Job Osazuwa
Civil Society Legislative Advocacy Centre (CISLAC), an advocacy group that is the Nigeria chapter of Transparency International, has thrown its weight behind government’s decision to buy drugs for the treatment and management of the human immunodeficiency virus (HIV) directly from original manufacturers.
With this move, the high cost of procuring the drugs will be reduced, while more people living with the Acquired Immune Deficiency Syndrome (AIDS) and HIV in Nigeria will be covered.
No doubt, the high cost of drugs comes with grave consequences of morbidity and mortality to patients. The non-affordability triggered by high production and supply costs encourages the sale of fake and substandard drugs in the country, while consumers who are compelled to seek cheaper drug alternatives become victims and casualties in many cases.
At a media parley in Lagos, the executive director, CISLAC, Auwal Ibrahim Musa, said, while international treaties and governments across the world recognize adequate, accessible and affordable health care as a fundamental human right, medicine financing in Nigeria is generally out-of-pocket.
He said the steady rise in price has made many essential and prescription medications unaffordable and inaccessible to a large number of Nigerians, especially those who live below the poverty line.
He noted that, as the Federal Government struggles to sustain provision of free anti-retroviral drugs as part of HIV programmes at health facilities in the country for millions of People Living with HIV/AIDS (PLWHA), this effort is mostly sabotaged by inflated prices quoted by supplying contractors.
“These dealers’ activities render government’s effort inadequate to eliminate the high and sometimes inequitable economic burden of HIV/AIDS on households. This exorbitant prices quoted by contractors renders government financially incapacitated to adequately provide for and make anti-retroviral drugs accessible across health care facilities, which records resultant regular stock-out, health hazards and relapse of illnesses.
“We observed the strong resistance by some contractors with support of some insiders to prevent the National Agency for the Control of AIDS (NACA) from buying HIV drugs directly from original manufacturers, which allows government to put more people on treatment. The CISLAC/Transparency International Nigeria is perturbed by the continued but unchecked attitudes of the fraudulent contractors, whose unlawful activities hitherto dominated the procurement process of NACA.
“This background informs the recent commendable decision by NACA to purchase anti-retroviral drugs directly from the manufacturers at half the cost quoted by the contractors and middlemen to enable adequate and sustainable provision of the drugs to wider coverage within the agency’s available resources,” the executive director said.
He said his organisation had gathered that the contractors currently sell the anti-retroviral drugs at $13 per patient as against $7 given by the manufacturers. He also expressed concerns that over-reliance on donor funds in the fight against HIV in the country constitutes a dangerous trend to sustainability, hence, the need for the Nigerian government to take full ownership of the prevention and treatment of HIV in the country.
“On this note, CISLAC/TI Nigeria insists that fraudulent contractors who undermine the Public Procurement Act must be thoroughly scrutinised and discouraged from defrauding the government through inflated anti-retroviral drugs supply services.
“We call on the director-general of NACA to engage stringent reforms in the agency’s procurement process for impactful, efficient and cost-effective, wider and sustainable service delivery in Nigeria, and for the agency to devise appropriate sustainability plan for the procurement of drugs and consumables.
“As part of the sustainability plan, CISLAC/TI Nigeria calls on regulatory authorities, like National Agency for Food and Drug Administration and Control (NAFDAC), to support and enhance local production of affordable antiretroviral drugs, with serious consideration while issuing marketing authorisation to local manufacturers
“There should be a review of heavy tax burden on the pharmaceutical sector to avert multiple taxation by local, state and federal governments as well as high tariffs on raw materials, packaging materials and other ancillary materials used to manufacture medicines, primarily to encourage local production in the country.
“Increasing transparency is important in health services. CISLAC/TI Nigeria is committed to ensuring that improving the lives of Nigerian citizens takes precedence,” Musa said.
Also at the event, a legal practitioner and board member of CISLAC, Adeshina Oke, harped on the importance of good health to leadership, productive economy, and healthy citizens. He noted that a sick country could not have a good leadership, neither could it have a productive economy. He advised everyone to get ready to get rid of anything capable of deteriorating Nigeria’s health care system.
“We cannot depend on donors forever as a country. In the long term, we must begin to look towards empowering our higher institutions for research purposes. These drugs could be a lot cheaper if they are manufactured here in Nigeria.
“Nigeria must empower her institutions so that they can be fit enough to uphold the country, in case that day comes and funding stops coming. And the time to start preparing is now,” Oke said.