Fighting Fake Drugs

Pills
Flickr, by Rodrigo Senna

One of the international community’s top priorities (Millennium Development Goal number eight) is to make sure people in developing countries have access to essential drugs and treatments.

Criminals have decided to help out.

Last week, Interpol coordinated police raids throughout East Africa — in Burundi, Kenya, Rwanda, Tanzania and Uganda — seizing 10 tons of counterfeit drugs and arresting some 80 people. The operation, dubbed Mamba III (in case it’s ever made into a movie, I guess), was done in cooperation with the World Health Organization’s International Medical Products Anti-Counterfeiting Taskforce (IMPACT).

Fake drugs are a big and growing problem, especially in Africa.

“The consequences of all this can be deadly,” said Andy Stergachis, a UW professor of global health active in the little-known field of “pharmacovigilance” (which, no, doesn’t make him a pharmaco-vigilante).

Fake or diluted malaria medications are especially popular among counterfeiters, Stergachis said, which pose a serious risk to more vulnerable groups such as children and pregnant women.

Some experts have estimated that 700,000 people in Africa alone die from taking counterfeit drugs that may contain just sawdust, baby powder or flour. Contaminated or diluted medications also pose a risk to the world at large because of the potential for creating drug-resistant bugs due to insufficient drug potency.

“This is becoming an increasingly serious problem in Africa and also Southeast Asia,” Stergachis said.

Stergachis just returned from Nairobi, Kenya, where he and others like Ghana’s Alex Dodoo met to explore methods for fighting this deadly trade, and for strengthening the pharmaceutical systems in the developing world. I met Dodoo (I already knew Andy) a few months ago when he came to Seattle to talk about Africa’s problem with fake drugs.

Ghanaians have come up with some particularly creative methods for fighting the drug counterfeiters, including text messaging.

Andy Stergachis and Alex Dodoo
by Tom Paulson

But it’s not just criminals who cause problems, Dodoo said.

“Some donated drugs are the ones nobody else wants and that drug companies are trying to get rid of,” said Dodoo, a pharmacologist from the University of Ghana Medical School who is pushing for better monitoring of drug safety and efficacy throughout Africa and the developing world.

At his talk in Seattle, Dodoo told a story about a potent anti-malaria drug, called LapDap, developed by a European drug company and promoted by health officials in Ghana.

Once put into wide use, it ended up causing serious side effects. Dodoo said later analysis showed an estimated 20 percent of Africans had a genetic variation that made the drug toxic given their different metabolism. The episode prompted public outrage, he said, and generated mistrust of the government’s anti-malaria campaign.

“We’re not immune to this problem here in the U.S. either,” said Stergachis, recalling the Heparin episode in 2008.

A batch of the blood-thinner Heparin — a licensed, legitimate drug — was recalled in 2008 only after the FDA began investigating reports of deaths and injuries. It turned out that a tainted and counterfeit ingredient had been supplied to its manufacturer, Baxter, by a Chinese pharmaceutical firm.

Many, if not most, active ingredients in drugs are now made overseas. Given the global nature of drug manufacturing and distribution, Stergachis said it is in everyone’s interest to fight fake drugs.

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Tom Paulson

Tom Paulson is founder and lead journalist at Humanosphere. Prior to operating this online news site, he reported on science,  medicine, health policy, aid and development for the Seattle Post-Intelligencer. Contact him at tom[at]humanosphere.org or follow him on Twitter @tompaulson.