HomeHealth#Rising Cost Of Medication: We Are Dying, Nigerians Groan

#Rising Cost Of Medication: We Are Dying, Nigerians Groan


In Nigeria, a troubling narrative has emerged amid the critical need for healthcare – a story of rising distress and tragic outcomes caused by skyrocketing drug prices and other healthcare essentials. As drug and medical care prices continue to rise, many Nigerians are gripped by a deep sense of frustration and desperation, forcing them to confront the harsh reality of inaccessible healthcare. Tragically, the affordability crisis is more than just a financial burden; it is a matter of life and death, as people are at the mercy of a system that is pushing them to the edge. This escalating crisis highlights the urgent need for long-term solutions to ensure that affordable healthcare is available to all Nigerians, CHIOMA UMEHA writes:

Prices of essential and non-es­sential drugs and medicines have risen over the last year, as Nigerians have lamented the country’s struggling economy. There have been several casualties and deaths, while others have turned to traditional medicines, which are widely available but not cheap.

However, experts have insisted that Nigeria should prioritise indigenous health research and development and stop importing all drugs. Some experts advocated traditional medicine devel­opment, claiming it is essential if Ni­geria is to achieve Universal Health Coverage (UHC).

One of them, Professor Martins Emeje, Director General/Chief Ex­ecutive Officer of the Nigeria Natu­ral Medicine Development Agency (NNMDA), stated that the only long-term solution is to conduct local research and development (R&D) to produce affordable medicines and healthcare.

Responding to the demand for al­ternative medicines, the distinguished professor of Drug Delivery and Nano­medicine stated, “I am not sure what you mean by alternative medicine practitioners. However, if you mean indigenous medicine, it is not an alter­native; instead, imported medicine is an alternative. I believe you already know my recommendation as the Director General of the only indige­nous medicine development agency and a western-trained chemist who returned to school to study tradition­al medicine, has conducted research in this area for over 20 years, and has consistently advocated both govern­ment and private sector investment in Indigenous R&D.

“To put it simply, we should prior­itise indigenous health research and development. Stop importing all drugs into the country. Traditional medicine development is essential if we are to achieve Universal Health Coverage (UHC).”

Professor Martins Emeje, Director General/Chief Executive of the Nige­ria Natural Medicine Development Agency (NNMDA), commented on the devaluation of the foreign exchange and rising drug costs in Nigeria say­ing, “As I have been saying for the past ten years that the prices of anything you do not produce cannot be under your control. So, whether there is de­valuation or not, as long as local R&D is not a priority, making local drug manufacturing a dream and essential­ly making us import everything, even from countries where we teach their scientists how to conduct research, and you do not want prices to rise. Let us stop blaming devaluation and do the necessary.

“The Nigeria Natural Medicine Development Agency (NNMDA) is already implementing its roadmap to address this issue, and you will see results soon.

Prof. Emeje who commented on the departure of big drug makers from the country and the impact on drug and healthcare prices said, “There were no big drug makers in Nigeria; I am a chemist, and I can tell you that there was and still is no big drug maker in Nigeria. We only have manufactur­ers who have taken advantage of our complete reliance on drug imports to bleed us to death. Go to Asia to see how large pharmaceutical companies operate. Mention one API or excipient manufacturing facility established by the so-called big drugmakers. My reaction to this is that it will force us to look inwards and develop our natural resources, manufacture our medicines, establish our responsible pharmaceutical industries, and stop acting like slaves who would rather eat from porcelain plates than seek freedom.”

In response to the forex allocation, the NNMDA Director General (DG) stated, “I am sorry, the only sustain­able way forward is local R&D for local drug production.” Which one is Forex allocation? Nobody should be assigned anything. Is this not business? How does the forex allocation benefit the millions of people in our villages who do not have access to healthcare?

Prof Emeje went on to criticise the idea of import rebates and special forex allocations for drug importers and manufacturers who would be of­fered import drugs. He responded, “I am the wrong person to be asked this question. I have been consistent in my pursuit of homegrown R&D for local drug manufacturing. I propose rais­ing import duties on all finished drug products and eliminating all drug im­portation rebates. By doing so, manu­facturers who currently prefer trading will begin to believe that innovation cannot come from buying and selling.

