Background: Pharmaceuticals are an integral component of health care systems
worldwide, thus, regulatory weaknesses in governance of the pharmaceutical system negatively
impact health outcomes especially in developing countries. Nigeria is one of a number of
countries whose pharmaceutical system has been impacted by corruption and has struggled to
curtail the production and trafficking of substandard drugs. In 2001, the National Agency for Food and
Drug Administration and Control (NAFDAC) underwent an organizational restructuring
resulting in reforms to reduce counterfeit drugs and better regulate pharmaceuticals. Despite
these changes, there is still room for improvement. This study assessed the perceived
level of transparency and potential vulnerability to corruption that exists in four essential areas of
Nigeria's pharmaceutical sector: registration, procurement, inspection (divided into
inspection of ports and of establishments), and distribution.
Methods: Standardized questionnaires were adapted from the World Health
Organization assessment tool and used in semi-structured interviews with key stakeholders in
the public and private pharmaceutical system. The responses to the questions were tallied and
converted to scores on a numerical scale where lower scores suggested greater vulnerability
to corruption and higher scores suggested lower vulnerability.
Results: The overall score for Nigeria's pharmaceutical system was 7.4 out of
10, indicating a system that is marginally vulnerable to corruption. The weakest links were the
areas of drug registration and inspection of ports. Analysis of the qualitative results
revealed that the perceived level of corruption did not always match the qualitative evidence.
Conclusion: Despite the many reported reforms instituted by NAFDAC, the study
findings suggest that facets of the pharmaceutical system in Nigeria remain fairly
vulnerable to corruption. The most glaring deficiency seems to be the absence of conflict of interest
guidelines which, if present and consistently administered, limit the promulgation of corrupt
practices. Other major contributing factors are the inconsistency in documentation of procedures, lack
of public availability of such documentation, and inadequacies in monitoring and evaluation. What is
most critical from this study is the identification of areas that still remain permeable to
corruption and, perhaps, where more appropriate checks and balances are needed from the Nigerian
government and the international community.