Public health: Is NAFDAC failing us?

BY MICHAEL OYEWOLE

The National Agency for Food and Drug Administration and Control (NAFDAC) is essential in protecting the health of Nigerians by guaranteeing the safety, quality, and efficacy of various products that profoundly impact public health. By design, NAFDAC plays a vital role in promoting public health in Nigeria.

By actively combatting counterfeit drugs, educating the public, and supporting local industries, this organisation significantly enhances the well-being of Nigerians and ensures a safer marketplace. Their unwavering commitment to these initiatives is crucial for the health and safety of the nation.

However, a critical evaluation raises questions about whether NAFDAC has fully realised its statutory responsibilities to the nation and its citizens. The palpable impact of NAFDAC’s efforts to protect the Nigerian public from counterfeit drugs is, at times, inadequate. Therefore, one is constrained to conclude, based on publicly available facts, that the last time this organisation recorded any major consequential impact was when it was led by Dora Akunuyili (God rest her soul). Since then, the prevalence of counterfeit and substandard products, including fake sachet water and adulterated foods, has surged. I know most Nigerians would agree with me on this. Let me also clarify that this does not in any way diminish the efforts of the previous and current director-generals.

I recall, vividly, a time when social media was littered with all manners of fake, counterfeit, poorly packaged water, among others. It is disheartening that most Nigerians seem to have resorted to faith in their choices of realistically consuming healthy consumables and administering standard drugs. These bad food and counterfeit drugs seem to be everywhere in our daily lives. So much so that one can barely confidently distinguish between what is fake and what is real. Not even sachet water is spared. It is that bad.

In commendation of NAFDAC, about three weeks ago, the organisation shut down the Eziukwu Market, Aba, Abia state, over fake and expired products worth five billion naira. According to NAFDAC, “the team uncovered large-scale production and distribution of fake and expired goods, including beverages, carbonated drinks, wines, spirits, vegetable oils, and revalidated food items such as noodles, powdered milk, and yoghurt.” Recall, in 2023, this same Eziukwu market was in the news for manufacturing all kinds of adulterated products especially different kinds of products from a wide variety of brands. NAFDAC raided over 240 shops-turned-factories where the harmful products were being produced and marketed for public consumption. In this same light, a few weeks ago, NAFDAC successfully shut down illegal packaging operations at Article Market in Abule-Osun, Lagos State.

Intriguingly, how was this market, a hub notoriously known for manufacturing all kinds of counterfeit and adulterated reponed after it was first shut down to continue its harmful operations to public health? Is NAFDAC complicit? Negligence? Poorly staffed? Or grossly incompetent? There are many instances like this.

The proliferation of counterfeit drugs presents dire public health risks, often culminating in grave health repercussions, including treatment failures for life-threatening conditions such as malaria, HIV, and tuberculosis. Many counterfeit products either contain inappropriate active ingredients or none at all, risking the deterioration of patient health and leading to severe complications, including strokes or myocardial infarctions, particularly among individuals with comorbidities like hypertension.

Moreover, many counterfeit drugs are tainted with toxic substances like industrial chalk, rodenticides, or heavy metals, which can induce acute toxicity or leading long-term health issues. For instance, counterfeit analgesics laced with fentanyl can result in respiratory depression and even death through overdose. The issue extends to antibiotic resistance, as counterfeit antibiotics may lack sufficient active ingredients, contributing to the rise of antibiotic-resistant bacteria— a critical global health threat.

Beyond physical health, the surge of counterfeit drugs can undermine trust in healthcare systems, leading to psychological stress and deterrence in seeking appropriate medical attention. More so, the economic impact is also notable; individuals may waste money on ineffective drugs, exacerbating financial strain, particularly in low-income areas.

Long-term exposure to unverified or harmful substances has resulted in dire health implications as well, with chronic exposure to unknown or harmful substances potentially causing organ damage or cancer. Additionally, in communities plagued by counterfeit drugs, the spread of diseases can worsen due to ineffective treatment, resulting in higher morbidity and mortality rates. On a broader scale, the existence of counterfeit medications can undermine public health initiatives, including vaccination programs, leading to outbreaks of preventable diseases.

Addressing these multifaceted challenges necessitates a concerted effort among regulatory authorities, healthcare practitioners, and consumers to ensure vigilance in the procurement of medications. Promoting public awareness about the hazards associated with acquiring drugs from unverified sources, coupled with initiatives aimed at strengthening regulatory frameworks, is critical to alleviating the crisis of counterfeit pharmaceuticals in Nigeria. NAFDAC, as presently constituted, operations-wise, is merely stretching the surface. The federal government and all relevant critical stakeholders must declare a state of emergency on substandard consumables and counterfeit drugs. We do have enormous problems on our hands, it is high time this menace is tackled head-on and permanently nipped in the bud. At least, to the barest negligible minimum.

The director-general of NAFDAC, Mojisola Adeyeye, has publicly stated in its 2025 strategic plan that the shortage of personnel headquarters and across state formations as the agency’s pressing challenge, among other things. It is pertinent to state that the overall well-being of a people has a direct impact on their productivity vis a vis the progress of the country. It is on this premise that we must demand, collectively, that this important agency must be well-staffed, funded, and accorded all the requisite instruments that will aid its optimal performance. Importantly, those who continue to undermine our public health via the production or packaging of substandard consumables and counterfeit drugs must be decisively dealt with to the fullest extent of the law when they are caught. Consistent public examples must be made of these bad actors to serve as some sort of deterrent. A slap on the wrist only gives them the leverage to reinvent their shady business operations thereby causing more harm to our health.

Michael Oyewole writes from Ilogbo-Ekiti and can be reached via [email protected]