An appraisal of Nigeria’s efforts to ensure that safe, effective, affordable and quality-assured medicines reach every Nigerian who needs them
By: Dr. Sabiu Adamu FPCPharm
When a Nigerian falls ill, one of the most important questions is often not whether there is a hospital nearby, but whether the medicine prescribed by the healthcare professional will be available and affordable. For some families, obtaining medicines has become a difficult struggle, particularly when treatment is required for a chronic illness that demands continuous medication. A prescription may be carefully written, a diagnosis properly established and professional advice appropriately given, yet the entire process can be undermined if the patient cannot find the medicine or cannot afford it.
This simple reality reminds us that medicines are not merely commodities sold in pharmacies; they are an essential part of healthcare and, in many circumstances, a matter of life and death.
It is against this background that Nigeria’s National Drug Policy deserves serious attention. The Third Edition of the National Drug Policy, introduced in 2021, provides a framework for ensuring that Nigerians have access to medicines that are safe, effective, affordable and of acceptable quality. The policy covers a broad range of issues, including medicine regulation, procurement, distribution, local manufacturing, rational use, quality assurance, pharmacovigilance, research and human-resource development. Its vision is therefore much broader than simply ensuring that drugs are available in hospitals and pharmacies. It seeks to establish a medicines system capable of responding to the health needs of the Nigerian population. The challenge, as with many Nigerian policies, lies not necessarily in the quality of the intentions but in translating those intentions consistently into reality.
Nigeria has made notable progress in the regulation and quality assurance of medicines. The National Agency for Food and Drug Administration and Control (NAFDAC) has over the years strengthened its regulatory activities, including product registration, inspection, surveillance and enforcement. These efforts have contributed significantly to protecting Nigerians from substandard and falsified medicines. The country’s pharmacovigilance system has also continued to develop, providing mechanisms through which suspected adverse reactions to medicines can be reported and investigated. These achievements should be recognised because ensuring that a medicine is genuine and of acceptable quality is just as important as ensuring its availability.
However, the availability of medicines remains a major concern. A medicine may be registered and approved by the regulator, yet remain beyond the reach of the patient who needs it. The rising cost of medicines has become particularly troubling in an economy where many families already struggle to meet basic needs. Inflation, exchange-rate fluctuations, transportation costs, energy costs and dependence on imported pharmaceutical raw materials all contribute to the increasing cost of medicines. When medicines become unaffordable, patients may reduce their doses, skip treatment days, purchase only part of a prescribed course or abandon treatment altogether. What may appear to be a simple economic decision can eventually result in treatment failure, complications, hospitalisation and unnecessary deaths.
This makes local pharmaceutical manufacturing one of the most important pillars of Nigeria’s medicines security. A country of Nigeria’s population and economic potential should not remain excessively dependent on other countries for essential medicines. Recent global health emergencies have demonstrated how quickly international supply chains can become disrupted, leaving countries that depend heavily on imports vulnerable. Strengthening domestic pharmaceutical manufacturing would therefore not only create employment and stimulate industrial development; it would also protect national health security. The government’s current efforts to encourage local production, including fiscal and regulatory incentives, are steps in the right direction, but these initiatives must be sustained and supported by reliable infrastructure, access to finance, research capacity, technology and a stable business environment.
There is, however, an important caution. The goal should not simply be to manufacture more medicines in Nigeria; the medicines must also be of consistently high quality. Nigerian pharmaceutical manufacturers should be encouraged to meet internationally recognised standards of good manufacturing practice, quality control and bioequivalence. Patients should be able to use locally manufactured medicines with confidence, knowing that they are safe, effective and therapeutically reliable. If properly implemented, the ambition to substantially increase local production could transform Nigeria from a predominantly import-dependent medicines market into a stronger pharmaceutical manufacturing hub in Africa.
Another area that requires renewed attention is the rational use of medicines. The right medicine can save a life, but the wrong medicine, used in the wrong way, can cause serious harm. Irrational prescribing, unnecessary polypharmacy, inappropriate antibiotic use, self-medication and poor adherence to treatment remain challenges within the Nigerian health system. Antimicrobial resistance is particularly worrying because the effectiveness of medicines that have saved millions of lives is gradually being threatened by inappropriate use. Healthcare professionals therefore have a major responsibility to ensure that medicines are prescribed and dispensed appropriately, while patients must also be educated about the dangers of using medicines without proper professional guidance.
The distribution of medicines presents another challenge. It is not enough for medicines to exist somewhere in the country; they must reach the health facility, pharmacy or community where the patient needs them. Weak forecasting, procurement delays, inadequate storage, poor transportation and inefficient distribution can create shortages even when medicines are available elsewhere. Strengthening the pharmaceutical supply chain should therefore remain a priority. Better information systems, transparent procurement processes, effective inventory management and stronger coordination between government agencies and other stakeholders can help reduce wastage and improve availability.
The problem of informal medicine distribution also deserves sustained attention. Open drug markets have provided access to medicines for many Nigerians, particularly where formal healthcare services are inadequate or distant. However, the risks associated with uncontrolled storage, inappropriate dispensing, self-medication and the circulation of poor-quality medicines cannot be ignored. The solution should not be limited to closing such markets; it should also involve strengthening legitimate pharmaceutical distribution networks and ensuring that affordable medicines are readily available through properly regulated channels. People will continue to patronise informal sources when the formal system fails to meet their needs.
Ultimately, the success of Nigeria’s National Drug Policy should be judged not by the number of policy documents produced, meetings held or targets announced, but by the experience of the ordinary Nigerian who walks into a health facility with a prescription. Can the patient obtain the medicine? Is it genuine? Is it affordable? Has it been properly stored? Is there a qualified professional available to provide appropriate advice? These are the questions that give meaning to medicines policy. Nigeria already possesses considerable professional expertise, regulatory institutions and a policy framework capable of supporting a strong medicines system. What is required now is sustained political commitment, adequate investment, effective coordination and, most importantly, consistent implementation. The journey from policy ambition to medicines security may be challenging, but it is a journey Nigeria must undertake if the promise of healthcare for all is to become a reality.
Dr. Sabiu Adamu FPCPharm is the Consultant Clinical Pharmacist, Fellow of the West African Postgraduate College of Pharmacists and Rtd Director of Pharmaceutical Services,
Federal Medical Centre,
Keffi. Nasarawa state. Email: sabiudm@gmail.com
