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  Fake Pharmaceuticals: Nigeria's Drug Czarina Risks Death to Take on Counterfeiters

Fake Pharmaceuticals Nigeria's Drug Czarina Risks Death to Take on Counterfeiters

By Samiha Shafy

Part 3: 'They're not Petty Criminals

The three visitors assure her that it isn't a problem at all. Then the younger of the two Indians, a gaunt man with a moustache wearing a black suit, speaks. He tells the director that his company deals in imported table salt and wants to build a production facility in the southeast. But the salt mine they want to use belongs to the state.

"Fantastic," Akunyili says slowly. "You want me to help you get the mine?" All three men nod enthusiastically. "Okay, I'll speak with the minister. More production in the country is good for everyone." She motions toward the door. "Next, please." The man with the moustache tries to hand her a gift wrapped in pink paper, but she turns him down.

There are also people in Lagos who prefer to work with Akunyili behind the scenes. "These drug counterfeiters, they're not petty criminals. If they found out that I'm harming their business, they could burn down the clinic and shoot me," says George Okpagu. He sits at his desk in a small hospital in Lagos. The air-conditioning isn't working. Okpagu, in a white doctor's coat, wears his hair cropped close to his head. He is barefoot. He has been in charge of the hospital for 22 years.

He often asks his patients to bring him the drugs they take. "If something looks like it's counterfeit, I ask the patient where he bought it. Then I call up the NAFDAC people and tell them that they should search this or that shop," he says. "This is the only way to support Dora Akunyili without putting myself in danger."

He laughs bitterly. Four years ago, he says, he almost died when he took counterfeit drugs to lower his blood pressure. "I bought the pills in a pharmacy when I was traveling. The package looked completely normal," he says. He says that he had been taking the drug for years and that he had always responded well to it. But a few weeks later he became dizzy at work. "The last thing I remember was another doctor taking my blood pressure: 200 over 110. Then I lost consciousness."

Okpagu had had a cerebral hemorrhage. He was unconscious for eight days. When he came to, he was temporarily paralyzed on one side of his body. In the meantime, his fellow doctors analyzed the pills -- and discovered that they contained no active ingredient. Today Okpagu blames himself, saying that as a doctor, he should have been monitoring his blood pressure. "But how many Nigerians have the money and the education they need to protect themselves against these murderers?"

But Nigerians do have Dora Akunyili. And for that they worship her. She is routinely showered with letters and poems, drawings, good luck charms and sweets. Strangers address her on the street, eager to touch her, but her bodyguards have to push them away. They call Akunyili "Mommy," a sign of respect in Nigeria.

Sometimes being a popular hero is exhausting. Akunyili plans to remain in office for another three years, until the end of her second term. She dreams of a more relaxing job -- perhaps as an ambassador in a faraway, peaceful country. She is convinced that she will have to leave Nigeria as soon as she gives up her position. "I wouldn't survive long without the bodyguards that the government provides for me."

Her children have been living in the United States for years. Her youngest son has just finished high school. His parents would have liked to keep him with them for a while longer, but after an attempted kidnapping four years ago they decided to send him away. "I thank God that neither my family nor I knew ahead of time how dangerous this job would be," Akunyili says quietly. "My husband lives in constant fear, and I'm worried about his health." But now is hardly the time to give up.

The green numbers on the television set in Akunyili's hotel room indicate that it's 2:00 a.m. She is exhausted, but she says that she still wants to make one thing clear. "What we are fighting here is not just an African problem," she says. "Resistant strains of bacteria, which are literally being cultured with poor copies of antibiotics, are spreading throughout the world." To address the problem, she plans to work more closely with health authorities in neighboring West African countries in the future.

Akunyili has already traveled to India and China to recruit inspectors and win over local authorities, with only moderate success. She is also the deputy chair of a special unit of the World Health Organization (WHO) established in late 2006 to improve international cooperation and encourage member states to enact tougher anti-counterfeiting laws.

Is she achieving anything? Can Akunyili truly change Nigeria? How does one measure success in a place like this?

The next day NAFDAC holds a public "destruction exercise" in Lagos. On a field outside the city, workers mound up boxes of drug packages and douse them in diesel. In the presence of TV cameras and journalists, a bald man in a black suit takes a torch and sets the pile of fake drugs on fire. The man's name is Dioka Ejionueme. He is the agency's director of enforcement. As the flames shoot up, he describes recent successes in a hoarse voice. This, he says, is the 116th public burning, and this time, once again, counterfeit drugs worth several million dollars have been destroyed!

But he only reveals the real news once the journalists have left. He seems slightly sheepish. Effective immediately, the director of enforcement whispers, the counterfeit drugs will no longer be burned publicly, but in state-of-the-art incinerators. It's Nigeria's contribution to protecting the environment.

Translated from the German by Christopher Sultan

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