Dora Akunyili looks remarkably serene for a woman who has escaped an assassination attempt, whose family has been persecuted, and who now has eight armed guards at her side at all times.
But, as she puts it: "If I leave this job, the drug counterfeiters would emerge victorious."
In the six years since she took over as director general of Nigeria's National Agency for Food and Drug Administration and Control (Nafdac), Akunyili has waged a relentless war against fake medicine in her country.
Her battle is a personal one. In 1988, her sister died because she was given fake insulin for her diabetes.
She recalls: "Not only was it fake and did not contain the insulin she was supposed to take, but it was also contaminated and gave her abscesses. She did not respond to antibiotics, and we just watched helplessly until she died."
Before Akunyili took the job, deaths linked to fake drugs were commonplace in Nigeria. At least 41% of the drugs in circulation were thought to be counterfeit. And this, she says, was a conservative estimate. Some reports suggested as much as 80% of medicine in the country was fake.
Last year, a survey of 600 samples of drugs in Nigeria suggested that the proportion had fallen to 16.7%. It is just one indicator, but it suggests that Akunyili is having some success.
The problem of counterfeit drugs is not just an issue in developing countries, it is a global one. The World Health Organisation estimates that annual sales of counterfeit drugs total about $32bn (£15bn). This costs the pharmaceutical industry about $46bn a year in lost profits and endangers the lives of millions of people.
Akunyili and her team — she oversees 3,000 people who speak more than 300 languages — have engaged in a non-stop battle against fakes in her country. They have raised public awareness of the problem through campaigns and school competitions, they have increased spot checks at sea and airports, and they have publicly burnt fake drugs worth more than $150m. The actions of the agency have led to 45 convictions and 60 court cases are pending.
As one of her colleagues at the WHO says: "If the African continent were full of Doras, it would be easier to get rid of counterfeits."
But this struggle has come at a price. Akunyili has received countless death threats, and is in permanent fear for her life. In 2003, her son narrowly escaped kidnap by insisting Akunyili was his aunt, not his mother. Some of Nafdac's offices and facilities have been vandalized and burned.
All this culminated in an assassination attempt on Akunyili herself at the end of 2003, when she was shot at while on her way to her village.
She recalls: "Bullets shattered the back windscreen of my car, pierced my head scarf and burned my scalp like a hot water burn. A bus driver was killed on the spot."
Married with six children, Akunyili said her family had repeatedly pleaded with her to quit her job. Most of her children went to live in the US after the family was awarded a green card in 1996.
She and her husband decided to keep their youngest son at home. After the kidnapping attempt in 2003, though, he was promptly sent to the US to join his siblings.
Asked if the danger she faces is worth it, she responds: "If I left, the drug counterfeiters would feel that they had won. It's going to discourage all the staff working with me, it's going to discourage any genuine person from taking up the job. And it's also going to be even more dangerous for me." With her eight armed guards and a bulletproof car, Akunyili is relatively protected. "So if I leave tomorrow without government support, then it is natural that these security people would be withdrawn and my life would be more in danger."
At the time of writing, though, her car was being repaired. "I am avoiding Lagos because it is not safe."
Akunyili grew up in an upper middle class family — the daughter of a renowned businessman and politician. Because she was a bright child, her father decided she should not do any chores at home, instead leaving them all for her brothers and sisters. "He would eat with me, he would not eat with my other siblings. He was treating me as if I was the only child. My mother was not happy, and my siblings were not happy."
And so, at the age of 10, she was dispatched to her grandmother's village in the south, where her uncle, who was a teacher, would give her a good education.
"Village life is hell on earth. It was a shock to me as a child who was used to eating good food, having running water, to find myself in the village with no toilet facilities, no running water."
But the young Dora worked hard at her studies, and got a scholarship to go to high school. After the Nigerian civil war interrupted her schooling, she won another scholarship to go to university to study pharmacy, and after working for a while in a hospital, studied for a PhD. She rose through the academic ranks as a lecturer in various universities and colleges, all the while carrying on with her research. She also became involved in local government, and in 1997 was picked to coordinate Petroleum Trust Fund (PTF) projects to improve infrastructure in the south-east of Nigeria.
The chance to challenge counterfeiters came when she contracted an illness in 1999 — an event that she says changed the course of her life. The wrong diagnosis was made, and she was sent to London for treatment. The PTF paid for the treatment and gave her £5,000 to pay for tests and £12,000 for surgery.
After the tests, the doctors found they could treat the problem with simple medication. So she asked for the £12,000 back, as she was not having surgery, and returned it to the PTF.
This did not go unnoticed in a country plagued by corruption. President Obasanjo himself was told about the woman who had returned £12,000 to her employer, called her in for an interview and promptly gave her the difficult assignment of cleaning up the drug watchdog.
There was stiff opposition to her appointment. She recalls: " I was not a card-carrying politician, I did not belong to the ruling party, I did not have a political godfather and gender was also an issue. Above all, I am Igbo, from the Igbo tribe. The then health minister was Igbo, and a lot of the drug counterfeiters are Igbos."
Akunyili recalls her insecurity at taking on the task of cleaning up the organisation. "People there did not believe that I could confront the mafia, who had been unchallenged for almost three decades. It was a rude shock to the counterfeiters that we refused any discussion or negotiation for business to continue as usual."
She also had to tackle internal corruption, and set about doing it by removing staff she deemed corrupt, and employing new people on merit, offering various welfare packages and rewarding hard work. She also rewards staff who find their colleagues doing anything untoward.
And she points out: "It's not only that the figures are down, but in hospitals, there are reports of declining death rates, doctors are happy, and businesses are booming because there is now an even playing ground. The local industries have grown from 70 in 2001 to 150.
Multinationals that left Nigeria through frustration are coming back because of an improved regulatory environment. A ban on made-in-Nigeria drugs in other west African countries has been lifted."
But she admits that the battle is far from over, and that globally, the situation is getting worse. "Every year, it is increasing tremendously. In developed countries, the purchase of drugs through the internet is fuelling the problem."
Even in Britain, which is heavily regulated, the regulator seized counterfeit medicines with a retail value of £3m in the financial year 2006-2007. The regulator says this is likely to be repeated next year.
In true Dora style, she emphasizes her point: "The evil of fake drugs is worse than the combined scourge of malaria, HIV/Aids, armed robbery and illicit drugs. This is because malaria can be prevented or treated, HIV/A ids can be avoided, armed robbers may or may not kill, cocaine and similar drugs are taken out of choice and by those that can afford them, but fake drugs are taken by all, and anybody can be a victim."
But beyond the brave façade, it is clear that Akunyili is scared. "They [the counterfeiters] keep swearing that no matter how long it takes them, they will get me. I pray, because I don't want to die. I want to see my children — I want to see my grandchildren."
She says she is intent on completing her second five-year tenure at Nafdac. "I believe very strongly that I will finish on a good note, if I am still alive to get there."
CV
Born July 1954, Makurdi, Eastern Nigeria
Education University of Nigeria Nsukka (UNN)
Career
1978-1981 University of Nigeria Teaching Hospital (UNTH), Enugu, pharmacist
1982-1992 UNN, faculty of Pharmaceutical Sciences, research fellow, rising to senior lecturer
1992-1994 UNTH College of Medicine, senior lecturer
1994-1996 Supervisor for agriculture for Anaocha, Anambra State
1996-1997 UNTH College of Medicine, senior lecturer and consultant pharmacologist
1997-2000 PTF, coordinator of all projects for five south-eastern states
2001-present director general of the National Agency for Food and Drug Administration and Control, Nigeria
Family Married to John, six children