Why is Africa dumping ground for fake drugs

Fake and substandard drugs are sending hundreds of thousands of people to early graves every year

Doctors called for concerted effort to combat a “pandemic of bad drugs that kill 250,000 children a year” after taking shoddy or outright fake drugs intended to treat malaria and pneumonia alone.

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In a paper that was published on Monday revealed that tests have identified fake and ineffective copies of drugs, including those for malaria, cardiovascular and cancer diseases, as well as antibiotics.

It also revealed that many fakes have been found to contain everything from printer ink and paint to arsenic material.

However, according to Pharmacy and Poisons Board CEO Fred Siyoi, only antibiotics occasionally fail tests in the Kenyan market over poor storage, but not for being phoney.

“If antibiotics are not stored well, they go bad. All our antimalarials usually pass the quality test,” Dr Siyoi said.

The board’s post-marketing surveillance, which is done after every three months, has never unveiled fake cancer drugs, he said.

Dr Siyoi said that 80 per cent of drugs in the Kenyan market are imported from India and China.

“Whenever there is a shortage of drugs in the country, people take advantage to fill the gap, which can be harmful to the lives of Kenyans, but with the strategies we have come up with, the gaps are closed,” he said.

“We have deployed various technologies such as the spectrometer (the portable device that scans medicines for active ingredients). If there is no active ingredient, we seize, quarantine or destroy the drugs and issue an alert.”

The Pharmacy and Poisons Board CEO Fred Siyoi

Falsified and substandard medicines lead to poisoning, untreated and resistant diseases, treatment failure and early death.

The board has come up with a mobile-based innovation that identifies whether or not a drug is genuine. It has created a unique code to help identify the quality of medicines, be they imported or locally made, and track their movement across the country.

The health safety code will be available for Kenyans at chemists, clinics and other health facilities.

“Patients will be able to tell if it is genuine paracetamol, its side-effects, the pharmacy that dispensed it, and whether it is registered using the unique identifier number and code,” he said.

Dr Siyoi said that the board had instituted measures to deal with an influx of fake drugs, including GPS mapping of registered pharmacies, incorporating new technologies such as online licensing and reporting, having drug inspectors at ports of entry and carrying out product registration and evaluation to check all drugs entering the market.

This is on top of regular checks on manufacturing sites, and working with the Anti-Counterfeits Agency, the Directorate of Criminal Investigations, Interpol and the World Health Organisation.

However, a study that the Kenya Medical Research Institute read at the 9th Annual Scientific and Health Conference last month noted that there is substandard amoxicillin in the market.

The study sampled 24 brands of the drug — an oral suspension antibiotic — 11 of which failed the quality test. And yet the drug is prescribed in almost all health facilities for bacterial infections.

Dr Lucia Keter, the co-principal investigator in the study, said that all the brands that failed to meet standards were imported from India, while the locally manufactured ones passed the test.

The study, done to determine the quality of amoxicillin in selected private retail pharmacies within Nairobi Country, selected many brands and only subjected 24 to analysis.

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“Overall, 46 per cent were of poor quality,” Dr Keter said.

“Our findings highlight the need for regular post-market surveillance to inform on the situation of antibiotic quality in the Kenyan market,” the study suggests.

Doctors have since called for the WHO drug surveillance programme and an update to the UN’s sustainable development goals in which governments would ensure that at least 90 per cent of medicines in their countries are of high quality.

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Fake drugs are a major driver of disease resistance, which fuels the rise of superbugs.

“This is an urgent public health issue and we need to take action,” the study published in the American Journal says.

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Up to 10 per cent of drugs in low and middle income countries are of poor quality or outright fakes. Poor-quality drugs cost economies up to $200 billion (Sh20 trillion) a year and contribute to the increasing peril of disease resistance.

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