In Nigeria, medicines meant to save lives can become instruments of harm before they reach the patient. Food intended to nourish can carry toxic consequences. And behind much of the problem, according to Mojisola Adeyeye, Director-General of the National Agency for Food and Drug Administration and Control (NAFDAC), is a regulatory system struggling to contain an expanding market of unregulated medicine sellers.
“If I were not a Nigerian and just resumed this job, I wouldn’t be in a good position to answer this question. But I grew up here and spent three decades of my life in Nigeria and knew a Nigeria that worked.”
The director-general of the National Agency for Food and Drug Administration and Control (NAFDAC), Mojisola Adeyeye, tells the full story:
“Before I left for the USA, we had patent and proprietary medicines vendors(PPMVs) but not many, and they were closely regulated by Director of Pharmaceutical Services under the control of Ministry of Health and Pharmacy Board of Nigeria. However the regulations varied from state to state. Since independence up to about 1990, this scenario played out until the Local Governments were being authorized to issue PPMV licence. This marked the onset of chaotic drug distribution in Nigeria where many who held the licenses are clueless about what is a medicine. It became politicised. The chaos led to return of authority in 2003 to issue licence to the then Pharmacists Council of Nigeria that is now called Pharmacy Council of Nigeria..”
“Today, PPMVs are in their thousands across Nigeria, but pharmacists are in hundreds. A PPMV is supposed to sell simple medicines such as Panadol, aspirin, etc., and in their original containers but they sell everything now. Some have become part of the open drug market.”
In 2016/2017, the Ministry of Health, NAFDAC and the Pharmacy Council of Nigeria came to the resolution that there must be Coordinated Wholesale Centres (CWC). But she regrets that, for long, there was no political will to do this until recently.
The CWC plan was established so that PCN and NAFDAC could have more control over the site/practitioners, and control of the quality of the products respectively. It was done to avert pain and severe health crises among adults and children (e.g., damage to kidner, liver, antimicrobial resistance and preventable deaths) that could be caused by substandard and falsified medicines, and unwholesome foods. These could result in economic loss and a loss of consumer trust in Nigeria. An extension of the economic loss could be seen in exports due to rejection of foods exported to other countries.
For long, regulatory efforts were hampered by weak enforcement and porous borders enabling smuggling. NAFDAC is strenuously fighting fake goods using mobile authentication services and routine seizures, but challenges remain.
Adeyeye finished her pharmacy degree in Nigeria in 1976. She became the head of pharmacy at the Baptist Hospital, now Bowen University Teaching Hospital, in Ogbomoso, Oyo State. She later went to the United States of America for further studies.
Back home, she could not believe how the food and drug administration field had been hijacked by people who are not competent in the respective fields.
In the real sense of the expression, Nigeria’s number one lifesaver is the Director-General of the National Agency for Food and Drug Administration (NAFDAC). The incumbent leads an agency that prevents human and animal populations from death or incapacitation from medication and the food they consume.
However, anyone occupying the position should better be sympathised with than envied for facing an uphill task.
In Africa’s most populous country, some foods that are meant to nurture people while drugs that are meant to cure them of ailments end causing harm.
Leafing through her trajectory, the woman’s life oozes professionalism and intellect.
However, all has never been smooth sailing. Indeed, it is the strength with which she has coped with some of the turbulence, including near-death experiences, that defines her success in life.
“My driving force is from a personal story,” she reflects. “I had my first child in Nigeria more than 50 years ago at University College Hospital (UCH) Ibadan. I was in labour for 37 hours after having been induced with oxytocin to make the labour faster. The drug didn’t work. A drug that was supposed to make labour happen faster didn’t work as expected because it was probably sub-standard. I was rushed to the theatre while my hospital gown was being ripped off with scissors for emergency C-section for fear that the baby and I might be in danger of death. I almost died and the child would have died too.”
That’s not the end. Her sister died at the age of 42 years from postpartum haemorrhage, leaving six children.
So, when she insists on adherence to international standards, you can know where she’s coming from.
