The need for vigilance at all times

Fake drugs1Recently a senior citizen came to show me a packet of an innovator (original manufacturer) drug bought by friend of his. He wanted me to verify its authenticity (counterfeit or otherwise) to allay the fears of his friend. Well, I assured him that the product was alright, but the interaction got me thinking.

Have we gotten to a point where the public is beginning to question the integrity of a pharmaceutical product on the open market?

Is the awareness/education on counterfeit/fake medicines achieving its purpose?

Is the public sufficiently on guard against the menace of counterfeit/fake medicines?

The enquiries by the senior citizen seemed to suggest a heightened awareness against counterfeit/fake medicines by the general public.

In late August, an initiative was launched by the Pharmaceutical Society of Ghana (PSGH) together with mPedigree and PopOut called PREVENT (Patients Research, Empowerment, Vigilance and Education through New Technologies) to empower patients/clients in the fight against counterfeit medicines in the country. mPedigree and PopOut are both local technological companies. PREVENT has two components, a social media strategy and a point of sale product authentication strategy.

Products from pharmaceutical manufacturers will be given unique identity codes covered, with safe scratch-off ink. With the help of GoldKeys technology, patients can verify at the point of sale or dispensing, by simply scratching to reveal the hidden numbers and then text for free to short code 1393 on all networks to confirm the authenticity of the medicine.

The social media strategy will use the PopOut technology, through a combination of social media tools (facebook, twitter, instagram, whatsapp) to engage a broad section of Ghanaians on issues pertaining to the impact of counterfeit and sub-standard medicines in the country. The PREVENT initiative by the PSGH was roundly endorsed by the Food & Drug Authority (FDA) and the Health Ministry.

In a similar vein, I came across a portable high-tech screening device (CD-3) developed by the Food & Drug Administration (FDA) of USA, to detect counterfeits. The FDA is going to try the device in Ghana and use its outcomes to roll it out internationally.

Two years ago a research by the Lancet Infectious diseases concluded that about a third of the antimalarials in Africa and Asia were fake or of bad quality.

Counterfeit and fake medicines have also been infiltrating the supply chains of developed economies. Currently, over 80 per cent of the active ingredients used in US pharmaceuticals are manufactured overseas.

The comment of the Commissioner of the FDA, Margaret Hamburg is most poignant “We live in a world where the marketplace is increasingly global, where the supply chain of drugs is increasingly vulnerable and we are seeing many more problems with substandard and counterfeit drugs around the world.

If anti-malaria drug resistance develops in Ghana and other regions, it impacts us, because it means that strains of malaria are circulating and anyone can be exposed to them when they are travelling, or when people who are infected come into the USA.”

CD-3, designed by FDA forensic scientists is a battery-operated device which shoots different wavelengths of light at a product, to determine its authenticity.

The device, which is about the size of a barcode scanner, compares scanned images to a stored image of the original product, picking up minute differences in packaging, pill colour or shape. The FDA is reported to have used CD-3 to screen a number of products (cosmetics, food, medical devices) imported to the USA, since 2010.

Field testing has begun at the US Pharmacopoeia Convention’s (USP) Centre for Pharmaceutical Advancement and Training (CePAT) in Ghana. I have checked this out. The field testing in Ghana has been completed, and the report will soon be out.

It is clear from the foregoing that there are still concerns about Counterfeit/fake medicines, globally. The story I recounted at the beginning of this piece is one potent and damaging effect of counterfeit medicines.

When the public begin to question the integrity of pharmaceutical products, everything needs to be done to restore confidence. Every pharmaceutical product sold or distributed in the country has an approved source.

As a beginning, every health care provider should make it a point to obtain pharmaceutical products from approved sources. Counterfeiters will always try to infiltrate the supply chain along the line, but getting products from approved sources acts as a preliminary check.

There are times you will need to spend some time to do background checks on a vendor, to get a fair idea of the track record over the years. You also need to be vigilant at all times, while maintaining close contacts with manufacturers or managers or representatives of these products (and feedback from clients), all in the name of securing patient safety.

By Edward O. Amporful

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