What fake products are doing to us

When we encounter fake or substandard products, whether they are medicines, food, or any essential goods, we risk not only our physical health but also our mental and spiritual well-being. Such products can lead to adverse health effects, suffering, and loss of trust in those who provide for us. This situation even creates significant sources of suspicion between consumers and the long-established companies that manufacture these goods, as people increasingly find it difficult to distinguish between the original products and the fakes.

Last week, former Vice-President, Professor Yemi Osinbajo, appeared at a public forum to contribute to the monster now confronting citizens with a shocking story about how his wife suffered from taking supposedly natural fruit juice, freshly extracted, without the prior knowledge that the fruits had been tainted by the use of chemical agents to forcefully ripen them.

But that is one family who knew how to investigate the problem and determine the origin of the health issues which his wife observed. Let us now hypothetically suppose that this was one family of illiterates hidden away somewhere in the rural middle belt of Nigeria! The cumulative effects of repeated exposure to such a sustained assault on the human body can be better imagined. And because so many people are unaware of the hidden dangers, these additives are wreaking havoc in the land.

The impact is very significant. Fake and substandard products, particularly medicines, food, cosmetics, and drinks, can seriously harm both individual health and wider public well-being in Nigeria. Their impact on health leads to treatment failures and preventable deaths. Fake medicines may contain the wrong ingredients, too little active ingredient, or no active ingredient at all. As a result, illnesses such as malaria, infections, hypertension, and diabetes may go untreated, even while the various patients are supposedly taking the required medications, often leading to complications or death.

The World Health Organisation notes that substandard and falsified medical products can fail to treat disease and may directly endanger patients. Drug resistance, a subject we have discussed in the last three weeks, can also result from using substandard antibiotics. These are especially dangerous because they may expose bacteria to doses that are too weak to kill them. This contributes to antimicrobial resistance, making future infections harder and more expensive to treat.

WHO identifies antimicrobial resistance as a major consequence of falsified medicines. In addition, poisoning and adverse reactions resulting from counterfeit products that contain toxic chemicals or harmful contaminants become more common. According to NAFDAC, substandard medicines can cause poisoning, treatment failure, drug resistance, and even death.

Then there is the problem of increased hospital admissions, which NAFDAC has highlighted to be directly attributable to the circulation of fake medicines. Other consequences are prolonged hospital stays and greater human suffering. Now, the financial hardship imposed on many Nigerians who buy cheaper products because of economic pressures may initially look like a wise investment in their health choices and treatment plans.

But when counterfeit products fail, patients often spend more money seeking further treatment, paying hospital bills, and replacing ineffective medicines. This increases out-of-pocket healthcare costs. When treatments do not work because medicines are fake, patients may lose trust in healthcare professionals, pharmacies, and regulatory institutions. The WHO notes that falsified products can lead to loss of confidence in medicines and distrust of healthcare providers.

The scope of the problem widens as patients and families may experience anxiety, fear, and emotional trauma after discovering that a product they trusted was fake, especially when serious illness or death results. People suffering complications from ineffective medicines may be unable to work, attend school, or care for their families, reducing overall wellbeing and productivity. The problem extends beyond individual consumers. The circulation of counterfeit products places an even greater burden on hospitals.

In the end, this increases health system costs, harms legitimate businesses, and discourages investment in the pharmaceutical sector. Health experts in Nigeria have described the counterfeit medicine trade as a major public health challenge with national consequences. Fake and substandard products have a severe impact on health and well-being in Nigeria. They contribute to illness, death, drug resistance, financial loss, and declining trust in the healthcare system.

While agencies such as NAFDAC continue to combat the problem through surveillance, enforcement, and public awareness campaigns, the persistence of counterfeit products remains a major threat to public health, mostly because pervasive corruption ultimately defeats some of the noblest aspirations of those agencies. NAFDAC regulates the manufacture, importation, distribution, and sale of medicines and other regulated products. It requires products to be registered and ensures imported pharmaceutical ingredients meet required standards.

However, once a product is registered, that agency seldom returns to inspect the facilities and the products made there. For legally registered products, therefore, compliance with required standards may be maintained for a brief period after inspections have been completed. But many fake producers conveniently circumvent even these requirements by locating their factories at opaque addresses. The problem is now a national emergency.

NAFDAC regularly issues public alerts when potentially dangerous or substandard products are identified. It directs surveillance teams to remove affected products from circulation and warns importers, retailers, healthcare professionals, and consumers. So, on the whole, NAFDAC’s efforts are not altogether futile. It is an agency trying its utmost in an environment so challenging that many people can barely imagine.

The agency conducts awareness campaigns to help consumers recognise genuine products, buy only from licensed suppliers, and check for NAFDAC registration details. Still, a lot more needs to be done, especially through effective collaboration with national and international bodies and international regulators to detect and prevent the movement of counterfeit products across borders. By doing so, NAFDAC has achieved important successes, including large seizures of counterfeit products and the prosecution of offenders.

