Imagine this: you are down with an ailment. You have been consistently taking your medication as prescribed by the physician. However, there is no sign of improvement. If anything, your health is deteriorating. You realise much later that you have been taking fake or substandard drugs. What is worse? You have irreversible effects.
Substandard medicines are a major public health threat in Africa. For instance, the World Health Organization(WHO) estimates that over 280,000 children die annually because of taking falsified or substandard medicines as treatment for pneumonia and malaria in sub-Saharan Africa.
When medicines do not work the way they should (as is the case with most substandard and falsified medical products), they can prolong illness and the inconvenience, time off work and often the misery that go with it.
“Doctors waste precious time trying out alternative treatments, when all that is really needed is a quality version of the same treatment. In the worst cases, several of which are described in this report, people die, either from untreated disease or because the product itself kills them,” says the WHO 2017 Global Surveillance and Monitoring System.
Africa suffers the most as an ‘easy target’ for counterfeiters. According to a November 2018 policy belief titled ‘The rise of counterfeit pharmaceuticals in Africa’ by Enact and European Union, the value of the illegal market for non-standard and falsified drugs is estimated to be worth $200 billion annually, or about 10-15% of the global pharmaceutical market. 42% of the detected cases of substandard or falsified pharmaceuticals occur in Africa.
Against this background, African countries are up to the challenge to deal with criminalizing trafficking in fake drugs.
The Presidents of the Republic of the Congo, Niger, Senegal, Togo, Uganda, Ghana and the Gambia met Lomé, Togo, on January 17 and 18 2020 to sign the Lomé Initiative, a binding agreement to criminalize the trafficking of falsified medicines.
Developed over two years and coordinated by the Brazzaville Foundation, the Lomé Initiative seeks to make presidents committed to introduce legislation which criminalises the trafficking of fake medicines. This is the first phase of a wider programme to ensure access to safe and effective medicines for all their citizens.
“It will help to combat a deadly trade that claims hundreds of thousands of lives every year in Africa and funds transnational crime and terrorism. Criminalising the traffic of falsified medicines is at the heart of the Initiative. This lucrative traffic threatens regional security as it yields huge profits for organised criminal groups,” the Brazzaville Foundation said in a press release.
It added: “In many African countries the necessary criminal legislation does not exist. The Lomé Initiative will result in new criminal legislation interdicting this traffic, imposing tough penalties and strengthening capacities for rigorous enforcement, in adherence with relevant international agreements. Other African countries will be encouraged to join this initiative.”
Jean-Yves Ollivier, President of the Brazzaville Foundation concurred that the proliferation of fake medicines is a public health crisis that “we can no longer afford to ignore. People all over the world are dying every day because this scourge has not been given the priority it deserves.”
Ollivier hopes that the commitment of the African heads of state will encourage other leaders on the continent to join the fight.
“The abhorrent traffic in falsified medicines also generates huge profits for criminals and terrorists, destabilising some of the most fragile countries. That is why we are proud to have developed the Lomé Initiative. We must all take a stand against this scourge,” said Ollivier.
Antimalarials and antibiotics are among the most commonly reported substandard or falsified medical products. In fact, UN Office on Drugs and Crime (UNODC) puts the percentage of failed malarial drugs test in Africa at between 12% and 82%. Every year, between 655,000 and 1.2 million people die from the P. falciparum infection that causes malaria. Children in sub-Saharan Africa and Southeast Asia are at highest risk of contracting and dying from the disease, and more than 3 billion people in 106 countries are at risk of contracting malaria.
Although more incidents of medical counterfeiting crime are reported in wealthier countries, there is growing evidence by UNODC that shows that the penetration of counterfeit pharmaceuticals is actually much greater in the developing world: that poorer countries experience about 30% penetration, as opposed to less than 1% in the developed world.
In most countries, national drug councils are working to tackle the new challenge with Interpol. For example, in 2016, about 103 countries were involved in the annual operation, coordinated by Interpol, which led to the suspension of 4932 Internet pharmacies and nearly 400 arrests. The underground market often takes advantage of the loopholes in drug distribution systems to channels counterfeits into hospitals, pharmacies and other distributors. Health workers and patients are often unable to detect or differentiate bed genuine medicines.
Since 2012, the WHO has issued 23 alerts for products in the Africa region.
By Carol Natukunda