Counterfeit Pharmaceuticals and the Necessity of Health in Nigeria
While drug smuggling and trafficking discourse tends to focus on flows of illegal narcotics, the flow of illicit pharmaceuticals is largely under researched and unknown. Counterfeit pharmaceuticals are not only found in developing countries, they can be found across the global market, even in developed countries. Limited access to health-care and lack of basic medicines can mean the difference between life and death for many in the developing world. In many African countries, illicit pharmaceuticals are the only option. It is important to not that many of these false pharmaceuticals are not produced in malice, but in consideration for the overall accessibility to all populations. Nordstrom (2007) discusses, “Drugs in licensed dispensaries were affordable to the wealthy, unlicensed street-market drugs were available and affordable to everyone,” making the claim that illicit pharmaceuticals are a necessity, regardless of risk. Much of the illicit pharmaceuticals based in Africa stem from Nigeria. In Nigeria, the pharmaceutical monopoly managed by foreign brand-name manufacturers combined with weak state powers has created a lack of accessible and affordable pharmaceuticals, which in turn, has generated high demand, allowing for illicit pharmaceutical smuggling to thrive.
The smuggling of pharmaceuticals is grouped with that of illegal narcotics, but is vastly different considering taking medicine is not seen as a luxury, but a necessity for well-being (Nordstrom, 2007, p. 131). In developing nations such as Nigeria, there is a strong need for HIV/AIDS medication, anti-malarial products, analgesics, and basic antibiotics. Yet, if these products are a daily necessity why are they not available to the general population? Structural adjustment in Nigeria lead to unsustainable markets for brand-name pharmaceutical companies forcing high prices, which encouraged counterfeit sales (Peterson, Interview with Premium Times, August 31, 2015). These structural adjustment policies devalued the Nigerian naira, making expensive pharmaceuticals, even more costly and difficult for the average Nigerian to afford. Many brand name pharmaceuticals either completely stopped production of products or moved to new locations outside of Nigeria (Peterson, 2014, p. 131). Without the presence of these brand-name companies, local Nigerians turned to other sources of pharmaceuticals, often lacking in quality. As the economy collapsed, the Nigerian government “liberalized drug import policies…freely import drugs and sell them at huge profits” (Peterson, 2012, p. 144), allowing civilians and military equivalents to engage in counterfeit dealings and be active members of the drug market. Without these generic and sometimes counterfeit drugs on the market, Nigerians were then forced to turn to alternative medicine, or forgo treatment all together. Coupled with the International Monetary Fund’s (IMF) structural adjustment policies, “high taxes placed on imported raw materials…the devaluation of currency… eliminated purchasing power for local manufacturers…[and] the purchasing power of the consumer was also devastated” (Peterson, 2012, p. 144). A lack of economic strength and reliability created an expanse opening for black market and under-the-table dealings. An overall decrease in national earnings, privatization of state industries and external austerity policies contributed to the public health system collapse. Without these formal institutions, chaos ensued at the expense of the local Nigerian population.
Nonetheless, Nordstrom argues that many pharmaceutical street vendors in Nigeria, sell counterfeit pharmaceuticals with good intentions and from a place of necessity. “Street vendors of pharmaceuticals provide a service, one that they are often proud of,” enhancing the image of the moral economy in a dire situation, where Nordstrom emphasizes that the market is so weak commodities such as cooking oil are sold as a luxury (Nordstrom, 2007, p. 132). Nordstrom highlights that while not all counterfeit products are safe and reliable, neither are all goods produced by licensed manufacturers, “licensed manufacturers produce a substantial number of substandard drugs” (Nordstrom, 2007, p.134). The notion that licensed manufacturers can also produce substandard pharmaceuticals, not just counterfeit producers presents a new challenge to pharmaceutical crackdown and regulation (Peterson, Interview with Premium Times, August 31, 2015). Many have critiqued large pharmaceutical companies at their hesitation to respond to the counterfeit drug problem. “It is difficult to declare a [fake drug] problem without damaging a legitimate business,” identifying that these claims can harm the pharmaceutical industry, but does little to address the issue as to why the prevalence of counterfeit drugs is so high (Cockburn et al, 2005, p. 0304). Pharmaceutical companies do face the risk of monetary loss, but poverty-stricken regions risk life when conditions force black market and counterfeit pharmaceuticals into the general mainstream market. The fiscal incentives of pharmaceutical companies illustrate the disconnect between large foreign corporations and local markets. “The result is that health and therapeutics are not valued on the basis of patient needs… [brand named pharmaceuticals are] geared toward maximizing growth and profits as primary ways to survive high financial risk,” Peterson (2014) comments on pharmaceuticals as a revenue generator for large pharmaceuticals companies (p.134), rather than counterfeit production and sales as a necessity for local populations as a means for survival. There is a fundamental difference between the motivations of big pharmaceutical companies and local pharmaceutical producers. For many, with their livelihood on the line, illegal and counterfeit pharmaceuticals are their only option.
