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Fake, unregistered asthma inhalers flood markets after GSK’s exit

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A year after British pharmaceutical giant, GlaxoSmithKline exited Nigeria and asthmatic patients who depended on its inhalers faced significant distress due to the medication’s scarcity, investigations showed that fake and unregistered inhalers have flooded Nigerian markets.

For a 28-year-old marketer, Rose Daniel, having to deal with the side effects of an anti-asthmatic tablet, was an experience she never wanted to have anymore.

Every time she took the medicines, uncontrollable tremors sent shivers down her spine, making her lead a less productive life.

But succour came when her consultant, eight years ago, prescribed an asthma preventer, Seretide Diskus inhaler, with zero side effects.

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However, following the exit of GSK last year, and the scarcity of the inhalers, the fear of a return to the daily tremors gripped Daniel’s mind.

Determined to spare no cost, the Cross River indigene reached out to notable pharmacies across the country and eventually bought three packs to last her for many months, pending when normalcy would return and the drugs become available.

Once the inhalers became available, Daniel said that she ensured she got her inhalers at a registered pharmacy she was sure sold genuine and approved drugs.

But one day, while at work, she saw the pack of a Seretide inhaler with a colleague and wondered why the pack looked different from hers.

After a quick perusal of the pack, the truth hit her in the face.

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“It had no NAFDAC (National Agency for Food and Drug Administration and Control) Registration Number!” she said.

Daniel said she was grateful that she had ensured she had only bought her inhalers and other drugs from a trusted pharmacy store.

On a journey to discovery

Following a tip-off from an asthmatic patient that fake and unregistered inhalers, Seretide inhalers, had flooded the market, PUNCH Healthwise embarked on a fact-finding mission to pharmacies and the drug market in Church Street, Idumota, Lagos State.

Entering into Church Street, the popular hub for wholesale and retail medicines, the tearing sounds of semitransparent adhesive tape (cellotapes) filled the atmosphere.

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Human load carriers bore several cartons of purchased medicines and hospital consumables on their back to deliver them to their respective buyers.

After a brief observation of the market nuances, this correspondent inquired at some shops about where to get Seretide Diskus. Then, the referrals began.

A tall, dark-complexioned middle-aged man enthusiastically greeted another man and boldly said in the Yoruba language, “We’ve been in this market since the 1980s.”

This man would later become a guide as he led this correspondent to the prescription shops where the inhaler could be bought.

“If I take you to the place where the other woman described, the price there is expensive, I’ll take you to this shop,” the guide responded.

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Unfortunately, the woman at the shop did not sell such a product, leading to another round of referrals.

At last, a young man garbed in native attire, called Nosa, was recommended.

This correspondent then showed him a picture of an unregistered Seretide inhaler, with the pack content written in English and Urdu, a language mostly spoken in Pakistan and India.

After a perusal of the picture, Nosa responded in the affirmative and led us to his ‘second shop’.

Nosa, this correspondent would later learn, sells wholesale and retail prescription medicines.

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Curious as to why his name rang through like an anthem on the lips of other sellers, this correspondent asked whether he was the main distributor of Seretide Diskus.

“I am not the only one, I sell prescription medicines,” Nosa opined, as he led us through the noisy market to another shop.

Once we got there, he asked his ‘brother’, Lucky, if the inhaler was available and he responded in the affirmative.

This correspondent was offered a seat on the bench placed by the narrow entrance to the shop to await the return of the salesperson assigned to ‘bring’ the inhaler from an undisclosed location.

Undoubtedly, the unregistered medicines were not to be displayed on the shelves. Only a specific request from a ready-to-pay buyer was the criterion for the inhalers to be brought out.

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After about 30 minutes of waiting accompanied by several pleas to be patient, the Seretide Diskus arrived wrapped in a medium-sized black nylon bag.

After checking the content of the bag to be sure “what I ordered was what I got,” this correspondent discovered that the name of the drug was written in Urdu language unlike the one presented.

Throwing further questions at Lucky, he responded, “Every batch comes with a new package but it is from the same producer as the one you showed me. This batch came in English. The one in Urdu was produced last year.”

However, an analysis of the packet showed that it was manufactured by “Glaxo Wellcome Production, France and the Batch Releasing Site: Glaxo Wellcome United Kingdom Limited, Brentford, Middlesex, UK and imported by Modern Pharma Trading Company.”

While the production and expiry dates read January 2024 and January 2026, respectively, the glaring absence of the National Agency for Food and Drug Administration and Control Registration Number rang the alarm bell.

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What makes them fake?

