Just like many Nigerians, Sulaiman, a talented young man in his late 20s, went to a patent store to complain about his fever and headache. The owner of the drugstore, who was renowned for prescribing medications to treat various illnesses, offered Sulaiman a combination of medications that included Septrin, Paracetamol, and other painkillers. A short time after taking the drugs, Sulaiman developed pain and itching. He was rushed to the hospital, where it was confirmed that his body had reacted to the drugs prescribed by the patent medicine store operator.
After spending about three months in and out of the hospital, Sulaiman discovered that he could not see clearly. Sulaiman visited more than two specialist hospitals, where it was confirmed that some particles had obscured his vision and that it would be challenging for him to see again.
Sulaiman’s family’s efforts to get him treated had been in vain. He had remained blind for more than nineteen years, and he continues to bear the agonies and pains that go along with vision impairment.
According to him, life has become more difficult since I lost my eyes. I couldn’t do anything; it was family members that were assisting me financially.
He added, “Before the incident, I was working at John West, but since I lost my eyes, my dreams have been shattered, and I have nothing to do with my life.”
While Sulaiman had accepted his fate, visiting patent shops was forbidden in his household. Nobody dares go to unregistered pharmacy shops or unrecognised hospitals to complain about any health condition. This is because they blame his sight problem on the drugs he procured from the patent medicine store.
Even though Sulaiman’s experience shaped how he views drug stores, many Nigerians have continued to be victims as the influx of illegal and unlicensed drug stores spread across Lagos and Ogun communities.
PUNCH Healthwise’s findings revealed that the activities of the patent medicine stores have made efforts to curb the growing problem of the distribution of substandard and falsified drugs in Nigeria difficult. Many of them have been fingered in the unethical distribution of drugs and not adhering to basic rules guiding drug stocking and sales.
Even though the Pharmacy Council of Nigeria, (PCN) authorised the patent medicine stores to sell only OTC drugs, many of the operators do not comply. They stock and sell all drugs including prescription medicines without any prescriptions from doctors.
Also, even though the PCN had issued a warning that patent stores are not allowed to sell performance-enhancing drugs, antibiotics, injections, and other control drugs, most of the patent medicines visited stock and dispense them.
While PUNCH HealthWise learnt that antibiotic drugs like Ampliclox, Amoxicillin, Augmentin, Aprotab, Doxycycline, Septrin, Metronidazole, and Enthromicin, among others, were not supposed to be sold or stored by patent store operators, almost all of them have them in stock and willing and ready to sell them without prescription.
Also, contraceptive and sexual booster drugs like Postinor, Combination 4, Iwofem, Postpil, Embarga, among others were available for sale at the patent medicine stores even though that was inappropriate.
Other drugs that the patent stores sock and are selling without approval and in contravention of the PCN guidelines include Amalgesic, Cocomadol, Tramadol, Meloxicam, Amolodipin, Normoretic, Bonduretic, Nifedipin, Nifenda, Losatan, Antenonol, and Anorol.
PUNCH Healthwise investigation revealed further that many of the patent medicine stores have no respect for professionalism as they operate in all sorts of inappropriate spaces and environments in different communities in Lagos and Ogun States.
Some of the stores are poorly ventilated and without windows, yet some of the drugs they stock, according to experts are not supposed to be stored in such an environment.
Most of the sellers are also not educated, yet claim to know everything about drugs and health issues and routinely dispense health advice and counselling to patients who visited them.
Many of the are located in strategic locations in the communities and are thus quite accessible to patients who have made them their first point of call for health issues. commodities to residents in addition to drugs. The residents appear unconcerned about whether the drugs were harmful, illegal, or expired.
Some of the residents who spoke with PUNCH HealthWise said they do not check the pack of drugs given to them to confirm if it has expired or is about to expire.
They noted that they found the patent medicine stores quite accessible and do not have to bother about visiting hospitals to get tested or get prescriptions as the stores do not ask for such before selling drugs to them.
A resident of a community in Ibafo, Qudus Famuyiwa, said, “When I am sick, I just go to them and complain about how I am feeling. They will give me different combinations like pain relief and antimalaria, among others.
“I have never entered the drug stores around here or any pharmacy with drug prescriptions. I will just tell them what I want, and they will give it to me.”
