23 August, Lomé (Togo) - The trafficking and consumption of falsified and substandard medicines (FSMs) is a scourge that does not spare Africa. On the 72nd session of the World Health Organization (WHO) Regional Committee for Africa, the Brazzaville Foundation co-organised a side event with the Ministry of Health of the Republic of Togo and the WHO Regional Office for Africa.
Watch the replay of the event below:
Entitled "Fighting medicines that kill in Africa: A collaborative and integrated approach", the meeting focused on the coordination of the fight against FSMs in Africa and included the following panelists: Dr Tedros Adhanom Ghebreyesus, WHO Director General and Dr Joseph Kaboré, WHO Director of Programme Management for Africa, Prof. Moustafa Mijiyawa, Minister of Health of the Togolese Republic, and his Rwandan peer, Dr Daniel Ngamije, Ms. Minata Samaté Cessouma, Commissioner for Health, Humanitarian Affairs and Social Development at the African Union, Dr. Mamessilé Aklah Agba-Assih, Minister of Health, Public Hygiene and Universal Access to Health Care of Togo and Mr. Richard Amalvy, Chief Executive of the Brazzaville Foundation.
Family photo of the participants (from left to right): Dr Mamessilé Aklah Agba-Assih, Minister of Health, Public Hygiene and Universal Access to Health Care of Togo; Dr Joseph Kaboré, Director of WHO Programme Management for Africa; Dr Tedros Adhanom Ghebreyesus, Director-General of WHO; Ms Minata Samaté Cessouma, Commissioner for Health, Humanitarian Affairs and Social Development of the African Union; Dr Daniel Ngamije, Minister of Health of Rwanda; Mr. Richard Amalvy, Chief Executive of the Brazzaville Foundation.
A dynamic of mutualisation and cooperation
This exchange was part of a new dynamic in Africa regarding access to quality and affordable medicines. Firstly, through the operationalisation of theAfrican Medicines Agency (AMA) which will be based in Rwanda.. Secondly, a pilot project was launched in Togo at the end of the year to set up a national plan to combat QIFM. This project is part of the Lomé Initiative (LDI), launched at a summit summit organised by the Brazzaville Foundation in 2020 in Togo, resulting in the Lomé Declaration signed by six African states.
Prof. Moustafa Mijiyawa, Minister of Health, Public Hygiene and Universal Access to Health Care of the Togolese Republic, and also the political coordinator of the IDL, recalled the systemic nature of the trafficking of ITMs: "Everyone agrees that a national action is ineffective. Everyone agrees that one sector within a country cannot deal with it." Dr Tedros Adhanom Ghebreyesus, Director-General of WHO, who was also present at the Lomé summit in January 2020, named the three factors that drive the proliferation of IPMs in Africa: "Lack of access to quality and affordable medicines, [...] lack of good governance, [...] and lack of technical capacity." He also emphasised political commitment as the driving force behind solving the problem of IMFs. "If there is real commitment, there will be information sharing, financial investment, mobilisation of international support and, most importantly, capacity building."
The pharmaceutical supply chain
Corrupting agents are multiplying throughout the supply chain. To secure the entire drug distribution circuit in Togo, the Centrale d’Achat de Médicaments Essentiels Génériques du Togo (CAMEG-TOGO) acts on the pharmaceutical supply chain. Dr Mamessilé Agba-Assih, Director of CAMEG-TOGO and Minister Delegate to the Minister of Health, Public Hygiene and Universal Access to Health Care, Togo, in charge of Universal Access to Health Care, acknowledges the difficulty of identifying reliable suppliers. She advocates the establishment of the IDL: "We must succeed through these regional initiatives in setting up supply systems that we control from end to end." The means include centralising purchases at regional level to benefit from a volume effect.
Moreover, 70% of the medicines consumed in Africa are imported. To reduce this dependence and build a resilient health system, the aim is to coordinate local production of medicines and to use the 400 existing pharmaceutical factories in Africa.
Levers for action to organise the fight
The two levers identified are interministerial action supported by appropriate legislation and the need for coordinated action by the public authorities, the private sector and civil society. For Dr Mamessilé Agba-Assih, this implies better communication: "There is a dialogue to be put in place between certain administrations, notably customs and the police [...] and an inter-country dialogue, via information sharing." She also referred to the courage needed, in addition to the political will already expressed by the IDL promoters.
Strengthening and harmonising the regulatory framework
Richard Amalvy, Chief Executive of the Brazzaville Foundation and moderator of the event, presented the lAfrican Union Model Law on the Regulation of Medical Products. One of the recommendations of this law is the creation of a national regulatory authority for medicines. At the continental level, this is the expected role of the AAM. Today, 23 countries have signed the treaty creating the AAM. According to Ms. Minata Samaté Cessouma, Commissioner for Health, Humanitarian Affairs and Social Development at the African Union, the harmonization of member states' legislations on the basis of the AU model law is the sine qua non condition for the success of the AAM.
 Ghana, Niger, Uganda, Republic of Congo, Senegal, Togo