BBC World Service
BBCAn Indian pharmaceutical firm is manufacturing unlicensed, extremely addictive opioids and exporting them illegally to West Africa the place they’re driving a serious public well being disaster in nations together with Ghana, Nigeria, and Cote D’Ivoire, a BBC Eye investigation has revealed.
Aveo Prescribed drugs, primarily based in Mumbai, makes a variety of drugs that go below totally different model names and are packaged to appear like authentic medicines. However all comprise the identical dangerous mixture of substances: tapentadol, a robust opioid, and carisoprodol, a muscle relaxant so addictive it is banned in Europe.
This mixture of medication will not be licensed to be used wherever on this planet and may trigger respiratory difficulties and seizures. An overdose can kill. Regardless of the dangers, these opioids are widespread as avenue medication in lots of West African nations, as a result of they’re so low cost and extensively accessible.
The BBC World Service discovered packets of them, branded with the Aveo emblem, on the market on the streets of Ghanaian, Nigerian, and Ivoirian cities and cities.
Having traced the medication again to Aveo’s manufacturing unit in India, the BBC despatched an undercover operative contained in the manufacturing unit, posing as an African businessman seeking to provide opioids to Nigeria. Utilizing a hidden digicam, the BBC filmed considered one of Aveo’s administrators, Vinod Sharma, displaying off the identical harmful merchandise the BBC discovered on the market throughout West Africa.
Within the secretly recorded footage, the operative tells Sharma that his plan is to promote the drugs to youngsters in Nigeria “who all love this product”. Sharma does not flinch. “OK,” he replies, earlier than explaining that if customers take two or three drugs without delay, they will “loosen up” and agrees they will get “excessive”. In the direction of the tip of the assembly, Sharma says: “That is very dangerous for the well being,” including “these days, that is enterprise.”
It’s a enterprise that’s damaging the well being and destroying the potential of hundreds of thousands of younger individuals throughout West Africa.
Within the metropolis of Tamale, in northern Ghana, so many younger individuals are taking unlawful opioids that one of many metropolis’s chiefs, Alhassan Maham, has created a voluntary process drive of about 100 native residents whose mission is to raid drug sellers and take these drugs off the streets.
“The medication devour the sanity of those that abuse them,” says Maham, “like a hearth burns when kerosene is poured on it.” One addict in Tamale put it much more merely. The medication, he stated, have “wasted our lives”.
The BBC staff adopted the duty drive as they jumped on to motorbikes and, following a tip off a couple of drug deal, launched a raid in considered one of Tamale’s poorest neighbourhoods. On the best way they handed a younger man slumped in a stupor who, in keeping with locals, had taken these medication.
When the supplier was caught, he was carrying a plastic bag crammed with inexperienced drugs labelled Tafrodol. The packets had been stamped with the distinctive emblem of Aveo Prescribed drugs.
It is not simply in Tamale that Aveo’s drugs are inflicting distress. The BBC discovered comparable merchandise, made by Aveo, have been seized by police elsewhere in Ghana.
We additionally discovered proof that Aveo’s drugs are on the market on the streets of Nigeria and Cote D’Ivoire, the place youngsters dissolve them in an alcoholic power drink to extend the excessive.
Publicly-available export information present that Aveo Prescribed drugs, together with a sister firm referred to as Westfin Worldwide, is transport hundreds of thousands of those tablets to Ghana and different West African nations.
Nigeria, with a inhabitants of 225 million individuals, offers the most important marketplace for these drugs. It has been estimated that about 4 million Nigerians abuse some type of opioid, in keeping with Nigeria’s Nationwide Bureau of Statistics.
The Chairman of Nigeria’s Drug and Legislation Enforcement Company (NDLEA), Brig Gen Mohammed Buba Marwa, instructed the BBC, opioids are “devastating our youths, our households, it is in each neighborhood in Nigeria”.
In 2018, following a BBC Africa Eye investigation into the sale of opioids as avenue medication, Nigerian authorities tried to get a grip on a extensively abused opioid painkiller referred to as tramadol.
The federal government banned the sale of tramadol with out prescription, imposed strict limits on the utmost dose, and cracked down on imports of unlawful drugs. On the identical time, Indian authorities tightened export rules on tramadol.
Not lengthy after this crackdown, Aveo Prescribed drugs started to export a brand new capsule primarily based on tapentadol, an excellent stronger opioid, combined with the muscle-relaxant carisoprodol.
West African officers are warning that opioid exporters look like utilizing these new mixture drugs as an alternative to tramadol and to evade the crackdown.
