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How Nigeria can save $6 on every anti- retroviral drugs purchased directly from manufacturers

The continued rise in price has made many essential and prescription medications unaffordable, and therefore inaccessible, by quite a large number of Nigerians, who live below the poverty line. This without doubt comes with grave consequences of morbidity and mortality to consumers of health care products in Nigeria.

To be on course to end AIDS as a public health threat by 2030, The Civil Society Legislative Advocacy Centre (CISLAC) and Transparency International (TI) is saying that Nigeria expects to save $6 for every antiretroviral drug it buys from manufacturers, as against those bought through suppliers.

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 ceaselessly fall prey to fake and substandard drugs with damage to their health.

“CISLAC/TI Nigeria gathered that the contractors currently sell the anti-retroviral drugs at $13 per patient as against $7 given by the manufacturers,” said Auwal Ibrahim Musa, executive director, CISLAC

According to Musa, we are also concerned 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 government to take full ownership in the prevention and treatment of HIV in the country.

He added that as the Nigerian government struggles to sustain provision of free antiretroviral drugs as part of HIV programmes at health facilities in the country for an estimated 3.1 million people living with HIV/AIDS, Musa stated that this effort is mostly sabotaged by inflated prices quoted by supplying contractors, whose 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 existing 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 the Government to put more people on treatment,” he said.

The executive director further said that CISLAC/Transparency International Nigeria is perturbed by the continued but unchecked attitudes of the fraudulent contractors, whose unlawful activities hitherto dominate 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.

“While we acknowledge NACA’s plan to establish an HIV Trust Fund driven by the private sector to support existing efforts of the government, we observe that without current support by the US Government and the Global Fund, it would cost Nigeria N50 billion to treat one million people living with HIV annually,” said Musa.

However, giving the existing cost-efficient practice by the United States Government and Global Fund involving direct purchase of the drugs from the manufacturers, we are worried by the ill-informed, pocket-serving and discrediting petitions by some vested interest, who have endlessly benefited from inflated prices of the drugs in the last five (5) years, to discourage the ongoing effort of NACA to directly source the drugs primarily for sustainability and wider coverage.

“Corruption in the treatment of HIV/AIDS is no different from the corruption in the health sector. In 2003, Nigeria’s ARV programmes attracted much criticism when treatment centres were alleged to be handing out expired drugs and rejecting patients,” said Musa.

He stated that in a detailed investigative news report of December 28, 2018, the International Centre for Investigative Reporting (ICIR) revealed that hundreds of millions of naira released for HIV campaigns, counselling and testing services might have ended in private pockets of contractors and government officials, as companies were specifically registered to siphon funds meant to save the lives of the infected.

“We call on the Federal Government to insist 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 also call on the newly appointed 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,” said Musa.

Also speaking at the event, Adeshina Oke, a Legal Practitioner and a board member of CISLAC harped on the importance of good health to leadership, productive economy, and healthy citizens.

According to him, “A sick country cannot have a good leadership; neither can it have a productive economy or citizen. Hence we must get read of anything capable of deteriorating our health as a nation.

“And 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, should in case that day comes and funding stops coming in for purchase of retroviral drugs. And the time to start preparing is now,” Oke stated.

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