Why you should care
Vivian Nwakah’s startup connects reputable manufacturers with consumers in a bid to save lives.
Vivian Nwakah was told she wouldn’t survive in Nigeria, and she started to believe it. While her glistening dark skin makes her look just like most others in the capital city of Lagos, her American accent means she’s not like everyone else; and all of her friends who arrived around the same time as she did have since moved back to the U.S.
Nwakah’s mission, and the reason she stays, became clear shortly after her arrival in Lagos. Before she had gotten her driver’s license, Nwakah relied on a friend to drive her around. One day, after being diagnosed with malaria, that friend died — not from the disease, but from the fake malaria medication he was taking. In 2017, Nwakah launched Medsaf to help tackle the counterfeit medicines that run rampant in Nigeria.
About 17 percent of Nigeria’s generic drug supply was fake in 2015, down from 40 percent in 2001, according to government data. Improved technology has helped. Yet roughly 116,000 deaths per year in sub-Sarahan Africa are linked to counterfeit or substandard anti-malaria drugs alone, according to the World Health Organization.
We aren’t out to make profits — that’s easy. We are interested in making quality drugs the only drugs in Lagos.
Temitope Awosika, co-founder, Medsaf
Medsaf started as a vitamin company, but it has become a curated platform that connects pharmacies and hospitals with safe, cost-effective medications. When I meet Nwakah, 35, in her office on Lagos’ booming Victoria Island, she and Medsaf co-founder Temitope Awosika are bent over a laptop discussing numbers and new distribution targets as they plot a regional expansion. Because Nigeria accounts for more than 60 percent of the drug supply in West Africa, the counterfeit drug problem extends far beyond its borders.
Nwakah grew up in the Chicago area. Her father left Nigeria in the early 1970s, after the civil war, with several friends, all determined to study in the United States and become lawyers, doctors and bankers — to live out the American Dream with their families. Nwakah’s father became a banker and provided a comfortable life for his daughter. Both her parents have a complicated relationship with their homeland. “While my family is proud of the work I’m doing, they sometimes still think I won’t last in Nigeria,” she says.
Nwakah followed the highly educated path established by her father and started traveling abroad while enrolled in an international MBA program at Georgia State University. She studied in Rio de Janeiro and Paris before moving to Lagos to intern at a cable television company, where she made little more than $50 a month. Since then, she has moved across industries, with her most recent stint as a vice president for a Lagos-based clean energy company looking to help resolve the issue of Nigeria’s erratic power supply for local corporations.
The death of Nwakah’s friend inspired her to team up with Awosika, a pharmacist by training whom she met via mutual friends, to start Vitamins.ng. But as they surveyed manufacturers, hospitals, pharmacies and drug consumers, their focus turned to medicines. Trying to create a different kind of culture proved difficult, as sales reps typically “go outside under the scorching sun to sell and meet a quota,” Nwakah says, instead of the relationship-focused approach that she and Awosika favor. Medsaf’s staff has grown to 10 people in Lagos, mostly scientists and pharmacists, and there is another smaller team in Portugal to manage the website.
While Nwakah doesn’t feel embraced in Nigeria, her stubbornness and refusal to be fake are what make her perfect to run a business in the country, according to her co-founder. “From the very beginning, Vivian had a clear idea of how we needed to run, and that vision has helped us make better decisions, including the hard decisions,” Awosika says. “We are currently on course to [meet] all of our targets. We aren’t out to make profits — that’s easy. We are interested in making quality drugs the only drugs in Lagos.”
Since its launch, Medsaf has partnered with more than 500 pharmacies and close to 100 hospitals to sell medication around the country, processing 150 million doses of drugs. Funded primarily out of pocket, the startup is generating between $15,000 and $20,000 per month. But the bureaucratic hurdles to clear in getting these drugs to consumers are daunting. “Most of the drugs needed in Nigeria are either not available or not composed properly, and getting them manufactured and then registered in Nigeria tends to be a serious problem,” Nwakah says.
While the Pharmaceutical Society of Nigeria gave a “good faith” registration and induction to the startup, the National Agency for Food and Drug Administration and Control (NAFDAC) — which is well-attuned to the fake drugs crisis — can be more demanding. Nwakah says Medsaf must cover travel expenses for NAFDAC officials to inspect the startup’s drug manufacturers, most of which are outside Nigeria.
Medsaf is a valuable validator for medicines, but the biggest problem for the startup is one it cannot solve: poverty. Nigeria recently overtook India as the world’s poverty capital — with 87 million people living in extreme poverty. Though it is falling, inflation remains above 11 percent, further sapping purchasing power. “Nobody sets out to buy fake drugs, but with so many unregulated versions in shops and kiosks without licenses that are cheaper, the average poor Nigerian will take it,” says Zubair Abdulahi, a doctor who has worked in the biggest teaching hospital in Lagos. “Nigeria in recent years has turned into a dumping ground for lesser-quality variants from other countries. And without a government clampdown, Medsaf’s efforts, while noble, will not quite do anything constructive.”
Nwakah is more focused on finding a new and better way to distribute safe, effective medicines in Nigeria, and hopes to raise $5 million in capital and expand to 4,000 medical facilities. She won’t solve her adopted country’s ills herself, but if one malaria sufferer can get lifesaving instead of life-ending medicine, it’s worth it.