Nigerians are increasingly turning to risky and harmful alternatives as the cost of medications spike, posing serious threats to public health.
Unable to afford conventional treatments, many individuals are resorting to substandard or counterfeit drugs, risking ineffective treatment outcomes or even harmful consequences.
Iya Khalid from Shomolu area of Lagos State, a mother of three, exemplifies this trend: “Before, I relied on conventional medications for my children’s illnesses, but with drug prices beyond my means, I’ve turned to homemade remedies and traditional herbs as our elders did in the past.
“I am using concoction as an alternative solution. According to her, in pidgin language, “I no say this Agbo no fit work like wetin I go buy for chemist.”
Despite her concerns about their effectiveness compared to pharmaceutical drugs, financial constraints compel her to continue this makeshift healthcare approach.
A confirmation of this shift came from a woman who has an Agbo shop somewhere in Yaba, Lagos.
Speaking with our correspondent on the increasing level of patronage she enjoys these days, the woman who introduced herself as Madam Tosin, said she noticed that something was going on when many more people, including those she never believed could look into her shop began to do so.
“I have been selling Agbo for over 10 years now. Around September last year, I noticed that many more people were coming to my shop to request for mixtures for malaria and Typhoid. The number has continued to increase.
“Even some people that I never believed would look into my shop are now my customers. Some of them come when nobody will see them. I understand them too. People complain that drugs are very costly so they are looking at other ways to help themselves,” she said.
Pharmacist Peter in Lagos echoes the challenges, citing unprecedented sales dynamics and price instability in Nigeria’s drug market, particularly in purchasing and reselling, which have reached unexpected levels of instability.
“Constant price fluctuations force retailers to purchase drugs at higher costs, depleting their stock levels. Drug marketers release prices every week, this situation forces retailers to repeatedly purchase drugs at prices higher than their previous cost, leading to a continuous depletion of their stock levels.
“Factors like foreign exchange challenges and the withdrawal of majors like GSK and AstraZeneca pharmaceutical companies further exacerbate the situation, casting a negative light on the Nigerian drug market and increasing demand for essential products,” he said.
Peter further said that essential malarial medications like Lonart rose from 1,200 to 2,700, Coartem rose from 1,800 to 3,500, and Augmentin 625 mg is priced at 25,000 compared to 7,500 previously.
According to him, Ventolin inhaler now costs 22,000 as opposed to 4,500 and Avamis is priced at 26,000.
He noted that the alarming price hikes has rendered such drugs increasingly inaccessible to ordinary Nigerians.
“The coartem subsidized one by 24, which previously offered significant benefits to the public is no longer available. This, coupled with shortages in government-owned hospitals, leaves patients struggling to obtain necessary medications,” he said.
Drugs that were once affordable for common ailments like malaria and typhoid have become increasingly inaccessible for the average Nigerian. Similarly, antibiotics, inhalers crucial for asthma patients, which were once easily obtainable, are now considered a luxury.
The value of the naira has continued to weaken and foreign exchange has become scarce, the Nigerian pharmaceutical industry deals with keeping essential medicines affordable for the public.
Import costs have surged by more than 40 percent since June 2023 posing a critical challenge for the industry in ensuring access to healthcare for all, adding to the challenge, government-owned hospitals frequently experience shortages, leaving patients with prescriptions but no means to obtain the necessary medications.
While politicians seek top-tier medical care abroad, the populace resorts to hazardous remedies due to lack of affordable options.
Experts emphasise the need for comprehensive policy solutions to address medication cost spike, including promoting generic drugs, improving healthcare financing, strengthening regulatory oversight, and raising public awareness of safe medication practices.
In an interview with Ignatius Anukwu, chairman, Association of Industrial Pharmacists of Nigeria (NAIP) on drug price hikes, access, and affordability concerns in Nigeria, he said the pharmaceutical sector is largely import-dependent for raw materials and finished goods, any adjustments on the exchange rate have a direct impact on the prices of the commodities.
To mitigate these effects, Anukwu suggested that the Federal Government should consider interventions such as making foreign exchange available to genuine players at official or subsidised rates.
Additionally, he proposed that the federal and state governments may procure pharmaceutical products and distribute them through their Ministries, Departments & Agencies MDAs to tertiary, secondary and primary healthcare facilities,
Furthermore, Anukwu stressed the need for a review of tariffs and taxes imposed by government agencies, which are often burdensome to private sector players in the pharmaceutical industry. He emphasized that these costs are ultimately transferred to consumers, exacerbating the affordability crisis.
In advocating for long-term solutions, Anukwu stressed the importance of creating an enabling environment and providing adequate funding for indigenous pharmaceutical manufacturing. By bolstering local production capacity, Nigeria can meet its domestic pharmaceutical needs and even become a net exporter of pharmaceutical products.
Anukwu also addressed systemic issues within the healthcare system, lamenting the lack of adequate provision of basic healthcare services to the populace. He criticized government-owned hospitals for frequently lacking essential drugs, forcing patients to purchase medications privately. Anukwu highlighted the stark contrast between the quality of medical treatment and drugs available domestically versus what obtains abroad.
Anukwu urged the government to reassess its priorities and allocate resources to ensure the provision of essential healthcare services and commodities to all citizens. He emphasized that addressing these fundamental issues is crucial to improving healthcare outcomes and fostering a healthier population.
However, exploring ways of addressing problems confronting the sector, especially hike in prices of drugs. Mohammed Ali Pate, Nigeria’s coordinating minister of Health and Social Welfare has begun an engagement with pharmaceutical companies to explore strategies for reducing drug prices.
“Tinubu administration is focused on what we can do to reduce the burden of high cost of drugs on Nigerians especially the poorest and the most vulnerable ones as the health and welfare of all Nigerians is key to us.
“So, this first consultation with pharmaceutical stakeholders is very important as they are responsible for the research, development, production and distribution of medications. The pharmaceutical local manufacturers will ensure that the industry strives and Nigerians have affordable medicines that can improve the health of the population of this country.”
NAFDAC warns against concoctions
Despite the spike in the cost of drugs and the difficulty in accessing medication, the National Agency for Food and Drug Administration and Control (NAFDAC) has continued to advise Nigerians to be wary of the liquid herbal concoctions.
Mojisola Adeyeye, director general, NAFDAC, had recently urged Nigerians to take precautions when consuming herbal medicine.
She called for caution with the use of herbal medicine to prevent avoidable deaths and complications.
“After 14 days, if it is liquid, it may start to develop bacteria that can make people sick,” she said.
The general public should use herbal medicines with care because you don’t know the quantity that you are supposed to take.
“The fact that it is natural doesn’t mean it is not toxic.”
She explained that the toxicity of such medicines is not about the volume consumed, but that the quantity could be contaminated.
Adeyeye also said the hawking of herbal preparations under the heat of the sun may cause decomposition of active ingredients in the medicines, and this may pose significant health risks for those consuming them.
“That’s why herbal medicines in Nigeria have to be handled with care. Some people take herbal medicines like vaccines.
“Herbal medicines are derived from plants mostly, sometimes, from animals in few cases while vaccines are from human or animal cells that have been programmed to elicit immunologic effects in the body.”
Adeyeye, who advised against combining the use of herbal medicines with other drugs, said herbal preparations may reduce the effectiveness of conventional drugs.