Cholera outbreak: Scarcity of infusion hits Nigeria

…Pharmacists blame NAFDAC

By Hassan Zaggi

The scarcity of essential medicines, especially infusion/drip has hit most cholera endemic states in Nigeria.

This has also affected adversely the treatment of patients and consequently increased the mortality resulting from Cholera related complications.

Infusion therapy, according to medical experts, is when medication or fluids are administered through a needle or catheter. It’s a way of delivering medication that can’t be taken orally, or that need to be dispensed at a controlled pace.

Medical experts further explained that, since the symptoms of cholera include regular stooling and vomiting,  the process of restoring lost water (dehydration) to the body tissues and fluids is the first priority in the treatment of cholera. It is done through injecting infusion or what is popularly called drip.

It would be recalled that some states in Nigeria have been contending with cholera outbreak since the past few months.

According to the Nigeria Centre for Disease Control (NCDC), between  January 1 and August1, 2021, 31,425 suspected cases of cholera, 311 confirmed cases and 816 deaths have been reported from 22 states and FCT.

The affected states, the NCDC said, include Benue, Delta, Zamfara, Gombe, Bayelsa, Kogi, Sokoto, Bauchi, Kano, Kaduna, Plateau, Kebbi, Cross River, Niger, Nasarawa, Jigawa, Yobe, Kwara, Enugu, Adamawa, Katsina, Borno and FCT .

Investigation by our correspondent in some hospitals in Nasarawa State and the Federal Capital Territory (FCT), indicated that there is inadequate supply of infusion, leading to the increased in the price by almost 200 per cent.

Responding to questions from our Correspondent, the Medical Director of NISSI, a popular private health facility in Masaka, Karu Local Government Area of Nasarawa State, Dr. Onuche Ijaja, revealed that the Cholera situation is on the increase by the day.

He, however, regretted that the increasing cases of Cholera was further compounded by the lack of the needed drug- infusion for the treatment of the disease.

According to him: “As at yesterday evening, I had three cholera patients receiving treatment in this facility. This is apart from those we treat and discharge on a daily basis. Even this morning my attention has just been drawn that there are two cases of the disease. There is no day in this hospital that we don’t admit cholera patients.”

The challenge, Dr. Ijaja said, was the lack of infusion/drip which is mostly needed for the treatment of cholera.

According to him:”I have contacted my friends from major pharmaceutical outlets both in Nasarawa State and the FCT, but they told me that they don’t have the medicine.

“It’s a friend who also owned a hospital that rescued me with just one carton of the product. But I have to pay at a higher price.

“This morning, a friend gave me 10 cartons for 160,000 naira. Which means a carton now sales for 16,000. But before the scarcity sets in, this 160,000 can give us 64 cartons. Which means each carton then was being sold to us at 2500 naira.”

The situation, according to him, is pathetic which has gone beyond the reach of the common man.

“We that practice in the communities, we are just helping people to live, we are not practicing to make money. Most times you treat patients and they don’t have money to pay. You cant keep them. My conscience and by the nature of our training, I cant keep any patients because of lack of money and I cant turn my eyes from a patient because he does not have money.

“My happiness is that since the outbreak of cholera this year, I have never lost any patient as a result of the disease. I am fulfilled with this.”

Dr. Ijaja, therefore, called on the relevant authorities to do something about the scarcity and subsequent rise in the price of medicines in recent days. This, he said, is for the interest of the common man in the country.

In another twist, however, some major importers of pharmaceutical products interviewed by our correspondent blamed the National Agency for Food and Drug Administration and Control (NAFDAC) for the scarcity and rise in price of medicines in the country.

A source, an Abuja-based major dealer in pharmaceutical products who pleaded anonymity while responding to questions from our Correspondent, said that the policy on increase of tariff on Good Manufacturing Practices (GMP) introduced on importers of pharmaceutical products by NAFDAC is the major reason for the scarcity of drugs in the country.

He, however, warned that the scarcity will worsen in the days ahead if well-meaning Nigerians do not mount pressure on NAFDAC to change the policy.

The pharmaceutical importer, however, recalled that sometimes in May, Pharmaceutical Society of Nigeria (PSN), Lagos State branch, raise the alarm that there is an imminent scarcity of drugs in Nigeria, but that Nigerians did not understand what they were saying.  

According to him: “One of the major challenge is that we are a dependent nation in everything. Nigeria is not producing enough of anything.

“NAFDAC which is the regulatory agency, came up with a controversial policy. They call that policy payment of Good Manufacturing Practices Act.

“NAFDAC increased its charges and charged importers/manufacturer of the drugs 110,000 dollars on any import. The charge this money directly.

“This affected the importers and manufacturers of drug in the country and that is what is beginning to manifest resulting in the scarcity of drugs.”

A  renown pharmacists in Nasarawa State also corroborated the same thing, insisting that until, something is done urgently, the days ahead will be too tight for Nigerians in terms of having access to medicines.

It would be recalled that in May this year,  in a statement titled: Pharmacy not for sale; the PSN Chairman, Lagos state chapter,, Gbolagade Iyiola, alleged that: “It is also an irony that NAFDAC inspectors have been invading retail Pharmacy outlets under various guises of regulatory violations imposing fines on perceived offences.

“Some of the arbitrarily imposed fines are as heavy as N500,000 in some instances. NAFDAC has also insisted on continuing its agenda of forcing importers of the drug to pay as high as N4.2 million per foreign manufacturer facility for GMP clearance when the reality is that India which is the biggest exporter of drugs to Nigeria has banned exports of Pharmaceuticals to Nigeria because of the peculiar challenge of COVID-19 which continues to ravage its local population.

“The management team of NAFDAC led by its Director-General has frustrated all entreaties to dialogue on this particular subject matter which is potentially detrimental to the availability of life-saving drugs for Nigerians.”

However, our correspondents reached out to the NAFDAC through its media consultant, but as at 5:38pm when this story is rounded up, there was no response from the agency.

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