Towards the development of blue print for health security in Nigeria by 2050: A review of drug development, supply of quality medicines and treatment issues

Abstract

Background: Drug development, distribution and supplies require efficient supply chain systems and appropriate regulation to ensure that the medicines that reach the consumer are in their intended qualitative states thereby guarantee rational use and optimal outcome. This review was therefore designed to explore drug development, supply of quality medicines and treatment issues in Nigeria, with a view to develop a blue print for health security in Nigeria by 2050. Method: A systematic search of relevant studies and documents on drug development, national drug distribution and treatment guidelines was done within a period of three-weeks. Results: Forty-six percent of the key medicines were available in public health facilities and 23% of the average weekly expenditure of people went into the treatment of an episode of illness in a member of their household. Medicine financing in Nigeria is generally out-of-pocket as the National Health Insurance Scheme is still facing challenges of sufficiently providing needed services to its subscribers. Approximately 70.2% of Nigerians live below the poverty line of less than 1 USD a day, while medicines are unaffordable to 90.2% of Nigerians. Generic medicines were generally more available in all outlets, but the availability of the basket of 34 priority medicines was low in all sectors, especially in the public and private health clinics. Issues surrounding access to medicine in Nigeria range from an uncoordinated medicines supply chain to lack of price regulation resulting in shortage of essential medicines in healthcare facilities across the country. Conclusion: Concerted efforts should be made to review and implement national, regional and continental strategies towards availability and accessibility of medicines for use in Nigeria and in Africa as a whole. In general, a pragmatic approach focusing on the short, medium and long-term goals should be vigorously pursued.