How open market drugs merchandise destroy lives – Experts

The upsurge in drug hawking in public places— streets, commercial buses, motor parks, and marketplaces, among others, has been generating lots of concern, as experts say it poses a serious threat to the health of the populace.

Medical professionals have explained that drugs sold through unregistered outlets by non-pharmaceutical professionals have been linked to terrible health conditions, including failure of such organs as kidney, liver, and lungs. Oftentimes, they even lead to individuals’ death due to wrong medications, dosages, as well as consumption of expired, falsified, and substandard medicines by unsuspecting consumers.

Not only do drug hawkers display medicines in an unhygienic environment, but they also sell prescription medicines, such as antibiotics, strong painkillers, multivitamins, antimalarial, medicines for diarrhoea and common body pain, among others.

Similarly, they prescribe medicines, recommended dosages, and offer general body checkups, which most times have negative effects, leading to severe health conditions.

Such was the case of Francis, who narrated his experience to The Guardian after buying malaria drugs from a hawker.

He said: “I bought a malaria drug from a woman that hawked medicine along the road on my way back from my sister’s place. After taking it, I stayed outside for fresh air, as there was no electricity. Immediately I returned to my room, I started gasping for breath. My body became light and I was shaking as if I had not eaten for two days. At that moment, it was past 11 pm. I felt like dying but I struggled to come out to seek help.

“When my neighbour, who lives in the backyard, saw my state, she was scared and thought the worst would happen. I begged her to give me food, but I was only able to eat very little. I returned to my room and lied on the bed, expecting the worst. I never knew I would make it through the night.”

Chima Eze was, however, lucky that he did not experience any side effects after taking some so-called malaria drug. The medicine he bought at Oshodi was just ineffective. So, he went to the hospital for proper treatment.

“I bought the drug at Oshodi from those roadside sellers,” he said. “I told them how I was feeling and they mixed several drugs for me, saying the symptoms were that of malaria. I took the drugs, but they didn’t work. My condition kept deteriorating until I went to the hospital, where I was given proper treatment.

Posing Danger To Public
A drug hawker at Egbeda, Omolara (surname withheld), however, explained that they sell drugs to people with ‘mild ailment.’

“We sell pain relievers for mild fever, cold, cough, and catarrh. We administer vitamin C for sneezing. We prescribe and sell Flagyl and tetracycline for N50.”

Omolara said they also prescribe drugs and recommend dosage for people, after describing their health condition and symptoms.

“We also prescribe multivitamin for those feeling weak. This is because if a person does not take the multivitamin drugs and then end up in the hospital, needing a blood transfusion, it is very costly. I think it costs N25, 000.

When asked if drug hawkers have license or formal acknowledgment from Pharmacists’ Associations, Omolara, who is in her 50s, replied in the negative.

“We don’t have license to sell drugs, it is just a business we do,” she said. “When I was younger, I trained as a nurse, and we were taught that paracetamol is for body pain and slight headache. But those that have a severe fever, we tell them to go to the hospital.”

On how they identify fake and substandard drugs, Omolara explained that drug hawkers usually test new drugs on themselves before selling to customers.

She said: “When we go to the market to buy drugs, we check if the drugs have the National Agency for Food and Drug Administration and Control (NAFDAC) registration number. If any drug doesn’t have it, we don’t buy, regardless of persuasion from the sellers that such drugs are good and effective.

“After learning that a new drug is out, we, drug hawkers, normally buy a sample to test on our bodies before buying it and selling to the people.”

She disclosed that people patronise hawkers because their drugs are cheap and available. They also sell on credit to customers, which is another incentive.

In spite of Omolara’s explanation, however, experts have repeatedly warned that drug hawkers endanger people’s lives. For starters, drugs meant to be stored at a certain temperature and in a dry place, are exposed to hot temperatures in the course of hawking, thereby losing their quality and efficacy. Some the drugs also expire earlier than the recommended date, making them dangerous when administered. There is also the issue of fake or relabeled expiry dates. Oftentimes, these drugs do not have NAFDAC number.

