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The “Trovan” story by Idris Mohammed

Dr Idris Mohamed was the Chairman of the Taskforce of the Federal Republic of Nigeria sent to manage the Outbreak of Cerebrospinal Meningitis when the unfortunate trail of trovofloxacin took place among Nigerian children in Kano.

He recently wrote a book: “Academics, Epidemics and Politics”….and eventful career in public health

You would have read my earlier blog on the book. I still recommend that you buy the book. Buy the book, read the book.

Now…to be clear, and in response to a comment on the last blog, I have drawn no conclusions about the validity of Dr Mohammed’s statements in his book. Autobiographies are by definition always an exercise in self adulation. However the issues Dr Mohammed has raised in this book are extremely extremely important. They need to be in the public space. This is not just anybody. This is the man that was the Chairman of the Taskforce of the Federal Republic of Nigeria sent to manage the Outbreak of Cerebrospinal Meningitis when Pfizer came in to do what is now generally accepted to be a criminal trial in the most unethical of circumstances. The case is still in court today…12 years after.

One thing that I have never come to understand about this episode is the role of our Government and its agents in their regulatory capacity. This book has only increased my confusion. I have always been plagued by a simple question.

Did our government or its agents give approval for the trial to take place?

Below is an excerpt from a letter from the Minister of Health at the time to Dr Mohammed as it appeared in his book;

“You were the chairman of the Task Force on epidemic control; you were reported to have expressed satisfaction with the protocol before the trial begun, and you participated in the trial in a supervisory role. More importantly, you were also the Minister’s representative. In this capacity, you were in the best position, if you were in doubt, to ensure that all the requirements were fulfilled before the commencement of the trial. (…). Nigerian doctors (including you) supervised the management and treatment of the patients. You started crying foul only when you relationship with Pfizer soured, when the company could not reportedly meet your personal demands”

To this Dr Mohammed responds strongly saying:

“I state categorically that I never authorised the trail of trovofloxacin by Pfizer during the epidemic of CSM in Kano, neither did I take part in any capacity whatsoever as claimed by the minister of health. Therefore, as the minsters representative I can state categorically that Pfizer did not receive governments approval for the trial, since by implication I held the power for such approval on behalf of the government of the Federal republic of Nigeria”

….c’mmon. Pfizer could never come in and conduct this trial without the active collaboration of some Nigerians…

So Nigerians, so while we continue asking Pfizer the tough questions, Isn’t it time we also turn to our Government and ask…

  1. The goal of any drug company is to bring as many products to the market as possible to maximise its profits. The role of our Government is to protect us by regulating the drug industry as they do so. The primary liability in this case I suggest lies with my Government. To date, there has not been a clear open and categorical statement from the Federal Republic of Nigeria to say NO, at no point, under any circumstances was any permit given to Pfizer by us or any of our agents to conduct the trials in Kano.

  1. From the communication revealed by Dr Mohammed in this book our Government has been privy to the “irregularities” (using the mildest possible term) of this trial from the very beginning. Why did it take the efforts of The Washington Post to bring the matter to the public in 2000, 4 years after it occurred? Why was the first case against Pfizer by the Government (not the patient groups) instituted in 2007, 11 years after the event.

  1. Our Government set up a panel of enquiry to look into this matter in 2001. At least there was a chance to redeem itself, but no. No report was released until again The Washington Post got a copy of report and made the entire report available online for all to read in 2006. Why this report was kept hidden for 6 years?

The only ratification we can feel today is that things have changed. The medicines regulatory environment has changed. Can you see this happening in the context of Prof. Akunyili’s NAFDAC? There are lessons in this event for Nigerians. Pfizer is an easy target…and rightly so. They should pay! But they are not the only ones that have a case to answer…

… it is always easier to blame a crime on an outsider than on one of your own.

Buy the book and read it!

Next is the final part of this series: How our National Programme for Immunisation (NPI) took vaccination coverage to an enviable 13% (no typo!). Don’t wait for the blog… Buy the book and read it!

…it I published by Bookcraft ( Contacts of the publishers are,

23 Adebajo Street, Kongi Layout. Ibadan, NIGERIA.+234 2 8103238; +234 2 7517153, +234 803 3447889; +234 8037220773

Never doubt that a small group of thoughtful committed people can change the world; indeed it is the only thing that ever has…Margaret Mead

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