Consumers of counterfeit pharmaceuticals present a complex dichotomy to the rhetoric of the drug trafficking crackdown. Many drug companies have published public safety statements and other warnings regarding counterfeit versions of their drugs. Cockburn (2005) claims that the pharmaceutical industries have done little to warn their consumers, “that the pharmaceutical industry, which is such a benefit to our health, is harming both patients and itself by not vigorously warning the public of fake products when they arise” (p. 0306). In countries such as Nigeria, drug dispensing from legitimate ventures can still be a risky gamble. The pharmaceutical industry in Nigeria has suffered greatly from structural adjustment policies and globalization, forcing unprecedented change and economic restructuring. Without proper regulation and the proper agencies to oversee and regulate pharmaceuticals in Nigeria, the dispossession of the pharmaceutical industry created a scarcity of imported, regulated, and quality medicines for the local population. Peterson (2012) addresses how the IMF and its state regulation “would lay the ground for new proprietary pharmaceutical capital, counterfeit drugs, which made up about 80 percent of the national drug market,” a lack of controlled substances in a country with a dire need for antivirals, antimalarial medication, and basic antibiotics was forced to turn to alternative methods of “self-medicating” (p.145). An unconventional and illicit method of maintaining healthcare standards without formal institutions was to use counterfeit and contraband pharmaceuticals.
The lack of readily available and high quality pharmaceuticals as a result of a weakened economy, puts the most strain on the underserved, poverty stricken, most at risk populations of Nigeria. Wealthy Nigerians and foreigners can afford the cost of legitimate pharmaceuticals and to seek out private healthcare alternatives. But for the majority of the country, they must turn to street “pharmacies”, where the risk is high. Unequal distributions of wealth and weak state infrastructure and regulation only exacerbate the problem, “the legal is expensive, highly taxed, unattainable. … As long as the gap between what the people have and can have ... not only in having to access illegal pharmaceuticals, but in all aspects of their life” (Nordstrom, 2007, p. 136). Vendors of these illicit and illegal pharmaceuticals work within the moral economy of providing for their community but also within the extralegal realm of counterfeiting and imitation of regulated drugs. Foreign stakeholders in Nigeria’s pharmaceutical industry in addition to the IMF intervention and enactment of policies to strengthen the economy, have deconstructed the healthcare systems of Nigeria, forcing citizens to turn to illicit pharmaceutical production and smuggling as a means for survival. Thus, erroneously shifting the blame of counterfeit involvement from foreign pharmaceutical conglomerates to local populations with no other alternative.
Gun Control and School Shootings
In the United States residents have become all too accustomed to news headlines depicting unsolicited acts of violence, “Active Shooter”, “Gunman Opens Fire at Local High School”, “Multiple Casualties at Batman Premier”. The Columbine High School Shooting on April 20, 1999 was one of the first mass shootings that captivated the nation’s attention.
Eric Harris and Dylan Klebold entered Columbine High School with firearms and explosive, killing twelve students and a teacher before killing themselves in the library. Immediately, the public was quick to place the blame on someone. Many blamed the parents of these children, some blamed the rise of violent video games, and some blamed the social exclusion that the two felt at the school.
