Nigeria takes lead, rolls out policy documents to improve availability and access to controlled medicines and improve drug treatment standards

L-R: The Project Coordinator, Mr. Glen Prichard; the Officer-in-Charge of the UNODC Country Office in Nigeria, Ms Elisabeth Bayer; the Permanent Secretary, Federal Ministry of Health, Mr Clement Uwaifo; the NAFDAC Director General, Professor Mojisola Adeyeye; Deputy Chairman of House of Representatives Committee on Health Institutions, Hon. Mohammad Usman; and Director, Food & Drug Services, Federal Ministry of Health, Mr Mashood Lawal displaying the publicationsFour policy documents namely 'The National Policy for Controlled Medicines, National Guidelines for Quantification of Narcotic Medicines, National Guidelines for the Estimation of Psychotropic Substances and Precursors and the National Minimum Standards of Drug Dependence' were formally presented to the public by the Federal Minister of Health, represented by the Permanent Secretary at an event in Abuja, Nigeria on 5 February 2018. All these documents were approved at Nigeria's 60th National Council on Health meeting in November 2017.

The unveiling of the publications was an important milestone for the ongoing project 'Response to Drugs and Related Organised Crime in Nigeria' being funded by the European Union (EU) under the 10 th European Development Fund.

The UNODC implemented project has supported the development and implementation of the National Drug Control Master Plan of Nigeria (2015-2019). The Master Plan contains components on drug law enforcement and drug demand reduction and notably also supports responses on the access and control of narcotics and psychotropic substances for medical and scientific purposes. The latter area is one where the global response needs to be strengthened.  In Nigeria, the government has recognized the need for a policy and implementation framework to address the issue of access and control of narcotics and psychotropic substances.

Controlled medicines, especially schedule I narcotics, have remained largely unavailable and inaccessible for medical use in several developing countries, including Nigeria. The Global Access to Pain Relief Initiative (GAPRI) in 2012 showed that only 0.1% of patients that required narcotic medicines to manage moderate and severe pain in HIV/AIDS and accessed these medicines.

To address these gaps and improve the provision of these life-saving medications for Nigerians, the Federal Ministry of Health in collaboration with the UNODC developed the National Policy for Controlled Medicines and Its Implementation Strategies, which includes the two Guidelines for Quantification and Estimation respectively. As part of the piloting of these guidelines, in 2017 the project supported the first ever national survey to scientifically quantify the needs of controlled medicines, psychotropic substances and precursors for medical and scientific purposes and is set to repeat this national survey in 2019. The results of these surveys will go a long way in improving access to these medicines, but importantly this data can also be used by law enforcement officials to monitor the use of precursor chemicals and their potential misuse.

The development of the National Policy for Controlled Medicines and its Implementation Strategies is anchored on a recognition that patients need, human rights and global best practices underpin the response. The policy elaborates practical approaches to ensure improved availability and accessibility to controlled medicines including local manufacturing of Schedule 1 narcotics, decentralization of its warehousing, as well as sustainable funding mechanism. The Policy aims to improve the provision of life-saving medications for Nigerians by addressing existing barriers to ensure sustained availability and access to controlled medicines for medical and scientific purposes in the country while preventing diversion and abuse. This is in tune with the spirit of three International Drug Controlled Conventions. This is further corroborated by the Sustainable Development Goals, target 3.8b which focuses on increasing access to safe, efficacious, quality and affordable medicines and vaccines for all.

Another area of work that was highlighted at this event was on drug dependence treatment. The Ministry in collaboration with WHO and UNODC has developed the Minimum Standards for Drug Dependence Treatment in Nigeria. This is an important policy document to guide policy makers and hospitals to assess compliance with standards by the health facilities involved in the treatment of drug dependence. This document too has already been used to assess the standards in 11 hospitals in the country. It is expected that the newly constituted Drug Demand Reduction Unit in FMOH will continue to use this to assess other facilities and provide support through training and advice to improve treatment standards.

Nigerian experts from diverse fields, including pharmacists, anaesthetists and surgeons, amongst other experts in this field, made critical inputs into the development of the comprehensive policy framework under the guidance of UNODC technical experts, including from the Drug Prevention and Health Branch of UNODC Headquarters. The implementation of the project has considerably enhanced Nigeria's ability to address the issues of drug supply and drug demand through a balanced and integrated approach, thereby ensuring improved quality of healthcare to address the issues of drug trafficking, use and organized crime.

Over 100 guests attended the event, which was presided over by the Permanent Secretary of FMOH, the Director General of the National Agency for Food and Drug Administration and Control and the Officer in Charge of UNODC's Country Office of Nigeria. The event received widespread media coverage, recognizing how Nigeria is taking the lead in the development of these policies in guidelines within Africa.