The response of young Africans to counterfeit medicines

by MMC
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Africa is one of the regions worst affected by the global trade in counterfeit medicines, which has led to deaths and damaged economies. But a growing number of innovative young people are adopting technology to combat this trend. Their efforts are paying off.

Africa counterfeit medicine market is as complex as its distribution networks and the people involved in their management. The sector is estimated to be worth 200 billion dollars each year, which makes medicines the most counterfeited consumer good in the world.

According to the World Health Organization, one in 10 medical products in low-income countries, such as those in Africa, is of substandard or false quality. The organization further emphasized that 42 percent of all fake medicines reported to it between 2013 and 2017 came from Africa.

Make use of the crawl space

What has now become a public health crisis is fueled by the fact that with underdeveloped health sectorthe continent imports between 70 to 90 percent of all drugs, which represents approximately $14 billion per year.

The situation is particularly dire in sub-Saharan Africa, where up to 500,000 people die from consuming counterfeit medicines, according to one report. report by the United Nations Office on Drugs and Crime (UNODC).

Additionally, more than 160,000 deaths each year in the region are linked to substandard or falsified antibiotics used to treat serious pneumonia in children. The annual cost of treating people who have used counterfeit malaria drugs in the region is between $12 million and $44.7 million, according to the WHO, cited in the UNODC report.

In a case that has captured worldwide attention, Nigerian authorities have revealed how more than 80 children had died after consuming teething syrup containing a chemical commonly used in engine coolants that triggers kidney failure.

In March 2019, Cameroonian authorities sounded the alarm over fake hypertension medications, while the Nigerien government warned against fake hypertension medications. meningitis vaccines and the The WHO has drawn attention to falsified versions of the Augmentin antibiotics that were in circulation in Kenya and Uganda.

“Investigations have revealed the involvement of a wide range of opportunistic actors in the trafficking of medical products in Sahel countries, from pharmaceutical company employees, civil servants, law enforcement and agency agents health professionals to street vendors, all motivated by potential financial gain. “, reads the UNODC report.

John Otieno, a medical expert who studies counterfeit markets in East Africa, told FairPlanet that a cocktail of factors is responsible for the unprecedented proliferation of fake medicines in Africa.

“This is a complex and sophisticated network that has taken advantage of weak legislation, enforcement problems and porous borders,” he said. “A growing demand for medicines caused by a lack of infrastructure in Africa to produce them locally has led to a shortage of supply which has created this gap.”

Experiment with technology

As the situation worsens, so do efforts to tame and counter the impacts of black business. Young Africans and startups across the continent are launching a wave of innovations, including apps, barcode technology and scanners, aimed at identifying counterfeit medicines.

They are motivated by their personal experiences with counterfeit medicines and their desire to find local solutions to local problems, at a time when the continent is experiencing a technology boom and a growing number of young innovative minds.

The Save a Soul team, a group of Nigerian technicians, manages a mobile application called FD Detector, Fake Drug Detector. It allows health officials and customers with smartphones to scan a medicine’s barcode and verify its authenticity while indicating its expiration date. The technology also allows users to report fake medicines to the relevant authorities.

While appreciating the central role innovation plays in stemming the flow of counterfeit medicines, Otieno, the medical expert, says it is limited in terms of scalability, given that much of the population is illiterate and unable to access smartphones.

“(People) in rural areas have limited access to smartphones. It might be difficult for them to authenticate these medications, which is why alternatives such as short SMS codes that work with feature phones are proving useful.” , did he declare. “But, more importantly, a lot of investment needs to go into raising awareness and empowering citizens in this space.”

In Tanzania, Bukhary Kibonajoro is the brains behind Okoa, Swahili for to safeguardcloud-based software that allows health officials, government personnel and citizens to access data reports on the movement of medical supplies from national stores to local health centers and to patients.

The platform automatically generates reports that help identify any cases of theft throughout the supply chain while informing patients of the availability of medicines at different healthcare facilities before visiting them. This closes the loopholes of theft and corruption, says Kibonajoro.