Curiously, despite sensitisation campaigns on the activities of these drug hawkers and the health implications of patronising them, some people still go ahead to patronise them.

The head, Research, Documentation, and Industry Liaison Committee, Pharmaceutical Society of Nigeria, Dr. Lolu Ojo, lamented that the danger drug hawkers pose to the health of individuals, community and the nation’s wellbeing, is enormous.

Ojo told The Guardian that drug hawkers are the purveyors of fake and substandard drugs, which put the consumers at a serious health risk.

He disclosed that hawkers sell a combination of drugs, which, when consumed, could damage vital organs of the body, adding that they give fake or false promises on the action and uses of drugs that “ignorant consumers” follow to their detriment.

“They sell dangerous drugs to the public, making Nigeria an epicentre of drug and substance abuse. Now, with the Coronavirus pandemic, the danger posed by drug hawkers will be grave. Original drugs will be scarce and more expensive when available, and people are likely to seek succour in this itinerant drug dealers and there will be more cases of organ failure,” he said.

Similarly, the Secretary, Association of Community Pharmacists of Nigeria (ACPN), Lagos State, Jonah Okotie, said drug hawkers provide unguided access to poisons.

“Medicines are poisons that ought to be used, not only with the utmost caution but also when necessary.

Secondly, the storage condition protocols are not followed. The medicines are exposed to the elements and often dispensed in small quantities, like they are dispensing shots of alcohol in a pub, which may be outright underdose, depending on the class of medicine involved,” he explained.

Okotie lamented that people were exposed to unnecessary and wrong medicines, which often cut across different brands, sometimes up to four or more of analgesics for complaints of pain. They also supply damaged medicines.

“For instance, exposing tetracycline to the sun guarantees its expiration before time, just as wrong doses of antibiotics and medicines for chronic conditions such as high blood pressure and diabetes, among others, is fatal.

The ACPN Secretary said these have debilitating effects on consumers’ lives.

“Economically, there is no end to the unnecessary expenses to individuals, families, and even government. The increased incidents of kidney failure, high blood pressure, and related issues may not be unconnected with the use of these things,” he said.

The National Chairman, Association of Hospital and Administrative Pharmacists of Nigeria (AHAPN), Dr. Kingsley Chiedu Amibor, told The Guardian that indiscriminate hawking of drugs in public places has become a common feature in most cities and rural areas.

He said part of the consequence is that some patients who were prescribed drugs that are not available inside the hospital pharmacy may end up buying falsified and substandard medicines from open drug markets.

He disclosed that Nigeria had lost millions of dollars to the activities of drug merchants operating in open markets, since the outbreak of COVID-19, as they have seized the opportunity to supply outright fake, falsified, and substandard medicines to fill the gap.

“In an attempt to fill the lacuna created by exorbitant and scarce pharmaceutical products, charlatans, drug merchants, unscrupulous patent medicine dealers, and drug hawkers are capitalising on the challenges of medicines unavailability and high cost to revisit falsification of drugs in Nigeria,” he said.

Amibor disclosed that the preponderance of drug and substance abuse, with Nigeria, rated as one of the highest in the world, is closely linked to easy access to these drugs, due to the activities of drug hawkers and others mentioned above.

Lamenting that the pharmaceutical industry could not manage street hawkers, as it is the government’s duty to do so, Ojo noted that the major challenge is the enforcement of relevant laws to rid society of drug hawkers.

“Who will enforce the existing laws and statutes,” he queried. “They are everywhere and display their wares for all to see, even in front of Police stations! The best we have done and that we can do is advocacy at all levels – consumer education, health awareness campaign, liaison with government agencies and officials, among others. We have achieved limited results. It will take decisive and focused action of the government to remove the menace.

“It is the government’s responsibility to safeguard the citizens’ health. The pharmaceutical industry is doing its best and we will continue to do it, but let governments at all levels be alive to their responsibilities,” Ojo said.