Counterfeit drugs are a deadly and growing problem globally, particularly in developing countries where supply chain security is limited, undermining progress towards meeting the Sustainable Development Goals (SDGs). The World Health Organization estimates that one in ten medical products circulating in developing countries are substandard or falsified.
The problem is rife within Africa with dire consequences. Of all the fake drugs reported to the WHO between 2013 and 2017, 42 percent of the reports came from the African region. In March 2019 alone, the WHO raised alerts for fake meningitis vaccines in Niger and fake hypertension drugs in Cameroon. Then, in August, falsified versions of the antibiotic Augmentin were discovered in Uganda and Kenya.
Counterfeit medicines have both health and economic consequences for the continent. They leach money from healthcare systems and kill thousands of people, mostly within vulnerable communities. However, from the counterfeiters’ point of view, this is a lucrative industry, with a global market worth roughly $200bn. Medicine counterfeiting has become an international operation involving many actors across different countries and sectors. It has become more lucrative than trafficking in hard drugs.
Q: Counterfeit medicines have both health and economic consequences for the continent. They leach money from healthcare systems and kill thousands of people, mostly within vulnerable communities
The continuous rise of substandard, falsified and counterfeit (SFC) medicines demands the development of innovative anti-counterfeiting measures to secure Africa’s medicine supply chain.
Leveraging global advancements in technology to develop fast and effective methods of identification of poor-quality medicines throughout the supply chain, stringent supply chain regulations, and enforcement regimes, amongst others, must be deployed to combat counterfeit medicines on the continent.
There is also a need to decentralize this role to ensure that each player in the supply chain can monitor quality. This can only be achieved by the use of appropriate technology.
Challenges impeding the fight against counterfeit medicines in Africa
Although the problem of illicit trade of counterfeit medicines in Africa is widely acknowledged, its complexities are poorly understood. Among other factors, the difficulty in combating counterfeit medicines stems from poor drug traceability, which relates to poor infrastructure, inadequate resource allocation to routine quality control (QC), and poor tracking across borders.
Also, Africa has no official data collection for counterfeit medicines, and tends to view healthcare and corruption as two distinct areas of public policy. For the criminals responsible for drug counterfeiting, these factors make Africa highly vulnerable and the continent may be seen as easy pickings. The counterfeiters are getting more sophisticated in their operations, hence the demand for much more resources and skill by regulators to counter them.
Tougher regulations and sentencing of medicine counterfeiters
Manufacturing and distributing counterfeit drugs are terrible crimes that cost lives and millions in enforcement budgets, yet punishment still does not fit the crime. International calls for tougher sentences on pharma fakers are getting louder, particularly in Africa. African governments need to introduce legislation with tough new criminal penalties and enforce it.
This will deter medicine counterfeiters and restore some sanity to the medicine supply chains. Community engagement and coordination among government agencies will be necessary to achieve this. Also, a continuous messaging on the impact of this crime on public health and economy needs to be sustained.
Africa regulators must be innovative and develop a practical and sustainable approach to combating counterfeit medicines on the continent. Fortunately, advancements in technology have led to the development of applications that provide efficient and reliable means of detecting counterfeit medicines. Other players in the supply chain beyond the regulators can actually deploy these technologies.
Deployment of technology in the fight against counterfeit medicines
Health Tech companies have developed various screening technologies (STs) for detecting falsified medicines and they are fast emerging as invaluable tools for quality evaluation in field-testing, as they provide on-site and in-time results. Unlike traditional QC confirmatory technologies, STs require significantly fewer resources and can test a larger number of samples within a short time.
They offer National Medicines Regulatory Authorities and other players fast and reliable means of detecting SF medicines on the field and removing them from the medicine supply chain. STs also enable pharmacists, who play a critical role in the supply chain, connecting producers and distributors to consumers, to authenticate the quality of medicines purchased for sale.
As several other screening technologies emerge, there is a need to carry out validation studies before deploying them for public use.
This will ensure they are accurate and comparable with QC data obtainable in the lab. In line with this, Bloom Public Health has partnered with the University of Michigan in a USAID-funded project to carry out a nationwide medicine quality study in Nigeria, evaluating screening technologies for combating counterfeit drugs.
The project is ongoing and hopes to show the comparability of a relatively new technology with existing ones. The study will show the causal impact of using STs in identifying and removing nefarious suppliers and reducing the incidence of adverse reactions and illnesses from low-quality medicines.
Conclusion
Counterfeit medicines undermine Africa’s hard-won progress on health, and erode trust in its emerging healthcare systems. Adopting innovative anti-counterfeiting measures is therefore necessary to achieve medicine security in Africa and make progress towards meeting Sustainable Development Goals.
Anyakora is the CEO of Bloom Public Health and a public health expert & Odibeli is a pharmacist and the regional communications manager at Bloom Public Health