Another resident in the Mushin area of Lagos State simply identified as Tunji said he used to buy different banned drugs at drug stores in the area.
He explained, “They used to sell codeine and other banned drugs here. It’s just that they need to recognise your face or you go with someone familiar with the area.
“I have never bought a sexual booster by presenting a doctor’s prescription. It is a normal thing such from the stores without presenting any formal paper, just have your money.”
Illegalities persist despite several clampdowns
Between 2018 and 2022, the PCN claimed the institution had sealed not less than 19,059 illegal premises out of the 27,262 facilities it visited for enforcement activities.
The Registrar, PCN, Babashehu Ahmed, at a press briefing in Abuja in September 2022, said out of the 19,059 illegal premises shut down, 1,780 were premises sealed for operating illegally as pharmaceutical premises while 16,502 others sealed were patent medicine shops.
Ahmed also said that a total of 110 people were arrested in connection with illegal premises and are at various stages of prosecution.
Despite several clampdowns by the regulatory body, findings by PUNCH HealthWise revealed that drugs are still indiscriminately sold, distributed, and administered by quacks across drug in Nigeria with little or no monitoring in sight.
Although PCN-licensed pharmacies and patent medicine shops are expected to display their licenses or evidence of registration conspicuously within the premises, PUNCH Healthwise, however, observed that all 15 stores visited were not PCN-licensed patent medicine shops.
At a patent medicine store in the Mao Junction area of Kola, in Lagos State, the owner was ready to sell a contraceptive drug to our correspondent without a prescription.
The drug known as Postinor, used to prevent pregnancy at an early stage, was kept in a safe box, where it was brought out by the store operator identified as Ikechuckwu.
Scanning through Ikechuckwu’s medicine store, there was no certificate to indicate he was a PCN-licensed patent operator.
Other unauthorised drugs like Ampliclox were also on display at the shop.
Our correspondent also visited patent medicine stores in Mushin and Oshodi Isolo Local Government Areas of Lagos State and found that many of them stock and sell prescription medicines without a care about the health implication.
Streets like Wahab, Adebeshin, Kumuyi, and Coker were visited in Mushin LG. Places like Adewale Crescent, Adeyemi Street, Afariogun Street, Akinpelu Street, and Alimi Oke Street were visited in Oshodi.
Our correspondent also visited three patent stores located in the Ibafo area of the Obafemi-Owode local council in Ogun State.
To virtually all the patent medicine store operators, drugs are just like any other commodities of trade and are treated as such. They display drugs alongside alcoholic drinks, beverages, and other food items without caring about any regulations.
PUNCH HealthWise discovered that some of them have a safe where those unauthorised drugs were kept and only bring such drugs out to sell after they have sealed a sale agreement with the buyer.
Our correspondent, who pretended to be interested in obtaining some of the unauthorised drugs, discovered that the stores were willing to sell as long as you had the cash.
The unauthorised drugs were, however, sold by the patent store operators at an exorbitant price.
Our correspondent was able to confirm that many of the patent stores sell almost all unauthorised drugs to interested customers.
While some sell only to known customers, others were only concerned with maximizing profits.
Sex-enhancing drugs like Viagra and Lion were also on display at many of the patent stores visited.
‘How we store unauthorised drugs, evade arrests’
How illegal medications were sold and stored was exposed by one of the errant operators who spoke with PUNCH HealthWise.
The operator simply identified as Bola, claimed that many unlicensed patent shops typically kept the unauthorised drugs in a safe to prevent exposure.
She added that they were always wary of strangers and that the unauthorised drugs were only sold to well-known customers.
Speaking about how they avoid being arrested, Bola claimed that some PCN and other regulatory agency officials always inform them when a raid is planned, alleging that those officials were on their payroll.
She said, “There are some drugs that we don’t display. We just store them somewhere and take them only when we need them.
“You know, because they are unauthorised drugs, we cannot display them. Some of those drugs are not kept in the shop; they are stored somewhere beyond the eyes.
“Once you have a good relationship with some PCN officials and other regulatory agencies like the NDLEA, it would be difficult for them to arrest you. We used to settle those officials so that they could inform us when they were coming for inspections.
“When we know that they are coming for an inspection, we may not open shop for like two to three days just to avoid getting caught.”
