Key takeaways
- The spread of counterfeit medications poses a serious threat to public health, particularly in Africa.
- In addition to failing to produce the desired therapeutic effects, counterfeit drugs can also have serious health consequences and, in some cases, cause death.
- However, African healthtech startups are actively assisting in the fight against fake medicines by utilising technology.
In its latest threat assessment report published in February 2023, the United Nations Office on Drugs and Crime (UNODC) discloses that consuming counterfeit and substandard drugs results in roughly 500,000 fatalities yearly in sub-Saharan Africa.
Among these fatalities, 167,271 deaths are linked to falsified antibiotics used to treat severe paediatric pneumonia, while 267,000 deaths are connected to falsified antimalarial medications yearly.
The report reveals that 40% of substandard and falsified medical products detected in Sahel countries —Burkina Faso, Chad, Mali, Mauritania, and Niger — between 2013 and 2021 were discovered within the regulated supply chain.
These countries rely heavily on imported medical products because their pharmaceutical industries are still in the early stages of development.
The high prevalence of infectious diseases, including malaria, combined with issues regarding the accessibility, affordability, and availability of healthcare, creates an environment where the demand for medical products and services is not entirely satisfied through formal channels in the Sahel countries and their neighbours.
The gap between supply and demand for regulated pharmaceutical products fosters trafficking, encourages the involvement of organised crime groups, and exacerbates the threat to public health and safety in Sahel countries.
Further, despite the difficulty of making an accurate confirmation, the UNODC says it believes 50% of medicines in West Africa are either fake or of poor quality.
Definition of terms
Before we continue, we must understand the terms used throughout this article, such as falsified, substandard, and counterfeit.
- A counterfeit medicine (drug) is purposefully and fraudulently mislabelled in terms of identity and/or source. Branded and generic products can be the target of counterfeiting, and these products may have the correct or incorrect ingredients, no active ingredients, insufficient amounts of active ingredients, or fake packaging.
- Substandard, also called "out of specification," refers to approved medical products that don't meet their quality requirements/specifications.
- Unregistered/unlicensed medical products do not comply with national or regional regulations and laws and have not undergone evaluation and/or approval for the market in which they are marketed, distributed, or used.
- Falsified medical products intentionally or fraudulently misrepresent their identity, composition, or source.
How technology is combating Africa's fake drug epidemic
Research shows a significant prevalence of substandard medications in many developing nations. The issue is exacerbated by poverty, corruption, and a lack of regulations and policies.
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However, new technological advancements and innovations are being used to help curb this global health threat.
1. Mobile technology
Mobile technology is critical in combating counterfeit drugs in Africa. It helps people confirm the authenticity of medications by scanning holograms, QR codes, and other identifiers found on drug packaging using mobile applications and SMS-based platforms.
mPedigree, a Ghanaian startup, is one startup that uses mobile technology to combat drug counterfeiting.
Customers can send a unique code found on drug packaging via SMS to a centralised database for verification. Users quickly receive a response confirming the drug's authenticity, which helps them avoid buying fake medicines.
Consumers can also use a distinctive product identification marker from mPedigree to assess authenticity. They simply remove the label or reveal a barcode to send a code via text message or a mobile phone camera.
Additionally, mPedigree has a mobile application called "GoldKeys" that lets users scan unique codes or holograms on drug packaging to confirm authenticity.
The app offers real-time feedback, assisting users in spotting fake medications and selecting reliable healthcare options.
Chekkit, a Nigerian healthtech startup, provides a similar service via mobile phone. When a consumer picks up a drug and scratches off the sticker label, they will see a PIN that they can authenticate using the USSD option or by scanning the QR code with the ChekkitApp on their smartphone.
Chekkit gathers consumer data through surveys, which it then offers to brands as intelligence. Customers, on the other hand, receive loyalty rewards for providing information.
Because they receive immediate feedback and real-time authentication, these technologies enable consumers to make informed decisions and steer clear of counterfeit medications.
2. Artificial Intelligence (AI)
AI algorithms can detect anomalies and flag potential fake drugs by analysing large datasets, including market trends, pricing data, and distribution patterns.
