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Fake drug threat: What to do

THE problem of substandard and falsified medical products was once considered to be a problem of developing and low-income countries, but it has now become an issue for all. The problem affects countries from North America, Europe, all through to sub-Saharan Africa. The 2017 World Health Organisation (WHO) report on fake medicines estimates that at least 1 in 10 of all drugs sold in developing countries are fake or substandard. Sub-Saharan Africa is the worst hit and accounts for 42 percent of all substandard drugs. Zambia is among the countries that have reported these counterfeit medications.

Fake drugs generally contain wrong doses, incorrect ingredients or no active ingredients at all. In addition to this, a great number of registered medicines fail to meet the quality standards because of improper storage. Substandard medical products are authorised products that fail to meet the quality standards or specifications or both.

Unregistered or unlicensed medical products are products that have not undergone evaluation or approval by the National Regulatory Authority for the market in which they are marketed or distributed. Falsified medical products are those that deliberately or fraudulently misrepresent their identity, composition or source.
Fake or substandard drugs can lead to thousands of deaths. It has been reported that between 2007 and 2016, 72,000 deaths from childhood pneumonia could be attributed to the use of antibiotics with reduced efficacy and increasing to 169,000 deaths with drugs that had no activity at all.
The poor efficacy drugs can also add to the danger of antibiotic resistance and this can undermine the strength of life-saving medicines in future. Other studies have estimated that about 116,000 deaths from malaria annually could be due to substandard anti-malarials in sub-Saharan Africa.
Research has indicated that constrained access to affordable, quality, safe and effective medical products and low standards of governance such as poor ethical practices in healthcare facilities and medicine outlets, through to corruption in both the public and private sectors are the chief contributing factors to fake drugs. The other factor is the lack of tools and technical capacity to ensure good practices in manufacturing, quality control and distribution.
In the Zambian scenario to tackle the problem of fake drugs, solutions should include increased international collaboration and exchange of intelligence with other countries. This will help in the prevention of manufacture, sale and consumption of substandard and falsified medical products. The solutions should also be multidisciplinary and involve a wide range of professionals. There should be regular communication and interaction with healthcare professional organisations, the pharmaceutical industry, civil societies and players within the supply chain.
Another key solution is the increase in education and awareness among all stakeholders. This will involve the providing of accurate and balanced information on the dangers of fake drugs. The education should also include how to detect fake drugs and how to avoid the fake medical products. There is also need to train and support a network of national focal point persons in various sectors and develop tools to efficiently report fake medicinal products.
Additionally, to tackle fake medicines, there is need to have strong institutions for effective and transparent regulations which should be tailored to Zambia’s needs and according to WHO standards. Institutions such as the Zambia Regulatory Authority (ZAMRA) should also be strengthened and concerned stakeholders should support the organisation’s current efforts towards the tackling of fake drugs. Other institutions such as the Zambia Revenue Authority (ZRA), Anti-Corruption Commission (ACC), Drug Enforcement Commission (DEC) and the Zambia Police (ZP) should jump on board to tackle the problem.
The quality of medicines and medical products is one of the many things that can influence a person’s quality of life and productivity. There is therefore need for effective global coordinated mechanisms to tackle fake medications. With all the latest advances in technology, the world has never been better equipped to tackle the problem of substandard and falsified medical products.
This is also an opportunity for innovation and enterprise as new technologies are needed to detect substandard and falsified medical products. Apart from that, the manufacturing industry in Zambia needs support order to produce high-quality medicines with strict standards.
There is also greater need for political will to sustain the worldwide efforts and collaboration with various decision-makers. This also calls for every citizen to be very vigilant and contribute to the prevention, detection and action against fake drugs. It is also important for every person to ask critical questions before consuming medicine.
The authour is a pharmacist and staff development fellow at the Copperbelt University. Email: