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Scoop: Inside the Federal Govt’s codeine and substance abuse policy

Healthcare

Scoop: Inside the Federal Govt’s codeine and substance abuse policy

In an internal report seen by TheScoop, the National Agency for Food and Drug Administration and Control (NAFDAC) has submitted a number of policy proposals to the Health Minister, Isaac Adewole, for consideration with respect to the ban on codeine.

The policy recommendations followed a meeting convened by NAFDAC with other regulators, professional associations and pharmaceutical industry representatives.

Why It Matters:

Codeine abuse in Nigeria has become a major public health concern and witnessed a lot of activism in the past few months. A BBC documentary forced the government to take actions including a ban on the product and an embargo on import permits for the Active Pharmaceutical Ingredient of the substance.

Critics have said that the ban is not a policy and may only exacerbate the crisis by creating room for illicit trade.

The NAFDAC Director-General, Prof. Moji Adeyeye claimed that over 34 containers containing Tramadol had been illegally imported into the country “within the period of the codeine saga.”

The report was split into two parts:

  • The first part outlines policy recommendations of the government and stakeholders while,
  • The second contained a briefing on the recall efforts of the product as directed by the Agency.

    Policy Recommendations:

– Development of a national program on substance abuse with social and behaviour change campaigns. Campaign is to involve traditional rulers, community leaders and parents.
– Review of target populations, indication for use of Codeine and re-scheduling of Codeine containing products as Prescription-Only-Medications in Nigeria.
– Restricted permit for “very few” qualified manufacturing companies
– Another drug (name withheld) to be used as Codeine alternative in Cough Syrup but the “information should not be made known to the public”.
– NAFDAC to establish Narcortics desk offices in six geopolitical zones as part of plans to intensify pharmacovigilance.
– Ban remains in place while administration of the drug should be used for in-patient care only
– Engage with Indian government and others to prevent smuggling of the products to Nigeria

The recall status and one BIG Issue: 

  • 23 companies have NAFDAC permits to manufacture cough syrups containing codeine.
  • According to NAFDAC, over two million bottles of Codeine have been recalled from about 15 of those companies.
  • Five of the companies recorded zero recall.
  • Government is exploring two options with regards to the recalled products which constitute a major loss to the manufacturers. One: Government buys the stock from Manufacturers and pays within 30 days and Two: Reschedule it as a Prescription-only-medicine (POM) while manufacturers relabel and redistribute the recalled products but with strict supervision and monitoring by the government.

Curious takes:

Two things we find curious about the report and don’t necessarily agree with.
– The report claimed that the elites are worst hit by the drugs and substance abuse crisis. Would be interesting to see the figures NAFDAC is relying on.
– The agency lacks access to supply data or IT platform to monitor drug distribution in Nigeria.

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