In this context, a counterfeit and fake drug is defined by NAFDAC as any drug or drug product which is not registered by the Agency by the provisions of the Food, Drugs and Related Products.

Furthermore, the NAFDAC Drug and Related Product Labelling Regulations, 2019, prohibits the manufacture, import, export, distribution, advertisement and display for sale or use of any drug or drug product that is not labelled by the regulation.

It further reads, “The outer and inner labels of a drug shall clearly show the registration number of the Agency (NAFDAC REG. NO.) assigned to it as indicated on the Certificate of Registration in a manner prescribed by the Agency.”

Any conviction of contravention of the Regulations prescribes the guilty individual to one-year imprisonment or a fine of N50,000 or both and the corporate body to a fine of N100,000.

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Providing further insights, the former president of the Pharmaceutical Society of Nigeria, Olumide Akintayo, stated that having fake drugs was a serious offence that violated sections 1.1 and 2.1 of the Fake Drug Acts.

Aside from the violation of the law, Akintayo explained that the influx of fake drugs portends a high incidence of morbidity and mortality rates.

He further discouraged the sale and handling of unregistered drugs and food substances and urged government agencies that have oversight responsibilities to move into action to stem the tide of fake drugs.

The battle for ‘breath’

PUNCH Healthwise had in November 2023, reported the travails of asthmatics, who after GSK’s exit, could no longer find the inhalers.

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For those who found them, the astronomical price increase was a burden too heavy to bear, as some of them resorted to using little dosages of the medications for them to last longer, while others bought other brands with cheaper prices.

Lifelong treatment

Although asthma is not curable, inhaled medication, oral and injectable medications can control asthma symptoms, allowing people with asthma to lead normal, productive and active lives.

This made asthmatics use their preventive inhalers daily and go about with the reliever inhalers.

According to the World Health Organisation, asthma is a major non-communicable disease affecting both children and adults but is the most common chronic disease among children.

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Asthma symptoms are caused by the inflammation and narrowing of the small airways in the lungs, which can lead to a combination of cough, wheezing, shortness of breath and chest tightness.

As of 2019, the Nigerian Thoracic Society stated that 15 million people were asthmatics. This implies that 15 million out of the over 213 million Nigerians, have asthma.

Many asthmatics use Seretide

The president of the Nigerian Thoracic Society, Professor Musa Babashani, confirmed to PUNCH Healthwise that although alternative controller inhalers were available, many asthmatics in Nigeria rely on Seretide.

With over 13 million Nigerians living with asthma, the NTS president warned that the influx of fake controller inhalers would make it even more difficult for patients to manage their symptoms, potentially leading to higher morbidity and mortality rates.

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Health

Ebola Scare: FG Moves to Establish Treatment Centres in States as Contacts Rise to 53

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The Federal Government has intensified emergency measures to contain the possible spread of Ebola Virus Disease in Nigeria, with plans to establish treatment and isolation centres in states hosting designated ports of entry.

The development follows an increase in the number of persons identified as contacts of Nigeria’s confirmed Ebola patient from 44 to 53.

The national incident management system has also been activated under the coordination of the Minister of Health and Social Welfare, Prof Muhammad Ali Pate.
The confirmed case involves a woman who travelled to Nigeria after visiting Uganda, following an earlier trip to the Democratic Republic of the Congo.
She reportedly developed symptoms on October 7, sought medical attention in Abuja on October 11 and tested positive for the Bundibugyo strain of Ebola on October 20.
The World Health Organisation is investigating the possible source of the infection.
Health authorities have urged Nigerians to remain calm, maintain proper hygiene, avoid direct contact with the bodily fluids of suspected Ebola patients and promptly report suspected infections.
The NCDC also warned against stigmatising persons undergoing monitoring, stressing that public cooperation, early detection and effective contact tracing remain critical to preventing further transmission.

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Nigeria’s Ebola Patient Identified as Wife of Swiss Diplomat, Infection Traced to Uganda

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The woman who tested positive for Ebola in Nigeria has been identified as the wife of a Swiss diplomat stationed in Abuja, with preliminary investigations suggesting that she contracted the deadly virus during a recent trip to Uganda.

According to Reuters, Switzerland’s Federal Department of Foreign Affairs confirmed on Thursday that the 42-year-old Ugandan-born woman tested positive on October 20, marking Nigeria’s first confirmed Ebola case in over a decade.

The Swiss authorities disclosed that the patient had spent approximately one week receiving treatment at a private hospital in Abuja after developing symptoms before laboratory tests confirmed the infection.

The ministry explained that the woman was believed to have contracted the virus during a visit to Uganda about two weeks earlier.

Her husband, who accompanied her on the trip, has since been placed in isolation as a precautionary measure, although he has not exhibited any symptoms of the disease.