Within the Aveo manufacturing unit there have been cartons of the mix medication stacked on prime of one another, nearly ceiling-high. On his desk, Vinod Sharma laid out packet after packet of the tapentadol-carisoprodol cocktail drugs that the corporate markets below a variety of names together with Tafrodol, the preferred, in addition to TimaKing and Tremendous Royal-225.
He instructed the BBC’s undercover staff that “scientists” working in his manufacturing unit might mix totally different medication to “make a brand new product”.
Watch India’s Opioid Kings from BBC Eye Investigations on iPlayer or, in case you are outdoors the UK, watch on YouTube.
Aveo’s new product is much more harmful than the tramadol it has changed. In line with Dr Lekhansh Shukla, assistant professor on the Nationwide Institute of Psychological Well being and Neuro Sciences in Bengaluru, India, tapentadol “provides the consequences of an opioid” together with very deep sleep.
“It might be deep sufficient that folks do not breathe, and that results in drug overdose,” he defined. “And together with that, you’re giving one other agent, carisoprodol, which additionally provides very deep sleep, rest. It seems like a really harmful mixture.”
Carisoprodol has been banned in Europe as a result of it’s addictive. It’s authorised to be used within the US however just for quick durations of as much as three weeks. Withdrawal signs embrace anxiousness, insomnia, and hallucinations.
When combined with tapentadol the withdrawal is even “extra extreme” in comparison with common opioids, stated Dr Shukla. “It is a pretty painful expertise.”
He stated he knew of no scientific trials on the efficacy of this mixture. Not like tramadol, which is authorized to be used in restricted doses, the tapentadol-carisoprodol cocktail “doesn’t sound like a rational mixture”, he stated. “This isn’t one thing that’s licensed for use in our nation.”
In India, pharmaceutical corporations can’t legally manufacture and export unlicensed medication until these medication meet the requirements of the importing nation. Aveo ships Tafrodol and comparable merchandise to Ghana, the place this mixture of tapentadol and carisoprodol is, in keeping with Ghana’s nationwide Drug Enforcement Company, unlicensed and unlawful. By transport Tafrodol to Ghana, Aveo is breaking Indian regulation.
We put these allegations to Vinod Sharma and Aveo Prescribed drugs. They didn’t reply.
The Indian medication regulator, the CDSCO, instructed us the Indian authorities recognises its accountability in direction of international public well being and is dedicated to making sure India has a accountable and powerful pharmaceutical regulatory system.
It added that exports from India to different nations are carefully monitored and that lately tightened regulation is strictly enforced. It additionally referred to as importing nations to assist India’s efforts by guaranteeing they’d equally sturdy regulatory methods.
The CDSCO said it has taken up the matter with different nations, together with these in West Africa, and is dedicated to working with them to forestall wrongdoing. The regulator stated it should take fast motion in opposition to any pharmaceutical agency concerned in malpractice.
Aveo will not be the one Indian firm making and exporting unlicensed opioids. Publicly accessible export information recommend different pharma corporations manufacture comparable merchandise, and medicines with totally different branding are extensively accessible throughout West Africa.
These producers are damaging the repute of India’s fast-growing pharmaceutical trade, which makes high-quality generic medicines upon which hundreds of thousands of individuals worldwide rely and manufactures vaccines which have saved hundreds of thousands of lives. The trade’s exports are price no less than $28bn (£22bn) a 12 months.
Talking about his assembly with Sharma, the BBC’s undercover operative, whose id should stay hid for his security, says: “Nigerian journalists have been reporting on this opioid disaster for greater than 20 years however lastly, I used to be nose to nose… with one of many males on the root of Africa’s opioid disaster, one of many males who really makes this product and ships it into our nations by the container load. He knew the hurt it was doing however he did not appear to care… describing it merely as enterprise.”
Again in Tamale, Ghana, the BBC staff adopted the native process drive on one ultimate raid that turned up much more of Aveo’s Tafrodol. That night they gathered in a neighborhood park to burn the medication they’d seized.
“We’re burning it in an open glare for everyone to see,” stated Zickay, one of many leaders, because the packets had been doused in petrol and set ablaze, “so it sends a sign to the sellers and the suppliers: in the event that they get you, they will burn your medication”.
However even because the flames destroyed just a few hundred packets of Tafrodol, the “sellers and suppliers” on the prime of this chain, 1000’s of miles away in India, had been churning out hundreds of thousands extra – and getting wealthy on the income of distress.
