ASSESSMENT ON PUBLIC HEALTH IMPLICATIONS OF FAKE DRUGS IN PATENT MEDICINE STORES IN ABA MARKET

CHAPTER ONE INTRODUCTION 1.1 Background to the Study The menace of fake drugs constitutes one of the gravest threats to public health in developing countries, with Nigeria ranking among the most affected globally. Patent medicine stores, especially those concentrated in commercial hubs like Aba Market, have become notorious entry points for counterfeit pharmaceuticals (Okonkwo & Adebayo, 2021). These outlets, often operated by unlicensed or minimally trained individuals, lack regulatory oversight and sophisticated inventory systems. Consequently, they serve as conduits for substandard, expired, and outright fake drugs, leading to widespread health risks including treatment failures, drug resistance, and mortality (Ogundipe et al., 2023). The Nigerian pharmaceutical sector is plagued by systemic challenges—weak regulatory enforcement, porous borders, and a flourishing informal market—that collectively provide fertile ground for counterfeit drug circulation. The World Health Organization (2022) estimates that 1 in 10 medical products in low- and middle-income countries is either substandard or falsified, with significant concentration in regions like West Africa. Patent medicine stores in markets such as Aba’s Ariaria Market are particularly vulnerable due to high consumer traffic, limited awareness, and price-sensitive demand patterns (Chukwu & Iwu, 2023). These factors create an enabling environment for unscrupulous vendors to market counterfeit drugs under the guise of affordability and accessibility. Moreover, the health implications of consuming fake drugs go beyond immediate physiological damage. Fake antibiotics, for instance, contribute directly to antimicrobial resistance (AMR), which is one of the most pressing global health challenges today (Nwachukwu & Ezeani, 2021). When patients consume ineffective or contaminated medications, pathogens are not effectively eradicated, leading to prolonged illness and potential outbreaks. This scenario is common in densely populated commercial cities like Aba, where a single counterfeit batch can affect hundreds of unsuspecting consumers in a short time. Economic and social consequences also underscore the urgency of this issue. Patients who use fake drugs often experience prolonged illness, increased healthcare costs, and in severe cases, permanent disability or death. These outcomes, in turn, diminish public trust in the healthcare system and disincentivize engagement with formal health providers (Ifeanyi & Onwuka, 2022). Vulnerable populations—such as low-income earners, children, and the elderly—are most at risk, as they often rely on patent medicine vendors as their primary source of medical care due to affordability and proximity. The problem is further complicated by the limited capacity of regulatory agencies like the National Agency for Food and Drug Administration and Control (NAFDAC) and the Pharmacists Council of Nigeria (PCN) to enforce compliance at grassroots levels. Surveillance activities are often sporadic, reactive, and underfunded, thereby failing to deter the proliferation of fake medicines in informal drug markets (Umeh & Adesanya, 2020). Technological interventions such as the Mobile Authentication Service (MAS) have been introduced to address these gaps, but adoption remains limited, especially in areas with low literacy or digital penetration. In light of these challenges, a localized investigation into the public health implications of fake drugs sold in patent medicine stores within Aba Market is both timely and necessary. This study seeks to assess not only the prevalence and types of counterfeit drugs but also the health outcomes experienced by consumers and the systemic gaps enabling this trade. Understanding these dynamics is essential for developing evidence-based interventions that can safeguard public health and improve pharmaceutical governance in Nigeria. 1.2 Statement of the Problem The proliferation of fake drugs in Nigeria, particularly in unregulated patent medicine stores, presents a serious and escalating public health crisis. Aba Market, as a major commercial nerve center in southeastern Nigeria, hosts a large number of informal drug vendors who often operate without adequate licensure or training. These vendors provide easy access to medications, yet their inventories are frequently infiltrated by counterfeit, substandard, and expired products. The routine consumption of such drugs leads to treatment failure, severe side effects, and in extreme cases, fatalities. Despite several policy and enforcement efforts, the circulation of fake drugs persists at alarming rates. Research by Emefiele and Okoli (2023) indicates that over 40% of drugs sold in open markets in southern Nigeria may be compromised. In Aba Market, this trend is worsened by socio-economic pressures that drive consumers to prioritize cost over quality, often opting for cheaper drugs without verified sources. Patent medicine vendors capitalize on this demand by stocking medications from questionable