Dr. Dora Akunyili and her family were driving down a rural road in Nigeria three years ago when snipers opened fire on her car. "The back windscreen was shattered," she says. "A bullet pierced through my head scarf and grazed my scalp." Akunyili had been targeted by a drug gang--but not the kind that sells heroin or cocaine. These drug dealers traffic in counterfeit medicine--ineffective at best, deadly at worst--and as director general of the National Agency for Food and Drug Administration and Control (NAFDAC), Akunyili's job aims to put them out of business.
Bad medicine is a huge problem in Nigeria. Before Akunyili took over her post in 2001, a staggering 80% of the medications sold there were deficient in one way or another. Some contained less of the active ingredient than was specified on the label. Others were past their expiration date. Some were filled with inert lactose or powdered chalk. Still others were poison. In 1990 more than 100 Nigerian children died from a painkiller that had been made with toxic ethylene glycol instead of propylene glycol. In 2003 phony adrenaline led to the deaths of three children undergoing surgery in the city of Enugu. Akunyili's sister Vivian, a diabetic, died in 1988, a victim of fake insulin.
Akunyili's first move, when she took over the drug-control agency, was to restrict pharmaceutical imports to just two airports and two seaports, each staffed by NAFDAC officials. The agency also made a list of 19 Indian and Chinese companies that had been indicted for manufacturing fake drugs and banned their products. It placed analysts in India and China to recertify any drugs manufactured in those countries before they could be shipped to Nigeria.
NAFDAC went on the offensive back home as well, conducting nearly 800 raids on drug-distribution outlets and 90 "destruction exercises" on counterfeit or substandard medicines. "We are winning," says Akunyili. "Made-in-Nigeria drugs are now acceptable in other West African countries. Multinational [drug manufacturers] that left out of frustration are coming back."
None of this has made her very popular with the local drug cartels. The sniping incident was only one of several attempts on her life. NAFDAC'S offices have been fire bombed and its personnel attacked by gunmen. No wonder her family wants her not to accept another five-year term when the current one expires next year. But Akunyili, 51, has not made up her mind. "God gave me the opportunity to do something," she says, "and so far, God has been protecting me."
Like many committed health professionals in the developing world, Akunyili brings an almost messianic zeal to her work. "Drug faking or counterfeiting is the greatest evil of our time," she says. "Malaria can be prevented, HIV/AIDS can be avoided and armed robbery may kill a few at a time, but fake drugs kill en masse."