- Says: Tinubu is revatilising health sector
- 98 percent of fake drugs imported
- Explains why drugs are expensive
The outgoing Managing Director and Chief Executive Officer of Fidson Healthcare Plc, Mr Fidelis Ayebae, spoke with Deputy Editor EMMANUEL OLADESU and Health Reporter CHINYERE OKOROAFOR on the challenges confronting the pharmaceutical industry, why drugs are costly, how regulatory authorities are combating the menace of fake drugs, strategies for stemming the tide of HIV-AIDS and how the Tinubu administration is repositioning the health sector for better service delivery.
WHAT is your assessment of the country’s health sector?
The health sector, generally speaking, is improving; yes, I would say so. What drives any sector under a good government is policy, and this current administration, through the Minister of Health and the Minister of State for Health, has articulated sound and fundamental policies that are poised to drive the growth of the health sector. They’ve tackled virtually every factor responsible for improving health outcomes, whether it’s access to health commodities, the training of medical professionals, or other critical components. The Health Minister, Professor Ali Pate, and Dr. Tunji Alausa, the Minister of State for Health, are very hands-on. We see them practically every month. Honestly, they are among the most active and engaging health ministers I’ve worked with in the past 30 years. So, for me, the sector is on the right path, largely because of these well-thought-out policies. That’s one.
Secondly, they’ve made strong moves in the area of pharmaceutical commodities. They recognised that no matter how many consultations are done, or how skilled the consultations are, without the necessary medical commodities to back them up, it’s all just talk. It’s the commodities that treat and heal, and they started well in addressing this. One policy pronouncement by the Special Adviser to the President on Health, Mrs. Salma Anas, really stood out to me. She said the government aims to raise the contribution of locally manufactured health commodities to 70%, up from the previous 30%. Importantly, they backed this with a policy that removes import duties on raw and packaging materials used in pharmaceutical production. This kind of policy is a game-changer for the health sector. As we speak, I am almost certain that the contribution of local manufacturers to the supply of health commodities has risen to nearly 50%. Every one of us in the pharmaceutical space is reinvesting and expanding capacity. Across the board, we’re seeing real progress.
Would you say that government policies and programmes are now bridging the gap between expectations and reality in the health sector?
You see, government plays a huge role in the life of any nation. One of the major tools it uses to fulfil that role is policies and programmes. So, yes, the sound policies and programmes that this government has introduced and announced since coming into office are what’s currently driving change and helping bridge the gap between expectations and reality in the health sector. Now, regarding the challenge of manufacturing in the health sector; manufacturing is one of the most difficult sectors to operate in, in any country. That’s why many nations remain unindustrialised, because production is not easy. It demands enormous capital, planning, and resilience. Only someone with the heart of an elephant like Dangote or a crazy person like me would venture into that lion’s den. It is very, very tough. The capital investment is massive, and the return on that investment is a long, slow, and often painful journey. It might take 20 or even 30 years before you break even or begin to see meaningful returns. But once manufacturing is established and properly managed, it becomes a lasting legacy. That’s the beauty and long-term value of investing in production.
How would you address the problem of quackery in the sector?
Quackery is indeed one of the challenges in the health sector. However, it’s important to clarify that the major manufacturing challenges are not necessarily internal; they are universal to manufacturing across the world. The real issue is quackery in the form of fake or falsified drugs, and that is not a locally manufactured problem. It is, in fact, an imported one. About 98 to 99 percent of fake or substandard drugs in Nigeria are imported. They are not produced locally. Why? Because the regulation of the pharmaceutical manufacturing sector in Nigeria is extremely stringent. If you are a registered manufacturer, certified by the Pharmaceutical Council of Nigeria or NAFDAC, and even one of your products falls short of the required standard, you risk being shut down. This year alone, NAFDAC shut down about four local manufacturers, and not even for quality-related issues, but for minor housekeeping lapses. That tells you how tight the regulation is. So, the real problem lies with traders who import falsified versions of popular, locally produced brands from countries like India, China, and Pakistan. These products make their way into the Nigerian market. But I must say, NAFDAC is doing its job. Out of ten containers, they’ll likely catch eight. Yes, two might slip through, but they are definitely working hard to protect the system. This is why we must manufacture more of our own pharmaceutical products. People complain about the rising cost of drugs, but that price increase isn’t unique to healthcare. Food prices, for instance, are rising even faster; and we grow our own food. Drugs, however, rely heavily on imported raw materials, excipients, packaging, machinery, electricity, and taxes. When you factor in all of that, it’s not surprising that drug prices are high.
