After complaining of certain health issues, the physician made some prescriptions for Mrs. Bola Okunola. Among the drug list was blood tonic. She promptly took it to her trusted neighbourhood pharmacy. The superintendent pharmacist dispensed the drugs, with full explanations on how to use them.
Unknown to Okunola, the blood tonic was more of a poison. She narrates, "In less than 30 minutes after I ingested it, my entire body system went berserk. I developed diarrhoea and, at a point, I started feeling faint.
"My husband rushed me to the hospital, with the drugs in our hands. On presentation, the doctor singled out the blood tonic as the 'culprit,' saying it was counterfeit.
"He gave me further treatment which eased off the counterfeit drug's effects. Later, I took the blood tonic to the pharmacist. He was surprised, but he confirmed what the doctor had said. He apologised and gave me a replacement.
"He also said it sometimes happens that, in a pack of 20 bottles or packets of drugs, one may turn out to be a counterfeit and that, that was what happened in the case under review.
"I've always known that counterfeit drugs abound all over the place, and that's why I'm careful to buy my drugs in registered pharmacies. But now, I will be more careful."
Though Okunola is lucky to have remained alive, many people have not been so lucky, as they have been maimed or killed outright, after taking what was meant to relieve their symptoms.
The World Health Organisation defines a counterfeit medicine as one "which is deliberately and fraudulently mislabelled with respect to identity and/or source." This applies to both branded and generic products.
Those death-in-the-bottles/packs come in different hues. They may be products without active ingredients, representing 32.1 per cent of global fake pharmaceutical burden; they may have incorrect quantities of active ingredients (20.2 per cent); wrong ingredients (21.4 per cent), correct quantities of active ingredients but with fake packaging (15.6 per cent); copies of an original product (one per cent); or they may be products with high levels of impurities and contaminants (8.5 per cent).
The Director-General of the National Agency for Food Drug Administration and Control, Dr. Paul Orhii, last Thursday, decried the activities of counterfeit drug manufacturers and importers when the agency paraded six suspects at its Lagos office, among whom was a trained pharmacist -- a middle-aged mother of four.
While NAFDAC has earned global commendation for reducing to five per cent the incidence of fake/counterfeit drugs in urban areas in Nigeria, the battle to save pharmaceutical products users from crooks is still intense in rural areas, where you have concentration of people with low level of education and poor means of livelihood.
What drugs are most likely to be counterfeited? Orhii answers, "They are drugs that are always in demand, and they include antimalarials, antibiotics, pain killers, HIV/AIDS medications, drugs for erectile dysfunction, cancer drugs, as well as medications for psychiatric issues."
Experts say using a counterfeit version of any drug could make you sicker, as it will not cure the ailment. Worse still, they warn, the drugs may be tainted with unconventional or some other dangerous ingredients and toxic compounds.
What are the likely ingredients in a counterfeit drug? Orhii proffers an answer, "They include heavy metals like mercury, aluminium, lead, cadmium, arsenic, chrome, uranium, strontium and selenium.
"Another is actual poison, such as polychlorinated biphenyl (aka PCB, which has been banned in U.S. since 1979), benzopyrenes, rat poison, boric acid, and anti-freeze.
"Others may be common household items like floor wax, paint thinner, and wall paint."
Pharmacists even say some of these concoctions are not drugs at all, as they are just a potpourri of dextrose, dextrin, lactose, starch, saline and salt.
Decrying this trend at an earlier media encounter, the Chairman, Lagos State
Chapter of the Association of Community Pharmacists of Nigeria, Mr. Anieh Felix Anieh, says, "The result is that you are offered a drug you didn't ask for."
Lamenting the effects of fake drugs on users, he says, "They increase mortality and morbidity, engender drug resistance and loss of medicine efficacy, as well as loss of confidence in the health system and health workers."
He also says it leads to an economic loss for patients, their families, health system, and the producers/traders in good-quality medicines
Not only drugs are counterfeited; packaged foods, beers and wines (such as Red Label whisky, Johnny Walker, and Carlo Rossi) have joined the list, as evidenced by last week's interception of four trucks carrying suspected fake alcoholic beverages on the Lagos/Ibadan Expressway.
Three of the trucks, belonging to Ejulo Investments Limited, contained 3,547 cartons of McDowell Reserved Whisky; while the fourth contained 3,300 cartons of Gino tomato paste, belonging to Mr. Tochukwu Eze of 5, Oworeaja Street, Obosi, Anambra State.
Mr. Nne Ikenna of 5, Arochukwu Street, Ejigbo, Lagos, specialises in the manufacture and packaging of counterfeit drugs that include Zentel (a worm expeller) tablets and Lincocin (an antibiotic) capsules.
When security operatives and NAFDAC officials invaded his firm, they not only found fake drugs worth N31.2m, they also impounded rolls of aluminium foil, as well as dry-ink coding machines used for blister packaging and labelling.
The most surprising case is that of Mrs. Mary Awoyinka, who claims to hold a B.Sc in Pharmacy from Ahmadu Bello University, Zaria, having graduated in 1996.
She is the superintendent pharmacist of Uchest Pharmaceuticals Ltd. located variously in 9, Ekwulummri St., Iyiowa Odekpe Layout, Ogbara; and Block 237, Niger Head Bridge Market, Onitsha, both in Anambra State.
Before her arrest, she helped her clients to use forged Pharmacist Council Annual Licence to import a container of Dexacee tablets, and also for the retention of premises.
NAFDAC also alleges that Mr. Maduabuchi Abuzu of 21, Ashogbon Street, Idumota, Lagos, is a member of a syndicate in China which specialises in faking antimalaria drugs like Amalar, Coartem, Maloxine and Ibuprofen. Goods seized from him were valued at N19.5m.
Orhii offers some comfort, though: approved drugs not only have NAFDAC registration numbers, they also have certain codes that can be texted to 38353 for instant verification of originality and safety.