Nigerians living with diabetes have called on the federal government to remove excise duty on the drugs and test kits for diabetes, as the soaring price is making life unbearable for them.
LEADERSHIP findings revealed that a diabetic patient in Nigeria spends about N30,000 per month on medication and test kits in 2022, compared to 2019, when drugs for diabetes cost about N10,000.
This is even as stock outs of insulin and shortage of diabetes specialists (endocrinologists) are exacerbating the plight of people living with diabetes in the country.
Recent data estimates that about six million adult Nigerians are living with diabetes. Meanwhile, experts have opined that this figure may be far from reality as estimated two-thirds of diabetes cases in the country are undiagnosed, resulting in an increase in the burden of diabetes complications and deaths.
Despite the rising prevalence of this condition, diabetes specialists remain inadequate in the country, with an estimated population ratio of 1 to 600,000.
The burden of treatment of diabetes remains significantly greater in Nigeria and other low to medium-income countries (LMICs), even as a new report on diabetes care published by the Access to Medicine Foundation (ATMF), a Netherlands-based non-profit organisation, revealed that the number of people with diabetes worldwide is expected to reach 570 million by 2030, and 700 million by 2045, rising most rapidly in LMICs as the burden of non-communicable diseases grows.
The CEO of Access to Medicine Foundation, Dr. Jayasree Iyer, said the prevalence of diabetes in Nigeria is projected to rise to eight million by 2045.
He said the costs associated with the prevalence of the disease are not only social but economic, adding that “The health expenditure related to diabetes care in Nigeria and other African countries is about $12.5 billion and this really reflects the fact that most people pay for relatively expensive and unaffordable insulin treatment.”
He said the average diabetes-related health expenditure per person amounts to approximately $500 a year, which is a huge financial burden if the patient has to pay it all or partially out-of-pocket.
A renowned health journalist in Nigeria, Mr. Sam Eferaro, who was diagnosed with diabetes for more than a decade, told LEADERSHIP that he spends between N25,000 and N30,000 every month on the treatment of diabetes, compared to 2019, when the same drugs were sold for less than N10,000.
Eferaro said this increment is not restricted to diabetes drugs alone, adding that generally, costs of drugs have gone up. “People living with diabetes feel the increase more because they have to be on the drugs for life. Same for people with hypertension and other non-communicable diseases,” he added.
He disclosed that African countries like Cameroon or even Ghana have programmes for people living with diabetes, especially children. “No such programme in Nigeria. The Nigerian government has no programme or plans to reduce the cost of diabetes management. Rather, the cost of drugs and monitoring devices are rising every year because of tax and import duties that pharmaceutical companies must pay to bring them in.
“Same for cancer drugs which is why chemotherapy is so expensive and patients have to sell all they have to pay for treatment. Truth is the government is making money off sick people instead of introducing measures to prolong their lives,” he lamented.
In the same vein, a diabetic patient, Mrs. Helen Moses, said she used to buy a cup of diabetes test strip for N5,000, but it had increased to about N7,000 recently.
To alleviate the sufferings of Nigerians living with the condition, Eferaro has therefore called on the federal government to allow the importation of drugs for conditions like diabetes and cancer on zero duties.
“From my interaction with some of the multinational pharmaceutical companies, drugs in Nigeria are sold at special discounted rates but the discounts can still be increased.
“However, the best way to reduce the cost of drugs for conditions like diabetes and cancer is for the government to allow their importation on zero duties. Let the government cut the taxes, and we will have (according to industry experts) between 30 to 40 per cent reduction in diabetes and cancer drugs and monitoring devices,” he pleaded.
For the chairman, Board of Trustees, Diabetes Control Media Advocacy Initiative (DICOMAI) Dr. Afoke Isiavwe, the financial burden of diabetes is too huge for one to bear, even as she called for more awareness about the condition, which remains a key factor in saving the lives of several people walking around in every part of Nigeria who are oblivious of the fact that they have the disease and those already diagnosed who do not know how to manage or control it.
Referring to the theme of this year’s World Diabetes Day: “Education to protect tomorrow,” Isiavwe disclosed that the aim of the campaign was to focus on the need for better access to quality diabetic education both for healthcare professionals and people living with diabetes.
She further urged Nigerians to be aware that factors such as a family history of diabetes, overweight, unhealthy diet, physical inactivity, increasing age, high blood pressure, poor nutrition during pregnancy, impaired glucose tolerance and history of gestational diabetes had been closely associated with type 2 diabetes, the commonest diabetes type and advised families to recognize their presence so as to prevent the condition and its deadly consequences.
She, however, called on governments, healthcare providers and other stakeholders to intensify their efforts in providing adequate information to assist the public in recognising the signs and symptoms of the condition and the available prevention options.
In commemoration of the World Diabetes Day, the Diabetes Association of Nigeria in partnership with the Nigeria Health Watch with support from the National Action on Sugar Reduction Coalition is holding a symposium in Abuja, calling on policy makers to increase access to diabetes education to improve the lives of those living with diabetes in the country.
The president, Diabetes Association of Nigeria, Dr Alkali Mohammed, said “Reducing the burden of diabetes requires education regarding accurate diagnosis and risk factors for Non-Communicable Diseases”.
He added, “As part of activities to ensure effective knowledge and awareness among citizens and stakeholders, the 2022 World Diabetes Day will be used to launch a comprehensive media campaign to raise awareness about the need for government to successfully implement the new tax and increase resources for the government to develop a national response on diabetes and other NCDs.”
Meanwhile, the World Health Organisation (WHO) has identified the known risk factors for diabetes as family history, age, being overweight, having a sedentary lifestyle, unhealthy diet, or use of alcohol or tobacco.
The organisation said if left unchecked, without management and lifestyle changes, diabetes could lead to heart attack, stroke, kidney failure, lower limb amputation, visual impairment, blindness and nerve damage, including erectile dysfunction.
The global health body, therefore called for investment in insulin, blood glucometers, test strips availability to all communities, adding that it should be backed by training of health workers in non-communicable disease prevention and management at the district and community level towards improving service availability.