However, the challenge remains significant because of factors such as porous borders, complex supply chains, and the demand for cheaper alternatives to genuine products. Continued enforcement, public vigilance, and cooperation between agencies are therefore essential. We will continue to see evidence of kidney-related deaths, a rise in cancers and other non-communicable diseases which could be traced back to the sustained consumption of these fake goods.

Questions and answers

Sunday Doctor, thank you for discussing river blindness in last Sunday’s Punch. May God continue to bless you and all yours. According to the 1993 edition of a medical textbook with me, “ Mectizan kills baby worms SLOWLY, leaves the adult worms to reproduce and can’t be taken more than once in 6 months. However, it does not cause the dangerous reactions of other treatments.  (b)  DEC (Diethylcarbamazine Citrate) (Hetrazan, Banocide) kills the young worms quickly but spares the adult worms and causes a marked reaction (with fever, joint pains and much itching, which is worse at night) as the young worms die. As the adult worms remain alive and reproduce, repeat courses have to be given. Phenobarbitol tablets (whose overdose may slow down or stop breathing) may be needed to help sleep at night during the reaction. (c)  Suramin is more effective than DEC in killing adult worms but sometimes poisons the kidneys and must be given intravenously with the assistance of an experienced health worker. It should be used after treatment with DEC, when reactions have nearly stopped (to avoid using it for long and risking kidney problems).”    Has any better drug or treatment option been discovered since then?                                     +23481*******

Thank you very much for your comments and your prayers. As you emphasised in your contribution, the use of either regimen of treatment spares the adult worms. That is the major reason why treatment cannot be taken as a one-off attempt but must include mass eradication campaigns that will take these residual reservoirs into consideration. Such campaigns have to be periodic and sustained. Unfortunately, insecurity, sustained loss of qualified personnel to drive these efforts, and the loss of mostly American aid have stymied such efforts and have even seen a reversal in some areas over successes recorded in the past. With regard to drugs, no new medicines have been formulated or are currently in use, mostly because this is basically a problem that even these old medications remain effective against.

 Sunday Doctor, I have recently found my legs to be swelling up to the extent that I cannot wear shoes. I am a 68-year-old man who has recently returned from a long stay in Canada. However, apart from my blood pressure, which has been under good control and my well-controlled diabetes, for which I am on medications, I don’t have any other health issues. Currently, my family physician started me on Lisinopril 10mg and Aldactone 25mg daily for my blood pressure and Metformin 250 mg with Empagliflozin 25 mg daily for the diabetes. The leg swelling began a week ago and has reached my knees. I am very disturbed about this, even though the doctor told me that it is due to prolonged standing and sitting. When I place my legs on a pillow overnight, they are normal by morning. What is the implication of this, sir? Are my kidneys failing?                                                          0803*******

Thank you very much for your question. It is natural to be concerned, and it is my belief that your doctor is comfortable enough about your current condition. However, you will need to move around more if you are the sort of person who sits for long hours. That helps the fluid pooled in the legs mix with your blood and reduce the swelling. Secondly, you need to see a physician here to specifically examine the status of both your heart and kidneys. Lastly, if you find relief when you raise your legs, it could mean that the valves responsible for propelling blood flow in your legs have begun to fail. So, the use of a pressure garment may be helpful.

 Sunday Doctor, I am 36 years old with diabetes, and I take insulin injections twice a day. Last week, after an injection in my stomach, I developed a swelling that I have been using an ice pack for, but it is not going down. I am afraid that it is an abscess. What should I do? Please see the picture I will send on WhatsApp and advise me, sir.                0806*******

That picture shows an injection given in the wrong quadrant of the abdomen. You should take the injection in the lower part, below the navel, where there is more fat. It is also easier there. But this upper part is close to your ribs. There is less fat. But that swelling is not red, and it is not likely that an abscess is forming. Just take Paracetamol for the next 3 days and see if it reduces.

Sunday Doctor, I appreciate your good works on this column. My problem is that I am a 62-year- old woman on Sirdalud and Biopentin prescribed for me by an orthopaedic surgeon for my back pain. The pain is killing me. I cannot stand for up to 15 minutes in one spot or walk for more than 10 minutes without having pain shooting to my feet from my waist. Sometimes, even the feet are numb. I have been on these medications for more than 6 months. Drugs are so expensive, and although physiotherapy has helped me, the relief does not last more than 2 days after a session. What should I do now?                  0806*******

Good evening, madam. Thank you so much for your prayers and warm words of appreciation. We are unable to be categorical about what you should do because your imaging studies are not available to us. However, it is very likely that your surgeon has discussed with you what treatment options you have. With symptoms as serious as these, you will need some form of surgery either to relieve the pressure on the nerves in that area or to fuse some of the vertebral bones.