FX crunch threatens Nigerians access to life-saving drugs

The lingering foreign exchange shortage in Nigeria is crimping the ability of the pharmaceutical industry to import products and raw materials, a development that is threatening patients’ access to life-saving medicines.

Gaining access to some of the drugs that tackle major causes of death has become a hassle as key drugmakers such as GSK have stopped production in the country owing to the FX crisis rocking many sectors of the economy.

Many Nigerians who are already battered by runaway inflation with about 80 percent out-of-pocket health expenditure cannot easily find the most effective drugs, even if they can afford them.

The cost of Augmentin, an antibiotics drug produced by GSK, was N18,500 two weeks ago when Ekene Christopher, a pharmacist around the Jakande Isolo area of Lagos, sold the last batch on his shelf. It was sold for N5,000 in 2022.

Read also: Price of inhalers surge 450% on worsening FX scarcity

“It has been difficult to restock both due to the dwindled supply and the disincentive of tying a significant chunk of working capital to products that people now avoid due to cost,” he said.

He has been promoting to his customers other brands of antibiotics which cost below N3,500 but struggle to compete with the efficacy rate of Augmentin.

“There are many other alternatives and customers are happy to get them, even though most of them are fixated on Augmentin due to the high efficacy rate.

“It is left for me to convince them to try alternatives and they are gradually getting comfortable. Customers who have high trust in the brand however still demand for Augmentin. So it’s safe to have like three to five on the shelf for those people,” he told BusinessDay.

The challenge cuts across drugs that cater to neonatal disorders, malaria, diarrheal diseases, pneumonia, bronchitis, tuberculosis, HIV/AIDS, ischemic heart disease, stroke, congenital defects, tuberculosis, and meningitis.

The price of Ventolin inhaler (Pfizer), which was N1,500 in January, has surged to N11,000, while that of paracetamol has jumped from N150 to N300. Lonart, a malaria drug, is inching towards N3,000 from N1,200.

Okechukwu Ekemezie, director of Docotal Health Foundation, fears the decreasing supply of drugs could cause a proliferation of fake drugs, which could precipitate another major health crisis in the country.

Read also: Why Medical, dental consultants may go on strike in three weeks

“Recently, I prescribed Augmentin for a patient but a few days later, he was not getting better. I discovered that the drug the patient bought was fake. When you don’t have basic drugs which are meant to treat basic illnesses, it becomes an epidemic,” Ekemezie said.

Funmi Akintoye, a Lagos-based pharmacist, groused about the lack of funds to bring in large quantities that are needed for average inventory. This, he said, has reduced the quantity of his company’s imports by half and is driving people to start looking for alternatives like herbs and other natural drugs.

Sam Ohuabunwa, former president of the Pharmaceutical Society of Nigeria, said the pharmaceutical chain of the health industry has struggled with access to FX for many years, reducing imports, especially for raw materials.

He said the decline in imports is not a consequence of increased local production but because the Central Bank of Nigeria cannot meet the sector’s dollar demand adequately, leaving drugmakers to resort to the black market for a significant chunk of their FX needs.

“The reduction in imports is the fallout of the economic realities of access to foreign exchange, inflation, and consumer demand. The devaluation of the naira, which has increased the cost of FX, has led to a depression in demand for drugs,” Ohuabunwa told BusinessDay in an interview. “And with inflation and devaluation, it becomes difficult to recover the price and when you try to recover it, you just become or make yourself unaffordable.”

Frank Muonemeh, executive secretary of the Pharmaceutical Manufacturers Group of Manufacturers Association of Nigeria, said the government must prioritise the local manufacturing pharmaceutical sector to achieve adequate supply of medicines.

He said the greatest challenge is political will and that the government needs to see adequate supply of medicines as an act of defence, diplomacy, and development.

Citing the national drug policy, which says 70 percent of the drugs used in Nigeria must be local content by the year 2025, he said a staunch devotion to policy and creating an enabling environment is crucial.

“We have more than 120 members in our association. Right now, manufacturers are doing group procurement, where we come together as a group to supply drugs to states in the country. If the government is intentional and focused on the sector, you can imagine the kind of contributions it would have to our GDP,” he said.

According to the 2018 WHO Non-Communicable Diseases (NCD) country profile for Nigeria, NCDs accounted for about 29 percent of all deaths in Nigeria, with cardiovascular diseases responsible for 11 percent; cancers, four percent; chronic respiratory diseases, two percent; and diabetes, one percent. Estimated premature mortality between ages 30 and 70 from the four main NCDs stands at 22 percent.

A recent report by the World Health Organization (WHO) categorised Nigeria as one of the countries most affected by drug shortages. The report found that 50 percent of essential medicines were out of stock in Nigeria, and the figure is expected to rise amid the worsening FX shortage in the country.

The FX shortage is caused by a number of factors, including low oil prices and a decline in foreign investment. This has made it difficult for companies to import essential drugs.

The drug shortage is having a devastating impact on Nigerians and key stakeholders expect the government to act.