The Politics and Pathology of Drug Service Administration in Third World Countries: Lessons of Two Drug Distribution Experiments in Nigeria*

Abstract

This paper emphasizes the importance of a good drug distribution system to the realization of the objectives of the health and drug policies of any country. This, it notes, is very true of many Third World countries, Nigeria inclusive, where healthcare delivery and the attainment of health targets have been significantly hampered by poor healthcare policy making and implementation practices. Among other factors, effective drug service administration has been affected in such countries by lack of political commitment to strong pharmaceutical regulation to ensure the quality of products and regulate prices. Some fall outs of this include the existence of poor drug distribution systems or practices in such countries; circulation of drugs of doubtful or outright negative therapeutic effects; the pricing of drugs above the reach of the average citizen; and increasing cases of drug tragedies and fatalities. The paper notes that although the problem of poor drug distribution can be addressed through policy, legislation and affirmative action, some governments are not paying sufficient attention while others gloss over the key issues. In Nigeria, this has led to the emergence of two new experiments, located in Benue and Ekiti states, in spearheading the reform of the drug distribution system in the country. In view of the strategic importance of the drug component to efficient healthcare delivery, this paper examines the lessons of the two efforts for the restructuring of ineffective drug distribution systems in parts of the Third World. For this purpose, the paper compares the two experiments in terms of funding, operation and outcomes, particularly on the question of ensuring physical and economic access to quality drugs by the citizenry. The paper concludes by outlining the lessons of the two experiments for evolving appropriate drug distribution systems as a key step towards ensuring effective and affordable drug treatment for citizens of many Third World countries where such cannot be taken for granted. Keywords: Healthcare, Medical care, National Drug Policy, Drug Distribution system