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

By Samiha Shafy

Pharmacologist Dora Akunyili is a remarkably honest woman. The trait earned her a job as Nigeria's pharmaceutical industry enforcer. Her campaign against the country's counterfeiters has put her life in danger, but she has no plans to back down.

Dora Akunyili and her brother were sitting in the back seat of a dark limousine, chatting and laughing. They had no idea that killers were tailing the car.

A police officer was sitting in the front passenger seat and other bodyguards were in cars ahead of the limousine. It was a sunny winter afternoon. Akunyili had just come from a festival and was on her way to visit relatives in her native village.

She felt the pain at the top of her skull and heard the rear window shattering at the same time. When she reached up to touch the silver scarf she had wrapped around her head, she realized that there was a hole in it. Only then did she comprehend what had happened. "Officer, help me, I have a bullet in my head!" she cried. The police officer turned around and yelled back: "Be quiet, madam. If you had a bullet in your head, you wouldn't be speaking!"

Nowadays Akunyili has to laugh when she thinks about the incident. "The bullet grazed my head. It singed the skin on my skull and a few hairs, and the spot where it had hit me was swollen for a few days," she says, opening her eyes wide and wrinkling her nose. It wasn't until later that she learned that a bus driver had been mortally wounded in the assassination attempt. "We simply took off as fast as we could to the next police station."

Akunyili, 53, a pharmacologist and the mother of six children, has a round face and a fondness for colorful traditional robes. As the Director General of Nigeria's National Agency for Food and Drug Administration and Control (NAFDAC), she is constantly in danger of attack.

She is fighting a battle for the health of 140 million people. Globally, the trade in counterfeit drugs costs hundreds of thousands of human lives, and few countries are more affected than Nigeria. A toxic mix of oil dollars, violence and corruption has turned the country into a major hub in a multi-billion dollar business.

Counterfeit drugs consist of pills, drops and ointments containing either incorrect active ingredients or none at all. Sometimes the active ingredients are so diluted that the drugs are completely ineffective. In their least harmful form, the fake drugs are vitamin tablets made of chalk or erectile dysfunction drugs made of cornstarch. All too often, though, they are ineffective or even toxic copies of brand-name drugs used to treat cancer, hypertension, diabetes, malaria and AIDS.

Most fake drugs come from India and China. An international network of dealers distributes them, usually in developing countries. Nigeria, considered one of the most important centers in the pirated drug trade, set a sad record a few years ago when, according to studies, up to 70 percent of all drugs in the country were found to be fake.

That number has apparently dropped to just below 20 percent today. The decrease is principally the achievement of this robust woman in a blue-and-gold outfit. Sinking her exhausted body onto the sofa in her hotel room in Lagos, Akunyili removes her shiny red pumps with a sigh.

It's almost midnight at the end of a long day in the Nigerian capital of Abuja, where NAFDAC has its headquarters. Akunyili has just flown to Lagos, a chaotic city filled with mountains of garbage and millions upon millions of people, a foul-smelling hell, and one of the world's most dangerous cities. More than 15 million people struggle to survive in Lagos, one of the world's most dangerous cities. Nigeria's government, meanwhile, decided to abandon the city long ago: In the early 1990s, the Nigerian government built Abuja, a smaller, more organized and more easily controlled capital in the country's interior.

In Lagos, Akunyili only feels relatively safe inside the walls of the heavily guarded Sheraton Hotel. Guards stand at the hotel's entrance manning the security doors. Patrols monitor the floors and the building's opulent gold-and-marble lobby. Thanks to the Sheraton's tight security, Akunyili's bodyguards can relax for a few hours while their boss tells the story of how she became the drug counterfeiters' worst nightmare.

It all began because of Akunyili's basic sense of honesty. Seven years ago, she was suffering from gastrointestinal complaints. Doctors were stumped. Her employer, the Petroleum Special Trust Fund, generously offered to give her a check for 17,000 pounds ($33,000) for treatment in London. But when she learned that the costly treatment wasn't necessary, and that all she needed was a specific drug, she thanked her supervisor and returned the money. "He was quite impressed," she recalls, giggling. In Nigeria, no one returns money.

Akunyili's boss related the story to an acquaintance, who in turn told the president. Two weeks later, on a Sunday afternoon, Akunyili received a call from the president, who told her that she would be just the right person for the job of running corruption-plagued NAFDAC.

It was a tough assignment. In 2001, when Akunyili was appointed Director General of the agency, other African countries had recently banned the importation of drugs from Nigeria for safety reasons. The country's honest drug merchants had given up when they were unable to compete with the counterfeiters' cut rates. Pharmaceutical corporations that produced genuine drugs had abandoned the country.

"People are dying all over the world because they take counterfeit drugs," says Akunyili. "But here in Nigeria, there is a victim in almost every family." She presses her lips together and stares down at her hands. "My sister Vivian died of diabetes when she was 21. She simply went into a coma and died." It turned out Akunyili's sister had been given fake insulin.

Akunyili's first move in her new position was to clean up the 3,000 person agency, promptly firing about a tenth of its staff. "Most of them weren't even aware that they were supposed to be performing a control function. Any merchant could bring drugs to NAFDAC, and they were simply registered, without further ado," she says, shaking her head. "Of course, the employees wanted money in return for the registrations. Most of them were corrupt."

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