Asthma sufferers among those rationing drugs amid shortages and high prices after the pharmaceutical company ceased business in Nigeria this year.
Salamat Olashile takes a tablet from a white-and-green sachet. Five minutes later, her breathing is still laboured. “It will soon come down,” she says. She used to have an inhaler, which would have eased her asthma attack faster, but prices have increased dramatically since GlaxoSmithKline (GSK) “exited” the country. She is now reliant on a slower-working tablet called Araminol.
GlaxoSmithKline Nigeria, the country’s subsidiary of the British pharmaceutical firm, first announced in June that Nigeria’s economic problems and foreign currency crisis were severely affecting its work. In August, it said that it would be shutting down operations.
A GSK Global spokesperson said the company was not exiting, but pivoting to a “third-party distributorship”, which it is still processing. “In common with many companies operating in Nigeria, the significant challenge in accessing foreign currency in recent years impacted our local operations and has affected our ability to maintain consistent supply of medicines and vaccines in the market,” the spokesperson said.
Nigerians are now familiar with the resulting shortage of medications – and a spike in cost for inhalers such as Ventolin and Seretide Diskus, antibiotics such as Amoxil, as well as allergy relief drugs, an antimalarial drug and even over-the-counter painkiller, Panadol.
“I’ve been using Ventolin inhalers for eight years now,” says Jalaalah Shittu, a university student first diagnosed with asthma in 2015. “With Ventolin, there’s a hope I can still live a normal life. It provides an almost immediate relief.” But that relief has proved difficult for patients like Olashile and Shittu to replicate with other drugs.
Last week, Olashile’s father went out to get her Ventolin inhaler and came back with Araminol tablets. After a week of her asthma getting worse, he found an inhaler for 9,000 naira (£9), almost four times its usual price.
Olashile says: “My symptoms were worse because of the harmattan – a season characterised by harsh dusty winds and low humidity.” She has stopped going out and is trying to preserve the Ventolin for emergencies.
Shittu, meanwhile, is suffering unpleasant side-effects from alternative drugs. “I start to feel very weak and have a faster heartbeat and shaky body until the drug wears off, and that can take hours,” she says.
Oluwakemi Ebire of Famasi Africa, a digital health platform, says the situation is forcing people to ration medications of all kinds. “The ripple effect of these circumstances on patients is deeply concerning. For those without access to the right information, financial constraints can push them towards counterfeit medication, risking drug-adverse effects, drug resistance, treatment failure and even death.”
Nigeria has an estimated 13 million asthma sufferers, one of the highest rates in Africa. Ebire says: “I spearhead the care and management of chronic patients who depend on these medications for the rest of their lives, and I can tell you that these past few months have been very difficult for our patients, both financially and emotionally.”
In October, Famasi Africa registered a 15% drop in medication adherence rate among diabetic patients under its care, accompanied by a 10% increase in blood sugar levels.
The spokesperson for GSK said none of the medications supplied by the company is considered to be medically critical, and all have generic alternatives. It hoped that new third-party distribution plans could mean some drugs returning to the market early next year.
By Olatunji Olaigbe, The Guardian