However, uncertainty remains over the actual source of the infection, as international health agencies intensify efforts to reconstruct the patient’s travel history and identify possible exposure routes.

Ugandan authorities had suggested that the woman visited eastern Democratic Republic of the Congo before travelling through Uganda, but the World Health Organisation (WHO) and Africa Centres for Disease Control and Prevention (Africa CDC) said the claim had not been independently verified.

Africa CDC official Wessam Mankoula disclosed during an online briefing that Nigerian and Ugandan health authorities were exchanging information to establish the patient’s movements.

He maintained that there was currently no validated evidence confirming that the woman travelled to the Democratic Republic of the Congo.

Providing further clarification, WHO Representative in Nigeria, Pavel Ursu, said available records indicated that the patient travelled to Uganda on September 16 and returned to Abuja on October 3.

Ursu also confirmed that the woman remained hospitalised, adding that medical indicators showed signs of improvement.

Meanwhile, WHO Emergency Response Manager Patrick Otim said investigations were continuing to establish where the infection originated and identify health facilities the patient visited after developing symptoms.

The Nigerian case has been linked to an outbreak involving the Bundibugyo strain of Ebola, first reported in the Democratic Republic of the Congo in May.

Ebola is transmitted through direct contact with the blood or bodily fluids of infected persons, including deceased victims. Common symptoms include fever, vomiting and diarrhoea, while severe infections can result in death.

Health authorities are currently tracing the patient’s contacts and reviewing her movements to identify individuals who may have been exposed and prevent further transmission of the virus.

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Abuja Ebola case: Enugu Govt strengthens surveillance, puts health officials on alert

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The Enugu State Government says it has strengthened its disease surveillance and puts health officials on alert within the 17 council areas in the state.

The Commissioner for Health, Prof. George Ugwu, said this on Wednesday in Enugu during a press conference on Actions of the State Government in Response to Confirmed Case of Ebola in Abuja.

Ugwu said that following the confirmation of the case, the government had reactivated and strengthened the Enugu State Public Health Emergency Operations Centre (PHEOC) to coordinate preparedness, surveillance and response activities.

“Specifically, the State has intensified disease surveillance across its 17 Local Government Areas and strengthened coordination with relevant agencies and partners.

“Surveillance activities around the Akanu Ibiam International Airport are also being strengthened in collaboration with Port Health Services and other relevant stakeholders.

“The state is further maintaining its Rapid Response Teams and relevant technical personnel on standby, while preparedness measures are being reviewed to ensure that the state is able to respond promptly should a suspected case be identified.

“Public awareness and risk communication activities are also being strengthened to ensure that members of the public receive accurate and timely information,” Ugwu, who is a Member of Presidential Committee on Ebola Prevention, said.

He said that health ministry would continue to work closely with Federal Ministry of Health and Social Welfare, its agencies and other partners to ensure effective preparedness, early detection, appropriate response and timely communication

The commissioner said that the government considers the health security of the state’s residents as a major priority and had taken appropriate precautionary measures without creating unnecessary fear or panic.

He urged health workers to maintain a high index of suspicion, strictly observe infection prevention and control measures, use appropriate protective equipment, and promptly report any suspected case through the established channels.

According to him, the government will continue to provide the necessary support and guidance to ensure health workers safety and effective response.

“To the good people of Enugu State, I urge you to remain calm and vigilant. There is currently no confirmed case of Ebola in Enugu State, and the measures being taken are precautionary.

“The public is advised to maintain good hand hygiene, avoid contact with the body fluids of sick persons, seek medical attention promptly when necessary, and report suspected sick person,” he said.

He specifically urged public and private health facilities across the state to remain on heightened alert and maintain a high index of suspicion for suspected cases, particularly among persons with relevant travel or exposure history.

“All suspected cases should be promptly isolated and immediately reported to the appropriate Disease Surveillance and Notification Officer (DSNO) or the State Public Health Emergency Operations Centre, while strict infection prevention and control measures are observed.

“I urge all health facilities to cooperate fully with the Enugu State Ministry of Health and other response agencies, as early detection and prompt notification are critical to preventing transmission,” he said.

It would be recalled that state government, through the Ministry of Health, for months had been undertaking Ebola Prevention Preparedness mesdures at Akanu Ibiam International Airport, Enugu, which is an international entry point.

The current Ebola Prevention measures at the airport is undertaking with collaboration of the Nigeria Centre for Disease Control and Prevention (NCDC), Federal Ministry of Health and Social Welfare, Port Health Services, airport authorities and other relevant partners.

