to pay for few, while abandoning the rest and there is no way to achieve optimal healthcare because of limited access to medicine, and it can be incredibly tough and emotionally challenging to witness the suffering and loss of those under your care as a health worker.  Helplessly watching their condition deteriorate due to their inability to afford medication is devastating, we only pray and hope that things will get better soon,” She said.

Federal University Teaching Hospital, Owerri, Imo State. Photocredit: Armada News

Beyond lamentations by the Manufacturers Association of Nigeria (MAN) and importers of goods regarding the exchange rate, there is growing concern among Nigerians battling severe health challenges regarding the escalating prices of drugs. This alarming trend, influenced by the fluctuating value of the dollar, is feared to have dire consequences for those in need of imported medications, potentially leading to premature death.

Experts say the falling value of the Naira is taking its toll on businesses in Nigeria, especially the pharmaceutical industry.

How GSK’s exit is complicating Nigeria’s drug problem

With Nigeria being an import-dependent country the current forex crisis has had a huge effect on a lot of businesses, and they have found it difficult to import goods and services, which is a result of the naira constantly depreciating against the US dollar, making it more expensive for businesses to buy foreign currency.

GlaxoSmithKline (GSK) imports most of its products into Nigeria, and the forex crisis has made it difficult for the company to obtain the foreign currency it needs to import its products. This led to the decision for GSK to cease its operations in Nigeria; this decision has raised concerns among the company’s stakeholders, such as shareholders and consumers.

Some GSK products in Pharmacies. Photocredit: Online

Shareholders are concerned about the impact of the decision on GSK’s profits. As the company’s revenue from Nigeria is significant, this decision could lead to a decline in profits, this could led to the recent announcement by the UKGroup, GlaxoSmithKline (GSK)to wind down operations in Nigeria after 51 years of operation.

Not a few people bemoaned the exit of this pharmaceutical giant from Nigeria after 51 years of operation.

As we delve into the implications of this decision, Barrister Eze, a father of 4, whose wife just delivered in Nyanya, Abuja shared his worries with The Insight, “GSK’s products has been helpful, they were available in every pharmacies at a very affordable prices, I have been using them for my kids for years, but now the products are so expensive and not even available to buy even if you have the money”, he said.

“I have to pay roughly three hundred thousand naira for service rendered to my wife when she delivered her baby at Apex Hospital, Karu, instead of the usual one hundred and fifty thousand naira.  Fifty to sixty thousand naira in government owned hospital which we normally pay for that same service before the inflation.

Although, most the pharmacists interviewed pleaded anonymity as they feared victimization by industry stakeholders some of whom do not encourage speaking to the media about prices but some like Bitrus, a pharmacist in Adamawa tells The Insight that there is shortage of GSK products and they e are forced to purchase substitutes from other manufacturers. These substitutes may be of lower quality, which could have negative consequences for patients’ health, and because of the decreased competition other companies are charging more on their products without fear of losing customers.

“They refer you to check the naira to dollar exchange rate when you complain, and truly naira has been depreciating against the US dollar in recently” he said.,

“I really felt the exit of this company, from Nigeria because it is a brand that I trusted and they’ve kept my family healthy and my customer like their product also, but now I’m not sure what our alternatives are” he said.

In a chat with The Insight, the Chief Executive Officer of a pharmacy, who pleaded anonymity, said the impact of the exit of GSK was felt in the pharmaceutical industry long before it was made public.

He said “the company’s products had become unusually scarce – a development he said shot up the prices of their products owing to the forces of demand and supply”.

Speaking on the effects on public health, the pharmacist raised concerns about affordability of drugs, possibility of fake products flooding the Nigerian market and GSK’s products that have no substitutes.

The company’s products had become unusually scarce

“Some of their products don’t have substitutes in the market. Since their existence in Nigeria, they import their products and distribute them, which curbs fake products in the market.

“With their exit now, a lot of people will get the opportunity to import their products and that may give room for substandard products to flood the market. Another issue is affordability. People would find it difficult to afford them. So, it affects public health. It has so many implications. And it’s not just GSK,” he added.

Speaking on how to curb Nigeria’s dependence on imported foreign drugs to make the same drugs available locally, a consultant pharmacist and medical director who pleaded anonymity said, “It is essential for the government to align its priorities with the needs of the citizens, particularly in sectors that directly impact their well being. This includes a more prudent use of resources to ensure that healthcare services are accessible and affordable for all Nigerians instead of wasting resources on mundane things, borrowing money to finance ostentatious and luxury lifestyles of government functionaries.

“Investing in research and development to improve indigenous production in pharmaceutical industries is a crucial step towards reducing the cost of healthcare in Nigeria. By promoting local production, the government can establish a sustainable supply chain of essential drugs, reduce dependence on expensive imported medications, and make healthcare more affordable for the citizens,” the expert noted