West Africa in fight to keep bad medicines off the shelves


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 or­gan­is­ing 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 said.

For Sene­gal’s ru­ral house­holds, up to 73% 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 via their cell­phone.

For those too poor to buy drugs, 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) she scraped to­gether to buy treat­ment and med­i­ca­tion for her sick six-mon­thold baby, fi­nally beg­ging a doc­tor for help.

“She had rashes all over her arms,” Ba said, ex­plain­ing how the free treat­ment spon­sor­ship scheme made all the dif­fer­ence.

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.

Coun­ter­feited drugs from China and India are awash in West African mar­kets, ac­cord­ing to the Paris-based In­ter­na­tional In­sti­tute of Re­search Against Coun­ter­feit Medicines.

And they are of­ten in­dis­tin­guish­able from the gen­uine item, it warned. – AFP

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