 

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There is no confirmed case of diphtheria in Enugu State’ 

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The Enugu State Government says there is no confirmed case of diphtheria in the state, urging residents to disapprove unfounded ongoing rumours.

The Commissioner for Health, Prof George Ugwu, made the clarification in a briefing on Wednesday in Enugu on update on the rumoured suspected case of a diphtheria patient in University of Nigeria Teaching Hospital (UNTH), Ituku/Ozalla, Enugu.

“In response to this, the Public health and Surveillance unit of the State Ministry of Health are already at alert and to ensure appropriate prevention control measure and early detection as may be necessary.

“A few days ago, there was a report of suspected case of diphtheria at the University of Nigeria Teaching Hospital (UNTH), Enugu which was followed by our team.

“However, the diagnosis of diphtheria could not be sustained or confirmed; while the patient, wito was rumoured and suspected to have diphtheria,
had tonsillitis,” he said.

The commissioner noted that accordingly, contact traces and other appropriate measures are ongoing and “yet diphtheria are not diagnosed or confirmed in the state.”

He explained that the suspected patient had been traced to his home in Achara Layout in Enugu and he did not have any record of travel and had not being to the northern part of the country as rumoured.

“Our surveillance and tracing teams have also contacted his family members and others but no trace of diphtheria established,” he said.

Ugwu noted that although the state had remained on high alert against infectious diseases, “Enugu State is never at high risk of contacting diphtheria”.

“For the state, we have a robust routine and mop up vaccination especially on Penta 3, which provides effective immunisation against diphtheria for a whole life time.

“In 2026 Vaccination, we had 91 per cent record of coverage on Penta 3 vaccination, which is even above the national target or threshold,” he said.

The commissioner urged residents to remain calm and avoid spreading rumours or unverified information as well as seek medical attention promptly if they develop symptoms of any sickness.

He said, “The ministry is calling on parents and caregivers to ensure children are fully immunised with diphtheria containing vaccines (Penta 3).

“Residents are urged to follow the advice of health authorities during contact tracing and monitoring.

“Healthcare workers are urged to maintain appropriate standard precautions, promptly notify suspected cases through the surveillance system and ensure appropriate infection prevention and control measures.

“The Enugu State Ministry of Health, in collaboration with UNTH and relevant international partners, continues to monitor the situation and will be proactive for further information as necessary,” he added.

It would be recalled that there is an outbreak of diphtheria in Nigeria and 19,799 suspected cases sent to molecular laboratory test; with 15,309 confirmed cases and 517 confirmed death across 26 states and 357 Local Government Areas.

The worst affected states accounting for over 98 per cent cases of diphtheria are Kano, Bauchi, Borno, Kastin, Sokato, Zamfara, Kaduna and Plateau according to Nigeria Centre for Disease Control and Prevention (NCDC).

Diphtheria is a serious but vaccine preventable bacterial disease that can spread though respiratory droplets and close contact.

Symptoms of Diphtheria include: fever, sore throat, difficulty or pain when swallowing, cough, difficulty breathing, swelling of the neck and greyish/white membrane in the throat.

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UNTH Begins Contact Tracing After Suspected Diphtheria Case

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The University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu State, has urged patients, visitors and members of the public to remain calm following the management of a clinically suspected case of diphtheria at the hospital.

The reassurance followed concerns over the admission and subsequent death of a paediatric patient at the hospital’s Children’s Emergency Room (CHER).

According to a statement issued by the hospital management on Wednesday, the patient received medical intervention immediately after admission but died two days later despite efforts by the attending medical team.

The hospital said a subsequent clinical post-mortem review suggested that the severe symptoms may have been caused by severe pharyngotonsillitis with massive exudate, rather than diphtheria as initially suspected.

However, as a precautionary measure, UNTH said comprehensive contact tracing had commenced to identify and monitor individuals who may have had close contact with the deceased.

The hospital also confirmed that the Children’s Emergency Room had undergone standard decontamination in line with established infection prevention and control protocols.

UNTH said it had previously managed sporadic cases of diphtheria successfully and possesses the specialist personnel, isolation facilities and medical equipment required to manage infectious disease cases.

The management urged members of the public to remain vigilant for symptoms associated with diphtheria, including persistent fever, severe sore throat and difficulty swallowing.

It advised anyone experiencing such symptoms, as well as parents whose children develop them, to seek immediate medical attention at a recognised healthcare facility and avoid self-medication.

Healthcare workers, patients and visitors were also advised to maintain proper hand hygiene and respiratory etiquette while within the hospital premises.

The hospital management assured the public that it would continue to prioritise community safety and public health, while providing updates based on verified medical information.

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