Towards sustaining war against counterfeiting

Two professions have always appealed to Francis since his childhood. The successful businessman that he lives with and the Reverend Father he sees every worship day, both enticed him to their callings.

Unable to endure the rigours of business apprenticeship he settled for the seminary. His intelligence was a good head start but for innate trickery and his over-ambitious for power.

At the point of confirmation, authorities concluded that “Father Francis” was not good enough for priesthood and had to be de-robed. As compensation, he received a good sum of money, which launched him back into business.

Six-months in Libya taught Francis a new trade of drug manufacturing and how to travel the goods straight into the porous Nigerian market. He was making all manner of drugs under already known brands and getting high returns.

From Libya, he became known in China, ordering products – all faked – for Idumota and Aba open drug markets. Like a fallen angle, he was quick to ouster marketers of original brands out of the market because he was offering the perfect replica of popular products’ – readily available, very cheaply and with better packaging – to the wholesalers.

Francis has found his calling. He was rich in billions and known internationally. Police tracked and arrested him at the Murtala Muhammed International Airport almost 10 years after his ouster from the seminary.

Almost at the period when Francis was been tried in court, a particular trend was noticed in a popular hospital in Ibadan. Patients were dying of malaria; as none of the antimalarial dosages worked. It was the pre-ACT period. Chloroquine was the in-thing in malaria control but quite short in supply.

Regulatory agency later found that a precocious young chemist has latched on to the scarcity, sprayed some homemade chalk-tablets with chloroquine (to replicate the popular scent), packaged same under a popular brand and sell to the hospitals for dying patients to ingest. It turned out to be lethal doses that killed a handful before the chemist was uncovered.

Like Francis, like the chemist, the faceless act of counterfeiting has taken several dimensions, not only in Nigeria, but globally.

While the National Agency for Food, Drug Administration and Control (NAFDAC) recently said the act of counterfeiting had reduced to barest minimum, keen observers in the sector are terrified that the illicit trade had in fact gone haywire and defiant with improved technology.

In 2001, NAFDAC estimated that 40 per cent of drugs in circulation were counterfeited. Some independent opinions said the figure was underestimated. But by 2005, counterfeiting has reduced to 16.7 per cent and 6.4 failure rates on all the samples tested in 2014.

The regulatory agency had during the period under review increased enforcement and introduced cutting edge technology to combat the menace. The use of technology like Truscan, Infrared device, RFID, Mobile Authentication Services (MAS) among others in the detection of fake from the original has achieved a lot of results.

Industrial pharmacists, who actually feels the pinch the most, disagreed with the regulatory agency. From their perspective, for every rebranding a manufacturer engages, new strategy by policy makers or brute force by law enforcement agencies, the network of counterfeiters is always a step ahead of the game. The outcome is always a public health disaster.

The implications include treatment failure, death, increase hospital stay, more burden on the hospital and financial burden on patients paying out-of-pocket and the system at large.

Chairman of the National Association of Industrial Pharmacists (NAIP), Gbenga Falabi said NAFDAC and World Health Organisation’s (WHO) recent verdict that counterfeiting had dropped under 10 per cent was hard to marry with growing complaints that drugs were not working and patients are not getting well.

Falabi, at the bi-monthly meeting of the association in Lagos recently, said the regulatory agency should be questioned where they had conducted the survey.

“We should ask from which population was the sample size derived? Was it from Banana Island or Ikoyi? Because it is from Mushin or Ikire (Osun State) or from Ariaria or other places in the hinterland, I doubt you will get the same figure,” he said.
Continuing, Falabi said: “People are complaining that drugs here are not working and that is why many people are not going to hospitals.

“Somebody said to me just yesterday that ‘I don’t trust myself to modern medicine anymore because it is like committing myself to death.’ We need to reverse that and need to build greater confidence in what we do. We know that the health industry is 60 per cent pharmaceuticals and we must not rest on our oars until we have taken this battle to the counterfeiters’ door step.”

A population of about 170 million people, surrounded by 924,000 sq. km porous borderline (largely unmanned), is attractive to world counterfeiters and their targeted products are just logical too.