Harris and Klebold were targets of bullying by many of their peers. The boys were active members of a gaming community where they openly discussed their hatred for their community and the world. However, their first encounters with the law began the year prior to the shooting. They had both been charged with breaking and entering, trespassing, and theft. They also published a video for a school project expressing their desires to shoot up the school and kill their classmates. All of the weapons were not bought by Harris or Klebold, as they were both underage, but bought by others for their use. The firearms were modified, with the ends sawed off.
Both shooters had the desire for international recognition and notoriety. In their journals, references to the Oklahoma City bombings, the Vietnam War, and the Waco siege. After the massacre, many people came forward describing the intense and extensive bullying that Harris and Klebold faced at school. The objective of these actions was to exact revenge on their perpetrators and to do wrong on the world that had wronged them.
In the article, “What Drives Suicidal Mass Killers”, Lankford discusses the three main motivations of mass killers: a general struggle with mental health problems, a sense of victimization and belief that their life has been ruined at the hands of someone else, and that violent vengeance is justified for their mistreatment (Lankford, 2012). Both students had a history of behavioral conduct, mood, and anxiety disorders. They also both felt victims of constant bullying and social exclusion. Klebold and Harris sought vengeance for their maltreatment and lack of assimilation into popular student culture. This can be tied back to the psychological theories of crime. The idea that there are criminal personalities that can use justification and neutralizations to account for behavior. For these killers, the justification was reflected through the social exclusion they felt and the neutralization that similar events had occurred and the instigators names had been etched in fame. Concepts of psychopathy and abnormal psychology can also be seen through this approach; such as their mental health issues and the actions taken to validate their sense of worth.
The second theory this relates to is the social control theory. In Colorado on April 20th, 1999, state and federal law allowed the minimum age to purchase a firearm set at 18 years old. Background checks were only mandatory with federally licensed dealers and not by private dealers, as was the case with Harris and Klebold (Hong, Cho, Allen-Meares, & Espelage, 2011). Social control theory explains why most people do not commit crimes. The certain factors that “control” others from committing crimes were rejected, allowing their belief of crime to be “normal”.
A theory that directly contradicts this massacre and its instigators is social disorganization theory (Shaw & McKay). These theorists argue that social conditions including poverty, residential instability and turnover, and ethnic heterogeneity can all promote crime. Both students came from a middle-class neighbor, with nuclear family structures, and access to educational and extracurricular opportunities. This is contrary to the previously conceived notion that most school shootings were “urban gang-related, or they were stabbings, or they involved money” (Springhall, 1999, pg. 625). Harris and Klebold were not exposed to any gang-related violence or traditional depictions of large scale aggression. Their only exposure to these types of violence and massacre were news outlets and video games, which they frequently engaged with.
While the gun control debate is one of the most highly contested topics in today’s public sphere, I believe horrific incidents like this will not stop until action is taken. But gun control is not so plain and simple. As a country, the United States of America is consistently one of the leading countries in gun deaths. Had there been stricter gun laws in the state of Colorado at the time, could this have been prevented? Evidence points to yes. Social control theory also explains how laws and regulations can act as a deterrence from committing crime, in this case a mass shooting. Stricter laws and regulations would have made it harder for Harris and Klebold to acquire their guns through background checks and a federally regulated request. Both of these factors could have contributed to the overall deterrence of obtaining firearms. While many may counter that people who want to have guns will find a way to have them, I believe, and lots of evidence supports it, that this would severely cut down on the number of people who believe they do deserve to have a firearm in their possession.
The right to bear arms is an explicit basic right of any citizen of the United States. I do not disagree that as citizens we should have these rights. However, I do believe that policy can strongly minimize the frequency of events like this. Eliminating the ability for anyone to acquire a gun without any form of waiting period, background check, or mental health examination can help solve this problem.
Many policies surrounding stricter gun control have been presented on state and federal levels; some successful, some not. A complete overhaul of the system will not be successful. Policy makers must first start with small-scale changes, and then slowly build up to larger goals. This is especially true and crucial when some of the largest opposition to gun laws comes from the NRA (National Rifle Association), a large organization that is a heavy financial contributor to many political campaigns. These laws can not only reduce large scale violence, but small scale accidents involving firearms as well.