The CEO of the Nigeria Natural Medicine Development Agency stat­ed, “I have been advocating that Nige­ria establishes an industrial base to manufacture active pharmaceutical ingredients (APIs) and pharmaceuti­cals. However, we must do it properly, as a result of research, development, and innovation. For example, look at countries that have established func­tional pharma parks, which serve as a hub for science, technology, and inno­vation. We can produce our excipients, active crude extracts (ACE), and active pharmaceutical ingredients (API) in Nigeria. The most important infra­structure required to complete this task is human capital, which we have. Nigerian professionals, both at home and abroad, are willing to share their expertise for free. Since I became DG about a year ago, we have had about six Nigerian professors and professionals work with us for free, three of whom are in the Diaspora.

On the call for a stronger health insurance scheme, citing the high cost of medicines and healthcare as out-of-pocket expenses, he asked rhe­torically, “Please, which of the health insurance schemes do we want to strengthen? Anyone who discusses health insurance in Africa without incorporating traditional medicine into the strategy is either dishonest, intentionally mischievous, or out of touch with African realities. Imported health insurance models are ridicu­lous. I was president of the FMST Co­operative Thrift and Credit Society for four years, and I asked SMEDAN and over 2000 civil servants what we did with the cooperative. See, there is no rocket science in insurance; our poor rural dwellers are already doing local insurance; instead of developing our models, we want to copy them.”

He also criticised the funding of the health sector. “Funding is never enough, so I agree. But, more impor­tantly, there is a need to shift strategy; let us look inward. The most effective strategy for renewing our people is to return to our abandoned cultural heritage. Industrialisation does not happen by chance; it is the result of science, technology and innovation.

Dr. Osahon Enabulele, immediate past president of the World Medical Association (WMA), stated, “Various factors contribute to the skyrocketing cost of drugs, medical products, and technologies.

“The most significant factor is Nige­ria’s political leaders’ cumulative poor economic management and incorrect fiscal policy options. This has resulted in unprecedented inflation and a neg­ative impact on the Consumer Price Index. This has had an impact on the prices of almost every commodity, good, and service, including essential medicines.”

Enabulele stated, “Before now, Ni­geria had an unenviable out-of-pocket expenditure by its citizens of more than 70%. This is undoubtedly worse now, with an increasing number of Ni­gerians incurring catastrophic health costs and being unable to obtain essen­tial medicines and healthcare in gener­al. With rising poverty and poor access to healthcare, there is an unfortunate increase in illnesses, morbidities, and deaths.” He stated that the productivi­ty of Nigeria’s workforce is also likely to suffer, with a significant negative impact on wealth creation in Nigeria.


Enabulele added, “So, it is a vicious cycle that can only be broken by pro­gressive actionable steps taken by the Federal Government, particularly in the area of granting tax rebates and waivers, intervention funds, and other incentives to make life easier for im­porters and local manufacturers of essential medicines, medical products, and medical technologies.

“When I was President of the Nige­rian Medical Association (NMA) from 2012 to 2014, we proposed to President Goodluck Ebele Jonathan’s Federal Government the establishment of a health-related intervention develop­ment fund known as the Health and Hospital Development Intervention Fund (HHDIF). The government ap­proved this but did not take action. The current administration can revitalise this initiative.

“I expect the Federal Government to declare this an emergency and take immediate action to address the situ­ation as well as promote indigenous manufacturing of essential medicines, medical products, commodities, and technologies.”

Enabulele responded to the depar­ture of major drug companies from the country, saying, “While I find this quite unfortunate, I see it as another reminder for governments at the federal, state, and local levels to get se­rious about their commitments to In­digenous manufacturing of essential medicines, vaccines, and medicinal products.”

On the way forward, the former NMA President stated, “Government intervention is required. Short-term interventions to support them through progressive fiscal and monetary poli­cies are critical, as are medium- and long-term investments in indigenous manufacturing.

Enabulele suggested offering im­port rebates and special Forex allo­cation for drug importers and manu­facturers as a short-term solution to alleviate current challenges.