But let me assure you: Nigeria still has the cheapest drugs in Africa. I’ve travelled across the continent, and up until about two years ago, I was the Chairman of the Pharmaceutical Manufacturers Group of the Manufacturers Association of Nigeria (PMG-MAN). We export our products to other African countries. A card of paracetamol that costs ₦200–₦300 in Nigeria might sell for ₦600 or more in Benin Republic, Togo, or Ghana, because those countries don’t have the capacity to produce their own drugs. So, despite everything, Nigeria remains one of the most affordable pharmaceutical markets in Africa.
You seem to have a lot of good words for this administration.
I must commend this administration for doing what it can to prevent a total collapse of the real sector. Two major policies made a significant impact. The removal of fuel subsidy forced us to deal with actual costs and helped put the economy on a more sustainable path. Also, devaluing the naira to reflect its real value removed a lot of corruption and manipulation. In the past, manufacturers had to lobby and beg at banks just to access foreign exchange. Now, it’s a level playing field. If forex is available, you buy it. If it’s not, you source it elsewhere. Yes, the country is in pain, but it’s a necessary pain for a brighter future. We were living a lie; fuel was subsidised; electricity was underpriced, and school fees were unrealistic. These things made the system unsustainable. Look at education, for instance. Public university tuition used to be around ₦100,000 per session. That amount cannot educate one student, yet we expect miracles. Professors earn little, and their retirement packages are poor, despite being the ones shaping the future of the country.
If we continue to live in denial, we’ll never fix the system. Today, fuel is no longer subsidised, and the market is beginning to self-correct. The same principle should apply across all critical sectors. People will adjust. I personally drive one car, not because I’m the MD of Fidson and should drive ten. But because I need to manage resources wisely. When prices reflect true costs, people will naturally begin to live within their means. It’s tough, yes, but necessary. With these steps, we’re slowly but surely building a more honest and sustainable Nigeria.
What measures can be taken to curb medical tourism and strengthen our domestic healthcare services?
It happens everywhere in the world. Even in countries like England and Canada, which have some of the best publicly funded healthcare systems, though not fully 100% funded, you still find elements of medical tourism. Due to delays and systemic constraints, often tied to their welfarist structures, some citizens seek treatment abroad. So, it’s not unique to Nigeria. However, in Nigeria, medical tourism will gradually decline. Why? Because fewer people can afford to travel abroad for treatment. As a result, they will have no choice but to rely on local healthcare. Fortunately, our hospitals are improving. Every day, we see new facilities springing up, and more investments are being made in the sector. Many Nigerian doctors who had practiced abroad are returning to establish specialty hospitals here, covering areas like cancer care and other non-communicable diseases. As more of these specialty centres emerge, and as they increase in number, the cost of healthcare will begin to drop, and quality will improve. Over time, this will make local healthcare more accessible and attractive. Of course, those who can afford to travel will continue to do so. That’s not something we can stop. But for people like me, and most Nigerians, who may not be able to afford a $10,000 medical trip abroad, we’ll rely on competent local professionals. For instance, if Dr. Ogbamide is in my neighbourhood and can give an accurate diagnosis, I’ll follow his advice, buy my medication, and get well. Even the president, if he chooses to go abroad for treatment, it’s not necessarily a vote of no confidence in Nigerian doctors. Sometimes, it’s about long-standing relationships with personal physicians or accessing specialists familiar with one’s medical history. Confidentiality also plays a role, especially at that level. So, we shouldn’t be in a hurry to eliminate medical tourism. With time and the right investments, it will reduce on its own as confidence in local healthcare grows.
How can we reduce brain drain in the health sector?
We cannot completely stop brain drain. These are young people with dreams, aspirations, and expectations, and Nigeria, at the moment, is struggling to meet those expectations. How much are we paying our doctors? Brain drain is largely driven by poor remuneration and poor working conditions. So, the moment a better opportunity presents itself abroad, it’s only natural they would take it. It’s like asking your own son, who is a doctor, to stay back in Nigeria when he has the chance to work abroad simply because you want to curb brain drain. It’s unrealistic. What we need are better policies. But beyond that, Nigerians are naturally brilliant, ambitious, and restless. They won’t wait around. They’ll go wherever opportunities exist, especially if their own country isn’t providing them. That said, brain drain isn’t entirely a bad thing. It’s a double-edged sword. Many who leave get exposed to modern practices and better systems. Some eventually return and bring those skills and experiences with them, which then benefit our health system. Others may stay permanently—and that also happens in places like India and Pakistan. These are developing nations that, like us, are yet to find a way to fully engage their youthful, energetic population. So, honestly, I don’t think we can stop it, not until we improve the reward system and working environment. All my children studied abroad. Their brains were trained there. But now, two of them are back, working with us here, because we’ve created a conducive environment that assures them of a dignified life. That’s the only way.
The Federal Government has announced a loan facility for big businesses. Are operators in your sector taking advantage of this opportunity?
