West Africa fights to keep bad medicine off shelves

Kuwait Times - - HEALTH & SCIENCE -

As West Africa de­clares war on the mar­ket for ex­pired and coun­ter­feit medicines, start-ups are putting qual­ity con­trol in the hands of pa­tients to stop them risk­ing their lives try­ing to get well. Not only can such drugs fail to treat the dis­eases they are bought to com­bat, ex­perts say, but they may en­cour­age re­sis­tance to an­tibi­otics and even cause death as dis­eases con­tinue to course unchecked through the body. At an April meet­ing in Liberia, the 15-mem­ber Eco­nomic Com­mu­nity of West African States (ECOWAS) an­nounced a re­gion-wide in­ves­ti­ga­tion into the traf­fick­ing of ex­pired and coun­ter­feit drugs, and a pub­lic aware­ness cam­paign.

Traf­fick­ers in bad medicine prey on some of the world’s poor­est and most in need, who also face high costs for health care and of­ten lack in­sur­ance, said Adama Kane, who founded the health start-up JokkoSante in Sene­gal to tackle the prob­lem. Per­versely, piles of per­fectly good med­i­ca­tion go un­used in Sene­gal, Kane noted - a prob­lem that JokkoSante tack­les by or­ga­niz­ing the col­lec­tion of un­used drugs from peo­ple who are awarded points in ex­change to ob­tain other medicines later. Hand­ing in asthma med­i­ca­tion at an ex­change point in a health cen­tre in Passy, cen­tral Sene­gal, JokkoSante user Marie Gu­eye is one of those to ben­e­fit. “My fam­ily and I no longer have prob­lems get­ting med­i­ca­tion. All we have to do is come here and col­lect the points,” she told AFP.

For Sene­gal’s ru­ral house­holds, up to 73 per­cent of health-re­lated ex­penses go on med­i­ca­tion, ac­cord­ing to JokkoSante re­search. Half the over­all pop­u­la­tion has no health in­sur­ance cov­er­age. “Our app is used by hos­pi­tals, phar­ma­cies and health cen­tres,” Kane said, adding it was still at the pi­lot stage with 1,500 users so far. Peo­ple cre­ate an ac­count and op­er­ate the points sys­tem all via their mo­bile phone. For those too poor to buy drugs at all, JokkoSante has teamed up with large com­pany spon­sors, in­clud­ing phone op­er­a­tor Sona­tel, who cover the cost of pro­vid­ing pa­tients with free medicine.

Again, the sys­tem op­er­ates through a mo­bile app. At Di­amnia­dio chil­dren’s hospi­tal, near Sene­gal’s cap­i­tal, Dakar, Yacina Ba de­scribed the fear of com­ing to the end of the 50,000 CFA Francs ($85, 75 eu­ros) she scraped to­gether to buy treat­ment and med­i­ca­tion for her sick six-month-old baby, fi­nally beg­ging a doc­tor for help. “She had rashes all over her arms,” Ba told AFP, ex­plain­ing how the free treat­ment spon­sor­ship scheme made all the dif­fer­ence.

‘Most vul­ner­a­ble peo­ple’

A health worker at the hospi­tal, who asked not to be iden­ti­fied, con­ceded that a lack of spe­cial­ists meant medics of­ten over-pre­scribe med­i­ca­tion to those able to pay. This can lead to stock­piles of un­used, ex­pired drugs which may then fall into the wrong hands. “Fake drugs are usu­ally bought by the most vul­ner­a­ble sec­tions of so­ci­ety,” said JokkoSante’s Kane, who now over­sees a small net­work of phar­ma­cies us­ing his plat­form, while the govern­ment con­sid­ers a na­tion­wide roll­out.

The Amer­i­can So­ci­ety of Trop­i­cal Medicine and Hy­giene es­ti­mated in 2015 that 122,000 chil­dren un­der five died due to tak­ing poor-qual­ity an­ti­malar­i­als in Sub-Sa­ha­ran Africa, which, along with an­tibi­otics as the two most in-de­mand, are the medicines most likely to be out-of-date or cheap copies.

China, In­dia drive traf­fick­ing

Coun­ter­feited drugs from China and In­dia are awash in west African mar­kets, ac­cord­ing to the Paris-based In­ter­na­tional In­sti­tute of Re­search Against Coun­ter­feit Medicines (IRACM). And they are of­ten in­dis­tin­guish­able from the gen­uine item, it warned. A joint IRACM and World Cus­toms Or­ga­ni­za­tion (WCO) seizure of med­i­cal sup­plies at 16 African ports late last year yielded no fewer than 113 mil­lion items of fake med­i­ca­tion, 5,000 med­i­cal de­vices and even vet­eri­nary prod­ucts. Every­thing from fake can­cer drugs to fake su­tures for op­er­a­tions can be found in such hauls. IRACM is work­ing with MPs on draft­ing leg­is­la­tion to crack down on traf­fick­ing in west Africa, but two in­no­va­tive com­pa­nies have al­ready taken the mat­ter in hand.

Sproxil, an anti-coun­ter­feit­ing start-up es­tab­lished in 2009, works by at­tach­ing a scratch panel to drug pack­ets. Con­sumers can check their prod­uct is the real deal by send­ing an SMS ver­i­fi­ca­tion code to the com­pany, which con­firms the au­then­tic­ity. In the last six years, the firm has had 50 mil­lion text mes­sages from cus­tomers across Africa and In­dia. Ireti Oluwagbemi, its Nige­ria-based spokes­woman, said fraud­sters “tar­get brands based on their mar­ket share”, mak­ing house­hold names the big­gest tar­gets.

There is plenty of money to be made. The global coun­ter­feit drug mar­ket is cur­rently worth around $85 bil­lion, ac­cord­ing to IRACM, and the pro­ceeds drive or­ga­nized crime. Sproxil’s clients in­clude pharma gi­ants such as Glax­oSmithK­line and No­var­tis, firms which lose mil­lions each year from pi­rated prod­ucts care­fully stamped with their brand­ing. “The con­se­quences of in­gest­ing these chem­i­cals can range from dis­com­fort to per­sis­tence of the dis­ease it’s sup­posed to be treat­ing, to death,” Oluwagbemi told AFP. —AFP

DAKAR: This file photo taken on April 21, 2015 shows peo­ple work­ing to de­stroy about 4 tonnes of coun­ter­feit and il­le­gal medicine seized in an op­er­a­tion as part of the fight against phar­ma­ceu­ti­cal crime called “Porc-Epic” (por­cu­pine) at the Champ de tir des Mamelles. —AFP

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