Relationship Between Fake Drugs And People’S Perception Of Healthcare Delivery System
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Relationship Between Fake Drugs And People’S Perception Of Healthcare Delivery System
Chapter one
INTRODUCTION
Drug fraud is a global public health issue since its consequences can be felt from both the place of manufacture and the recipient country. As a result of the improved skill of people who make and distribute counterfeit medications, national measures to combat them in the country may be insufficient (Bates, 2008).
Nigeria has always been plagued by the problem of counterfeit medications. Some people still prefer to self-medicate when they are ill, and the medications are frequently purchased from unregistered merchants whose drug quality is unknown.
Fake pharmaceuticals have been a major concern in Nigeria for the past two decades. Furthermore, fraudulent medications had a significant role in contributing to high fatality rates. In 1989, a medicine formulation error caused the deaths of almost 150 youngsters.
Such issues prompted the formation of NAFDAC, which aimed to help create a drug-free environment (NAFDAC consumer safety, 2003). The intention was to ensure the effective registration of high-quality, low-cost pharmaceuticals in Nigeria.
Since the establishment of the new NAFDAC in April 2001, Professor Dora Akunyili, the Director General, has worked hard to combat the problem of the sale of counterfeit medications, but the existence of such continues, leaving me to question why.
My queries are: “Why does Nigeria still have open drug markets?” Why do Nigerian drug dealers break the law and continue to operate, perpetrating mass carnage while smiling to their banks? How long will we fight the struggle against phoney drugs, despite the threats to our life if we want to protect the nation’s health?
My organization’s constant raids on fake drug traffickers who violate the applicable rules and regulations have aided in clamping down on the illegal drug trade. However, just when things appear to be improving, these illegal drug dealers emerge from their hiding places.
I continue to wonder why. may it be that the Agency isn’t doing enough to combat the wicked actions, or may the fault be with the drug merchants themselves? The unfortunate irony is that the problem of counterfeit drugs has persisted on Nigerian soil.
My research will not solve Nigeria’s drug problems. However, it prepares me for the problems that will be confronted at home in finding the next alternative solution to the problem
as well as providing insight to my colleagues in combatting the menace of fake medications sold in the streets and open markets, which have negative consequences for the consuming public.
Background of the Study
The benefits of a robust health-care delivery system to any population are evident and cannot be overstated. A healthy person is a significant asset not just to himself, his family, and his community.
The World Health Organisation (WHO) (1948) defines health as a condition of whole physical, mental, and social well-being, rather than simply the absence of sickness or infirmity.
In 1986, the WHO said in the Ottawa Charter for Health Promotion that health is “a resource for everyday life, not the goal of living.” “Health is a positive concept that emphasises social and personal resources, as well as physical abilities.” Physical, mental, emotional, and social well-being are various factors that contribute to overall health.
To attain total health, we require health care delivery systems (HCDS) that can provide high-quality medical treatment, are sensitive to the health needs and expectations of the communities they serve, and are reasonably priced.
On the other hand, efforts aimed at achieving overall health, also known as health care delivery, are the prevention, treatment, and management of illness, as well as the preservation of mental and physical well-being through the services provided by medical, nursing, pharmaceutical, dental, clinical laboratory sciences, and allied health professions.
According to WHO, health care delivery includes all commodities and services aimed to enhance health, including “preventive, curative, and palliative interventions, whether directed to individuals or populations”.
The organised provision of such services is known as a health care delivery system. When fraudulent pharmaceuticals are utilised in health care delivery, the primary goal of the system, which is to improve general health, is not met.
The relationship between fake drug use in the healthcare delivery system and how people view the healthcare delivery system will be better understood by examining the levels of health care delivery systems.
All health-care systems include four essential levels of care (Lunde, 1990):
1. Practice self-care.
2. Primary professional care.
3. General specialised care (secondary care).
4. Super specialist care, often known as tertiary care.
There is a fifth level of care: quaternary care.
The WHO defines self-care as “activities that individuals, families, and communities engage in with the intention of improving health, preventing disease, limiting illness, and restoring health.” These activities draw on information and skills gained through both professional and lay experience.
They are carried out by lay persons on their own behalf, either independently or in collaborative partnership with specialists.” Self-care skills and knowledge will be demonstrated in an individual’s ability to take appropriate action(s) to achieve overall health.
Such acts include knowing when to seek professional treatment, gathering information on what type of care to seek, and determining where to obtain desired medical services.
Reports from the media (print and electronic) and lay information on the occurrences and effects of counterfeit pharmaceuticals can impact an individual’s decision on how to obtain health care. As a result, it is vital to investigate the link between fake drug use in HCDS and how such use influences people’s perceptions of HCDS.
Primary health care (PHC), as defined in the Alma-Ata Declaration (1978), is essential health care based on practical, scientifically sound, and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self-determination.
Primary health care focusses on promotion, prevention, and rehabilitation. PHC-based health care include, at a minimum, immunisation against the major infectious diseases: measles, whooping cough, diphtheria, polio, tetanus, and tuberculosis, as well as other components of National Health Policy.
When false vaccines are administered and immunity is not conferred on the immunised, such individuals are predisposed to developing the specific disease.
Secondary health care refers to the services offered by medical specialists who do not typically have first contact with patients, such as cardiologists, urologists, and dermatologists.
