Op-ed: We need to curb the rising risk of fake medical products

Richard Amalvy, Chief Executive of the Brazzaville Foundation, Prof. Moustafa Mijiyawa, Minister of Public Health of Togo, Greg Perry, Assistant Director General IFPMA, and Michel Sidibé, Special Envoy for the African Medicines Agency of the African Union, published an op-ed on 28 May.

"Imagine a sick child in a lower-income African country, suffering from a life-threatening condition and being cared for by desperate parents. The family is offered medication at a price they can afford, but unbeknownst to them, the offer is by unscrupulous traffickers of fake medicines. The family parts with the little money they have.

They administer, in good faith, a medication that in the best-case scenario will do nothing and in the worst-case scenario would harm the child, failing to treat the disease.

For almost a quarter of the world’s population, this could be an all-too-familiar reality.  Astonishingly, nearly 2 billion people lack access to essential medicines, vaccines, and medical devices. 

Where there is demand, there will be supply, and this vacuum is, too often, filled by substandard and falsified medicines, peddled by organizations searching for profit, no matter what the human cost. 

These organizations will kill over 122,000 children under five, who die each year due to poor-quality antimalarials in sub-Saharan Africa. In several African countries, falsified medicines account for between 30% and 60% of all medical products.

In the latest four-year period, the World Health Organization received 1,500 reports of substandard or falsified products, with the largest number of the reports coming from the African continent. Since the onset of COVID-19, this figure has only increased, opening new challenges in supply chains with falsified vaccines, therapeutics, and diagnostics in circulation.

More shockingly, up to 169,000 children with pneumonia may be dying each year due to falsified or substandard antibiotics or antimalarials, with 116,000 deaths from malaria for similar reasons in sub-Saharan Africa.

COVID-19 has amplified the urgent need for African countries to invest in effective and efficient regulation of medicines, medical products, and technologies. The ratification and establishment of the African Medicines Agency will be an essential instrument to strengthen the fight against substandard and falsified medicines and medical products and enable all patients in Africa to have access to quality medicines that are safe and effective.

In January 2020, at the initiative of the Togolese President Faure Gnassingbé, the Brazzaville Foundation organized an international summit in Lomé to discuss the challenges that substandard and falsified medicines pose to global security, supply chains, and to some African communities.

The event brought together six African heads of state and ministers from the Republic of Congo, Ghana, Niger, Senegal, Togo, and Uganda. Together they launched the Lomé initiative to criminalize the increase and spread of falsified and substandard medical products. Gambia has recently announced that it is also joining this fight and the World Health Organization and African Union continue to support this unique global initiative.

The seven states that now support the Lomé initiative have committed to fighting the trafficking of substandard and falsified medicines via ratifying existing international agreements, introducing new criminal sanctions against traffickers, and raising awareness about this public health issue. 

But further action can and will be taken by implementing a roadmap that specifically will help with the development and implementation of national plans to combat this traffic in its systemic dimension via advocacy, a stronger regulatory framework, and capacity building. These plans will have to be designed in an inter-ministerial manner.

This week is Africa Week and the 74th World Health Assembly. These events follow last week’s Global Health Summit, where world leaders called for stronger and more transparent drug supply chains, strong regulatory systems as well as equitable access to medical supplies.

To pursue this vital conversation, the Brazzaville Foundation gathered a set of global leaders Tuesday to continue to discuss this worrying public health and security issue. Their impetus is to smash the estimated $200 billion illegal market of substandard and falsified medicines, representing up to 15% of all drugs in circulation. 

The roundtable discussed the challenge that despite holding 17% of the world’s population, Africa only produces a small portion of the medicines.

Panelists agreed that the implementation of the Lomé initiative would be paramount to respond to the needs of the most vulnerable in need of essential medicines. It was evident from recent discussions that the demand for essential medicines is outstripping supply in African nations — which illicit activity is taking advantage of.

Having taken stock of existing and new national and global initiatives, panelists have assessed how COVID-19 has exacerbated the increasing risk of falsified and substandard medicines circulating in Africa.

With leading figures from the African Union, WHO, and the United Nations Office on Drugs and Crime, we have discussed how to strengthen future health systems and supply chains and improve our security and state of law.

We agreed that only together, in partnerships, can we build robust supply chains and national plans to ensure that everyone has access to affordable quality medicines and medical devices to achieve universal health coverage by 2030."

See the article on the Devex website.

Greg Perry

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