“I must emphasise the importance of making appropriate research in­vestments, particularly in these prod­ucts and services.

In contrast to Prof. Emeje’s position, the former NMA president stated that a robust health insurance scheme is a significant solution to the quagmire. However, he lamented that health in­ surance in Nigeria has not delivered the expected dividends since its estab­lishment many years ago.

“Unlike less developed countries like Rwanda and Ghana, which have better universal health coverage, Nigeria’s level of health insurance coverage remains less than 7%. The government must prioritise achieving universal health coverage through a high-quality, effective, efficient, robust, and comprehensive health insurance programme. A lot of progressive and surgical measures will be required in this regard,” he said.

The Chief Consultant Family Phy­sician lamented that Nigeria has not done well in terms of health funding and budgeting. Unfortunately, he stated that Nigeria has yet to make a significant commitment to achieving a minimum of 15% budgetary alloca­tion to its health sector, as outlined in the 2001 Abuja Declaration.

“The 2024 Federal budget has per­formed poorly in this regard, falling short of expectations. The same is true for the budgets of most Nigerian state governments.

Dr. AbdulMuminu Isah, Coordina­tor, of Infectious Diseases Pharmacists of Nigeria, stated, “The devaluation of the naira has undeniably impacted drug prices in Nigeria. As manufac­turers struggle to afford raw materials and equipment due to rising foreign exchange rates, production costs rise, resulting in higher medication prices. This development is concerning be­cause it has a direct impact on Nigeri­ans’ access and affordability to essen­tial medicines. The government must intervene with economic policies that stabilise the naira and, more impor­tantly, support local manufacturing to keep medication costs manageable for the average Nigerian.”

Isah lamented, “The exit of major pharmaceutical companies from Ni­geria due to high forex rates is alarm­ing.” This exit exacerbates the drug supply crisis by reducing the availabil­ity of quality medications. To address this issue, a comprehensive strategy should include economic stabilisa­tion, incentives for local production, and creating a favourable business environment to retain and attract pharmaceutical companies.

He stated that to help drug im­porters and manufacturers who rely on imported active pharmaceutical ingredients (APIs), the government must provide supportive measures such as favourable forex allocations and import rebates.

However, the Senior Lecturer, De­partment of Clinical Pharmacy and Pharmacy Management, University of Nigeria, stated that “the long-term solution lies in encouraging local API production through investments in infrastructure and technology.” This is critical in reducing reliance on imports. Nigeria has capable and experienced chemists who are eager to help achieve this goal by ensuring that locally produced APIs meet the highest levels of quality and efficacy.

Dr. Isah, like the former NMA, believes that offering import rebates and special forex allocations to drug importers and manufacturers would help to stabilise drug prices. “These measures would reduce the financial burden on manufacturers while en­suring a consistent supply of essential medications. With the patient-focused ambition of the Clinical Pharmacists Association of Nigeria (CPAN), the desired hands-on skills that would optimise the outcomes of the avail­able drugs would have an impact on Clinical Pharmacists;

through their expertise in medica­tion management, they can help opti­mise the distribution and use of these imported and locally produced med­icines to maximise patient benefits.”

Regarding investment in alterna­tive medicines, Isah stated that “the World Health Organisation has been advocating the integration of indig­enous medical practice into the ‘con­ventional’ system.” That is the best solution for our country. Most people continue to rely on our extensive sys­tem of traditional medicine. The gov­ernment must invest in standardising training and regulating practices.

“Investing in alternative medicines can supplement conventional treat­ments, but such practices must be ev­idence-based and regulated to ensure safety and efficacy.” The federal govern­ment should fund research into alter­native medicine while ensuring that drug experts participate in the eval­uation and implementation of these treatments into the healthcare system.

He advocated improved healthcare infrastructure, including power and logistics systems. “Health Insurance: Strengthen health insurance plans to reduce patients’ out-of-pocket ex­penses. Research and Regulation: En­courage research into both traditional and alternative medicines, and ensure strong regulatory frameworks for safe­ty and efficacy.

“Public-Private Partnerships: Encourage collaboration among the government, private sector, and healthcare professionals to drive in­novation and improve healthcare de­livery,” Isah said.


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