I do not believe that we can ever fully live in a world that is free of violence, that would be a utopia. However, I would like to live in a world where children can go to school freely and not worry about a shooter coming into their school. Large-scale massacres such as the Columbine shooting have no reason to continue. Gun violence has no place in schools or anywhere. Until, people and policy really want to change how gun laws shape society, there will be no change, and that is not a risk I am willing to take. I have lived through too many incidents, far too close to home and far too frequent, for these acts of violence to continue.
Leap Poem Reflection
The piece of writing I chose to reflect on was my Leap Poem assignment from my Introduction to Creative Writing class with Brian Laidlaw. I initially registered for this course because it was a topic that was out of my comfort zone. This class presented a unique challenge within the confines of a safe and constructive space. When first tasked with this assignment I was at a loss of how to start. The prompt required us to use “imaginative leaps” within the poem, for a minimum of six times.
Prior to the start of writing, we had reviewed some examples of leap poems in class, but I struggled to embody what I had seen in the examples in my own work. Outside of class, I had never seen this literary technique used before. As I began writing, I felt that the piece was disjointed (not in the way that Brian had wanted them to be). The entire piece felt like a risk to me. I had to create “leaps” within my own ideas and stream of consciousness that still made sense to readers. I ended up mixing two main ideas for the piece and alternating between the two of them. I chose to focus on “feel-good” feelings, rushes, or certain emotions that feel ethereal or momentarily satisfying in a non-traditional way. I contrasted these feelings with places that also invoke similar feelings, ones that do not seem real or create a sense of false reality and time.
Throughout this process, I came to enjoy this style of writing. In the future, I would follow a similar process but elaborate more on my ideas. I would be interested to see how this piece could be extended beyond feelings and places to encompass a broader theme. This Leap Poem was fun and exciting for me partly due to how the style and structure unifies different
ideas and themes into one piece. This style of writing helped me get in touch with my creative side. I began to understand how there really are no rules or formalities in writing; writing is what you make of it. Poetry especially is a malleable and ever-changing form of writing that can be as abstract or uniform as one wishes. This poem was relatively different from my classmates’ work. Others tended to have more prose-like paragraphs, with complete thoughts and sentences. However, I do believe I was successful in invoking a similar mood and sentiment within all my readers, regardless of background. I wanted to create a sense of familiarity but also allow the reader to create their own images and ideas about what these spaces and feelings meant to them. I do think I was successful in that. This piece also left space for personal interpretation and connection, depending on the individual.
This piece was something I truly enjoyed writing. As someone who had little to no experience with poetry or creative writing, I was proud to produce a piece as coherent as this one. The combination of visuals and emotional resonance was something I had struggled to do in the past, but felt it showed my versatility as a writer and creator. A Leap Poem was something I never imagined myself doing but would love to try again to keep expanding my creative outlets
Newsreel Project
Script:
Surina: This is your newsreel report for the week of February 13th.
Audrey: Students at the University of Denver have been organizing themselves in protest over the situation regarding the apparent lack of internet connectivity. With midterms fading away and class registration beginning, these protests have almost turned into full-scale riots. Experts say that 6 in every 10 students find that slow Wi-Fi is impeding their homework. Students are now thinking that the university is prioritizing money over students learning because they are unwilling to pay to make the Wi-Fi faster.
Jackson: Students are now demanding that the university pay the students for their lost time trying to get on the internet. Members of the DU community have now banded together to create a coalition to end these deplorable conditions, and have now released a letter demanding reimbursement; otherwise, they threaten to secede from the union.
Surina: Students also mention that an inability to check Facebook and Instagram is causing them to waste more time because they must spend excess time waiting for their pages to load. What will the University do next? How will students complete their homework with such trying conditions? How are students expected to get jobs if they can’t even do their astronomy homework?
Jackson: Speaking of astronomy, recent reports from NASA say that a meteor the size of a small house has been discovered on a path toward Earth. While collision with Earth is unlikely, experts say that there is a 50% chance of collision with our moon, which could be just as devastating as if it hit Earth. A disruption of this caliber could lead to a shift in the gravitational energy of the moon, which in turn could have a massive impact on tides and therefore cause flooding in many coastal areas.
