Fake, Unregistered Asthma Inhalers Flood Nigerian Markets After GSK Exit

A year after the British pharmaceutical giant GlaxoSmithKline (GSK) exited Nigeria, asthmatic patients have been facing significant distress due to the scarcity of their medication. Recent investigations reveal that fake and unregistered inhalers have now flooded Nigerian markets.

For 28-year-old Rose Daniel, a marketer from Cross River State, the side effects of anti-asthmatic tablets were unbearable. The uncontrollable tremors she experienced after taking them made her life difficult. Relief came eight years ago when her doctor prescribed a Seretide Diskus inhaler, which had no side effects. However, after GSK’s exit last year and the resulting scarcity of these inhalers, Daniel feared a return to her debilitating symptoms. Determined to avoid this, she purchased three packs of inhalers from a trusted pharmacy to last her until the situation improved.

One day at work, Daniel noticed that a colleague’s Seretide inhaler looked different from hers. Upon closer inspection, she realized the inhaler had no NAFDAC (National Agency for Food and Drug Administration and Control) Registration Number. Grateful that she had purchased her inhalers from a registered pharmacy, Daniel’s discovery highlighted a growing concern—fake and unregistered inhalers were making their way into the market.

A tip-off from an asthmatic patient about the prevalence of these fake inhalers led to a fact-finding mission by Punch Healthwise. In Lagos, at the Church Street market in Idumota—a well-known hub for wholesale and retail medicines—shops were found selling unregistered Seretide inhalers. These inhalers, often hidden from plain sight, were brought out only on request and sold to buyers, usually wrapped discreetly in black nylon bags. Many of these unregistered inhalers were found to have instructions written in languages like Urdu, spoken in Pakistan and India, rather than in English, raising further suspicions.

During the investigation, sellers at Church Street assured buyers that despite the lack of NAFDAC registration numbers, the inhalers were safe and came from the same producers as the original ones. However, the absence of a NAFDAC registration number indicates that these products have not been approved by the Nigerian regulatory body, making them illegal and potentially dangerous.

According to NAFDAC, any drug without its registration number is considered fake. The agency’s regulations prohibit the manufacture, import, export, distribution, or sale of any drug not labeled according to its standards. Violating these regulations can result in imprisonment or fines.

The former president of the Pharmaceutical Society of Nigeria (PSN), Olumide Akintayo, expressed serious concern about the influx of fake drugs, warning that it could lead to higher morbidity and mortality rates. He urged government agencies to take immediate action to stem the tide of fake drugs in the country.

The scarcity of genuine inhalers following GSK’s exit has led to a rise in uncontrolled asthma cases. Many patients, unable to afford or find their usual medications, have turned to cheaper, often unregistered alternatives. This has resulted in poorly controlled asthma symptoms and an increased risk of hospitalization and death. Professor Musa Babashani, President of the Nigerian Thoracic Society (NTS), emphasized that many asthmatics in Nigeria rely on Seretide inhalers, and the influx of fake products could worsen the situation.

Punch Healthwise found that unregistered Seretide inhalers were being sold in both local and popular pharmacies, with prices varying significantly. These inhalers, although similar in appearance to the registered ones, lacked NAFDAC registration numbers and often had instructions in foreign languages. In some cases, pharmacists were willing to sell these unregistered products, though they kept them hidden from public view.

The rising prevalence of unregistered medicines in Nigeria increases the risk of using substandard or fake drugs. NAFDAC’s role in safeguarding the nation’s health includes ensuring that all drugs in circulation are properly registered and certified. However, the presence of fake inhalers in the market shows that more needs to be done to protect patients.

The National Chairman of the Association of Community Pharmacists, Ambrose Ezeh, attributed the influx of unregistered drugs to Nigeria’s porous borders. During an analysis of several inhalers bought during the investigation, only one was found to have a valid NAFDAC registration number.

Professor Cajetan Onyedum, a pulmonologist at the University of Nigeria, Nsukka, warned that the use of fake inhalers could severely impact asthma control in Nigeria. He called for regulatory agencies to tighten control over the importation and distribution of medications in the country.

NAFDAC Director-General, Professor Mojisola Adeyeye, emphasized that patients should not use unregistered products and must confirm that their medications are authorized by NAFDAC. The agency conducts routine surveillance to remove unregistered products from the market, but the fight against counterfeit drugs requires the cooperation of all stakeholders. Adeyeye confirmed that the Seretide inhaler with instructions in the Indonesian language was not licensed by NAFDAC.

The agency has pledged to intensify its surveillance efforts at entry points, selling outlets, and facilities to curb the spread of fake drugs. It also urged the public to report any suspicious products to help in the fight against counterfeit medicines.