Ibadan, Nigeria — When Gloria Mofifoluwa’s friend informed her in March that the price of inhalers had gone up in Nigeria, she didn’t think much of it.
The following week, when she went out to the city of Ibadan to replace her old Ventolin inhaler, the asthmatic was shocked to see that many pharmacies were out of stock and the only place where it was available was selling it for 7,500 naira ($5) – more double the 2,800 naira ($1.86) she paid months earlier.
This price increase – which followed the exit of a major healthcare pharmaceutical company from Nigeria – came as a shock to the 24-year-old university student who makes some money designing clothes. And the ripple effects were even worse.
Last month, while alone in her university hostel room and consumed with thoughts about her economic challenges, Mofifoluwa began hyperventilating and struggling to catch her breath.
Her roommate was out and there was no one to take her to the hospital. All she had on her was an Aeroline inhaler, which she explained didn’t work as quickly for her as the Ventolin she now struggles to get.
“I was just scared because not only was I alone in my room, but I was also on the floor [and without the medicine I most needed],” she told Al Jazeera, adding that all she could do was pray until she fell asleep, hoping to regain her strength when she woke up.
The shortage of pharmaceutical products and rising prices causing stress to asthma sufferers like Mofifoluwa end a chain of events that began in May 2023 when Bola Tinubu was elected president.
During the inauguration ceremony, Tinubu announced the removal of fuel subsidy, which resulted in an unprecedented increase in gasoline prices. This also affected the cost of various goods and services and contributed to an inflation rate of over 27 percent. The cumulative economic effects have been severe, especially for the vulnerable – including students and low-income workers.
Difficulties worsened as the president monetary policies pushed the naira to an all-time low against the US dollar, further leading to a downward trend as manufacturers struggled to meet production targets.
In the midst of the recession – which included exchange rate volatility, declining revenues and a general worsening of the investment climate in Nigeria – a significant number of companies, including international pharmaceutical companies, left the country.
Among those who left last year was the British company GlaxoSmithKline (GSK), which had operated there since 1972 and was the second largest pharmaceutical producer in Nigeria.
As a major supplier of inhalers to asthmatic patients – including the type Mofifoluwa depended on – GSK’s exit contributed to rising prices and increased drug shortages for many Nigerians.
GSK output
According to the World Health Organization (WHO), asthma cannot be cured, but common treatments, such as using inhalers that deliver medication to the lungs, allow patients to live normal, active lives.
The global health body recommends that people with asthma have access to adequate healthcare, but in developing countries like Nigeria, the situation is complicated.
This situation was worsened by the exit of companies such as GSK.
Although asthma inhalers were easily available and more affordable when the company existed, many now feel the medication is out of reach. Although alternative options exist, Nigeria now relies largely on imported medicines, meaning high operational costs are added to the price for consumers.
For the average patient, an inhaler lasts about two months, depending on usage, making it an expensive regular expense in a country where the monthly minimum wage is 30,000 naira (about $20).
Like Mofifoluwa, 21-year-old Joseph Biyi also battles asthma. The library, archive and information sciences student was diagnosed in the middle of last year, and has since been faced with rising inhaler prices.
The first time he bought a Ventolin inhaler, it sold for 3,500 naira ($2.30), but on his next visit to the pharmacy this year, the price jumped to 7,500 naira ($5).
Although Biyi has his parents to help him with money to buy inhalers, especially as prices have skyrocketed, he said he now also forgoes some essentials like groceries to save extra money for medicine, “just to avoid risks.”
High rates of asthma
The Nigerian Thoracic Society states that as of 2019, 15 million Nigerians were asthmatics, while a national study put the number at 13 million – one of the highest rates in Africa. With inaccurate data in Nigeria, because people in rural areas have limited access to quality healthcare or medical monitoring, the number could be even higher.
On World Asthma Day in 2023President of the Nigerian Society of Asthmatics, University College Hospital (UCH) branch, Professor Olusoji Ige, has said that more than 10 million Nigerians have asthma and about three-quarters of them are at risk of dying due to poor asthma control.
Mrs. Tinubu, the Matron of the University of Ibadan Asthmatic Club, who prefers to be identified only by her surname, said there are several factors responsible for asthma. However, she noted that the poorly equipped healthcare system makes the situation worse over time.
