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 Prescription drugs, primarily based in Mumbai, makes a variety of drugs that go beneath totally different model names and are packaged to appear like reliable medicines. However all include the identical dangerous mixture of components: tapentadol, a strong opioid, and carisoprodol, a muscle relaxant so addictive it is banned in Europe.
This mix of medication just isn’t licensed to be used anyplace on this planet and may trigger respiration difficulties and seizures. An overdose can kill. Regardless of the dangers, these opioids are in style as avenue medicine in lots of West African nations, as a result of they’re so low cost and extensively out there.
The BBC World Service discovered packets of them, branded with the Aveo brand, on the market on the streets of Ghanaian, Nigerian, and Ivoirian cities and cities.
Having traced the medicine again to Aveo’s manufacturing unit in India, the BBC despatched an undercover operative contained in the manufacturing unit, posing as an African businessman trying to provide opioids to Nigeria. Utilizing a hidden digicam, the BBC filmed one among Aveo’s administrators, Vinod Sharma, exhibiting 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 directly, they will “loosen up” and agrees they will get “excessive”. In 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 tens of millions 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 power of about 100 native residents whose mission is to raid drug sellers and take these drugs off the streets.
“The medicine devour the sanity of those that abuse them,” says Maham, “like a fireplace burns when kerosene is poured on it.” One addict in Tamale put it much more merely. The medicine, he stated, have “wasted our lives”.
The BBC group adopted the duty power as they jumped on to motorbikes and, following a tip off a couple of drug deal, launched a raid in one among Tamale’s poorest neighbourhoods. On the best way they handed a younger man slumped in a stupor who, in accordance with locals, had taken these medicine.
When the vendor was caught, he was carrying a plastic bag crammed with inexperienced drugs labelled Tafrodol. The packets have been stamped with the distinctive brand of Aveo Prescription drugs.
It isn’t 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 Prescription drugs, together with a sister firm known as Westfin Worldwide, is delivery tens of millions of those tablets to Ghana and different West African nations.
Nigeria, with a inhabitants of 225 million individuals, supplies the largest marketplace for these drugs. It has been estimated that about 4 million Nigerians abuse some type of opioid, in accordance with Nigeria’s Nationwide Bureau of Statistics.
The Chairman of Nigeria’s Drug and Legislation Enforcement Company (NDLEA), Brig Gen Mohammed Buba Marwa, informed 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 medicine, Nigerian authorities tried to get a grip on a extensively abused opioid painkiller known 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 laws on tramadol.
Not lengthy after this crackdown, Aveo Prescription drugs started to export a brand new tablet primarily based on tapentadol, a good 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 choice to tramadol and to evade the crackdown.
Within the Aveo manufacturing unit there have been cartons of the mix medicine stacked on prime of one another, virtually ceiling-high. On his desk, Vinod Sharma laid out packet after packet of the tapentadol-carisoprodol cocktail drugs that the corporate markets beneath a variety of names together with Tafrodol, the most well-liked, in addition to TimaKing and Tremendous Royal-225.
He informed the BBC’s undercover group that “scientists” working in his manufacturing unit may mix totally different medicine to “make a brand new product”.
Watch India’s Opioid Kings from BBC Eye Investigations on iPlayer or, in case you are exterior the UK, watch on YouTube.
Aveo’s new product is much more harmful than the tramadol it has changed. In response to Dr Lekhansh Shukla, assistant professor on the Nationwide Institute of Psychological Well being and Neuro Sciences in Bengaluru, India, tapentadol “provides the results of an opioid” together with very deep sleep.
“It could possibly 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 appears like a really harmful mixture.”
Carisoprodol has been banned in Europe as a result of it’s addictive. It’s accepted to be used within the US however just for brief durations of as much as three weeks. Withdrawal signs embrace nervousness, 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 mix. In contrast to 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 medicine until these medicine meet the requirements of the importing nation. Aveo ships Tafrodol and comparable merchandise to Ghana, the place this mix of tapentadol and carisoprodol is, in accordance with Ghana’s nationwide Drug Enforcement Company, unlicensed and unlawful. By delivery Tafrodol to Ghana, Aveo is breaking Indian regulation.
We put these allegations to Vinod Sharma and Aveo Prescription drugs. They didn’t reply.
The Indian medicine regulator, the CDSCO, informed us the Indian authorities recognises its accountability in direction of world 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 known as importing nations to assist India’s efforts by making certain that they had equally robust regulatory programs.
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 stop wrongdoing. The regulator stated it would take fast motion in opposition to any pharmaceutical agency concerned in malpractice.
Aveo just isn’t the one Indian firm making and exporting unlicensed opioids. Publicly out there export information recommend different pharma corporations manufacture comparable merchandise, and medicines with totally different branding are extensively out there throughout West Africa.
These producers are damaging the popularity of India’s fast-growing pharmaceutical business, which makes high-quality generic medicines upon which tens of millions of individuals worldwide rely and manufactures vaccines which have saved tens of millions of lives. The business’s exports are value a minimum of $28bn (£22bn) a 12 months.
Talking about his assembly with Sharma, the BBC’s undercover operative, whose identification 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 group adopted the native process power on one remaining raid that turned up much more of Aveo’s Tafrodol. That night they gathered in an area park to burn the medicine that they had seized.
“We’re burning it in an open glare for everyone to see,” stated Zickay, one of many leaders, because the packets have 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 medicine”.
However even because the flames destroyed a couple of hundred packets of Tafrodol, the “sellers and suppliers” on the prime of this chain, hundreds of miles away in India, have been churning out tens of millions extra – and getting wealthy on the income of distress.