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EQUIMEDS paper on Generic Antihypertensive Medicines in Nigeria

This month, the journal Global Heart published a paper by members of the 2015 Emerging Leaders cohort, which include JulieRedfern, HarparkashKaur, Rufus Adesoji Adedoyin, Sandra Ofori, RaghupathyAnchala, Ajay S.Vamadevan, Luciano De Andrade, Jose Zelaya, Dina Balabanova and Mahmoud Umar Sani. The published study, titled ‘Equivalence in Active Pharmaceutical Ingredient of Generic Antihypertensive Medicines Available in Nigeria (EQUIMEDS): A Case for Further Surveillance’, seeked to determine the quality of generic antihypertensive medicines available in the retail market of a developing country.

The results of the study showed that around 30% of generic antihypertensive medicines available in Nigeria were of substandard quality, highlighting the need for improved surveillance and awareness of substandard medicines.


We asked lead author Julie Redfern why the team decided to focus on this specific issue and what the results mean for the global response to cardiovascular disease.

Why did you and your team decide to focus on this specific project? Why is this issue important?

Our team sought to examine a health services issue related to availability of high quality medicines for hypertension. This is important because hypertension, diabetes and cardiovascular disease (CVD) account for the greatest disease morbidity and nearly one fifth of deaths globally and people in low- and middle-income countries (LMICs) are disproportionately impacted. We chose to focus on the African Region where the prevalence of hypertension is greatest with 35% of the adult population have hypertension in Nigeria.

Why are the results important and what do they mean for the global response to cardiovascular disease and hypertension?

The burden of hypertension is high across the world and to reduce this we need widespread availability of quality medicines for patients. We found that around one-third of commonly prescribed anti-hypertensive drugs available in Nigeria were of substandard quality. This result has the potential to negatively impact on public health management of hypertension. The findings highlight the need to improved surveillance and awareness of substandard medicines is needed. Education about the importance of high quality medicines if the full effectiveness of them is to be achieved.

What do you think the response should be to these results? What actions need to be taken?

Enhanced quality assurance processes in low-middle income countries such as Nigeria are needed to support optimum management. The results suggest that similar work should be done across other medicine classes and in additional countries.

What role did the Emerging Leaders programme play? How did it support your efforts?

The project protocol was conceived and developed during the Emerging Leaders session in Peru in 2015. We were then given the pilot funds by the WHF and we completed the study using these funds combined with in-kind support and contributions from the entire team. Our team collected the medicines and coordinated the packaging. Our team led al the writing and coordination of results interpretation. We were supported by the team of the Emerging Leaders programme throughout the entire project and have chosen to publish the primary results in the journal Global Heart.

Read the EQUIMEDS paper