She puts the monstrous challenge in perspective:
“There is so much talk about the sub-standard drugs and one area that requires greater attention too is the chemicals used in food production and preservation that are harmful to health. The Ministry of Agriculture has the primary mandate for fresh produce.
“However, because NAFDAC’s Veterinary Medicines and Allied Products Directorate regulate and control pesticides, the Agency took up the obligation to train farmers on how to use the pesticides based on directions on the label and best global practices. One challenge in terms of proper understanding of use of pesticides is due partly due to a certain level of illiteracy.
She says NAFDAC is doing all it can do to strengthen the nation’s food and drug regulatory systems. This has enabled Nigeria to achieve Maturity Level Three of the World Health Organisation (WHO) classification for medicines and imported vaccines, advanced digital regulation and tightened oversight across the supply chain.
The odds are heavy, but NAFDAC is striving to be on top of the game.
According to her:
“It is a journey and I will feel accomplished to some extent when we get to maturity level four (with the accompanying WHO Listed Authority), when the products we make in Nigeria have public trust and are traded internationally. At that point we can walk among the comity of nations as makers and suppliers of trusted products, not only consumers.”
On what her agency is doing to contend with the widespread abuse of popular substances, such as ‘man power’ with harmful ingredients, such as cannabis and other unregulated psychoactive substances, she says NAFDAC is doing a lot on its mandate but NDLEA is in charge of cannabis and sychoactive substances that are abused.
Regarding NAFDAC’s mandate and continued efforts of the Agency she gave an example:
“There is a place called Trade Fair in Lagos. We raid, evacuate, burn, arrest and jail but there are some merchants of death — people selling drugs and medicine who have no knowledge about what they are selling. We repeat raids in Trade Fair because when a place needs cleaning, don’t think you’re going to vacuum once. Our goal is to be consistent in reducing prevalence of sub-standard and falsified medicines to the barest minimum. Remember, substandard and falsified drugs (SFs) are a global problem that must be dealt with continually and consistently.
“In our raids, we find warehouses filled with drugs and dealers with re-validating machines changing the expiry dates. If a drug is to expire in 2020, they can change it to 2030. The Agency spends a lot money on creating awareness. Since 2019 we started ‘NAFDAC and Health’.” She says political will is increasing in support of the agency’s efforts.
“In terms of control of the open drug markets (ODMs), state governors (current and past) have a key role to play in collaboration with the federal institutions – the Federal Ministry of Health and Social Welfare, PCN, NAFDAC and the Federal Task Force that is domiciled in NAFDAC. The federal government cannot do everything”.
She appreciates the example of Governor Abdullahi Umar Ganduje in building the CWC in Kano during his tenure. Governor Sanwoolu is also collaborating with the Lagos State’s Idumota CWC that is under construction. Governor Chukwuma Soludo of Anambra has commenced the massive 50-hectare pharmaceutical hub or CWC at Ogbogwu while Governor Otti is planning for the CWC at Umuimo in Osisioma Ngwa Local Government Area.
“In a recent meeting with the Senate, they observed that NAFDAC’s revenue has been growing and asked how I was doing. I said it is because we are fiscally responsible; I don’t steal, and by so doing, I am setting precedence for others to follow.”
She has challenged the notion of NAFDAC being placed among revenue-generating agencies, insisting that it is a service provider.
She is satisfied that the new Minister of Finance is “working to return any unauthorised deductions and put NAFDAC on the non-revenue generating agencies.”
She stresses the efforts of the Federal Task Force against counterfeit and fake drugs and unwholesome processed foods created by the C34 LFN 2004, domiciled in NAFDAC at the Directorate of Investigation and Enforcement, which has 36 plus FCT State Task Forces, PCN and NAFDAC. It seeks to achieve synergy among stakeholders across tiers of government and agencies.
She was asked about succession after her tenure.
“You know, there is a song that says a wise man builds his house upon the rock,” she intones philosophically. “The wind, the storm and the rain came but the house remained standing. We are laying a strong foundation; this is what sustains systems or agencies. We are building a system that is reputable and will be reproducible time after time. So, any successor that wants to disrupt the built system will face difficulty.”
Hassan is a General Manager at BusinessDay
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