Yes, the government has introduced loan facilities for big businesses, but the institutions meant to disburse those loans, like the Bank of Industry (BOI)—don’t seem to have enough funds. BOI has historically been one of the best partners of the manufacturing sector, but as I speak, they appear underfunded. Many of us have been expecting loan disbursements for about a year now, but nothing has come through. Commercial banks are willing to give out loans, but the interest rates are very high. Even BOI and Nexim, which used to offer loans at 9% for qualified manufacturers, have raised their interest rates to around 10% or 11%, possibly more now. This is largely due to inflation and the global increase in borrowing costs. Unfortunately, Nigeria’s situation is particularly difficult due to the economic state inherited from the previous administration, which implemented unsustainable subsidies across sectors and nearly bankrupted the nation.
Why has Nigeria not conquered HIV/AIDS?
No country in the world has fully conquered HIV/AIDS. It remains a complex autoimmune disease. But the truth is, it’s preventable. If people are disciplined and avoid unsafe sexual practices, the risk of infection is significantly reduced. Using condoms or having a single sexual partner drastically lowers the chance of transmission. That said, science has made great progress. Transmission from mother to child is now much lower, and the overall population growth rate of the disease has declined. I’m not an expert in mortality rates, but one thing is clear: people who stick to their antiretroviral drugs can live long, healthy lives, well into their 80s or 90s. There are also newer medical developments, like long-acting injectable treatments that may be taken once or twice a year to prevent HIV infection entirely. Science evolves slowly, but it is moving forward. However, these gains can be reversed if the Nigerian government does not commit to consistently funding HIV programmes. The government has allocated funds, yes, but payments must be timely. Without timely disbursement, mortality and transmission rates may increase again. Back in 2003, Fidson was the first Nigerian company to locally manufacture HIV drugs. We were patronised by the government at the time, but that support was short-lived. The government shifted focus and began relying heavily on free support from organisations like USAID, PEPFAR, and the Global Fund. Unfortunately, the Global Fund only buys from WHO-prequalified manufacturers, and we were not prequalified at the time. As a result, our investments became obsolete. Now, with the support of the current administration and encouragement from the new Minister of Health, we are investing again to revive our HIV drug manufacturing line. By the end of this year, Fidson will resume local production of antiretroviral medications. We’ve also entered into a technical collaboration with a foreign manufacturer to align with updated standards and processes. Interestingly, as the U.S. begins to scale back programmes like USAID, it’s a wake-up call for Africa to take ownership of its healthcare. And I agree with that. It’s time we stopped relying on free aid and started managing our own systems.
What has been your experience with supplying products to government agencies or grocers and then facing difficulty recovering your payments?
It’s slow, our experience with recovering payments has been slow. But that said, I won’t put a gun to the government’s head. I simply take it as one of the realities of doing business, especially in this country. I manage a private business, and I know firsthand how challenging it can be. There are times we ourselves default on payments to our own suppliers. We say “30 days,” but end up paying on the 40th day. If a small business like ours can struggle to meet deadlines, imagine what it’s like for a government with enormous financial commitments across all sectors. I’m not making excuses for the government, but I believe this administration deserves some time. They inherited a mess. They just couldn’t come out to say it because it’s the same party, APC. APC can’t publicly blame APC. That’s why they’ve remained largely silent on the true state of what they met on ground.
Really?
The previous administration, in my view, was more of a sleeping landlord. The former president had a socialist philosophy, everything subsidised. That’s what he promised, and that’s what he delivered. But unfortunately, those policies nearly bankrupted the country. No serious government in today’s world runs on that kind of structure, not even China. In fact, China is a perfect example of what can happen when a country shifts toward a market-driven economy. In the last 30 to 40 years, they’ve transformed into a global superpower. Despite a population of 1.4 billion, they’ve largely eradicated hunger, provided housing for nearly everyone, and created a proud, self-reliant nation. That’s how countries should be built, on sustainability, not on unsustainable subsidies. Now, this current government is trying to fix deeply rooted structural problems. If they move too fast, people complain. If they move too slow, people still complain. So, what are they supposed to do? Personally, I’m willing to give them time. In fact, I’m willing to vote for them again in 2027, because I see courage and genuine intent to build a better Nigeria. As a country, we need to reorient ourselves. That’s the first thing. My advice to the government is simple: only procure what you can pay for—or what you already have funding secured for. If possible, to reassure suppliers, government agencies should be required to present some form of financial backing—like a bank guarantee—and where feasible, offer an advance payment of 50%. Why is this important? Because government debts can easily bankrupt any company. Even the strongest firms can go under when they are owed large sums by the government. And the frustrating part is: government knows who they owe, and yet they delay payments. You chase them, they ignore you. Sometimes, you’re left helpless. This has to change.