“Drug theft is an organized crime and a multi-million dollar business that involves high-profile figures, including central government officials, health facility officials, businessmen and doctors. I faced so much resistance from all sides that I almost gave up. I’m glad I never did,” Bukhary said, appreciating the central role that technology continues to play in streamlining the health sector on the continent.

“Technology is our saving grace, especially for vital sectors like healthcare. From early diagnostics, timely interventions, improving operations to fighting fraud,” he added. “If Africa wants to streamline its health sector, it absolutely must embrace technology there. There are no two ways about it.”

mPedigreea Ghanaian startup, is also on the frontline in the fight against fake medicines and generates SMS codes to help users authenticate the status of medicines.

The innovation tracks medicines from production to consumption using software that allows consumers to scan and verify the medicines they purchase through a code they text to a toll-free line or by scanning a barcode with their phone’s camera.

But while this innovation has been hailed as a watershed, some industry players and reports dispute the use of barcodes as a cure for counterfeits and point out that weaknesses in the system make the supply chain vulnerable to the proliferation of fake medicines.

“A glaring weakness is the barcode attached to the outer packaging of medicines – boxes containing blister packs of tablets and bottles containing loose pills,” noted one report by PwC Strategy entitled “Fighting counterfeit pharmaceuticals: new defenses against an underestimated – and growing – threat”. “This could allow a counterfeiter with a smartphone camera and access to production or distribution facilities to compromise codes on external containers.

It further reads: “Counterfeiters could take photos of legitimate package-specific barcodes and use the images to create counterfeits. They could then put the counterfeit codes on packets of falsified medicines and slip them through distribution channels with little chance of detection, provided that the counterfeits arrive at dispensing points before legitimate products bearing identical codes.

The wave of innovations is making a notable contribution to a sector of the continent that is both battered and crucial, and experts say technologies aimed at stemming the flow of illicit drugs will benefit greatly from increased political will and adequate policy frameworks.

A boon and a curse

But while the technology has been widely hailed as a miracle solution in the fight against counterfeits, it has also contributed to the proliferation of fake medicines. For example, illegal online pharmacies have proliferated, even in the most remote parts of the world. They bypass traditional physical security controls and barriers, making it even more difficult to track counterfeits.

According to the World Health Organization, 50 percent medicines available online are fake. At the same time, of the 50,000 operational online pharmacies, around 95% do not comply with consumer protection laws and industry standards, according to a PwC strategic report.

Dr Harrison Mueke, from Maseno University School of Medicine in Kenya, says collaboration between government and the private sector can go a long way in curbing the proliferation of fake medicines online as technology advances and that counterfeiters are looking for more innovative ways to circumvent the system.

“The government cannot do it alone,” he told FairPlanet. “The private sector is directly involved in the supply chain and understands the dynamics.”

A good example is the partnership between the Center for Safe Internet PharmaciesInternet service providers including Microsoft, Google and Yahoo and the US government, which have decided to close illegal sites while raising awareness of the threat of counterfeiting.

Experts further emphasize that innovations cannot operate in a vacuum and can only be effective if the appropriate policies and laws are adopted. And while most African countries have instituted regulations relating to fake medicines, their Achilles heel remains implementation, with many countries appointing numerous anti-counterfeiting agencies that vie for authority while giving a hard time to counterfeiters.

There is also the challenge of implementing regulations across borders. Some policies may apply and govern medicines produced and distributed within a single country or bloc of countries, but do not have the same force in their application in another. This compromises the integrity of the supply chain.

Many African countries are trying to fill this gap. In 2020, the heads of state of seven African countries met in the capital of Togo find a multifaceted and unified approach to combating fake medicines in the region. The result was the Lomé Initiative, a political declaration that seeks to classify the trade in fake pharmaceuticals as a serious crime punishable by the strictest laws.

As more innovations come into play to combat the counterfeit medicine crisis and the market for counterfeit medicines grows, information sharing, collaboration and the development of enforceable laws and policies could s prove to be a crucial step in getting ahead of counterfeiters, experts say.

Image of Maatla Seetelo.

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