A physician may choose to confine his or her practice to secondary care by denying patients who have not seen a primary care provider first, or a physician may be forced to do so under various payment arrangements (Wikipedia, 2009).
Tertiary health care is specialised consulting care provided by specialists in a centre with staff and resources for particular investigation, diagnosis, and treatment, typically following a referral by primary or secondary health care personnel.
Quaternary health care refers to highly specialised and rarely utilised drugs (Intota, 2009). It is the delivery of health care to patients in cardiac care, orthopaedics, neurosciences, oncology, renal care, and so on.
Given the current scenario in Nigeria, the environment is extremely stressful, and almost everyone’s health is in danger in some way. In times like these, our health care delivery system should bring relief to Nigerians, many of whom are constantly on edge (Adelusi-Adeluyi, 1995).
Unfortunately, the use of counterfeit pharmaceuticals in our health-care delivery system has exacerbated this already difficult scenario. It is important to highlight that decisions regarding the genuineness of pharmaceuticals consumed, as well as the appropriateness and competency of both health care facilities and workers, require careful consideration.
Because of the chaotic nature of drug distribution in Nigeria, the risk of becoming a victim of counterfeit medications is extremely high. After all, a house with over a thousand doors is more difficult to safeguard than one with only one or two.
In Nigeria, drug distribution involves a large number of handlers (intermediaries). Each intermediary represents a potential entry point for fake drugs.
According to WHO (2006), “a counterfeit drug is one that is intentionally and fraudulently mislabeled in terms of identity and/or source. Counterfeiting can occur with both branded and generic products, and counterfeit products may include products with the correct or incorrect ingredients, without active ingredients, insufficient active ingredients, or with fake packaging.”
The Nigerian Fake Drugs and Unwholesome Processed Foods (Miscellaneous Provisions) Decree 1993, as amended, defines a fake drug as:
“a. Any drug or drug product that isn’t what it claims to be; or
b. Any drug or drug product that is so coloured, coated, powdered, or polished that the damage is concealed or that is made to appear to be better or of greater therapeutic value than it really is, that is not labelled in the prescribed manner, or that label, container, or anything accompanying the drug bears any statement, design, or device that makes false claims for the drug or that is false or misleading; or
c. Any drug or drug product whose container is made, formed, or filled in a way that is misleading;
d. Any drug product whose label does not bear adequate directions for use and adequate warning against use in pathological conditions or by children where its use may be dangerous to health, or against unsafe dosage, methods, or duration of use; or
e. Any drug product that has not been registered with the National Agency for Food and Drug Administration and Control (NAFDAC) in accordance with the Food, Drugs, and Related Products Act (Registration, etc.).
The consumption of counterfeit drugs is the worst error that can happen in HCDS. It is an error because neither the health care provider nor the patient realise they are taking the incorrect medication. Fake drugs are undermining both the integrity of the health care delivery system (HCDS) and people’s trust in the system.
Counterfeiters target everything produced by the pharmaceutical industry, including life-saving drugs such as HIV/AIDS, antituberculosis, anticancer, antidiabetic, and antihypertensive medications, as well as recreational drugs.
The existence and functionality of our HCDS are under threat, as many pharmaceutical manufacturers who invest heavily in research, production, and supply of genuine drugs are being pushed out of business by counterfeit drug manufacturers.
The relationship between fake drugs and people’s perception of health care delivery system can be looked at from two perspectives:
Health care consumers’ perspective
Health care providers’ perspective
STATEMENT OF THE PROBLEM
Counterfeit drugs are believed to be poisonous, toxic, threats to life, health risks, without therapeutic usefulness, with insufficient therapeutic benefits; and can cause treatment failures, death, disease complications, worsening of disease conditions
development of drug resistance, delayed recovery and human organ damage. Because of these repercussions, the confidence of both the health care professionals and consumers in our health care delivery system is in doubt.
In the past, Nigerian government through its regulatory organisations like as NAFDAC had made substantial attempts toward rectifying this problem. The regulatory agencies have increased public awareness on fake drugs, ensured that drugs in use in Nigeria are approved and registered, known fake drug manufacturers are banned from marketing their products in Nigeria, re-inspection of production facilities to ensure that such facilities still conform to appropriate standards, and persons caught with fake drugs were made to pay heavy penalties.
Also, the agencies have communicated with several foreign governments to ensure that such countries’ pharmaceutical companies ship to Nigeria only authentic items.
This study will evaluate the association between fake drug use in health care delivery system and people’s impression of health care delivery system.
PURPOSE OF THE STUDY
We might have heard, we might have watched, and we might have read reports on difficulties with bogus pharmaceuticals. Unfortunately, what is known to the public as respects to the problem of phoney pharmaceuticals is a tip of the ice pack.
The genuine situation is far from known or published. The cause(s) of most fatalities are not discovered or verified through autopsy.
But how do these difficulties affect people’s impression of our health care delivery system? This question is what this study intends to answer.
Significance of the Study
It is my view that this study will
1. Increase the level of commitment of people to their health care needs.
2. Motivate individuals to guarantee that the quality of pharmaceuticals, health care services and qualification of their health care providers are as prescribed and regulated by government.
3. Encourage people to gain self-care knowledge and skills so that they may take a more active role in promoting their own health and influencing the factors that influence it.
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