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For decades, Nigeria has been plagued by counterfeit and poor-quality medicines, yet little information exists on the extent to which health care personnel are aware of counterfeit and substandard medicines, and how this influences their behavior.

Field researchers administered informal questionnaires to 211 healthcare personnel in Lagos, Ondo, and Ogun states of Nigeria about patient behavior and their own awareness of, and exposure to counterfeit and substandard medicines.

There appeared to be evidence of irrational drug use. Health care personnel reported that some patients acknowledge purchasing medicines from unregistered channels, and without valid prescriptions. Respondents frequently cited the high cost of medicine as explanation for the proliferation of poor-quality drugs. Most healthcare personnel were aware of the problem, but their ability to identify and respond to poor-quality medicines differed widely.

Researchers also procured a small sample of essential medicines from pharmacies in Lagos to assess basic drug quality within the city. 18% of drugs failed thin-layer chromatography and/or disintegration tests. These results support findings, including earlier research by some of the authors, that the prevalence of poor-quality medicines may be decreasing in Nigeria--possibly because of improved policing and prosecution of counterfeiters by the National Agency for Food and Drug Administration and Control. Government, industry, and the public health community can work together to improve consumer and health care worker awareness, and increase access to low-cost, high-quality pharmaceuticals.

And while Nigeria still has problems to overcome, it is well ahead of other African nations in combating the scourge of substandard drugs. Indeed, it could be viewed as a model for other countries in Africa--as such, the bar should be set high for combating poor-quality drugs in Nigeria.

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Roger Bate is the Legatum Fellow in Global Prosperity at AEI. Thompson Ayodele is the director of Initiative for Public Policy Analysis. Richard Tren is the director of Africa Fighting Malaria. Kimberly Hess is a researcher and editor at Africa Fighting Malaria. Olusegun Sotola is a research fellow at Initiative for Public Policy Analysis.