With the help of data-driven insights, authorities and regulatory bodies can take proactive action and effectively target counterfeit drug networks.
Nigerian RxAll uses AI to detect counterfeit drugs. RxScanner, its proprietary technology, is a handheld authenticator designed for patients to verify their medications. The RxScanner can assess the quality of prescription drugs in 20 seconds and shows real-time results through mobile apps. It does this by comparing the results to a large database of authentic drugs.
Cameroonian True-Spec Africa uses a portable device that employs AI to enable hospitals, pharmacies, pharmaceutical laboratories, and quality control centres to determine drug authenticity quickly and easily.
3. Blockchain
Healthtech startups use blockchain technology to enhance the pharmaceutical supply chain and boost transparency.
By establishing decentralised, immutable ledgers, these startups enable all stakeholders — manufacturers, distributors, and regulators — to track drug flow from production to delivery.
The security and efficacy of medications in Africa will be guaranteed by this technology, which makes it simple to identify and remove counterfeit drugs in circulation.
Medsaf is a Nigerian end-to-end pharmaceutical platform that uses this technology. The company provides hospitals, pharmacies, and patients with timely access to affordable, high-quality medications.
It has created a blockchain-based platform that allows users to track and confirm the flow of medications between pharmacies, distributors, and healthcare facilities. There is less chance of fake drugs entering the market, and the supply chain is guaranteed.
Chekkit also plans to develop its blockchain infrastructure after recently raising new funds. Cardano, a blockchain startup that invested through Adaverse, its accelerator division, is one of its investors.
Combating counterfeit drugs in Africa necessitates novel and comprehensive approaches. By leveraging mobile technology, blockchain, and AI, healthtech startups are revolutionising the fight.
But why are counterfeit drugs a problem in Africa?
The WHO estimates that Africa accounts for about 42% of all cases of counterfeit drugs globally. This lucrative industry generates about $200 billion in revenue annually.
For context, 42% of the fake drug reports sent to the WHO between 2013 and 2017 were from Africa.
In March 2019, Niger's Ministry of Public Health warned about the spread of falsified meningitis vaccines (Mencevax ACWY). Also, the WHO alerted the continent about the distribution of counterfeit hypertension medications in Cameroon.
Then, in August, counterfeit Augmentin antibiotics were found in Kenya and Uganda.
The primary suppliers of these medications are firms that export pharmaceuticals from nations like Belgium, France, China, and India.
These products are illegally removed from the legal supply chain or manufactured in nearby countries like Nigeria. Others are manufactured and distributed by criminal gangs, while some are poorly made or sold post-expiration.
The threat assessment report reveals that international operations conducted between January 2017 and December 2021 resulted in the seizure of at least 605 tons of illicit medical products in West Africa.
The main entry points for counterfeit medical products headed for the Sahel countries have been identified as seaports in the Gulf of Guinea, specifically Conakry (Guinea), Tema (Ghana), Lomé (Togo), Cotonou (Benin), and Apapa (Nigeria).
This alarming situation promotes toxic contamination and antimicrobial resistance while eroding faith in healthcare systems. Trafficking these products also has a direct economic impact on the countries involved.
The WHO claims that a whopping $44.7 million is spent annually treating people who have taken subpar or fake malaria medications.
Because they pose a significant threat (PDF) to global public health and result in tens of thousands of deaths annually, counterfeit drugs are a problem in Africa. Malaria, HIV/AIDS, and tuberculosis drugs are the three most frequently counterfeited types of medication on the continent.
How to identify counterfeit drugs
The WHO claims that some fake medical products are difficult to distinguish from genuine ones. But you can do the following:
- Check the packaging for damage, spelling, and grammatical errors.
- Confirm that the manufacture and expiry dates and dates listed on the inner packaging correspond to the dates listed on the outer packaging.
- Ensure the medication doesn't smell odd, hasn't deteriorated, and is not tainted.
- If you feel the product is not performing well or have experienced an adverse reaction, consult your doctor or other healthcare specialists as soon as possible.
- Report suspected medical products to your country's National Medicines Regulatory Authority.