Due to the poor state of the public healthcare system in Nigeria, after diagnosis, most people take it upon themselves to obtain medicines on their own.
Meanwhile, in Ibadan, some enterprising young Nigerians have been trying to help fill existing healthcare gaps.
Temitope Omosebi, a postgraduate psychology student, told Al Jazeera that after having an encounter with an asthmatic in 2023, he understood the full severity of the disease and wanted to do something to help.
That’s when he launched the #AtaqueContraAsma campaign at the University of Ibadan, to help at least some patients access interventions. The campaign helps provide various types of inhalers, including Sivobutamol, Aeroline, Ventolin and Fortide, to those in need. Last year alone, 40 inhalers were distributed and this year another 60 were disbursed free of charge; all were purchased with Omosebi’s own funds.
“The campaign is important because it addresses self-care medication for asthmatic patients, which has become highly expensive in recent times,” Omosebi said. “Our focus is specifically on college students – and individuals in low socioeconomic communities, hopefully soon – due to known financial challenges among these groups of people.
“In Nigeria, the government is not doing anything it should be doing,” he added,
‘All inhalers are expensive’
Olabitan Odunola, a doctor and leader of The Health City, a technology platform that focuses on preventive services and education, lamented the scarcity and cost of GSK products since the company exited the Nigerian market.
She said especially for asthma patients who depended on GSK inhalers, the new circumstances are upsetting and even alternative medicines are out of reach for most patients.
“In general, all inhalers are expensive,” Odunola said.
Patients have switched to alternatives like Longlife Pharmaceuticals, which primarily sells Aeroline inhalers, to find relief. There are also other options such as Symbicort inhalers, manufactured by AstraZeneca, and Fortide inhalers, distributed by Pakistani pharmaceutical company Getz Pharma. While all are recognized and available, they are also largely inaccessible.
Odunola said limited access to these preventatives could worsen health care outcomes for asthmatics. As the condition is long-lasting, she also feared it could lead to more deaths, especially in cases where someone had an asthma attack.
The poverty rate in Nigeria, according to the World Bank, has been estimated at 38.9 percent in 2023, and considering the relatively high prices of inhalers, patients may even turn to unproven asthma treatments out of desperation, experts fear.
There is a correlation between limited access to quality health services and the number of asthmatic patients in Nigeria, said Bello Wada, a doctor and current director of public health at the State Ministry of Health in Kano.
“This leads to delayed diagnosis, inadequate treatment and poor management of asthma, worsening the condition and increasing the number of patients,” he said.
Wada also highlighted that GSK’s exit from Nigeria further disadvantages those who have been diagnosed, as unaffordable inhalers can lead to increased morbidity and mortality rates.
Finding solutions
In January, the value of medicines imported into Nigeria was estimated at 900 billion naira ($606 million), demonstrating a high dependence on imported medicines.
In February, the federal government announced an investment of US$240 million in the local production of pharmaceutical products, but although this has not yet materialized, Wada wants the government to do more to resolve the situation.
“They must implement policies to make essential medicines more affordable, increase funding for health infrastructure and personnel, develop programs to improve access to quality health services, especially for vulnerable populations, and also engage with organizations international organizations to guarantee donations or reduced prices for essential products. medicines”, he stressed.
Nigeria’s Coordinating Minister for Health and Social Welfare, Professor Muhammad Pate, met with representatives and CEOs of pharmaceutical companies in Nigeria last year and said the government is concerned about the high cost of medicines and demand of solutions to the crisis.
“The Federal Ministry of Health and Social Welfare, @Fmohnigeria, is working on policy actions that can address high drug prices, especially for the most vulnerable Nigerians,” he said on social platform X in November.
Until that happens, to help with asthma and control costs, Mofifoluwa said he will continue to use Aeroline, which at 6,500 naira ($4.30) is slightly cheaper than Ventolin. Even though it doesn’t work as well for her, she feels the lower price makes a difference and allows her supplies to last longer.
“I don’t normally use Aeroline because Ventolin works faster. I had to start buying it because it’s cheaper,” she told Al Jazeera. “But I still have to manage when purchasing and using it based on the calculation [and only when necessary].
“During the exam period, I consume a lot because anxiety and stress take over me,” he added.
Now, with the high cost of the essential medicines she needs, school isn’t the only thing adding to her stress.
This story originally appeared on Aljazeera.com read the full story