Surina: If this meteor, nicknamed Section 46 by NASA, were to hit Earth, however, the effects could be disastrous depending on the location of impact. Scientists say that a chunk of rock this size could carry enough energy to wipe out an area roughly the size of Manhattan upon impact. There is little reason to worry though, because in the unlikely event of a terrestrial impact, odds are it will hit the ocean or a remote section of land.
Audrey: What should you do, you ask? In the event of a meteor shower and/or catastrophic impact, you should fire up the Google Machine and check Wikipedia for a quick solution. However, if your internet still is not working, experts say that there is probably no hope for warding off the sailing space stones, the safest option is to just stay inside and avoid the windows.
Jackson: If your area is in danger of being hit by a meteor, instead of evacuating in a mass-panic you could take a nice tropical vacation.
Surina: Have visiting the Great Barrier Reef on your bucket list? Sorry snorkeling fanatics. Cancel all your trips. Over 90% of the Great Barrier Reef’s coral is suffering from coral bleaching. One of the most iconic natural wonders of the world is dying. Chances are this phenomenon is occurring because global warming is causing rising sea levels and warmer ocean temperatures.
Audrey: However, many scientists say that they do not exactly know the cause of coral bleaching, and that Global Warming in fact does not exist. It is important to note that coral bleaching does not discriminate and all species of coral are at risk.
Jackson: The reef is protected from damage by humans, but it is not safe from the effects of a changing environment. Reef tourism is huge to Australia’s economy, so this could be detrimental to them as a country. Coral reefs are a vital part of the ocean’s ecosystem, and without them the underwater world as we know it, will suffer.
Surina: What will Pixar do next?
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Reflective Commentary:
The newsreel genre consists of many important factors. First, it is important to establish two of the main components. The rhetor is the person, or character who is orchestrating the situation. For the newsreel, this is traditionally the news anchor, or the voice over of the news. The audience is who the rhetorical situation is appealing to, or presented to entertain, those who are watching the newsreel. One of the main basics of the newsreel genre is to entertain, while still being informative. To do so, the rhetor must retain a certain degree of enthusiasm and presentation regardless of the topic of the newsreel. Constraints do not physically limit the rhetor or the audience but they shape various elements within the situation. Additional constraints for the newsreel are also finding topics that the audience can relate to, or that will affect them. The news is not limited to topics that will greatly entertain the audience, but there must be some requirement of keeping a viewer engaged and continuing to tune in. The exigence of newsreels can vary depending on the personal opinions and views of the audiences.
For our presentation, it was crucial to identify the audience –in this case, our classmates, and the rhetor(s) –Jackson, Audrey, and I. The topics we chose: poor Wi-Fi connection at DU, a fabricated story about a potential meteorite, and the coral bleaching of the Great Barrier Reef, all represent a variety of information. We chose to pick three different topics to briefly talk about to mirror the short, yet informative format of classic newsreels. The three stories were targeted for different levels to connect to the audience. The topic at DU was intended to directly meet the attention of our classmates, as we all suffer from the consequences of poor internet connection. Our other two topics were chosen at random, with little relationships between them. In the newsreels, we had viewed we noted that often the stories had no consistent relevancy to each other. We chose a fabricated story for fun, which made it easier to keep the tone light and engaging for ourselves and humorous for our classmates. The coral bleaching story was used to create a more realistic feel to our presentation. Newsreels are meant for entertainment but do contain factual information, this lead to the inclusion of a real-world story.
The range of topics also allowed us to employ pathos, ethos, and logos within the project. The ethos was found in the topic that directly impacted the students of DU, paired with our own personal experiences and opinions about the lack of connectivity. In each story, we tried to include some statistics to build our credibility and create a stronger sense of ethos and logos. One of the benefits of this project was that we knew the audience that we were trying to entertain and inform, which we could use to our benefit in creating our script. There were few constraints for our project, we attempted to eliminate some of the problems that could be considered as restraints by including various types of news. Overall, I really enjoyed this project and being able to apply what we have been studying to use.