A counterfeit drug is a medicine produced and sold as the genuine product without the consent of the original manufacturer. Counterfeit medicines may be fraudulently labelled, contain different ingredients to the genuine products or contain incorrect doses. The counterfeit drug trade is a lucrative one as medications are high value, in high demand and can be produced cheaply. Poor regulation and corruption is also a major factor in encouraging the counterfeit drug industry.
Corruption in the pharmaceutical industry in Nigeria
The counterfeiting problem in Nigeria can be traced to the Nigerian Government’s decision to award licences to import drugs during a time of scarcity in the 1980s. As licences were distributed mainly on the basis of political patronage, many people who had no business with drugs and pharmaceuticals became importers. Meanwhile, pharmacists, genuine manufacturers and importers were denied access to foreign exchange or forced to repurchase import licences from those whose ‘factories’ were located in their brief cases. The country’s markets were flooded with all sorts of fake, counterfeit and substandard products. In 2001 the World Health Organization estimated that more than half of all drugs in Nigeria were of this nature. Some were simply chalk or flour pressed into tablets and packaged to look like the real thing. Others had only a fraction of the active ingredient, triggering drug-resistant strains of the world’s biggest killers, malaria, tuberculosis and HIV.
The counterfeiting and dumping of drugs have their greatest impact on society’s most vulnerable: the poor and the sick. Dr Dora Akunyili, a pharmacologist, saw her diabetic sister die after using what she believes were fake insulin and fake antibiotics. In 2001 Dr Akunyili became director of Nigeria’s National Agency of Food and Drug Administration and Control (NAFDAC), a notoriously corrupt department. She immediately tackled the problem by confiscating and publicly destroying up to US$16 million worth of counterfeit medicines. She closed down the vast open-air medicine market in the northern city of Kano, set up a new team of mostly female drug inspectors, and began to prosecute importers of counterfeit drugs. Another initiative was a telephone hotline for the public to report corruption.
As a result of her work Dr Akunyili received death threats and her car was fired on, with a bullet grazing her head. The NAFDAC’s offices were also burnt down. Nevertheless, Dr Akunyili’s determination succeeded in restoring the credibility of the NAFDAC and led to an 80% reduction in the level of counterfeit drugs in the country.
In 2003 Dr Akunyili was one of the winners of Transparency International’s Global Integrity Awards, which are presented to individuals who have made an outstanding contribution to fighting corruption in their country.
Fighting corruption is a long, slow process, but there has been improvement. Transparency International’s Corruption Perceptions Index ranks countries from zero (highly corrupt) to ten (not corrupt) on the degree to which corruption is perceived to exist among its public officials and politicians. Nigeria’s score on the Index rose from 1.6 in 2004 to 2.4 in 2010.