TEXT OF A PRESS CONFERENCE ORGANISED BY CIVIL SOCIETY LEGISLATIVE ADVOCACY CENTRE (CISLAC)/TRANSPARENCY INTERNATIONAL NIGERIA TO SUPPORT GOVERNMENT TRANSPARENT DECISION TO BUY HIV DRUGS DIRECTLY FROM ORIGINAL MANUFACTURERS TO COVER MORE PEOPLE LIVING WITH HIV IN NIGERIA
While international treaties and governments across the world recognize adequate, accessible and affordable health care as a fundamental human right, medicine financing in Nigeria is generally out-of-pocket. 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 poverty line. This without doubt comes with grave consequences of morbidity and mortality to consumers of health care products in Nigeria.
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.
As the Nigerian government struggles to sustain provision of free anti-retroviral drugs as part of HIV programmes at health facilities in the country for an estimated 3.1 million people living with HIV/AIDS, 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 Government to put more people on treatment.
The Civil Society Legislative Advocacy Centre (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 HIV Trust Fund driven by private sector to support existing efforts of the government, we observe that without current support by US Government and the Global Fund, it would cost Nigeria N50 billion to treat one million people living with HIV annually.
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.
CISLAC/TI Nigeria gathered that the contractors currently sell the anti-retroviral drugs at $13 per patient as against $7 given by the manufacturers.
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.
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.
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.
On this note, CISLAC/TI Nigeria:
- Insists that fraudulent contractors who undermine the Public Procurement Act must be thoroughly scrutinized and discouraged from defrauding the government through inflated anti-retroviral drugs supply services;
- Calls on the newly appointed Director General of NACA to engage stringent reformsin the Agency’s procurement process for impactful, efficient and cost-effective wider and sustainable service delivery in Nigeria;
- Calls on the Director General to devise appropriate sustainability plan for the procurement of drugs and consumables through cost-effective and encourage technically know-how for domestic production in the presence of dwindling donors’ support; and avert recurring of challenges thrown at the country by Covid-19 pandemic;
- Calls on DSS to investigate the activities of Politically Exposed Persons (PEPs) who constitute themselves as faceless contractors and their relationship with the leadership of the Network of People Living with HIV, who we learnt are secretly used to obstruct and frustrate NACA’s effort from directly purchasing from manufacturers;
- As part of sustainability plan, CISLAC/TI Nigeria calls on regulatory authorities, like NAFDAC,to support and enhance local production of affordable antiretroviral drugs with serious consideration while issuing marketing authorisation to local manufacturers;
- Also, calls for review of heavy tax burden on the pharmaceutical sector to avert multiple taxation by local, state and federal governments as well as high tariffs on raw materials, packaging materials and other ancillary materials used to manufacture medicines, primarily to encourage local production in the country;
- Further calls on the government to develop a pricing policy to reduce reported high prices and wide disparity between prices of essential drugs in the country.
Increasing transparency is important in health services. CISLAC/TI Nigeria is committed to ensuring that improving the lives of Nigerian citizens takes precedence.
Auwal Ibrahim Musa (Rafsanjani)
Executive Director, CISLAC