News Update
Double Bind
In their new report on medicine distribution networks in Africa, CFAO Healthcare examines the destabilizing effect of substandard medicine markets on the entire healthcare ecosystem:
The trade in fake medicines endangers public trust in health and social systems. On one hand, the fake trade diverts people from the formal care pathway. Street markets are not exclusive to the most destitute patients – many people go to these markets out of habit for their daily shopping and pick up medicines, real or fake, at attractive prices. This ease of access, paired with a word-of-mouth factor, creates a negative dynamic for the official network, which suffers from a lack of proximity to populations.
On the other hand, the omnipresence of fake medicines erodes the messages and legitimacy of health actors. Certain patients believe that health authorities are unable to manage trafficking issues, while others deem them overly alarmist, attributing health officials’ opposition to traditional medicines to fallacious reasons, such as enriching large pharmaceutical companies. In the face of these obstacles, health authorities' awareness-raising efforts struggle to convince, particularly given that misinformation is widely present in Africa, as elsewhere.
The brief also includes several case studies from countries that have successfully implemented anti-fake medicine programs in these markets.
Legal Accountability
During a livestreamed WHA78 roundtable, Fight the Fakes Alliance Academic Chair Oksana Pyzik issued a powerful call to hold those responsible for producing and distributing falsified medicines accountable:
“We need to disincentivize this. This is a serious crime, even with substandard products. When the contamination is the to the point of mass poisoning, there is a legal argument around criminal negligence and we need to have accountability. The victims deserve a recourse for justice...for the loved ones they have lost. This affects real people, real lives, and fake medicines can cause real harm.”
The session, which was moderated by WHO’s Oyuntungalag Namjilsuren, also featured perspectives from Dr. Rutendo Kuwana, the WHO Team lead for substandard/falsified medical products and Dr. Obaidullah (Ph.D, MPH), Head of the Drug Regulatory Authority of Pakistan.
Bana Mangangas
Writing for ENAC, researcher Raoul Sumo Tayo argues that despite recent progress, Congo-Brazzaville continues to face considerable challenges in combatting the threat of substandard medicines.
Good manufacturing practices oversight for imported medicine is non-existent. This despite Congolese pharmacists advocating for government to expand the regulations on imported medication, particularly on the conditions of storage and handling and the associated risks of contamination of medical products. Despite signing the Lomé Initiative, laws against the sale and possession of drugs outside official channels remain unenforced in Congo, allowing vendors to operate with minimal risk. Although sporadic police raids occur where these products are sold, bana manganga [the sellers] return shortly after.
Efforts to combat street drugs often come up against conflicting stakeholder interests, hampering comprehensive action against illicit medicine sales. Disagreement about how to define illicit medicines among these actors complicates legal frameworks and punitive measures aimed at discouraging and penalising criminal activities surrounding it.
No Other Choice
Global Press Journal Reporter-in-Residence Gamuchirai Masiyiwa explores the smuggled medicine trade in Zimbabwe:
Some vendors even offer diagnoses to their customers, even though they don’t have any medical training. And in many cases, the medicine is fake. At any moment, police could swoop in for a raid. Vendors keep the medicine out of view, and buyers know who to ask.
Gladys Chihozhwa buys contraceptive pills from one of them, and even turns to the vendors for diagnoses when she’s sick. She knows the drugs might be expired, or even fake. That doesn’t deter her. “I buy them because they are cheap,” she says.
Disrupted Employment Chains
In her piece for The Chanzo Initiative, journalist Zahara Tundra interviews expert economist, Dr. Timothy Lyanga to get a better understanding of the ways in which counterfeit medicines can undermine economic growth. She writes:
Dr Lyanga explained that the loopholes allowing counterfeit goods into the country discourage investment and drive away investors who have already invested locally. If that happens, he noted, it creates a hostile environment for economic growth because the country will lack producers and instead depend on imports.
Regarding individual economic well-being, he explained that it deteriorates because domestic producers employ local people in various activities. “The employment chain in production is long and involves many people, compared to an importer of counterfeit goods who needs very few distributors,” he said. “As a result, a system that provides jobs to many collapses, replaced by one employing only a few,” he explained. “Those who lose their jobs lose their income, and the people who depended on them lose services. Gradually, the poverty chain spreads and affects everyone.”
Empowering Allies
In The Liberian Investigator, Edwin Dolo recaps recent remarks by Dr. Luke Bawo, head of Liberia’s health regulatory agency, urging sports journalists to join efforts to combat falsified medicines.
At the annual awards ceremony honoring Liberian athletes and sports journalists, the Liberia Medicines and Health Products Regulatory Authority (LMHRA) issued a strong call to action, urging members of the Sports Writers Association of Liberia (SWAL) to become allies in the fight against substandard and falsified medicines.
The authority outlined several ways SWAL can meaningfully contribute to this national campaign — from publishing in-depth articles that educate the public and athletes about the dangers of falsified medicines, to sharing real-life stories of athletes affected by such drugs.
Dr. [Luke] Bawo also encouraged sports journalists to investigate and expose cases of counterfeit medications in sports, hold perpetrators accountable, and collaborate with anti-doping agencies to promote clean competition. “Use your social media platforms to raise awareness and educate followers about the risks associated with fake medications,” he urged.
The call was part of a broader effort by LMHRA authorities to curtail the spread of counterfeit medicines nationwide by leveraging external stakeholders – including the media. In June 2024, for example, Dr. Bawo and his team held a special media workshop to help publishers better identify and block false health advertisements.
Supporting Oncology Providers
In April, Pfizer’s chief oncology medical officer Karin Tollefson and chief security office Lev Kubiak spoke with OncLive about the growing threat of substandard cancer medications, and outlined steps oncologists can take to ensure their patients only receive safe and effective treatments:
Some patients may not readily admit that they ordered from an online discount distributor. Physicians can ask gentle, open-ended questions such as, “By the way, have you found a reliable pharmacy for this prescription?” If they mention anything unusual, [Tollefson] added, physicians should educate them about recognizing a legitimate vendor and avoiding fakes; they also can provide tips for verifying URLs, looking for recognized seals (VIPPS in the US), and not purchasing products from sites that sell prescription medications without a prescription.
Oncologists also can offer brief printed tips or a digital resource that explains red flags (e.g., weird pill appearances, unbelievably low prices, websites with no clear contact information), Tollefson said. In parallel, [Lev] Kubiak emphasized, they can remind patients that they can access official financial assistance programs including manufacturer co-pay aids.
Counseling patients about safe purchasing channels is crucial, Tollefson agreed, adding, “I know these treatments can be expensive, but there are legitimate discount and assistance programs patients may qualify for.”
Websites We Follow:
World Patients Alliance
Advocating for patient safety around the world
Securing Industry
Anti-Counterfeiting news aggregator
International AntiCounterfeiting Coalition
Leading global organization focused mostly on IP, but also tackles medicine integrity
Feeds We Follow:
Twitter
@UNODC
United National Office on Drugs and Crime
Works to crack down on counterfeit and substandard medicines
@ASM_Asia
Alliance for Safe Medicines Asia
Collaborating to combat fake meds in the Asian continent