Experts express concern
A pharmacist and the Vice Chairman of the Pharmaceutical Society of Nigeria in Ogun State, Olumide Ogungbe, expressed concern over the selling of unauthorised drugs by the patent medicine store operators.
Ogungbe, while speaking with PUNCH HealthWise, noted that patent stores were solely intended to offer over-the-counter medications, stressing that dispensing additional medications without medical knowledge can exacerbate the patient’s health issues.
He said, “Patent medicine store operators are not trained to be selling antibiotics, not to mention antihypertensive or anti-diabetic drugs because those drugs are used for chronic illness.
“When you are not a professional, it is a crime to handle it, not to mention prescribing it for others to use. Those chronic ailments have their drugs, and these are drugs that they will be taking for a long period.
“Patent medicine sellers are not supposed to conduct any clinical research, such as taking patients’ blood pressure, checking blood glucose and hypertension levels, and so on. They are not trained to engage in such activities.
“For example, when an antihypertensive is wrongly prescribed, it can cause a lot of danger to the health of the patients using it. It should be a rational prescription, but when it is not, either you are giving the wrong dosage or underdosing, or you are giving the wrong drug entirely.
“So, the bottom line is that you are doing the wrong thing. It will affect the health of an individual that is affected by that ailment. They thought you were doing your neighbor a favor by giving them such medicine, but you are not doing them any good. You don’t know the consequences of the active ingredients that the drug contains. You might have been hearing about the constituents of the drugs, but you don’t know the level of each ingredient.”
Similarly, a medical doctor, Toyin Adedapo, said selling drugs to people without a prescription can lead to wrongful dosage.
Adedapo lamented that incorrect dosage can destroy the liver and lead to more serious health problems.
“We have limited control”
However, speaking with our correspondent, the President of the National Association of Patent and Proprietary Medicine Dealers, NAPPMED, Sunday Odil, said the association had limited control over the enforcement of the PCN guidelines as regards the sale of drugs to the public by patent medicine shop operators.
Odil, who noted that there are regulatory bodies charged with the responsibility of enforcement, however, revealed that NAPPMED also issues a fine to any of its members culpable of selling unauthorised medicine to the people.
He lamented that many of the illegal patent stores were not registered members of NAPPMED, adding that the association could not force them to join.
He explained further, “People are very stubborn; enforcing compliance is always very difficult in Nigeria because there are people who will work against it.
“Within the body, we have laws. For example, if you are caught engaging in activities that go against the establishment of the patent medicine, there is a fine you pay within the association.
“Even if the NDLEA or any other regulatory bodies happen to apprehend a member with an unauthorised substance, after facing the wrath of the law, you will still come to face the wrath of the association.
“The challenge is that there are some members we cannot control because they are not in the association. We cannot check them, and by the time they are doing all these things, in the end, they say NAPPMED members are the ones doing it.”
PCN blows hot, introduces new measures
The registrar of PCN, Babashehu Ahmed, attributed the system’s failure to the rise of patent medicine operators.
Ahmed revealed that the council has established a committee known as the Patent and Proprietary Medicine Vendors Committee to ensure consistent inspection, monitoring, and enforcement.
He added that the council is also introducing a mandatory six-week training programme for people interested in opening patent medicine stores.
He further said, “Many of those you see not displaying their licenses, the majority of them, I can assure you, are not registered by PCN; they are illegal operators.
“It was a result of the failure of the system that led to us having this large number of illegal operators. We have had a situation where some government officials dedicate the licensing of these patent stores to people that know nothing about it, and it was when the situation got worse that they took the regulation back to PCN.
“In handling the regulation of these patent stores, we have established what we called the patent and proprietary medicine vendors committee, and we have 37 of them covering the 36 states and the FCT. These are committees of the council that are usually chaired by the Director of Pharmaceutical Services in the state. The committee has the responsibility for inspection, monitoring, and enforcement.
“We have also taken steps to ensure that we reposition the regulations of these patent stores because, when they were established in 1936, the qualification is people with the ability to read and write.
“We are now introducing what we called a mandatory entry training programme where we organised a six-week programme at an accredited centre to ensure that before you come in, we put you through the rules and regulations guiding this operation. And at the end, they also write the exam. “It is only those that were able to meet up with the capacity that will be brought on board to be regulated.”
Source: healthwise.punchng.com
