Nigeria's reliance on drug imports in the time of COVID-19
The spread of COVID-19 has been slow in Nigeria compared to other countries on the continent. Nevertheless, the federal government has taken steps in readiness for a more rapid outbreak. Schools have been closed, public gatherings banned by some state governments and most public workers are required to work from home.
Nigeria's health system will find a full onslaught of COVID-19 difficult to handle. The main reasons are its lack of sufficient isolation centres and testing kits.
The other major challenge is that Nigeria has a very high dependency on imported drugs—70% are brought in from abroad, chiefly China and India. On top of this, Nigeria relies on imported active pharmaceutical ingredients as well as equipment used in drug manufacturing.
This dependency is of particular concern in the face of a threat such as COVID-19. The reliance on foreign countries may lead to a serious medical crisis in the country if it is unable to source the drugs it needs. China and India have both been hit hard by the pandemic.
It's important for Nigeria to take stock. It needs to look at lessons learned and build on them to respond better to ensure uninterrupted pharmaceutical supply during pandemics.
Drug security is important
With the numerous health challenges that Nigeria faces—ranging from communicable to non-communicable diseases—pharmacotherapy is the mainstay for vast majority of conditions. Ensuring national sufficiency and drug security is crucial in tackling diseases, reducing mortality and catering for other health care needs.
This no mean task with a growing population of over 200 million. It is important at the same time to combat falsified, substandard and counterfeit pharmaceutical products. All pose threat to the economy and security of the nation.
There are steps the country can take to offset the very high dependency on imports. Manufacturing is one such route.
The manufacture of drugs in Nigeria is on the decline. The main reasons for this are infrastructural challenges—like a lack of consistent energy supply—as well as inadequate financial support to the up-and-coming pharmaceutical scientists.
Others constraints include difficulties in the over-dependence of imported raw materials, weak technology and engineering base, weak industrial linkages and supply chain with high taxation.
Nigeria nevertheless has a relatively sizeable industry. The country is home to more than 115 pharmaceutical companies. These produce for the local markets and for export to neighbouring countries.
Nearly all of the local drug manufacturers purchase active pharmaceutical ingredients from other manufacturers and formulate them into finished drugs. This means that they are limited to purchasing drugs and repackaging them for use.
There is, however, some manufacturing. This includes analgesics, antimalarials, antibiotics, antiretrovirals and vitamins including tablets, capsules and syrups. Others include antitussive syrups, infusions, antacids, antiseptics/disinfectants and injectables.
But there is no significant research and development activity in the country. And most of the pharmaceutical companies in Nigeria have not been able to fully navigate the challenges which makes the operation in the country sub-optimal.
The overall impact of this pandemic may be felt soon, leading to shortages of active pharmaceutical ingredients. This should raise concern about the potential of an increase in fake and counterfeit medicines and drugs. Fighting the sale of fake, counterfeited and sub-standard drugs is a ongoing struggle in the country.
The COVID-19 pandemic should be an opportunity for drug manufacturers to pressure government into doubling efforts to ensure local drug manufacturing.
The federal ministry of health too needs to ensure that the medicines and drugs supply chains are well-coordinated and regulated to ensure that people who need them have access. It should ensure that all drugs listed on the national essential drug lists are readily available and well distributed across the country.
Nigeria is blessed with thousands of medicinal herbs. This is equally an opportunity for the country to strategically improve its research on herbal medicines for diseases management and improve access to medicines.
Developing a sustainable and efficient local drug industry in Nigeria would take decades of dedication by both the private sector and government. It is therefore important for the government to make the country attractive for foreign pharmaceutical companies and also to complement the development of drug manufacturing.
The National Agency for Food and Drug Administration and Control and Pharmacists Council of Nigeria have been making meaningful efforts to ensure and encourage local drug production. Both organisations should do more especially in getting government's political commitment to encourage local drug manufacturing.
The food and drug agency recently ordered manufacturing of chloroquine for emergency stock for possible clinical trial for COVID-19 treatment.
Interestingly, the federal government has directed the National Institute for Pharmaceutical Research and Development to start research on herbal drugs that will help combat COVID-19.
The challenges facing local drug manufacturing in the country cannot be completely solved during this pandemic. However, it should provide the opportunity for reflection as regards drug security during pandemic.