supply chains, some of which lack verifiable batch numbers or registration codes. Although institutions like NAFDAC have made strides in clamping down on illegal drug outlets, these interventions remain reactive and fail to address the root causes of the trade. The absence of consistent monitoring, coupled with low public awareness, means that the average consumer is largely defenseless against fake drugs. Additionally, the implications for public health are not confined to individual cases; rather, they ripple through the health system, contributing to increased disease burden, delayed recoveries, and overuse of healthcare resources. Hence, there is a pressing need for comprehensive empirical analysis to explore the extent and consequences of fake drug distribution within this context. 1.3 Objectives of the Study 1. To examine the prevalence of fake drugs in patent medicine stores in Aba Market. 2. To identify the public health risks associated with the consumption of counterfeit drugs in the study area. 3. To assess consumer awareness and response to fake drug detection and usage. 4. To evaluate the effectiveness of regulatory mechanisms in controlling fake drugs in patent medicine stores. 1.4 Research Questions 1. What is the prevalence of fake drugs in patent medicine stores in Aba Market? 2. What public health risks are associated with the use of counterfeit drugs in the area? 3. How aware are consumers about the dangers of fake drugs and how do they respond to such risks? 4. How effective are the current regulatory frameworks in addressing the fake drug crisis in Aba Market? 1.5 Research Hypotheses H₁: There is a significant relationship between the prevalence of fake drugs and the incidence of public health complications in Aba Market. H₂: Regulatory interventions significantly influence the availability of counterfeit drugs in patent medicine stores. 1.6 Significance of the Study This study holds significant implications for the pharmaceutical profession by providing empirical evidence on the distribution and impact of counterfeit drugs in commercial drug outlets. It offers a framework for developing strategies that can strengthen pharmacy regulation and support professional pharmacists in protecting public health. Moreover, it may inform curriculum design in pharmaceutical education, with a focus on ethics, regulatory compliance, and drug authentication technologies. For healthcare providers, the study will serve as a critical tool for understanding patterns of drug failure among patients who source medications from unregulated markets. It highlights the need for integrated patient education, better pharmacovigilance systems, and cross-sector collaborations to ensure drug safety and efficacy. Community health workers can leverage findings to tailor public health campaigns addressing drug quality concerns in high-risk areas. At the societal level, this research promotes health literacy by exposing the dangers of counterfeit medications and informing consumers on safer practices. Policymakers and civil society actors will also benefit from the study’s recommendations, which may support legislative reviews and community-level interventions. Ultimately, the study contributes to broader public health goals, including universal health coverage and health systems strengthening. 1.7 Scope of the Study This study focuses on patent medicine stores located within Aba Market, Abia State, Nigeria. It examines the prevalence and public health implications of fake drugs, using data collected from drug vendors, regulatory agencies, and consumers. The study assesses the types of counterfeit drugs, the conditions enabling their sale, and the health consequences reported by users. The population includes licensed and unlicensed patent medicine vendors, public health officers, and residents who patronize these outlets. The major variables in the study include the prevalence of fake drugs (independent variable), public health outcomes such as morbidity and treatment failure (dependent variables), and moderating variables such as regulatory enforcement and consumer awareness. While the findings are specific to Aba Market, they may provide useful insights applicable to other informal drug markets across Nigeria and West Africa. 1.8 Operational Definition of Terms • Fake Drugs: Pharmaceutical products that are deliberately and fraudulently mislabeled with respect to identity or source, including those with incorrect ingredients, insufficient active ingredients, or fake packaging. • Patent Medicine Store: Informal retail outlets, often operated without full pharmaceutical licensure, that sell over-the-counter and prescription drugs to the public. Public Health Implications: The broader health consequences affecting community well-being, including increased disease burden, treatment failure, and potential outbreaks, resulting from the use of counterfeit drugs. Regulatory Mechanisms: Institutional frameworks and activities—such as inspection, licensing, and authentication services—implemented by bodies like NAFDAC and PCN to control drug quality and distribution.