BusinessDay

Counterfeit drugs weakening Nigeria’s medicine security

Stiff scrutiny of the qualification and conformity of dealers with the standards of practice of the pharmaceutical business is the next tool to be deployed in Nigeria’s latest attempt to curb unsafe practices in its multibillion open drug market.

This was the introduction to the story ‘New Pharmacy Act aims to cripple multibillion open drug market’ last week in this medium.

The story went further: After several years of clamouring, the Pharmacy Council of Nigeria Bill received presidential assent on (last) Monday, empowering the council to oversee all players along the pharmaceutical chain and whip errant players into shape.

This comes about primarily as an attempt by the pharmacy union to curb the influx and circulation of counterfeit medicines, which the body believes thrives most among dealers in the Nigerian open drug market.

Manufacturing and distributing counterfeit drugs are terrible crimes that cost lives and millions in enforcement budgets, yet punishment still does not fit the crime

Counterfeit drugs are a deadly and growing problem globally, particularly in developing nations where supply chain security is limited, undermining progress towards meeting the Sustainable Development Goals (SDGs). The World Health Organisation estimates that one in ten medical products circulating in developing nations are substandard.

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. 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 remove 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 $200 billion.

The continuous rise in counterfeit 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, among others, must be deployed to combat counterfeit medicines on the continent. There is also a need to decentralise 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.

Although the problem of counterfeiting in Nigeria is widely known, but 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, 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. The counterfeiters are getting more sophisticated in their operations, hence the demand for much more resources and skill by regulators to counter them.

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 drug 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.

We have to commend the work of our local drug makers who have gone all out to reduce this menace by advising consumers to scratch and call the drug maker to authenticate the medicine. Also, the drug makers should strengthen collaboration with the NAFDAC in this fight against counterfeiting.

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.

Health tech firms have developed various screening technologies 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 confirmatory technologies, screening technologies 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 counterfeit medicines on the field and removing them from the medicine supply chain. Screening technologies 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 screening technologies in identifying and removing nefarious suppliers and reducing the incidence of adverse reactions and illnesses from low-quality medicines.

Counterfeit medicines undermine Nigeria’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 SDGs, note Chimezie Anyakora and Ofure Odibeli in an article.

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