Their targets include: Antimalarial, antibiotics, pain relievers, multivitamins, blood tonics, antifungals, anti-hypertensives and other lifestyle drugs that are all at the centre of our public health issues. With over 70 per cent of the population earning less than two-dollars a-day and paying for health out-of-pocket, they would settle for anything cheaper – counterfeit or substandard.

Assistant Inspector General of Police (retired) and pharmacist by training, Alex Emeka Okeke, recalled that the menace of drug faking had gone haywire in the last 30 years with the use of sophisticated technology that makes counterfeited products extremely hard to separate from its original.

Okeke, who was the head of Nigerian Police Medical Service until he retired in 2013, recalled that serious attempt against counterfeiting was made about 30 years ago during the military administration of Gen. Ibrahim Babangida, but along the line, “the effort tapered”, because there were “a lot of undercurrents” and lack of political will to execute recommendations that promulgated Decree 17 of 1989.

For the police boss – a member of the then police monitoring team against counterfeiting – it was a golden opportunity missed to curb the nuisance at its infancy. With the lack of commitment from the then ministry of health, arrested culprits from Idumota, Onitsha, Aba, Orlu, Jos, Kaduna and Kano all returned to the market with new fervour.

NAFDAC came into the picture along the line, though only to grope in the dark due to lack of capacity and motivation to enforce the laws. It therefore leaves no one in doubt that “the incidence of counterfeiting has reached a crisis situation”, because counterfeiting only thrives where regulatory measures are still ineffective, Okeke reckons.

The World Health Organisation (WHO) estimates that in wealthy and well-regulated economies, counterfeiting accounts for less than one per cent of market value, but 50 per cent of Internet sales are now counterfeit. In emerging economies, it ranges between 10 to 30 per cent.   According to World Customs Service, a counterfeiter is as rich as $200 billion a year.

Relaying the story of Father Francis’ arrest, he recalled that his imported products, coming from China, had better package than of the international brand, but found to contain just olive oil. “When apprehended, he didn’t even show any remorse or see anything wrong in what he was doing. That is a common trend among our fakers.”

Okeke agreed that the war against counterfeiting was on, but has to be intensified by collective efforts of the public, pharmaceutical sector and the government.

The ex-police chief warned that Nigeria should be on the guard, particularly in the wake of recent global offensive against narcotics trade, led by the United States and Mexico, which has led to drug barons shifting attention to into less risky and more lucrative drug counterfeiting, making the trade more sophisticated and militarized.

He opined that as long as the health sector continues to be under-funded and the people, poor and ignorant, would continue to find the products offered by counterfeiters attractive.

He added that the government had indeed shown the way with the planned implementation of the new National Drug Distribution Guidelines (NDDG) to phase out the porous market, but has to encourage collaboration; using the “carrot and stick approach” for genuine distributors so as not to worsen the already bad unemployment rate in the country.

While he urged the pharmacists on eternal vigilance and cooperation with regulatory agencies, he said the government must also support the local manufacturers to produce drugs of international standard that are also affordable to the public.

Chief Executive Officer, Evans Pharmaceuticals, Bunmi Olaopa, who was represented by Wale Oyenuga, noted that the lack of cooperation and collaboration among practitioners in the drug-manufacturing sector was the major reason dubious sales representatives and counterfeiters were prospering at the expense of the manufacturers and genuine importers.

The “over fragmentation” in the industry has till date prevented the manufacturers from rallying behind NAFDAC and co. to get more stringent punishment against counterfeiters from the National Assembly.

“The earlier we start to learn from what the banking sector had done with merger, to solve their problems, the better for us,” Olaopa said.

“The merger didn’t happen by decree, but by the bankers forming partnership to get the Central Bank and government on their side. Such approach may though by painful, but it will be for common good and solve our problems,” he said.

Besides the new drug distribution guidelines, Olaopa also proffered the use of a uniform electronic platform to monitor the drug supply distribution chain, with open access to all the stakeholders – including the police, custom, NAFDAC, Standard Organisation of Nigeria (SON), Pharmacists Council of Nigeria (PCN) among others – to monitor the flow and trace counterfeits.