‘How Low Drug Production Impedes Epidemic Control’

Experts put the cost of producing vaccines locally in the range of ₦6 billion if the indigenous industries get government support, thus helping to save an import bill of US$1.1 billion that government seeks to spend on procuring vaccines to fight meningitis in the five most affected states.

• Stakeholders seek good policies to halt trend • Survey blames inadequate financing, others

The inability of the Federal Government to manage disease outbreaks in the country, occasioned by the lack of political will and low capacity in local drug manufacturing, poses a serious threat to citizens’ well-being and the nation’s economic growth.

The Guardian Nigeria report continues:

The cases of epidemics such as meningitis, Lassa Fever, Ebola, pneumonia, polio and yellow fever in different parts of the country have shown its low level of preparedness to tackle a health crisis even when it comes with grave consequences.

With manufacturers and operators in the backward integration plan possessing capacities to produce mainly antibiotics and antimalarials, there are concerns about the value government places on the well-being of the citizenry, healthcare and the economy, when it has to continue relying on external support to tackle local challenges.

Already, experts put the cost of producing vaccines locally in the range of N6 billion if the indigenous industries get government support, thus helping to save an import bill of US$1.1 billion that government seeks to spend on procuring vaccines to fight meningitis in the five most affected states.

Local drug manufacturers believe that any country incapable of determining how its medicines are made is a disaster waiting to happen, noting that the Ebola experience where Nigeria was denied supplies should make anyone who still considers dependence on other nations for critical issues such as access to medicines to come to terms with reality.

So far, government has accessed 1.3 million vaccines from the World Health Organization (WHO), but still not sufficient to address the threat posed by the spread of the meningitis scourge in 16 states, prompting experts to call for a homegrown solution to salvage the situation once and for all.

With roughly 30 per cent local production capacity alongside heavy dependence on the importation of critical raw materials, mainly active pharmaceutical ingredients (APIs) and machinery inputs as well as competition from a poorly regulated market, indices point to the nation’s inability to manage emergency.

Specifically, no fewer than 760 Nigerians have been killed in the last couple of weeks from the fresh outbreak, especially in the northern part of the country. Also, since last December, about 53 deaths have been recorded from 196 cases of Lassa Fever in nine states.

Similarly, vaccine-preventable pneumonia-related fatalities continue to kill no less than 20 children hourly. Statistics have it that 200,000 children die yearly of pneumonia which is the major cause of deaths among under-five kids in Nigeria.

While operators remain divided over the suitability or otherwise of drug importation, the budgetary allocation, however, reflects a seemingly unpleasant situation where most of the funds go for overheads.

Health votes have over the years maintained the same pattern amid unfulfilled promises of a better healthcare delivery by successive administrations. For instance, the sector’s allocation in the 2017 appropriation bill pending before the National Assembly is ₦304 billion, a paltry 4.17 per cent of the total ₦7.298 trillion budget size.

By implication, each Nigerian is to spend ₦1,688 on healthcare for the entire year. In fact, capital expenditure was allocated ₦51 billion (representing 2.78 per cent), a far cry from the 15 per cent benchmark for African countries to enable them to catch up with the advanced countries.

The President of the Pharmaceutical Society of Nigeria (PSN), Ahmed Yakassai, noted that the dearth of vaccines was not due to lack of capacity locally but denial of approvals by government over the years.

He explained that vaccine production was public sector-driven and highly capital intensive, costing as much ₦6 billion. Yakassai claimed that May and Baker has been itching to sign a Memorandum of Understanding (MoU) with the Federal Government in the last 50 years to take over a facility in Yaba for the production of a yellow fever vaccine without success.

A former chairman of the Nigerian Economic Summit Group (NESG), Sam Ohuabunwa, blamed government’s bureaucracy and tardiness in getting progammes and policies implemented for the challenge.

He added that he was not unaware of government’s plan to partner the private sector on the matter but for the redtapism among officials. He urged government to not only support manufacturers with investment in infrastructure to enhance production, but also priorities procurement of local products to stimulate more investments from the private sector.

The Chairman of the Association of Industrial Pharmacists of Nigeria (NAIP), Gbenga Falabi, said though it is cheaper to import, “we all have the responsibility to grow this economy and we can only do that if we produce locally.”

He pledged the commitment of members to local manufacturing to reverse the import-dependent narrative about pharmaceutical needs in the country. To the Executive Secretary of Pharmaceutical Manufacturing Group of the Manufacturers Association of Nigeria (PMG-MAN), Dr. Obi Adigwe, government must come up with good policies to revive the nation’s drug manufacturing sector.

He noted that capacity utilization had been at a low level of 25 per cent. Nigeria was ranked lowest on the health governance capacity (HGC) index in a recent survey conducted by Brookings Institution to assess 18 nations in sub-Saharan Africa and Asia by examining 25 indicators related to management capacity, regulatory processes, health infrastructure and financing as well as systems and policy conditions.

The nation scored low on infrastructure and financing, management capacity and health systems, indicating that targeted efforts to improve those areas could have a significant impact on their ability to absorb new investments relevant to global health goals.

Adigwe, however, explained that the sector had witnessed a slight increase in the index due to the 2015 fiscal policies. “Our situation was what was obtainable in Bangladesh a few years ago. The manufacturers in that country, through good government policies have been able to increase their capacity utilization and now supply 97 per cent of the local market share. Additionally, they started exporting to the United States and Europe, earning serious foreign exchange.

“We need good government policies. Local manufacturers can supply up to 80 per cent of the medicines used in Nigeria. Imagine one of our members had to start giving out drugs freely to avoid waste. He has capacity to produce 908 million tablets of Amozil in a year, three times the capacity of what Nigeria needs in a year. He ends up giving them away free of charge to avoid the drugs expiring in the stores,” he added.