HMM!! : ‘Drug Holiday’ Exposes More Nigerians To Untimely Deaths

“His phone rang several times without response.   Due to the urgency of the call to discuss family matters, I rushed to the house. But to my greatest surprise, his cold body was being taken out of his room to the mortuary.     I watched  in disbelief but he was dead.”   These were the heart-rending words of Mrs. Esther Iheme when this reporter visited her last week. What was the problem? Esther is the younger sister of the late Mr. Kenneth Agwu who lost his life at  45.   According to Esther, Kenneth was full of life a day before he met his untimely death, no thanks to heart attack arising from  improper  management of hypertension.   They had met the previous day to discuss the forth coming burial rites of their uncle. Following  their discussion, they were supposed to meet for final arrangements but the meeting was never to be.   Kenneth placed  diagnosed of High blood pressure, HBP, at 37.   Since then, Kenneth had been  placed on  drugs until he lost his job.   Consequently, he  was not able to meet up with his daily drugs. “My husband will always struggle to ensure he takes his drugs but the last few months have been tough. The cost of the drugs went up but he fought,” the wife of the deceased, Mrs. Joy Agwu, said amidst tears. Kenneth is just one out of millions of people who die as a result of untreated hypertension annually. 25 year – old Alexander Udoh also suffered the same fate with Kenneth. It was unexpected.   He had no earlier health condition.   Alexander, an undergraduate of Business Administration was studying alongside his room-mates that fateful evening.   He was in the process of contributing to a heated discussion when suddenly, he collapsed. His friends tried all they could to revive him but there was no response from Alexander.   Sensed that he may be a few minutes away from death, they raised alarm and with the help of neighbours they got him to a nearby hospital. Immediately, doctors started work on him. Alexander had a heart attack. Further investigation showed that he had elevated high blood pressure. Even he did not know he was hypertensive. His blood pressure was 270/140. Efforts by the medical personnel to save him proved abortive as he never responded. Within 30 minutes, Alexander, was dead. Unlike Kenneth and Alexander, Mr. Bello Ishola was able to keep his blood pressure in check despite all odds.   The 62 – year- old retired civil servant, who had a blood pressure of 170/96 mmHg,   is alive today, courtesy of his children’s efforts to ensure that he takes his medication and eats healthy diets. “My children have spent a fortune on me.   They spent so much money to ensure I am alive. Every week I spend close to N20, 000 on hypertensive drugs alone.   You know how expensive fruits and vegetables have become? How many people can afford them?   If not for my children, I cannot afford it.”According to the World Health Organisation (WHO), hypertension is responsible for an estimated 45 percent of deaths due to heart diseases and 51 percent of deaths due to stroke globally. Studies have blamed the increasing prevalence of the condition on lifestyle and dietary factors, such as physical inactivity, alcohol and tobacco use, and a diet high in sodium usually from processed and fatty foods. Unfortunately, despite the fact that the control of hypertension has become a key  priority in many countries of the world, the crisis in the management of the condition continues unabated in Nigeria. In 2010, studies showed that more than 20 million cases of hypertension occurred in Nigeria affecting one in every three men and one in every four women while the figure may rise to 39 million cases by 2030. Meanwhile, statistics showed that before this year, about 70 percent of hypertensive patients go on drug holiday while the prevalence among Nigerians is dangling between 30 percent and 40 percent depending on the area of location. Findings   showed that  recent astronomical increase in hypertensive drugs is forcing  hypertension patients to go on  compulsory ‘drug holiday’.     It was learnt  that prices of the drugs have skyrocketed in the last seven months.   Some of the drugs, which sold for N150 per sachet at the beginning of the year, now sell for N200.   This has led to many  hypertensive patients seeking alternatives to their drugs. Some of the patients who spoke to  Sunday Vanguard, lamented the untold hardship the economic recessions and the imoplication for the fake of the Naira in the  foreign exchange market  has brought on them. According to them, some of the  drugs  imported for hypertension are disappearing from the shelves. One of the patients, Mr. Samson Adibe, admitted that it had  not been easy managing hypertension in  an economy in recession. “Poor health condition and drugs priced beyond our reach: It  is not good for us because it is  in double jeopardy. It is in fact a  death sentence,”  Adibe said.. “I have four children in school and a wife to take care of, how do you expect me to cope?   All I am saying, if there is any way government can help to crash the price let them help us.” Meanwhile, a  former Managing Director of Neimeth Pharmaceutical, Emmanuel Ekunno, in a report, said  Nigerians need to have access to cheap drugs because results of screenings for hypertension conducted in rural and urban communities revealed that almost 90 percent of hypertension cases occur in people living in urban cities in Nigeria. Ekunno said the screening also revealed that about 4.5 million people within the age of 15 are hypertensive and 40 percent of the adult populace have hypertension. Lagos State Chairman of the Association of Community Pharmacists of Nigeria, ACPN, Abiola Paul- Ozieh,   who described   hypertension as a condition and  not necessarily a disease, also  lamented that Nigeria is on the verge of crisis in the pharmaceutical sector because when people are not maintaining their blood pressure, anything can happen. According to her, the prices hypertensive drugs are on the rise  because a number of these drugs are imported.     “Some hypertensive drugs that we were selling per sachet at N120 before are now sold as high as N180 and N220 while the ones we sell for N150 have gone up to N300 and above.   Some of our patients walk away the moment you tell them the price, that is the situation,” Paul-Ozieh stated. “In the last four months, local manufacturing companies have been having problems importing raw materials to produce locally.   One of the indigenous companies that crashed their prices for hypertensive products, earlier in the year, all of a sudden, the same company has increased the prices more than even the  prices  before the  crash.   For wholesale, one of the drug sold for 3,800  now sell for over N4, 000. She  explained   that, in order to ensure that some of the products get alternative drugs, they introduced  cheaper brands. She regretted that management of hypertension requires usage of drugs on a lifelong  basis as it is a chronic condition. Cost implication The ACPN chief  expressed worry that if nothing  was done to arrest the situation in the drug manufacturing industry, many hypertensive Nigerians  may not live to tell their stories. “Right now, many of these patients are going on what we call ‘drug holiday’. What do they do?   They buy this week and don’t buy the following week. Instead of using the drugs for the entire month, they use it for three weeks” , she said.. “When patients skip drugs, their blood pressure tends to rise higher and that can lead to what we call ‘hypertensive.    “This may result to people fainting or dying. Some go into coma, some will have stroke and heart attack because their BP has not been controlled. “In the last two weeks, I have had experience of people that had serious challenges. Infact, as I talk to you now, one patient died last week because the person had stroke that is one of the complications that can come with an untreated HBP and government must come to the aid of pharmaceutical companies. “Another implication is that many of these patients are now going back to herbal medicines which may worsen their condition.   It will also increase incidences of non-communicable diseases, NCDs, because when people fail to arrest health issues like HBP, it leads to NCDs such as heart diseases.     It will get to the level that people will go to bed and will not wake up the next morning or you will see someone, today, tomorrow, you will hear that the person is late. Way forward “One area emergency must be declared is in the health sector, especially the pharmaceutical industry.   Nigerians deserve to have access to affordable and quality medicines. “Government needs to come to the aid of local manufacturers in terms of access to forex. Central Bank of Nigeria, CBN, should give manufacturers FOREX at subsidized rates because they are bringing in life -saving drugs and for those that are importing too, they should also be given at  affordable rates”