Dr. Ebun L. Bamgboye, consultant physician/nephrologists and clinical director, St. Nicholas Hospital, Lagos tells NKRUMAH BANKONG-OBI about the effect of bad drugs and why the regulatory agencies need to get them off the Nigerian market

Cases of organ failure have been increasing and it’s blamed on fake drugs and some other things. Do you agree?

Yes. If you are giving amala instead of procaine penicillin into the blood what do you expect? The greatest complication of fake drugs is that you don’t get healed from the illness. The biggest problem a patient is facing is that the illness never goes away. It could be an ulcer, hypertension or something else the problem could be getting worse. There are of course cases of drugs that can actually poison the kidney. But it is not one of the most important effects of fake drugs

What are the effects of fake drugs?

Fake drugs and alcohol all have effects on the kidney and the liver. In the first place, even your routine daily diets – what you eat and what drink are more or less normal for an average person, you will find that many of such things if you take them in excess even in a normal person, they will have a negative effect. That is why alcohol, if we can use that for an example, if you take it in excess you end up with liver cirrhosis and ultimately liver cancer. But on the other hand, even the orthodox drugs that are prescribed; things that you go to the hospital and somebody will say ‘okay, take this two or three times a day’ some of them are also known to be toxic.

I will take a very common example; your non-seroidal drugs, the things that your average person with back pains, cramps, arthritis would need to take to relieve him or her of the pain. Most of those drugs if you take them in excess actually cause irreversible damage to the kidneys. And in the presence of a condition that is already affecting the kidney; take hypertension or diabetes, the long term effective of that is to cause total degree of damage to the kidney. So, if you have that and then go ahead and start taking non-steroidal drugs you find that the pathway to kidney failure is accelerated. And we know that the elderly people who would want to use your non-seroidals for back pains are the ones that are more likely to be hypertensive and diabetic. So, it is not surprising that these people are coming down with kidney failure or with liver failure when you look at those drugs that can affect those organs.

•Dr. Ebun L. Bamgboye

Aside from this, you also have what is called idiosyncratic reaction, which applies to some people who react abnormally to even normal usage of certain drugs. That reaction is peculiar to certain people. Any time they take that drug, they react abnormally. It is almost like an allergic kind of reaction. That reaction is peculiar to those people. And those with idiosyncratic reaction can also lead to routinely taken prescription taken within the prescribed dosage. That is why it is dangerous to just go to a chemist and just buy any drug. All these we are talking about are routinely prescribed medication, some of which you can even buy over the counter, not to talk of the more dangerous ones that you need a doctor’s prescription to get. You now go on to the spectra of medications that are not steroidal – these are drugs that are sold either are herbal supplements. We have many of these companies that are marketing these drugs that you don’t need to go to a doctor to prescribe for you.

They attach to them all sorts of claims, I don’t want to mention names of makers and distributors of such products. And people must realise that in marketing those drugs, they are actually encouraging what we call ‘pyramid marketing’, where you encourage other people to buy and to buy and keep buying. And the people who are marketing are not pharmacists, they are not doctors. They are encouraging them to go and sell the drugs to other people. At the end of the day, what is happening is that people are using this medication without any medically or scientifically proven benefits to individuals. And many of these things(I don’t know what is inside them but I suspect that they include some orthodox medications just to give some kind of authenticity to the drugs) which will not now be adequately regulated . And the risk of individuals developing problems is high.

You now go to those who go and take the non-orthodox medications like agbo. I can tell you that many of those instances, something else happens. I give you an example. A gentleman who came to me and said 20 years ago he was diabetic. He went somewhere in Ijebu and he was discussing with a friend who said “No, my uncle had a similar thing and one man made a herb for him and after that the diabetes resolved.” So, he also went and they made the same herb for him and low and behold, you see claims that he was no longer diabetic. He didn’t even bother to check medically. Unfortunately, 10, 15, 20 years down the line he comes. And by the time we are seeing him, he is already down with kidney failure.

So, there is that angle to it that individuals take medications that have no potency and at the end of the day, the result is that the person, on account of his believing that he has been cured no longer does what he needs to do and he ends up with complications of that condition. We see a lot of that with HIV as well. There are people who go to these faith healers they give them one kind of water or the other and tell them ‘you are cured, throw away your drugs’ the person stops taking his standard medication and consequently he ends up with complications later.

We now come to the era of fake drugs. You can imagine the progression of orthodox drugs, the so-called herbal supplements some of which are not even made here – they are made in other countries to the unorthodox herbal preparations. Now coming back to even orthodox drugs that are fake and see what is there. It’s unfortunate when Dora Akunyili [God bless her soul] was alive she did a lot to reduce this scourge of fake drugs on our society. I still cannot understand the fact why some people prepare something that they know would ultimately result in the death of their fellow citizens. They don’t realise that they themselves could become victims at some point. If not themselves, perhaps one of their relatives could be a victim.